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Attention-Deficit/Hyperactivity Disorder in African American Youth

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Abstract

This article examines attention-deficit/hyperactivity disorder (ADHD) in African American youth. Tackling the myths and misinformation surrounding ADHD in the African American community can be one of the most difficult issues in mental illness circles. There is a lot of conflicting information about how African Americans are diagnosed, examined, and treated. This article clarifies some of the misconceptions and offers some comprehensibility to the issue of ADHD in African American youth. The incidence of ADHD is probably similar in African Americans and Caucasians. However, fewer African Americans are diagnosed with and treated for ADHD. That reality flies in the face of some perceptions in many African American communities. Reasons for this disparity have not been fully clarified and are most likely complex and numerous. Some barriers to treatment are driven by the beliefs of patients and their families, while others are the result of limitations in the health care system. Patient-driven obstacles to care include inadequate knowledge of symptoms, treatment, and consequences of untreated ADHD and fear of overdiagnosis and misdiagnosis. System-driven limitations include a lack of culturally competent health care providers, stereotyping or biases, and failure of clinicians to evaluate the child in multiple settings before diagnosis.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Rappley M: Attention deficit-hyperactivity disorder. N Engl J Med 2005, 352:165–173.

    Article  CAS  PubMed  Google Scholar 

  2. Lin KM, Anderson D, Poland RE: Ethnicity and psychopharmacology. Bridging the gap. Psychiatr Clin North Am 1995, 18:635–647.

    CAS  PubMed  Google Scholar 

  3. Bailey RK, Blackmon HL, Stevens FL: Major depressive disorder in the African American population: meeting the challenges of stigma, misdiagnosis, and treatment disparities. J Natl Med Assoc 2009, 101:1084–1089.

    PubMed  Google Scholar 

  4. Rowland AS, Umbach DM, Stallone L, et al.: Prevalence of medication treatment for attention deficit-hyperactivity disorder among elementary school children in Johnston County, North Carolina. Am J Public Health 2002, 92:231–234.

    Article  PubMed  Google Scholar 

  5. Safer DJ, Zito JM: Psychotropic medication for ADHD. Ment Retard Dev Disabil Res Rev 1999, 5:237–242.

    Article  Google Scholar 

  6. Zito JM, Safer DJ, dos Reis S, Riddle MA: Racial disparity in psychotropic medications prescribed for youths with Medicaid insurance in Maryland. J Am Acad Child Adolesc Psychiatry 1998, 37:179–184.

    Article  CAS  PubMed  Google Scholar 

  7. Pastor PN, Reuben CA: Attention deficit disorder and learning disability: United States, 1997–98. Vital Health Stat 10 2002, 206:1–12.

  8. Miller TW, Nigg JT, Miller RL: Attention deficit hyperactivity disorder in African American children: what can be concluded from the past ten years? Clin Psychol Rev 2009, 29:77–86.

    Article  PubMed  Google Scholar 

  9. Bussing R, Schoenberg NE, Perwien AR: Knowledge and information about ADHD: evidence of cultural differences among African-American and white parents. Soc Sci Med 1998, 46:919–928.

    Article  CAS  PubMed  Google Scholar 

  10. Davison JC, Ford DY: Perceptions of attention deficit hyperactivity disorder in one African American community. J Negro Educ 2001, 70:264–274.

    Article  Google Scholar 

  11. National Medical Association (United States): Journal of the National Medical Association. East Norwalk, CT: Appleton-Century-Crofts; 1909.

  12. Kaiser B, Rasminsky JS: Challenging Behavior in Elementary and Middle School. Upper Saddle River, NJ: Pearson; 2009.

    Google Scholar 

  13. • Fabiano GA, Pelham WE Jr, Coles EK, et al.: A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clin Psychol Rev 2009, 29:129–140. The effect sizes in this meta-analysis of 174 studies of behavioral treatment varied by study design but not by other study characteristics, such as demographics. Results from between-group studies (0.83), pre-post studies (0.70), within-group studies (2.64), and single-subject studies (3.78) suggested that behavioral treatments are effective across different settings and across individuals with diverse characteristics. The ADHD literature they used included non-Caucasian patients and girls with considerable comorbidity, recruited primarily from school or clinic referrals, and conducted in a variety of treatment settings. Behavioral parent training, classroom management (teachers), and peer relation–focused interventions are forms of the behavioral interventions used.

    Article  PubMed  Google Scholar 

  14. Arnold LE, Elliot M, Sachs L: Effects of ethnicity on treatment attendance stimulant response/dose, and 14-month outcome in ADHD. J Consult Clin Psychol 2003, 71:713–727.

    Article  PubMed  Google Scholar 

  15. Lomotey K: Encyclopedia of African American Education. Los Angeles: SAGE Publications; 2010.

    Google Scholar 

  16. Jackson Y: Encyclopedia of Multicultural Psychology. Thousand Oaks, CA: SAGE Publications; 2006.

    Google Scholar 

  17. Bussing R, Gary FA, Mills TL, Garvan CW: Parental explanatory models of ADHD: gender and cultural variations. Soc Psychiatry Psychiatr Epidemiol 2003, 38:563–575.

    Article  PubMed  Google Scholar 

  18. Dosreis S, Zito JM, Safer DJ, et al.: Parental perceptions and satisfaction with stimulant medication for attention-deficit hyperactivity disorder. J Dev Behav Pediatr 2003, 24:155–162.

    PubMed  Google Scholar 

  19. • Bussing R, Gary FA, Mills TL, Garvan CW: Cultural variations in parental health beliefs, knowledge, and information sources related to attention-deficit/hyperactivity disorder. J Fam Issues 2007, 28:291–318. A sample of 1615 parents were interviewed and filled out an ADHD knowledge and perceptions survey, behavioral questionnaires, and inquiries about ADHD detection and treatment. This study investigated the cultural variance in parental health beliefs, knowledge, and information sources related to ADHD. Some of the results showed that African American parents are less aware and have low self-knowledge and that they made more attributions to sugar intake and expected less benefit from treatment. The article noted concerns about how stigma related to emotional and mental disorders can become heightened when the child and parents are African American or members of another ethnic minority group.

    Article  Google Scholar 

  20. Mattox G: African American youngsters inadequately treated for ADHD. Psychiatr News 2001, 36:17.

    Google Scholar 

  21. • Pescosolido BA, Jensen PS, Martin JK, et al.: Public knowledge and assessment of child mental health problems: findings from the National Stigma Study-Children. J Am Acad Child Adolesc Psychiatry 2008, 47:339–349. A sample of 1393 adults completed a survey conducted by the National Stigma Study-Children regarding ADHD and depression and used descriptive and multivariate analyses to provide estimates. It was suggested that the public can and does discriminate between types of problems and ascribes different levels of severity, depression, and daily troubles. Some of the results reported that African Americans are less willing to seek advice of teachers, and parents are less willing to consult teachers and health professionals. Although the African American respondents are instructive, negative attitudes toward medicine are present, and the investigators suggested that this is an oversimplification, if not a stereotype.

    Article  PubMed  Google Scholar 

  22. Visser SN, Malone LM, Lesesne CA: Socio-demographic difference among a national sample of African-American and white youth with attention-deficit/hyperactivity disorder [abstract 55745]. Paper presented at the 131st Annual Meeting of the American Public Health Association. San Francisco, CA; November 17, 2003.

  23. National Institutes of Health Consensus Development Conference Statement: diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD). J Am Acad Child Adolesc Psychiatry 2000, 39:182–193.

    Google Scholar 

  24. Shavers VL, Lynch CF, Burmeister LF: Knowledge of the Tuskegee study and its impact on the willingness to participate in medical research studies. J Natl Med Assoc 2000, 92:563–572.

    CAS  PubMed  Google Scholar 

  25. Kendall J, Hatton D, Beckett A, Leo M: Children’s accounts of attention deficit/hyperactivity disorder. ANS Adv Nurs Sci 2003, 26:114–130.

    PubMed  Google Scholar 

  26. Gingerich KJ, Turnock P, Litfin JK, Rosen LA: Diversity and attention deficit hyperactivity disorder. J Clin Psychol 1998, 54:415–426.

    Article  CAS  PubMed  Google Scholar 

  27. Geiger JH: Racial stereotyping and medicine: the need for cultural competence. Can Med Assoc J 2001, 164:1699–1700.

    CAS  Google Scholar 

  28. Giles WH, Anda RF, Casper ML, et al.: Race and sex differences in rates of invasive cardiac procedures in US hospitals. Data from the National Hospital Discharge Survey. Arch Intern Med 1995, 155:318–324.

    Article  CAS  PubMed  Google Scholar 

  29. Shiefer SE, Escarce JJ, Schulman KA: Race and sex differences in the management of coronary artery disease. Am Heart J 2000, 139:848–857.

    Article  Google Scholar 

  30. Todd N, Samaroo N, Hoffman JR: Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA 1993, 269:1537–1539.

    Article  CAS  PubMed  Google Scholar 

  31. Bach PB, Cramer LD, Warren JL, Begg CB: Racial differences in the treatment of early stage lung cancer. N Engl J Med 1999, 341:1198–1205.

    Article  CAS  PubMed  Google Scholar 

  32. Young AS, Klap R, Sherbourne CD, Wells KB: The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry 2001, 58:55–61.

    Article  CAS  PubMed  Google Scholar 

  33. Anderson LA, Scrimshaw SC, Fullilove MT, et al.: Culturally competent healthcare systems. Am J Prev Med 2003, 24:68–79.

    Article  PubMed  Google Scholar 

  34. Livingston R: Cultural issues in diagnosis and treatment of ADHD. J Am Acad Child Adolesc Psychiatry 1999, 38:1591–1594.

    Article  CAS  PubMed  Google Scholar 

  35. Samuel VJ, Biederman J, Faraone SV, et al.: Clinical characteristics of attention deficit hyperactivity disorder in African American children. Am J Psychiatry 1998, 155:696–698.

    CAS  PubMed  Google Scholar 

  36. US Department of Health and Human Services: Healthy People 2010, edn 2. Washington, DC: US Government Printing Office; 2000.

    Google Scholar 

  37. Murray DW, Bussing R, Fernandez M, et al.: Psychometric properties of teacher SKAMP ratings from a community sample. Assessment 2009, 16:193–208.

    Article  PubMed  Google Scholar 

  38. Bussing R, Fernandez M, Harwood M, et al.: Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample. Assessment 2008, 15:317–328.

    Article  PubMed  Google Scholar 

  39. Odom SE: Effects of an educational intervention on mothers of male children with attention deficit hyperactivity disorder. J Community Health Nurs 1996, 13:207–220.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Lloyd C. Elam Mental Health Center, Meharry Medical College, 1005 D. B. Todd Jr Boulevard, Nashville, TN, 37208, USA

    Rahn K. Bailey, Shahid Ali, Shagufta Jabeen, Hilary Akpudo, Jaymie U. Avenido, Theresa Bailey, Jessica Lyons & Amelia A. Whitehead

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  1. Rahn K. Bailey
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  2. Shahid Ali
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  3. Shagufta Jabeen
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Correspondence to Rahn K. Bailey.

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Bailey, R.K., Ali, S., Jabeen, S. et al. Attention-Deficit/Hyperactivity Disorder in African American Youth. Curr Psychiatry Rep 12, 396–402 (2010). https://doi.org/10.1007/s11920-010-0144-4

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