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Attention Deficit Hyperactivity Disorder: an Aboriginal perspective on diagnosis and intervention

Published online by Cambridge University Press:  10 July 2017

Pek-Ru Loh ,
George Hayden ,
David Vicary ,
Vincent Mancini ,
Neilson Martin  and
Jan P. Piek
Pek-Ru Loh*
Affiliation:
School of Psychology & Speech Pathology, Curtin University, WesternAustralia. Department of Psychology, James Cook University, Singapore
George Hayden
Affiliation:
School of Psychology & Speech Pathology, Curtin University, WesternAustralia.
David Vicary
Affiliation:
School of Psychology & Speech Pathology, Curtin University, WesternAustralia.
Vincent Mancini
Affiliation:
School of Psychology & Speech Pathology, Curtin University, WesternAustralia.
Neilson Martin
Affiliation:
School of Psychology & Speech Pathology, Curtin University, WesternAustralia.
Jan P. Piek
Affiliation:
School of Psychology & Speech Pathology, Curtin University, WesternAustralia.
*
corresponding author: Dr Pek Ru Loh Department of Psychology James Cook University Singapore 149 Sims DriveSingapore387380 Tel: (+65) 6709 3740 Fax: (+65) 6709 3889
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Abstract

Attention Deficit Hyperactivity Disorder (ADHD) arising from a Western health model has generated much global debate about its relevance in Indigenous communities. More importantly, it has raised questions concerning acceptance of its diagnosis and intervention, hence affecting early identification and treatment compliance. The current study explored an Aboriginal perspective of diagnosis and treatment compliance of ADHD in an Australian Aboriginal community. Using a qualitative approach, 27 participants aged between 22 and 52 years from a Western Australian metropolitan Aboriginal community comprising community members, Aboriginal mental health and education professionals, and Aboriginal parents of children with ADHD, were interviewed either individually or in groups. Participants identified differences in child rearing practices, expectation of child behaviour in school, higher tolerance of hyperactive behaviour within the Aboriginal community and lack of information about ADHD as the main reasons for parents not seeking medical help for the child. Participants also saw the changes in a child's behaviour after medication as a loss of identity/self and this was reported to be the main contributor to treatment non-compliance. Overall, most participants recognised the detrimental effect of having ADHD. However, the current diagnostic process and treatment are not culturally appropriate to assist the Aboriginal community to effectively manage this disorder in their children.

Keywords

Attention Deficit Hyperactivity DisorderAustraliaAboriginal population
Type
Articles
Information
Journal of Tropical Psychology , Volume 7 , 2017 , e2
Copyright
Copyright © The Author(s) 2017 

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References

Alarcón, R. D. (2009). Culture, cultural factors and psychiatric diagnosis: review and projections. World Psychiatry, 8, 131–139.Google Scholar
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
Ardila, A. (1996). Towards a cross-cultural neuropsychology. Journal of Social and Evolutionary Systems, 19, 237–248.CrossRefGoogle Scholar
Australian Bureau of Statistics. (2005). National Aboriginal and Torres Strait Islander Health Survey, Australia 2004–05.Google Scholar
Australian Bureau of Statistics (2006). National Aboriginal and Torres Straits Islander Health Survey, 2004–2005, cat. No. 4714.0. Canberra: Australian Government Publishing Service.Google Scholar
Australian Institute of Health and Welfare (2008a). Australia's health 2008. Cat. no. AUS 99. Canberra: AIHW.Google Scholar
Australian Institute of Health and Welfare (2008b). Making progress: the health, development and wellbeing of Australia's children and young people. Cat. no. PHE 104.Canberra: AIHW.Google Scholar
Australian Psychological Society (1997). Guidelines for the Provision of Psychological Services for and the Conduct of Psychological Research with Aboriginal and Torres Strait Islander People of Australia.Google Scholar
Azevedo, P. V. B. & Caixeta, L. (2009). Do attention deficit/hyperactivity disorder symptoms exist among Brazilian indigenous children? Dementia and Neuropsychologia, 3 (1), 38–40.Google Scholar
Azevedo, P. V. B., Caixeta, L., Andrade, L. H. S. & Bordin, I. A. (2010). Attention deficit/hyperactivity disorder symptoms in indigenous children from the Brazilian Amazon. Arquivos de Neuro-Psiquiatria, 68 (4), 541–544.Google Scholar
Baydala, L., Sherman, J., Rasmussen, C., Wikman, E., & Janzen, H. (2006) ADHD characteristics in Canadian Aboriginal children. Journal of Attention Disorders, 9, 642–647.Google Scholar
Bennett, K., Hay, D., Piek, J., Pearsall-Jones, J., Levy, F. & Martin, N. (2006). The Australian Twin ADHD Project: Current status and future directions. Twin Research and Human Genetics, 9, 718–726.Google Scholar
Benoit, C., Carroll, D. & Chaudhry, M. (2003). In search of a healing place: Aboriginal women in Vancouver's downtown eastside. Social Science & Medicine, 56 (4), 821–833.Google Scholar
Bronfenbrenner, U. (1992) Ecological systems theory Six theories of child development: Revised formulations and current issues (pp. 187–249). London, England: Jessica Kingsley Publishers.Google Scholar
Bulter, C. (2012). Indigenous adolescent mental health: What is the role of primary health care? Available at https://www.phcris.org.au/puvblications/researchroundup/ Google Scholar
Burdekin, B. (1994). Report of the National Inquiry into the human rights of people with mental illness. Canberra: Australian Government Publishing Service.Google Scholar
Campbell, D., Pyett, P., McCarthy, L., Whiteside, M., & Tsey, K. (2007). Community development and empowerment. A review of interventions to improve Aboriginal health. In Anderson, I., Baum, F., & Bentley, M. (Eds), Beyond bandaids: Exploring the underlying social determinants of Aboriginal health, (pp. 165–180). Casuarina, NT: Cooperative Research Centre for Aboriginal Health.Google Scholar
Carey (2013). A qualitative study of a social and emotional well-being service for a remote Indigenous Australian community: Implications for access, effectiveness and sustainability. BMC Health Service Research, 13, 80.Google Scholar
Castle, L., Aubert, R., Verbrugge, R., Khalid, M. & Epstein, R. (2007) Trends in medication treatment for ADHD. Journal of Attention Disorders, 10, 335–342.Google Scholar
Dingwall, K. M. & Cairney, S. (2010). Psychological and cognitive assessment of Indigenous Australians. Australian and New Zealand Journal of Psychiatry, 44, 20–30.CrossRefGoogle ScholarPubMed
Dobia, B. & O'Rourke, V. G. (2011). Promoting the mental health and wellbeing of Indigenous children in Australian primary schools. Canberra: Commonwealth of Australia.Google Scholar
Dobson, I. & Darling, K. (2003). Aboriginal youth mental health partnership project: evaluation report. Adelaide: CAMHS Western Region.Google Scholar
Efron, D. (2006). Attention–deficit/hyperactivity disorder: Are we medicating for social disadvantage? (Against). Journal of Paediatrics and Child Health, 42, 548–551.Google Scholar
Elkin, A. P. (1994). Aboriginal men of high degree: Initiation and sorcery in the world's tradition. St. Lucia, Qld: University of Queensland Press.Google Scholar
Faraone, S. & Biederman, J. (1997). Do attention deficit hyperactivity disorder and major depression share familial risk factors? Journal of Nervous and Mental Disease, 185, 533–541.Google Scholar
Fielder, J., Roberts, J. & Abdullah, J. (2000). Research with Indigenous communities. In: Dudgeon, P., Pickett, H. & Garvey, D. (Eds.). Working with Indigenous Australians: A Handbook for Psychologists, CIRC, Centre for Aboriginal Studies, Curtin University of Technology, 349–356.Google Scholar
Goodman, R., Ford, T., Simmons, H., Gatward, R. & Meltzer, H. (2000). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. British Journal of Psychiatry, 177, 534–539.Google Scholar
Graetz, B., Sawyer, M., Hazell, P., Arney, F., & Baghurst, P. (2001). Validity of DSM-IV ADHD Subtypes in a Nationally Representative Sample of Australian Children and Adolescents. Journal of the American Academy of Child & Adolescent Psychiatry. 40 (12):1410–1417 Google Scholar
Government of Western Australia. A best practice model for health promotion programs in Aboriginal Communities. Available at: https://www.health.wa.gov.au/publications/subject_index/a/aboriginal_health.cfm Google Scholar
Hay, D., Bennett, K., Levy, F., Sergeant, J. & Swanson, J. (2007) A twin study of attention-deficit/hyperactivity disorder dimensions rated by the strengths and weaknesses of ADHD-symptoms and normal-behaviour (SWAN) scale. Biological Psychiatry, 61, 700–705.Google Scholar
Holman, C., Bass, A., Rouse, I. & Hobbs, M. (1999). Population-based linkage of health records in Western Australia: development of a health services research linked database. Australian and New Zealand Journal of Public Health, 23 (5), 453–459.Google Scholar
Hunter, E. (2007). Disadvantage and discontent: a review of the issues relevant to the mental health of rural and remote Indigenous Australians. Australian Journal of Rural Health, 15, 88–93.Google Scholar
Isaacs, D. (2006). Attention-deficit/hyperactivity disorder: Are we medicating for social disadvantage? (For). Journal of Paediatrics and Child Health, 42, 544–547.Google Scholar
Jiloha, R. C., Kandpal, M. & Mudgal, S. (2012). Role of culture in psychiatric evaluation and management. Journal of International Medical Sciences Academy, 25, 265– 267.Google Scholar
Kowal, E., Gunthorpe, W., & Bailie, R. S. (2007). Measuring emotional and social well being in Aboriginal and Torres Strait Islander populations: an analysis of a Negative Life Event Scale. International Journal for Equity in Health, 6, 18.Google Scholar
Loh, P. R., Hayden, G., Vicary, D., Mancini, V., Martin, N. & Piek, J. P. (2016). Australian Aboriginal perspectives of attention deficit hyperactivity disorder. Australian and New Zealand Journal of Psychiatry, 1–2. Doi: 10.1177/0004867415624551 Google Scholar
Luborsky, M. R. (1994). The identification and analysis of themes and patterns. Thousand Oaks, CA: Sage Publications.Google Scholar
Maher, P. (1999). A review of the ‘traditional’ Aboriginal health beliefs. Australian Journal of Rural Health, 7, 229–236.Google Scholar
Mannuzza, S., Klein, R., Bessler, A., Malloy, P. & LaPadula, M. (1998). Adult psychiatric status of hyperactive boys grown up. American Journal of Psychiatry, 155, 493– 498.Google Scholar
Martin, N., McDougall, M., & Hay, D. (2008). What are the key directions in the genetics of attention deficit hyperactivity disorder? Current Opinions in Psychiatry, 21, 356–361.Google Scholar
Martin, N., Scourfield, J. & McGuffin, P. (2002). Observer Effects and the Heritability of Childhood Attention-Deficit Hyperactivity Disorder Symptoms. British Journal of Psychiatry, 180, 260–265.Google Scholar
Martin, N. (1999). Structural equation modelling using twin data on childhood traits. PhD thesis. University of Wales College of Medicine Cardiff.Google Scholar
Ministry of Health (2009). A Focus on the Health of Māori and Pacific Children: Key findings of the 2006/07 New Zealand Health Survey. Wellington: Ministry of Health.Google Scholar
Moore, E., Sunjic, S., Kaye, S., Archer, V. & Indig, D. (2013). Adult ADHD Among NSW Prisoners: Prevalence and Psychiatric Comorbidity. Journal of Attention Disorders. DOI: 10.1177/1087054713506263 Google Scholar
NHMRC (2003). Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. Available at: https://www.nhmrc.gov.au/publications/synopses/e52syn.htm Google Scholar
Neuman, R., Heath, A., Reich, W., Bucholz, K., Madden, P., Sun, L., Todd, R. & Hudziak, J. (2001) Latent class analysis of ADHD and comorbid symptoms in a population sample of adolescent female twins. Journal of Child Psychology and Psychiatry, 42, 933–942.Google Scholar
Polanczyk, G., Lima, M. S., Horta, B. L., Biederman, J. & Rohde, L. A. (2007). The worldwide prevalence of ADHD: a systematic review and meta-regression analysis. American Journal of Psychiatry, 164, 942–948.Google Scholar
Polanczyk, G. & Rohde, L. A. (2007). Epidemiology of attention-deficit/hyperactivity disorder across the lifespan. Current Opinions in Psychiatry, 20, 386–392.Google Scholar
Slade, T., Johnston, A., Oakley Brown, M. A., Andrews, G., & Whiteford, H. (2007). National survey of mental health and wellbeing: Methods and key findings. Australian and New Zealand Journal of Psychiatry, 43, 594–605.Google Scholar
Sawyer, M., Arney, F., Baghurst, P., Clark, J., Graetz, B., Kosky, R., Nurcombe, B., Patton, G., Prior, Raphael, B., Rey, J., Whaites, L. & Zubrick, S. (2000). The Mental Health of Young People in Australia. Mental Health and Special Programs Branch, Australian Government Department of Health and Aged Care.Google Scholar
Thomas, A., Cairney, S., Gunthorpe, W., Paradies, Y., & Sayers, S. (2010). Strong Souls: development and validation of a culturally appropriate tool for assessment of social and emotional well-being in Indigenous youth. Australian and New Zealand Journal of Psychiatry, 44, 40–48.Google Scholar
Timimi, S. & Taylor, E. (2003). In Debate: ADHD is best understood as a cultural construct. The British Journal of Psychiatry, 184 (1), 8–9. DOI: 10.1192/bjp.184.1.8 Google Scholar
Vicary, D. & Westerman, T. (2004). ‘That's just the way he is’: Some implications of Aboriginal mental health beliefs. Advances in Mental Health, 3 (3), 103–112.Google Scholar
Vos, T., Barker, B., Stanley, L., & Lopez, A. D. (2007). The burden of disease and injury in Aboriginal and Torres Strait Islander peoples 2003. Brisbane: School of Population Health, The University of Queensland.Google Scholar
Walker, R., Schultz, C. & Sonn, C. (2014). Cultural competence – transforming policy, services, programs and practice. In Dudgeon, P., Milroy, H. & Walker, R. (Eds.), Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practices, 2nd edition. (Chapter 12), pp. 195–220. Barton, ACT: Commonwealth of Australia Google Scholar
Westerman, T. (2004). Guest Editorial: Engagement of Indigenous clients in mental health services: What role do cultural differences play? Australian e-Journal for the Advancement of Mental Health, 3 (3), 88–93.Google Scholar
Williamson, A., Anderson, M., Redman, S., Dadds, M., D'Este, C., Daniels, J., Eades, S. & Raphael, B. (2014). Measuring mental health in Indigenous young people: A review of the literature from 1998–2008. Clinical Child Psychology and Psychiatry, 19, 260–272.Google Scholar
Wood, N. & Daly, A. (2007). Health and Wellbeing of Children in Western Australia, July 2006 to June 2007, Overview of Results. Department of Health, Western Australia.Google Scholar
Ypinazar, V. A., Margolis, S. A., Haswell-Elkins, M., & Tsey, K. (2007). Indigenous Australians’ understandings regarding mental health and disorders. Australians and New Zealand Journal of Psychiatry, 41, 467–478.Google Scholar
Zubrick, S., Lawrence, D., de Maio, J. & Biddle, N. (2006). Testing the Reliability of a Measure of Aboriginal Children's Mental Health: An Analysis Based on the Western Australian Aboriginal Child Health Survey. Perth: Telethon Institute for Child Health Research and Australian Bureau of Statistics.Google Scholar
Zubrick, S., Lawrence, D., Silburn, S., Blair, E., Milroy, H., Wilkes, T., Eades, S., D'Antoine, H., Read, A., Ishiguchi, P. & Doyle, S. (2004). The Western Australian Aboriginal Child Health Survey: The Health of Aboriginal Children and Young People. Perth: Telethon Institute for Child Health Research.Google Scholar
Zubrick, S., Silburn, S., Lawrence, D., Mitrou, F., Dalby, R., Blair, E., Griffin, J., Milroy, H., De Maio, J. & Cox, A. (2005). The Western Australian Aboriginal Child Health Survey: The Social and Emotional Wellbeing of Aboriginal Children and Young People. Perth: Curtin University of Technology and Telethon Institute for Child Health Research.Google Scholar