The perceptions of the broader community towards ADHD have not been elucidated. Therefore, the aim of this systematic review was to synthesise research surrounding the community perceptions of ADHD.
A systematic rapid review was performed in February 2020 to search for peer-reviewed studies published between January 2014 and February 2020. Studies were included* if they were: published after 31 December 2013; written in English; peer-reviewed; available as a full-text; and had a focus on the perceptions of adult members of the broader community towards ADHD, individuals described as having ADHD or individuals displaying ADHD-related symptoms or behaviours.
In total, 10 studies were selected for inclusion in the review, four from the United States, two from Germany and one each from Australia, Finland, Indonesia and Korea. Out of the 10 studies, nine examined samples from broader communities and one examined a sample from university and college students. The sample sizes ranged from <200 to >1000 participants; seven studies employed a cross-sectional survey design and three employed an experimental design. Additionally, five studies examined attitudes towards ADHD symptoms and behaviours, three examined attitudes towards a diagnosis or label of ADHD and two examined differences between attitudes towards an ADHD diagnosis or label and attitudes towards ADHD symptoms or behaviours.
Knowledge of ADHD
There were five studies (Germany, Finland, Indonesia, Korea and the United States) that examined knowledge and identification of ADHD within the broader community. Populations in Indonesia and Korea generally had a low understanding of ADHD and the majority of participants could not correctly identify ADHD from a description of behaviours. However, most of the participants in German and Finnish populations had reported they had heard of ADHD or could recognise ADHD as a disorder. Two studies examined the broader community’s knowledge of the aetiology of ADHD symptoms. An American population sample generally attributed more blame for ADHD symptoms to ADHD itself, rather than attributing symptoms to the child or their parents. Furthermore, a German population sample mainly found that understanding of the causes of ADHD symptoms differed between child and adult ADHD. For example, symptoms of ADHD in children were attributed to environmental factors and symptoms in adults were attributed to biological causes. Education and familiarity with individuals with ADHD were associated with more positive attitudes towards ADHD in the broader community.
ADHD diagnosis, medication and treatment
Overall, three studies were identified that investigated attitudes towards stimulant medication treatment for ADHD in the general population samples. In a large Australian study (n=1293) and a German study (n=1008), more than one-third of the Australian sample and two-thirds of the German sample reported a belief that ADHD treatment medication is unacceptable. Additionally, more than three-quarters of participants from the Australian study believed that too many children are diagnosed with ADHD when they did not really have it. However, the authors of the studies believed that further education could improve the views of the general population to be more favourable towards the diagnosis of ADHD and medication.
Maintaining social distance
Five studies (Germany, Korea and the United States) were identified that examined participants’ desire to maintain social distance from individuals with ADHD. Overall, there was a general desire to maintain social distance from children and adults who were described as having ADHD symptoms but no label or diagnosis of ADHD was provided. Additionally, participants were reported to have more prosocial reactions and reduced desire to maintain social distance from a child or adult with core ADHD symptoms if participants had been provided with a biological explanation for ADHD symptoms or believed that ADHD symptoms exist along a continuum.
There were some limitations to this systematic review. Articles published in a language other than English were excluded and due to the literature search being a rapid review, only a select few databases were searched and so the literature was not extensively interrogated.
To conclude, the authors suggested that research findings from the few available sources provide a generally negative broader community view towards individuals with ADHD. In response, the authors emphasised that more representative population-based research with comparable methodologies should be performed to confirm attitudes currently held by the broader community towards ADHD. Furthermore, the authors stated that targeted ADHD-related literacy could aid improvement of the broader community’s attitude towards ADHD.
Read more about community perceptions of ADHD here
*Studies were excluded if they were supplemental abstracts, conference proceedings, review articles or thesis dissertations; or focused on the views of individuals with ADHD, the parents and families of those with ADHD, teachers and clinicians.
Bisset M, Winter L, Middeldorp CM, et al. Recent attitudes toward ADHD in the broader community: a systematic review. J Atten Disord 2021; Epub ahead of print.