Brewis, A.A., Schmidt, K.L. and M. Meyer 2000. ADHD-type Behavior and Harmful Dysfunction in Childhood: A Cross-Cultural Model. American Anthropologist 102(4): 823-828.

ABSTRACT Cross-cultural studies of psychiatric phenomena allow testing of assumptions of biological consistency and improved understanding of how disorders are culturally formulated. We used a comparative approach to test for populations variation in degrees of harmful academic and social dysfunction associated with children's display of behaviors considered symptomatic of Attention Deficit Hyperactivity Disorder (ADHD). Teacher ratings on psychometric scales described behavior and functioning in population representative samples of Colombian and United States schoolchildren. Mean levels of the behaviors were similar across populations, including a constant gender difference. A multiple regression model showed remarkably consistent relationships of hyperactivity and inattention to harmful dysfunction across populations and genders. Increasing inattention was associated with increasing harmful dysfunction. Increased hyperactivity was associated with improved functioning to a univform threshold, beyond which more hyperactivity was associated with greater harmful dysfunction. Patterns of relationships between ADHD-associated behaviors and their consequences may prove useful as a basis for cross-cultural investigation of ADHD. The idea of ADHD as a psychiatric disease concept or construct with some cross-cultural (external) validity is supported by these data.