Latinos and ADHD: The Impact of Culture on ADHD

[Anahi Ortiz M.D.]

  Recently I read a case study on a female latina who was diagnosed with ADHD in her 20's. She was also gay. It was a very interesting article which brought out several factors that prevented her being diagnosed till later and also brought out the difficulties involved in finding culturally sensitive and gay sensitive treatment. I researched extensively to see if there were any studies done on the gay populaton and ADHD but I could not find any. In terms of women and ADHD, there are books written on the topic. That will be the topic of my next blog.

   I went on to research the Latino population and ADHD.I found several studies that show Latino children are less likely than Caucasian or African American children to be diagnosed with ADHD. In addition, once diagnosed, Latino children use medications at less than half the rate of Caucasian children.

   Latino parents are more likely to report lower rates of symptoms. They may not recognize symptoms of ADHD or the symptoms may be atributed to e.g. being defiant,  as opposed to a symptom of a medical disorder. Different cultures often have varying thresholds for differentiating normal from abnormal child behavior. From personal experience, as a child I can still remember some of our Latino friends who were "wild" - now, I would describe it as impulsive, but their parents saw it as just "playing too hard". The degree with which ADHD is considered harmful is really culture bound. In addition, diagnostic rating scales although tested to be valid for the Spanish speaking population may not accurately reflect the child's functioning. Again, parents may view symptoms differently and not necessarily describe them as problematic.

   We know that medication can help the majority of those with ADHD but studies show that there are less Latino children using medication than the general population. This has been found to be due to parental beliefs about medication. Alternatively, if  parents agree to give medications to their children, they are less likely to find positive results.

   In terms of therapy or counseling, the case study I reviewed reveals the difficulties this particular young Latina had in finding a therapist who understood her culture and parental influences. Therapy is another area Latinos are very hesitant to use. Many view any mental health disorder as "being crazy" and therefore therapy is not sought out. Alternative treatments seen as cures are used instead.

   Now much of what I have noted above pertains to Latino families who are not acculturated to the culture here. Thus in any given culture living in America, you may see difficulties with diagnosis and treatment of ADHD due to their specific cultural beliefs and level of acculturation. The tragedy here is the loss of productivity and quality of life for many of those who are not diagnosed.

   The message here is that the professionals diagnosing, managing and treating ADHD need to be sensitive to the specific culture of the person they are working

[Anahi Ortiz M.D.]

Your absolutely right, Doug. It also depends to a large degree on how acculturated the families are to American life. For a third generation Latino family, therapy and medication may not seem as intolerable as a first generation family. It is a complicated but very serious issue to remember when working with families from other cultures

[doug puryear]

yes!   but it is hard to know what the specific cultural issues are, and even then each person and family is different too.  in hispanic or latino culture, i understand that it is family, respect, and often church - but not always, and can be hard to apply that knowledge in specific cases.  so looking forward to your follow up blogs.