The pathologization of childhood behavior: divergent pathways for attention-deficit/hyperactivity disorder and oppositional defiant disorder

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Abstract

Recent studies have shown that attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), two disorders commonly diagnosed in childhood, are disparately diagnosed by race. While both diagnoses have social and legal implications, an ODD one has greater consequences including increased barriers to disability accommodation in schools and higher assessments of criminality in the juvenile justice system. ADHD and ODD have similar presentation, to the extent that 60% of children diagnosed with ODD also have ADHD, so why do these diagnoses have such drastically different social meanings? To answer this question this paper conducts a genealogical analysis of ADHD and ODD as diagnoses. The diagnostic criteria in each edition of the Diagnostic and Statistical Manual of Mental Disorders, papers published in medical and psychology journals, and reports published by governmental agencies, such as the Department of Education, are used to identify the conditions that have created a racial disparity between ADHD and ODD today. Preliminary analysis suggests that this disparity is tied to two different state and social investments: one focused on addressing educational gaps in early childhood – ADHD – and another on addressing crime – ODD. ADHD now belongs to the new category of neurodevelopmental disorders while ODD remains tied to predictors of antisocial behavior and criminality. Through the study of the pathologization of childhood behavior, this work also complicates the relationship between medicalization, biologization, and pathologization.

Author

• Samantha Tesfaye, University of California-San Diego