Sociodemographic and Cultural Factors of Attention Deficit Hyperactivity Disorder Essay

Introduction

Attention deficit hyperactivity disorder (ADHD) is a neurological, behavioral, developmental disorder that originates in childhood and appears with symptoms such as hyperactivity, attention concentration difficulties, and poorly managed impulsivity. It bears mentioning that ADHD was initially described and diagnosed in the United States, where medication-based treatment for it has been developed and is still most actively used (Bergey, Filipe, Conrad, & Singh, 2018).

Researchers note that “until the 1990s, the United States was the country with the largest prevalence of ADHD in the world” (Bergey et al., 2018, p. 9). This is the reason for the particular urgency and significance of the research regarding this disorder. The study is addressed the possible sociodemographic and cultural factors of ADHD that are positively related to its intensification and increasing prevalence. This paper describes the issue background, poses general and specific problems, indicates the purpose of the research, and provides an overview of the research questions.

Background

The following section will discuss the background on the impact of ADHD on child development. It should be noted that this disorder is primarily associated with children and their school behavior and academic underperformance. Holdaway, Serrano, and Owens (2017) provide data that virtually every tenth child between 4 and 17 years of age was diagnosed with this disorder at a certain stage of development (p. 113). Children at this age have particular difficulties in retaining and concentrating attention and in controlling behavior, and this stage is sensitive to the development of these abilities.

The major adverse effect of ADHD is that the child’s nervous system cannot cope with the inhibition of impulsivity and hyperactivity of his attention and behavior, resulting in an inability to follow the classroom rules (Holdaway et al., 2017). There are various approaches to treating this disorder, including behavioral therapy, but the most common at the moment is a pharmaceutical one. The dynamics of ADHD prevalence and its possible long-term outcomes are especially sensitive concerns, and therefore research into the causes of this disorder becomes particularly relevant and enables preventive measures to be implemented.

General Problem Statement

The general problem is the increase in prevalence and impact of ADHD. National surveys on time-trends in ADHD among young people over the past two decades indicate a steady increase in its diagnostic prevalence (Safer, 2018). This observation is especially pronounced in the US, where the trend in diagnostic prevalence has reached 9.3 percent, while in the Netherlands, the same figure corresponds to 0.9 percent and in Taiwan – 1.6 percent (Safer, 2018, p. 109).

These findings can be explained by both the actual higher rates of ADHD prevalence in the US and the healthcare trends in diagnosis, according to which such symptoms are more commonly treated as ADHD. It stands to mention that the second explanation raises the question of which factors have a stronger influence on the development of the corresponding symptoms – neurobiological or sociodemographic and cultural.

The diagnosis of ADHD is getting progressively widespread, as specific behavioral patterns associated with this disorder are becoming more common among school and college children. According to Safer (2018), teachers’ ratings, describing these patterns, include “inattention, incomplete completion of tasks, disruptive behavior, and undue restlessness” (p. 111). Early identification of symptoms typical for this disorder offers the possibility of prompt therapeutic intervention and reduction of negative consequences (Holdaway et al., 2017). This approach addresses the effects of ADHD rather than its causes and factors. Moreover, it has a broader impact than poor learning performance and disruptive behavior in school.

ADHD has a reputation for being a mental disorder peculiar to children and occurring at school age. Nevertheless, there is evidence that it may “persist into adolescence and adulthood” and have a harmful influence on the patient’s further activities (Arnold, Hodgkins, Kahle, Madhoo, & Kewley, 2020, p. 73).

It was demonstrated that test results, as well as long-term academic performance scores, were lower in people with diagnosed but untreated ADHD than in individuals with treated ADHD or without diagnosed ADHD (Arnold et al., 2020). However, there are no longitude studies of ADHD dynamics in older generations due to the fact that this disorder began to be diagnosed not that long ago. Thus, there is no unequivocal evidence that ADHD is not a phenomenon of only the 20th and 21st centuries.

It should be emphasized that approaches to ADHD treatment are divided into pharmacological, non-pharmacological, and multimodal. The medication therapy for this disorder has given rise to particular concern and discussion and has acquired a number of opponents. Psychostimulants, such as methylphenidate and amphetamine, are used to correct ADHD in children, and they can be addictive and have side effects, as follows (Bergey et al., 2018).

The researchers note that the number of stimulants prescribed increases by approximately 3.4 percent each year, and “more drugs for ADHD are prescribed in the United States than in the rest of the world combined” (Bergey et al., 2018, p. 16). The extensive prescription of drugs to children and the related effects on their health has led to the search for preventive approaches to treatment.

Specific Problem Statement

The specific problem is uncertainty about the exact reasons for the development of ADHD and the factors influencing its increasing prevalence. Researchers provide data that patients with ADHD have biological deviations that cause this condition, and thus the disorder has neurobiological and genetic origins (Bergey et al., 2018). At the same time, “currently there are no identified biomarkers (e.g., genetic markers, brain structure abnormalities, blood-based proteins) that can be used to validly and reliably diagnose ADHD” (Holdaway et al., 2017, p. 118).

Thus, scientists and doctors are unaware of the exact genesis nature of this disease. In addition, there is criticism in the literature of research designs on the neurobiological basis of ADHD. Perez-Alvarez (2017) states that “the supposed ‘neuronal bases’ for ADHD do not consist of anything but correlations and correlates” (par. 45). The author of the article discusses the nature of the relationship that researchers find between ADHD symptomatology, on the one hand, and genes and neural circuits, on the other (Perez-Alvarez, 2017). These studies are usually referring to correlations rather than causation.

Consequently, it can be argued that specific impairments in the nervous system are associated with ADHD, but there is no definite confirmation that they cause it. This raises the issue of the existence of other affecting factors that were studied in less detail. Particular attention will be drawn to the fact that this diagnosis is mainly addressed to children. It also bears mentioning that the symptoms of ADHD were only compiled and described as a specific disorder in the 20th century. Arguably, a number of sociodemographic factors and a changing cultural environment contribute to the development of the behavioral patterns mentioned above.

In modern times, children are very early in their use of digital technologies and social media, which can lead to attention overstimulation. Moreover, children who live in an urban environment are exposed to the constant impact of information noise in the form of multimodal advertising, rapidly changing news, and the like. These conditions could contribute to behavioral patterns such as hyperactivity, attention concentration difficulties, and poorly managed impulsivity. Adults with an already formed nervous system and cognitive basis may be less affected by these influences than children in a sensitive developmental period. These hypotheses should be tested in an appropriate exploratory study.

Purpose Statement

The purpose of this research is to determine whether particular sociodemographic and cultural factors are positively related to the intensification and increasing prevalence of ADHD. The study will test hypotheses that ADHD may be more prevalent in urban than in rural areas and that symptoms of this disorder are statistically significantly higher in children than in adults. The study will also test the existence of a positive relationship between the early use of digital telecommunication devices and diagnosed ADHD. The outcome of this study will be a primary understanding of the contribution of sociodemographic and cultural factors to the development of ADHD and a guide to future research and effective prevention measures regarding it.

Research Questions

The research intends to address, in particular the following research questions:

1. Is there a statistically significant difference between the prevalence of ADHD in urban and rural areas?
2. Is there a correlation between the early use of digital telecommunication devices and social media, on the one hand, and the increased potential risk of ADHD, on the other?
3. Is ADHD more prevalent among children and young people than among adults and older people?

References

Arnold, L. E., Hodgkins, P., Kahle, J., Madhoo, M., & Kewley, G. (2020). Long-term outcomes of ADHD: academic achievement and performance. Journal of Attention Disorders, 24(1), 73-85.

Bergey, M. R., Filipe, A. M., Conrad, P., & Singh, I. (Eds.). (2018). Global perspectives on ADHD: social dimensions of diagnosis and treatment in sixteen countries. Baltimore, MD: JHU Press.

Holdaway, A. S., Serrano, V. J., & Owens, J. S. (2017). Effective assessment and intervention for children with ADHD in rural elementary school settings. In K. D. Michael & J. P. Jameson (Eds.), Handbook of Rural School Mental Health (pp. 113-127). New York, NY: Springer, Cham.

Perez-Alvarez, M. (2017). The four causes of ADHD: Aristotle in the classroom. Frontiers in psychology, 8. Web.

Safer, D. J. (2018). Is ADHD really increasing in youth? Journal of Attention Disorders, 22(2), 107-115.