Understanding the Complexity of ADHD and Bias in Healthcare

ADHD is a complex condition that affects individuals in various ways. Nicole Clark from the NYTimes mentions in No One’s Ever Talked to Me About This Before that there are at least 3 forms of ADHD: “inattentive, hyperactive, or (a) combined type”. It’s a field of research that is historically based on white men, and although it is often overdiagnosed and overmedicated, diagnoses still fall short for POC, especially women of color. To understand this statement, it is important to be aware of how racial injustice in our social system affects the possibility of insurance that might provide a diagnosis and treatment, as well as gender bias in healthcare (Clark). Social norms are also an obstacle for many women of color questioning if they have ADHD. Clark retells the experience of Tiffany Bui and mentions that many of the traits of ADHD were viewed as faults by her family growing up. To make up for these traits, Bui found it necessary to adapt to a neurotypical world by “masking” these traits through methods, such as setting alarms for certain tasks (Clark).

    Jasmine Kwasa’s writing in Top-down Attention Modulates Auditory-Evoked Neural Responses in Neurotypical, but Not ADHD, Young Adults also focused on ADHD, specifically the ability to “sustain attentional focus on a single ‘target’ stream and the ability to monitor the target but flexibly switch attention to an unpredictable ‘interrupter’ stream from another direction” (2, Kwasa). Kwasa initially hypothesized that throughout this experiment, people with ADHD would have a harder time with the task and therefore would also have “weaker neural signatures of attentional control” (2). The paper describes that although this is true, they additionally observed a variation in performance level, stating that their “results demonstrate that people vary widely in how flexibly they can use attention to modulate sensory responses based on task goals” (2).  

One of the more salient statements Kwasa made in her writing was that “the outcome of this attentional contest depends on the strength of an individual’s ‘top-down’ control of attention relative to their susceptibility to ‘bottom-up’ attentional capture” (2). Such a claim expands the range of questions that must be posed concerning ADHD and its complexity. This understanding may be able to contribute to an understanding of “masking” and the various ways subjects with ADHD have adapted to a neurotypical world. This additionally connects our understanding of ADHD and focus. Kailey Horan from Psychology Today, mentions in 7 Ways ADHD Shows Up in the Brain that the DSM used to diagnose ADHD has an outdated definition that excludes an understanding of hyperfocus. Where individuals with ADHD only struggle with focus in some areas, but perform well in others, such as those they are interested in. Further research is necessary to reach a deeper understanding of Kwasa’s statement and why the outcomes varied by individual. An understanding of the complexity of ADHD and medical bias is necessary to provide an accurate diagnosis and an accurate understanding of the condition. 

Works Cited

Clark, Nicole. “'No One's Ever Talked to Me about This before'.” The New York Times, The New York Times, 24 May 2021, www.nytimes.com/2021/05/24/style/adhd-online-creators-diagnosis.html. 

Horan, Kailey S. “7 Ways ADHD Shows up in the Brain .” Psychology Today, 31 Dec. 2021, www.psychologytoday.com/ie/blog/the-reality-gen-z/202112/7-ways-adhd-shows-in-the-brain. 

Kwasa, Jasmine A., et al. “Top-down Attention Modulates Auditory-Evoked Neural Responses in Neurotypical, but Not ADHD, Young Adults.” 2021, doi:10.1101/2021.02.11.430824.