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A Linguistic Analysis of In-Office Dialogue Among Psychiatrists, Parents, and Child and Adolescent Patients With ADHD

¹ Case Western Reserve University
² University of Connecticut
³ University of California Irvine
⁴ MBS/Vox

^* To whom correspondence should be addressed. E-mail: ceagan{at}commonhealth.com.

	Abstract

Objective: The aim was to evaluate in-office discussions of ADHD and psychiatric comorbidities. Method: Naturally occurring interactions among 11 psychiatrists, 32 patients and their parents were recorded, with a focus on "complicated" patients (i.e., having or suspected to have 1 psychiatric comorbidities and/or learning disabilities in addition to ADHD). Participants were interviewed separately post visit. Transcripts were analyzed using validated sociolinguistic methodologies. Results: Some 62% of patients were male, with an average age of 12.5 years, and 79% had a family history of ADHD. Visits were psychiatrist-driven, focusing on medication management and school performance, leaving management of comorbidities largely unaddressed. Post visit, 78% of parents and psychiatrists disagreed on patients’ "most concerning behavior." Parents most often reported concern about aggression and oppositionality. Psychiatrists and parents emphasized different aspects of patients’ personality, using deficit- and strength-based models, respectively. Conclusion: Psychiatrists and parents interpreted the relationship between ADHD and comorbidities differently. The significant incidence of misalignment regarding worrisome behaviors warrants further exploration. (J. of Att. Dis. XXXX; XX(X) xx-xx)

First published on September 2, 2008, doi:10.1177/1087054708323002

Journal of Attention Disorders 2009;13:78.

A more recent version of this article appeared on July 1, 2009


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