Understanding parental causal explanations and help seeking in attention-deficit/ hyperactivity disorder:...

Research on parental understanding of causation and help-seeking for ADHD comes from ethnic minorities in developed nations; research from Asia is scarce. Our purpose was to explore perceptions of Indian parents regarding causation and diagnosis of problematic childhood behaviors diagnosed as ADHD or hyperkinetic disorder, and to understand the process of decision making and help seeking using a qualitative study design.

In-depth, semi-structured interviews were conducted with 52 parents (33 mothers and 19 fathers), focusing on initial emotional reactions and cognitive appraisals, decision making, parental causal explanations and perceptions regarding diagnosis and symptom labeling.

Mothers were decision makers for seeking professional help either singly or jointly in 76.1% of cases. Initial reactions ranged from those with negative valence (negative emotional reactions and cognitive appraisals) to ambi-valence (recognition of problems, but at the same time not accepting completely) and positive valence (sense of relief and hopefulness). Psycho-social explanations (63.46%) were more common than biological explanations (51.82%), with 19.23% reporting both explanations. Biological explanations included illness model (e.g. brain problem, obstetric complications), hereditary and intellectual disability. Psycho-social explanations included psychological (e.g. lack of motivation) and social (e.g. problems with disciplining at home) causations. Irrespective of initial reactions and causal explanations, a significant majority of parents were aware of the diagnosis and labeled problems as symptoms attributable to ADHD.

Our findings provide insights for development of culturally sensitive psycho-social interventions; from understanding of causal attributions, process of decision making and help seeking.