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While the debate rages on about the proper conceptualization of ADHD behaviors, parents and children are caught in the middle. Much research has found that actions consistent with ADHD in a child have negative implications for that child's relationship with his or her parents. In general, households with children who have ADHD are characterized by higher parental stress and distress and more parent-child conflict than households without children who have ADHD. Studies of parents' self-reports find that mothers and fathers of these children have trouble relating to their off spring, often lack a sense of closeness with the child, and view themselves as less skilled and competent as parents. Commonly, these parents experience feelings of hopelessness and desperation to find help. In efforts to address the challenges they face, some parents display negative reactions to their children, including being excessively controlling, viewing the youths less positively, and resorting to more authoritarian discipline styles.

In addition to these joint concerns, studies have found issues unique to mothers and to fathers regarding their children with ADHD. For example, research has found a correlation between depression in mothers and parenting children with ADHD. Following a social tradition of disproportionate responsibility for rearing children, many mothers internalize the notion that they are to blame when their sons or daughters misbehave. This history of mother blaming has been somewhat relieved by the rise of the medical model for ADHD, which takes the liability away from mothers and places it on the child's internal defects that are outside their control. Despite this, a number of mothers today are still deeply troubled when their children behave negatively, both out of concern for the quality of life of the child and for others' potentially hurtful perceptions about their parenting.

Many fathers of children with ADHD experience their role differently from mothers. For example, one study found that fathers were much less willing than mothers to accept the medical view of their children's difficulties. Additionally, this research noted that many fathers were not active in the diagnostic and treatment process of their children's disorder, but they did not stand in the way of it either. Often they were sidelined during this progression, some by choice and others in an effort to avoid conflict in the marital relationship.

One notable finding by researchers, such as psychiatrist Ilina Singh, is that a number of fathers feel guilt in connection to their sons' ADHD. The medical model for this behavioral disorder proposes a genetic linkage that passes ADHD from father to son. Due to this, some fathers blame themselves for causing their sons' problems. One consequence of acknowledging their possible responsibility is that men think back to their own childhoods, in which they behaved similarly to their sons, and question whether they should have been given the same diagnosis.

Finally, discord can arise between a husband and wife as they struggle to deal with their child with ADHD for a number of reasons. One example is a disagreement over the true nature of their off spring's problems. Also, trouble can emerge simply from the general stress of the environment. Partners who are feeling upset about issues with their child may take out their emotions on one another. Another source of conflict might be a husband's opinion that his wife is at least somewhat responsible for their child's unruly behavior because she is too indulgent, a sentiment some fathers report they have.

Critics of the medical model and of the medicalization of ADHD sometimes condemn parents for their willingness to accept such a label for their children. Some of these critics believe that parents today take the easy way out, choosing to take their children to a doctor for medication rather than altering their parenting styles to address difficult behavior. Contrary to this perception, however, many parents report experiencing great worry over the decision to seek treatment for their children. Many would likely report that these actions were a last resort. A great number of ADHD diagnoses are initiated at school. Parents are often called to school repeatedly to address a child's unruly behavior, and eventually a teacher or administrator suggests an ADHD evaluation. If a parent is reluctant, this suggestion may continue to be made until he or she gives in. Regardless of whether they feel the ADHD label is appropriate, if a practitioner tells a parent that a son or daughter has ADHD, that parent has additional pressure to take steps to address it. Many parents, who may see themselves as grossly unqualified to determine the nature of their children's problems, eventually defer to the opinion of the experts (teachers, doctors, psychologists) and accept the ADHD diagnosis and treatment. Despite critics' claims, these parents would surely report that this decision is anything but easy.

ADHD is an issue touching more and more lives in the United States each day. Extensive research has been done on this topic, ranging from medical investigation to social interpretation, yet it remains an area ripe for exploration and debate. Science continues to seek definitive proof that a deficiency or imbalance in the brain, transmittable by DNA, causes recognizable unwanted behaviors that can be labeled and treated as a disease. At the same time, those opposed to this view continue to study and question the social factors surrounding this issue and disprove any biological basis. Neither side has had absolute success, so the controversy continues.

Regardless of where one stands in the debate, it is hard to deny that an increasing number of parents and children are being faced with the ADHD label. Those parents who hear competing information from various sources in the controversy often feel torn over the right thing to do and experience negative feelings, regardless of their decision. Perhaps one day an irrefutable medical discovery will be made to mark ADHD as a disease. Perhaps social opinion on children's behavior will shift, and more rambunctious or unruly behavior will not be considered as problematic as it is today. Either of these events could result in an end to the debate surrounding ADHD. However, at this point, there is no indication that either type of solution will occur any time soon. Thus, ADHD diagnoses are sure to continue, with proponents' blessings and critics' curses.

Bibliography:

Armstrong, Thomas, "ADD: Does It Really Exist?" In Taking Sides: Clashing Views on Controversial Issues in Abnormal Psychology, 3d ed., ed. Richard P. Halgin. Dubuque, IA: McGraw-Hill/Duskin, 2002.

Barkley, Russell A., Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 3d ed. New York: Guilford Press, 2006.

Conrad, Peter, and Joseph W. Schneider, Deviance and Medicalization: From Badness to Sickness. Philadelphia: Temple University Press, 1992.

Hallowell, Edward M., "What I've Learned from ADD." In Taking Sides: Clashing Views on Controversial Issues in Abnormal Psychology, 3d ed., ed. Richard P. Halgin. Dubuque, IA: McGraw-Hill/Duskin, 2002.

McBurnett, Keith, and Linda Pfifner, eds., Attention Deficit  Hyperactivity Disorder: Concepts, Controversies, New Directions. New York: Informa Healthcare, 2008.

Singh, Ilina, "Boys Will Be Boys: Fathers' Perspectives on ADHD Symptoms, Diagnosis, and Drug Treatment," Harvard Review of Psychiatry 11 (2003): 308–316.

Timimi, Sami, Naughty Boys: Anti-Social Behavior, ADHD and the Role of Culture. New York: Palgrave Macmillan, 2005.

Wegandt, Lisa L., An ADHD Primer, 2d ed. Mahwah, NJ: Lawrence Erlbaum, 2007.

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