ADHD is associated with stigma, but whether stimulant medication use contributes to this is unknown. We examined how perception of a young woman may be influenced by visible ADHD symptoms and/or prescribed stimulant medication use (PSMU).
Method:
Three-hundred-fourteen undergraduates were randomly assigned to watch one of four videos: a woman portraying (a) neither symptoms of ADHD nor PSMU, (b) no ADHD symptoms but disclosing PSMU, (c) ADHD symptoms but no PSMU, or (d) both ADHD symptoms and PSMU. Participants then completed measures of their liking of and desire for affiliation with the woman.
Results:
Analyses suggest that visible symptoms of ADHD were perceived negatively and are associated with less liking and desire for affiliation. PSMU was associated with negligible additive stigma.
Conclusion:
This supports that noticeable ADHD symptoms may be the primary driver of the stigma associated with the disorder, and specifically that directed at young women with ADHD.
AduenP. A.DayT. N.KoflerM. J.HarmonS. L.WellsE. L.SarverD. E. (2018). Social problems in ADHD: Is it a skills acquisition or performance problem?Journal of Psychopathology and Behavioral Assessment, 40(3), 440–451. https://doi.org/10.1007/s10862-018-9649-7
2.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
3.
AndersenM. M.VargaS.FolkerA. P. (2022). On the definition of stigma. Journal of Evaluation in Clinical Practice, 28(5), 847–853. https://doi.org/10.1111/jep.13684
4.
BearmanS.KorobovN.ThorneA. (2009). The fabric of internalized sexism. Journal of Integrated Social Sciences, 1(1), 10–47.
5.
BensonK.FloryK.HumphreysK. L.LeeS. S. (2015). Misuse of stimulant medication among college students: A comprehensive review and meta-analysis. Clinical Child and Family Psychology Review, 18(1), 50–76. https://doi.org/10.1007/s10567-014-0177-z
6.
BiedermanJ.FaraoneS. V. (2004). The Massachusetts General Hospital studies of gender influences on attention-deficit/hyperactivity disorder in youth and relatives. Psychiatric Clinics of North America, 72, 225–232. https://doi.org/10.1016/j.psc.2003.12.004
7.
BiedermanJ.MickE.FaraoneS. V.BraatenE.DoyleA.SpencerT.WilensT. E.FrazierE.JohnsonM. A. (2002). Influence of gender on attention deficit hyperactivity disorder in children referred to a psychiatric clinic. American Journal of Psychiatry, 159, 36–42. https://doi.org/10.1176/appi.ajp.159.1.36
8.
BissetM.WinterL.MiddeldorpC. M.CoghillD.ZendarskiN.BellgroveM. A.SciberrasE. (2022). Recent attitudes toward ADHD in the broader community: A systematic review. Journal of Attention Disorders, 26(4), 537–548. https://doi.org/10.1177/10870547211003671
BrouwersE. P. M. (2020). Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues: Position paper and future directions. BMC Psychology8, 36. https://doi.org/10.1186/s40359-020-00399-0
11.
BunfordN.EvansS. W.LangbergJ. M. (2018). Emotional dysregulation is associated with social impairment among young adolescents with ADHD. Journal of Attention Disorders, 22(1), 66–82. https://doi.org/10.1177/1087054714527793
12.
CanuW. H.NewmanM. L.MorrowT. L.PopeD. L. W. (2008). Social appraisal of adult ADHD: Stigma and influences of the beholder’s Big Five personality traits. Journal of Attention Disorders, 11(6), 700–710. https://doi.org/10.1177/1087054707305090
13.
Castaldelli-MaiaJ. M.ScompariniL. B.de AndradeA. G.BhugraD.de Toledo Ferraz AlvesT. C.D’EliaG. (2011). Perceptions of and attitudes toward antidepressants: Stigma attached to their use – a review. Journal of Nervous and Mental Diseases, 199(11), 866–871. https://doi.org/10.1097/NMD.0b013e3182388950
14.
Center for Disease Control and Prevention. (2022, August9). Data and statistics about ADHD. Retrieved February 7, 2023, from https://www.cdc.gov/ncbddd/adhd/data.html
ClementS.SchaumanO.GrahamT.MaggioniF.Evans-LackoS.BezborodovsN.MorganC.RüschN.BrownJ. S. L.ThornicroftG. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11–27. https://doi.org/10.1017/S0033291714000129
17.
CorteseS.AdamoN.Del GiovaneC.Mohr-JensenC.HayesA. J.CarucciS.AtkinsonL. Z.TessariL.BanaschewskiT.CoghillD.HollisC.SimonoffE.ZuddasA.BarbuiC.PurgatoM.SteinhausenH.-C.ShokranehF.XiaJ.CiprianiA. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: A systematic review and network meta-analysis. The Lancet Psychiatry, 5(9), 727–738. https://doi.org/10.1016/s2215-0366(18)30269-4
18.
CostrichN.FeinsteinJ.KidderL.MarecekJ.PascaleL. (1975). When stereotypes hurt: Three studies of penalties for sex-role reversals. Journal of Experimental Social Psychology, 11(6), 520–530. https://doi.org/10.1016/0022-1031(75)90003-7
19.
DavisC. C.ClaudiusM.PalinkasL. A.WongJ. B.LeslieL. K. (2011). Putting families in the center. Journal of Attention Disorders, 16(8), 675–684. https://doi.org/10.1177/1087054711413077
20.
De CrescenzoF.CorteseS.AdamoN.JaniriL. (2016). Pharmacological and non-pharmacological treatment of adults with ADHD: A meta-review. Evidence Based Mental Health, 20(1), 4–11. https://doi.org/10.1136/eb-2016-102415
21.
EdinoffA. N.NixC. A.McNeilS. E.WagnerS. E.JohnsonC. A.WilliamsB. C.CornettE. M.MurnaneK. S.KayeA. M.KayeA. D. (2022). Prescription stimulants in college and medical students: A narrative review of misuse, cognitive impact, and adverse effects. Psychiatry International, 3(3), 221–235. https://doi.org/10.3390/psychiatryint3030018
22.
FairmanR. T.VuM.HaardörferR.WindleM.BergC. J. (2020). Prescription stimulant use among young adult college students: Who uses, why, and what are the consequences?Journal of American College Health, 69(7), 767–774. https://doi.org/10.1080/07448481.2019.1706539
GarciaJ. L.JohnsonA. J.CarlucciM. E.GroverR. L. (2020). The impact of mental health diagnoses on perceptions of risk of criminality. The International Journal of Social Psychiatry, 66(4), 397–410. https://doi.org/10.1177/0020764020913322
25.
GodfreyE.FuermaierA. B. M.TuchaL.ButzbachM.WeisbrodM.AschenbrennerS.TuchaO. (2021). Public perceptions of adult ADHD: Indications of stigma?Journal of Neural Transmission, 128(7), 993–1008. https://doi.org/10.1007/s00702-020-02279-8
26.
GudjonssonG. H.SigurdssonJ. F.SigfusdottirI. D.YoungS. (2014). A national epidemiological study of offending and its relationship with ADHD symptoms and associated risk factors. Journal of Attention Disorders, 18, 3–13. https://doi.org/10.1177/1087054712437584
27.
HinshawS. P. (2018). Attention deficit hyperactivity disorder (ADHD): Controversy, developmental mechanisms, and multiple levels of analysis. Annual Review of Clinical Psychology, 14, 291–316. https://doi.org/10.1146/annurev-clinpsy-050817-084917
28.
HolzingerA.FlorisF.SchomerusG.CartaM. G. (2011). Gender differences in public beliefs and attitudes about mental disorder in western countries: A systematic review of population studies. Epidemiology and Psychiatric Services, 21(1), 73–85. https://doi.org/10.1017/S2045796011000552
29.
JudsonR.LangdonS. W. (2009). Illicit use of prescription stimulants among college students: Prescription status, motives, theory of planned behaviour, knowledge and self-diagnostic tendencies. Psychology, Health & Medicine, 14(1), 97–104. https://doi.org/10.1080/13548500802126723
30.
KoenigA. M. (2018). Comparing prescriptive and descriptive gender stereotypes about children, adults, and the elderly. Frontiers in Psychology, 9, 1086. https://doi.org/10.3389/fpsyg.2018.01086
31.
KokF. M.GroenY.FuermaierA. B.TuchaO. (2016). Problematic peer functioning in girls with ADHD: A systematic literature review. PLoS One, 11(11), e0165119. https://doi.org/10.1371/journal.pone.0165119
LloydC. E. M.PanagopoulosM. C. (2022). ‘Mad, bad, or possessed’? Perceptions of self-harm and mental illness in evangelical Christian communities. Pastoral Psychology, 71, 291–311. https://doi.org/10.1007/s11089-022-01005-3
35.
LorenzoG. L.BiesanzJ. C.HumanL. J. (2010). What is beautiful is good and more accurately understood: Physical attractiveness and accuracy in first impressions of personality. Psychological Science, 21(12), 1777–1782. https://doi.org/10.1177/0956797610388048
36.
MasuchT. V.BeaM.AlmA.DeiblerP.SobanskiE. (2018). Internalized stigma, anticipated discrimination and perceived public stigma in adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 2018, 1–10. https://doi.org/10.1007/s12402-018-0274-9
37.
McKeeT. E. (2017). Peer relationships in undergraduates with ADHD symptomatology: Selection and quality of friendships. Journal of Attention Disorders, 21(12), 1020–1029. https://doi.org/10.1177/1087054714554934
38.
MurphyK.BarkleyR. A. (1996). Attention deficit hyperactivity disorder adults: Comorbidities and adaptive impairments. Comprehensive Psychiatry, 37(6), 393–401. https://doi.org/10.1016/S0010-440X(96)90022-X
39.
PartridgeB.LuckeJ.HallW. (2014). Over-diagnosed and over-treated: A survey of Australian public attitudes towards the acceptability of drug treatment for depression and ADHD. BMC Psychiatry14, 74. https://doi.org/10.1186/1471-244X-14-74
40.
PaulsonJ. F.BuermeyerC.Nelson-GrayR. O. (2005). Social rejection and ADHD in young adults: An analogue experiment. Journal of Attention Disorders, 8(3), 127–135. https://doi.org/10.1177/1087054705277203
41.
PescosolidoB. A. (2013). The public stigma of mental illness: What do we think; What do we know; What can we prove?Journal of Health and Social Behavior, 54(1), 1–21. https://doi.org/10.1177/0022146512471197
42.
PescosolidoB. A.Halpern-MannersA.LuoL.PerryB. (2021). Trends in public stigma of mental illness in the US, 1996-2018. JAMA Network Open, 4(12), e2140202. https://doi.org/10.1001/jamanetworkopen.2021.40202
43.
PrenticeD. A.CarranzaE. (2002). What women and men should be, shouldn’t be, are allowed to be, and don’t have to be: The contents of prescriptive gender stereotypes. Psychology of Women Quarterly, 26(4), 269–281. https://doi.org/10.1111/1471-6402.t01-1-00066
44.
QuinnP. O. (2005). Treating adolescent girls and women with ADHD: Gender-specific issues. Journal of Clinical Psychology, 61(5), 579–587. https://doi.org/10.1002/jclp.20121
45.
RösslerW. (2016). The stigma of mental disorders: A millennia-long history of social exclusion and prejudices. EMBO Reports, 17(9), 1250–1253. https://doi.org/10.15252/embr.201643041
46.
SacchettiG. M.LeflerE. K. (2017). ADHD symptomatology and social functioning in college students. Journal of Attention Disorders, 21(12), 1009–1019. https://doi.org/10.1177/1087054714557355
47.
ScuttioM. J. (2015). ADHD knowledge, misconceptions, and treatment acceptability. Journal of Attention Disorders, 19(2), 91–98. https://doi.org/10.1177/1087054713493316
48.
SpeerforckS.StolzenburgS.HertelJ.GrabeH. J.StraubM.CartaM. G.AngermeyerM. C.SchomerusG. (2019). ADHD, stigma and continuum beliefs: A population survey on public attitudes towards children and adults with attention deficit hyperactivity disorder. Psychiatry Research, 282, 112570. https://doi.org/10.1016/j.psychres.2019.112570
WaiteR. (2007). Women and attention deficit disorders: A great burden overlooked. Journal of the American Academy of Nurse Practitioners, 19(3), 116–125. https://doi.org/10.1111/j.1745-7599.2006.00203.x
51.
WalsterE.AronsonV.AbrahamsD.RottmannL. (1966). Importance of physical attractiveness in dating behavior. Journal of Personality and Social Psychology, 4(5), 508–516. https://doi.org/10.1037/h0021188
ZoromskiA. K.OwensJ. S.EvansS. W.BradyC. E. (2015). Identifying ADHD symptoms most associated with impairment in early childhood, middle childhood, and adolescence using teacher report. Journal of Abnormal Child Psychology, 43(7), 1243–1255. https://doi.org/10.1037/t62909-000
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