Case Study 3

The following case study illustrates help-seeking behavior in regards to ADHD in a Chinese family. The case study provides a question for viewers to consider and reflect on.

Case Study 3: Attention deficit hyperactivity disorder (ADHD) (Chinese

(Adapted from Young, 2012).

Jing is a sixteen year old Chinese adolescent. She was born in China but raised in New Zealand from the age of six. Jing is the only child in her family. She says that her parents are understanding of her ADHD symptoms and do not “push” her to excel, although Jing’s parents are both highly educated with graduate degrees. Her father has a Ph.D in a science field and her mother has a Master’s degree in Information Technology. Jing does not indicate that her parents benchmark her success by the use of social comparison with others. Jing attends her local secondary school where she has been a high achiever and was top of her class in maths and science last year. Her aim is to be a doctor. However, recently her grades have dropped. Socially, Jing doesn’t feel that she “fits in” at school. She has a reputation for being a “space cadet,” and she is still somewhat aloof from others, having few friends (none of whom are of Asian descent). Jing considers herself to be “strange” in high school. She feels alone and different from others. Recently, she has had problems focusing on, and staying interested in her studies.

This year Jing came across her ADHD diagnosis by accident. While surfing the internet, she came across an ADHD checklist of symptoms as a method of self-assessment. She was able to endorse most if not all the criteria for ADHD on the self-assessment. Jing provided the self- assessment inventory to her friend so that she could rate Jing. The friend’s assessment results were similar to those obtained by Jing. This provided Jing with the necessary data to approach her parents about her findings. Jing’s parents initially responded in a supportive way. Her parents “always knew something was wrong with” her. Jing’s parents sought the help of CAMHS to address her ADHD symptoms, namely, medication therapy. However, despite their initial support, Jing’s parents eventually stopped her medication therapy due to the possible side effects she was experiencing, including feeling slowed down in her thinking. As well, Jing’s parents do not believe in mental health care, which may also account for their discontinuing psycho- pharmacological intervention. Jing quotes her parents as saying that ADHD “doesn’t exist in China, it was made up just to sell drugs in western countries.” As Jing is their only child, her parents want to provide her with the best opportunity to perform well academically and hence they were initially open to allowing Jing to be given medication therapy, despite being dubious about the applicability of the ADHD label to Chinese people.

Since stopping medication Jing’s condition appears to have “spilled over” beyond her academic pursuits to affect her daily routines and personal relationships. Jing reports that she has lost her house keys on several occasions and has also lost her cellphone five times. She loses track of time. She talks about having difficulty successfully interpreting social cues, such as those expressed non- verbally. Jing often forgets to do her household chores, such as emptying rubbish and tidying up after herself. This lack of consideration irritates her parents.

Jing says that she doesn’t know if she really believes in mental illness or ADHD. “I haven’t talked to anyone about it really. I just thought it was how I was. I’m strange. The medication made me feel really slow and I thought, ‘boy is this how normal people feel?’ Since stopping medication Jing says that she struggles to get out of bed some days. She has difficulty focusing on her school work and says that she is being lazy. Jing reports that the medications were effective in allowing her to focus more as it “slowed her down” and made her feel “normal”.

Neither Jing nor her parents have talked to her school teachers for fear of “losing face”, and of being perceived as being lazy and making excuses for her lack of achievement of recent times.

Jing is not currently in any treatment service. She acknowledges that she was performing better academically when she was taking medication than she is now without medication therapy. Jing is considering going back to CAMHS to restart her medication. She acknowledges her parents’ beliefs regarding medication, but wants to consent to treatment services on her own. Jing is willing to do anything that she thinks will assist her in performing academically.