Attention Deficit Hyperactivity Disorder (Adhd)
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ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) – A DIAGNOSIS FOR CHILDREN OR A CURE FOR PARENTS? A CRITICAL ANALYSIS OF THE NATURE AND PREVALENCE OF ADHD, AND PARENTS’ PERCEPTIONS Anthony William Oswald Dillon B.Sc (Hons) University of Southern Queensland MTrainDev Griffith University A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy (Psychology) Educational Excellence and Equity (E3) Research Program Centre for Educational Research College of Arts University of Western Sydney © Anthony W. O. Dillon, 2011 ii And it isn’t easy to listen to someone who would challenge those ideas of yours which have come to be so precious to you Anthony De Mello iii Statement of Authentication The work presented in this thesis is, to the best of my knowledge and belief, original except as acknowledged in the text. I hereby declare that I have not submitted this material, either whole or in part, for a degree at this or any other institution. Anthony Dillon March, 2011 iv Acknowledgements There are many people who deserve thanks, and deserve more than I am able to offer here, but I will do my best. Firstly, to my wonderful primary supervisor, Professor Rhonda Craven (Australia’s hardest working supervisor). Your enthusiasm carried me through and your expertise guided me towards being a better researcher. Special thanks go to my secondary supervisor Dr Gawaian Bodkin-Andrews. You were always there for me, thank you very much. You stood in on short notice, and that will always be appreciated. For my other supervisors, Professor Ian Wilson, Dr Helen Correia, and Associate Professor Alex Yeung. Each of you contributed your own expertise that provided me with the confidence I needed to write this thesis. Special thanks to Dr Paul Ginns and Dr Linda Graham for your advice throughout this thesis. To my good friend Dr Phil Harker, thank you so much for your insights at every stage of my life’s journey. For Dr Jay Joseph, thank you for your expert advice and ongoing assistance in matters relating to your field of expertise (genetics). For Robert Craig, thank you for your early help. And for the University of Sydney, thank you for all your support. Here, at Educational Excellence and Equality (E3) Research Program, is the best research environment any researcher could hope to work in. The administration and support team have been fantastic – thank you Lisa Car, Deb Blackmore, and Ferina Khayum. For my fellow students/researchers with whom I have spent the most time, thank you very much. Samantha Hornery, Natasha Magson, Lucy Hobby, Kat Newey, Linda Finger, Marjorie Seaton, Jinnat Ali, and Gin O’Rourke, you have made coming to E3 a pleasure. And of course, my friend Kurt Marder – you have been an excellent sounding board and mentor. Three other people from the University of Western Sydney deserve acknowledgment here. Firstly, Professor Marsh, your influence is well noted by the high esteem my colleagues here at E3 hold you in. Secondly, Professor Atherton, your support and encouragement have always been valued. Finally, Professor Jim McKnight, thank you so much for your initial interest and encouragement in my research – we at UWS miss you. v Table of Contents ABSTRACT .......................................................................................................... xviii CHAPTER 1 INTRODUCTION ....................................................................................................... 1 CHAPTER 2 A CRITICAL ANALYSIS OF COMPETING VIEWS OF THE SCIENTIFIC STATUS OF ATTENTION DEFICIT HYPERACTIVITY DISORDER ............ 7 Introduction .............................................................................................................. 7 Differences of Opinion About the Scientific Status of ADHD ................................ 8 What is ADHD, How is it Diagnosed, and Does it Exist? ................................... 8 What Causes ADHD-Type Behaviour? ............................................................. 11 Treatments for ADHD-Type Behaviour ............................................................ 13 Critique of Some Arguments Used to Support ADHD as a Medical Condition .... 15 Overview: Arguments, Proofs, and Biases ........................................................ 15 The Mental Health Profession Asserts That ADHD is a Medical Condition .... 16 Inclusion of ADHD in the (DSM-IV) Lends Legitimacy as a Medical Condition ............................................................................................................ 18 ADHD is Portrayed as a Real Disease Just Like any Other Disease ................. 19 What Current Brain Imaging Research Can and Cannot Tell Us About ADHD ................................................................................................................ 20 Genetics and ADHD as a Heritable Disorder .................................................... 22 Possible Reasons Why the Medical Model of ADHD is Readily Accepted .......... 32 Overview ............................................................................................................ 32 Physical Problems are Easier to Conceptualise Than Those of Psychological Origin ................................................................................................................. 33 Ethical Dilemmas ............................................................................................... 33 The Disparagement of Researchers who Criticise the Medical Model of ADHD ................................................................................................................ 34 vi Repetitious Exposure ......................................................................................... 35 ADHD – A Diagnosis for Children or a Solution for Parents? .............................. 36 Implications for the Present Investigation ............................................................. 37 Chapter Summary................................................................................................... 38 CHAPTER 3 THEORETICAL OVERVIEW OF UNDERPINNING PSYCHOLOGICAL CONSTRUCTS FOR THE PRESENT INVESTIGATION AND THEIR INFLUENCE ON BELIEF FORMATION ........................................................... 40 Introduction ............................................................................................................ 40 Theoretical Concepts and Constructs ..................................................................... 40 Overview ............................................................................................................ 40 The Nature of Constructs ................................................................................... 41 Conceptualising a Construct .............................................................................. 42 From Conceptualisation to Operationalisation................................................... 43 Construct Validity .............................................................................................. 44 Important Considerations Regarding Construct Validity ................................... 46 A Final Word on Constructs and Their Validation ............................................ 47 Theoretical Perspectives of the Self-Concept Construct ........................................ 48 Overview ............................................................................................................ 48 The Self .............................................................................................................. 49 Conceptualising and Defining the Self-Concept ................................................ 50 The Elusive Nature of the Self-Concept ............................................................ 51 Structural Aspects of the Self-Concept .............................................................. 52 Parenting Self-Concept and its Potential Relation with the ADHD Diagnosis . 53 Conceptualising and Defining Self-Esteem ....................................................... 55 Disagreements and Controversies With Self-Esteem ........................................ 56 One Self-Esteem or Many? ................................................................................ 58 Self-Enhancement .................................................................................................. 59 The Universal Tendency to Self-Enhance .......................................................... 59 Acceptance of the ADHD Label and Self-Enhancement ................................... 60 Other Constructs of Interest ................................................................................... 62 Stress and Relief in Relation to an ADHD Diagnosis........................................ 62 Other Constructs of Interest ............................................................................... 64 vii Measuring the Constructs in This Research ........................................................... 64 Chapter Summary................................................................................................... 64 CHAPTER 4 AIMS AND HYPOTHESES ................................................................................... 66 Introduction ............................................................................................................ 66 Brief Description of the Three Studies Comprising the Present Investigation ...... 67 Research Questions and Hypotheses ...................................................................... 67 Study 1: Psychometrics