Retour Research - Agitated children, turbulent trajectories

Thesis “The ADHD social plasticity: A mapping of doctors’ discourses and practices in the mental health care for children in Santiago, Chile”

Pia Uribe defended her doctoral thesis in sociology on 19 October 2021 in Paris, in co-tutorship University of Paris/CERMES3 – University of Chile/LaPSoS.

Investigations on Attention Deficit Hyperactivity Disorder – ADHD – have referred to certain contemporary social and cultural conditions to explain its global extension as a diagnosis. Nevertheless, these approaches are not sensitive towards local issues associated with this highly prevalent category. In Chile there is an evident lack of expert controversy regarding the social issues involved in the approaches of this diagnosis and its treatment, which turns into tension with the structuring value acquired by ADHD inasmuch as medical diagnosis in the field of mental health.

The purpose of this thesis is the study of the social dimensions involved in the practice of diagnosis and medical treatment of ADHD: How doctors represent the social dimensions involved in the attention of children’s mental health regarding ADHD? How these social dimensions affect their practices of diagnosis and treatment? How do they resolve the tensions between the medical and social dimensions involved in the approach to this diagnosis on their own practice? To answer these questions, this investigation is based on an analysis of secondary literature and 35 ethnographic interviews with doctors working in the field of children’s mental health in Santiago de Chile.
This analysis shows that, in the field of medical practice, there is a multiplicity of problems, definitions and explications of this disorder, a situation that would make ADHD a plastic diagnosis, exposed to multiple uses. At the same time, the problems “associated” with this category show that they are not exclusive of a social group, and that in fact they present themselves differently depending of the context of attention. This allows to assert that ADHD is a transclass diagnosis. The social dimensions of diagnosis showed that they were recognized and used differently by doctors on their practice. The social complexity involved in the multiple “uses” of ADHD on the medical field, show social and cultural characteristics of the way in which children’s mental health is treated in Chile.