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Rethinking medicalization: discursive positions of children and their caregivers on the diagnosis and treatment of ADHD in Chile1 1 This article is part of the research project “Trayectorias de malestar en niñas y niños diagnosticados con Trastorno de Déficit Atencional e Hiperactividad (TDAH): experiencia subjetiva y social de un sufrimiento multiforme”, which received funding from the Concurso de Fortalecimiento de Productividad y Continuidad en Investigación (FPCI) of the Faculty of Social Sciences of the University of Chile, as well as from CONICYT through its International Cooperation Program: Support for the Formation of International Networks between Research Centers (2017), nº REDES170095. Álvaro Jiménez-Molina received funds from the Millennium Science Initiative of the Ministry of Economy, Development and Tourism, grant “Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay”.

Abstract

The debates around the diagnosis and pharmacological treatment of Attention Deficit and Hyperactivity Disorder (ADHD) have traditionally been approached from the perspective of the “medicalization processes” of children’s behaviour. However, this perspective tends to overlook the meanings of diagnosis and treatment of ADHD for children and their caregivers. The purpose of this article is to describe the discursive positions of children and their caregivers on the diagnosis and treatment of ADHD. In-depth interviews were conducted with seven Chilean children and their caregivers. The material was analysed following the procedures of the discourse structure analysis. A discursive structure was identified that configures four emerging realities: the myth of origin of the child’s behaviour and learning problems; the ambivalences in/of medicalization; the process of identity (dis)stabilization under diagnosis and treatment; and the subversion of medicalization. It is observed that the subjective experience of the diagnosis and treatment of ADHD is not homogeneous, since different discursive positions, family and institutional understandings that enter into conflict cross it. The experiences of ADHD are shaped by discursive structures that condition the meanings of this experience. The medicalization process is not univocal, but can take different forms and have consequences on children’s experiences and social trajectories.

Keywords:
ADHD; Medicalization; Childhood; Discourse Structure Analysis

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