Exploring stimulant treatment in ADHD: narratives of young adolescents and their parents
1 Program in Child Health Evaluative Sciences, Research Institute The Hospital for Sick Children, Toronto, Canada
2 Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Canada
3 Department of Psychology, University of Victoria, Victoria, Canada
4 Community Health Systems Resource Group, The Hospital for Sick Children, Toronto, Canada
5 Program in Neurosciences and Mental Health, Research Institute The Hospital for Sick Children, Toronto, Canada
6 Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA
BMC Psychiatry 2014, 14:110 doi:10.1186/1471-244X-14-110Published: 12 April 2014
Young adolescents’ and their parents’ experiences with Attention-Deficit/Hyperactivity Disorder (ADHD) and its treatment were explored to investigate beliefs and attitudes regarding use of stimulant medication, and their influence on treatment decisions.
Using in-depth qualitative interviews, 12 adolescents with ADHD aged 12 – 15 years, and their parents described their experiences of ADHD and its treatment. Twenty four interviews, 12 with adolescents and 12 with their parents elicited detailed descriptions of beliefs about ADHD, attitudes about stimulant use and the circumstances surrounding treatment decisions. Verbatim transcripts were iteratively analyzed by a team of researchers following an interpretive interactionist framework.
Young people offered three themes describing ADHD: 1) personality trait, 2) physical condition or disorder, and 3) minor issue or concern. Regarding medication use, youth described 1) benefits, 2) changes in sense of self, 3) adverse effects, and 4) desire to discontinue use. Parents’ beliefs were more homogeneous than youth beliefs, describing ADHD as a disorder requiring treatment. Most parents noted benefits from stimulant use. Themes were 1) medication as a last resort, 2) allowing the child to reach his or her potential; and 3) concerns about adverse and long-term effects. Families described how responsibility for treatment decisions is transferred from parent to adolescent over time.
Young adolescents can have different beliefs about ADHD and attitudes about medication use from their parents. These beliefs and attitudes influence treatment adherence. Incorporating input from young adolescents when making clinical decisions could potentially improve continuity of treatment for youth with ADHD.