Illness-perception in adolescent attention-deficit/hyperactivity disorder: A qualitative study

Abstract

Background: Adolescents with attention-deficit/hyperactivity disorder (ADHD) experience aspects of their lives in diverse ways. They often have more energy and creativity which are positive traits of ADHD, while their inability to control their actions in academic or social spheres may cause feelings of inadequacy.

Aim: To explore illness-perception, including emotional experiences, in adolescent ADHD.

Setting: Using convenience sampling, 12 adolescent participants, eight boys and four girls, diagnosed with ADHD, were included. Participants followed up at Weskoppies Tertiary Psychiatric Hospital’s child-and-adolescent outpatient clinic.

Methods: This qualitative study used semi-structured question guides to conduct interviews that allowed participants to actively construct their knowledge of their disorder. Maintaining a phenomenological perspective, thematical analysis of data was done.

Results: Adolescents’ perceptions of their ADHD could be placed into three categories. ‘Negative self-perception in ADHD’ represented adolescents’ descriptions of ‘inability’ and ‘lack of control’ over their cognitive processes, behaviour, emotions, and restlessness. Adolescents perceived ‘feeling judged by others’, amplified self-stigmatisation and discrimination. This antagonistic environment caused conflict between their self-perception and others’ perception of them, further intensifying feelings of ‘not being normal’. The theme ‘self-empowerment strategies’, included controlling external stimuli, accepting support from others, and personalised learning strategies.

Conclusion: Adolescents with ADHD struggle with cognitive, behavioural, and emotional control, and frequently experience stigmatisation and discrimination. They often learn to rely on self-taught coping strategies.

Contribution: This research grants perspective to educators and clinicians on experiences of adolescents with ADHD, and identifies the need to address stigmatisation. It recognises the value of personalisation of coping methods.