The global rise in children’s attention-deficit/hyperactivity disorder prevalence: a macro-sociological explanation

Abstract In the past three decades, the global diagnosis rate of attention-deficit/hyperactivity disorder (ADHD) has grown drastically. While existing sociological studies demonstrate the complexity of ADHD diagnoses and treatment in specific national contexts, their ability to explain ADHD’s global growth is limited. In this article, starting from a macro-sociological perspective and drawing on world society theory, we empirically investigate the prevalence of ADHD diagnosis rates across 135 countries from 1996 to 2019. We find that the increasing rates of ADHD diagnosis worldwide since the 1990s are linked to two interconnected global cultural processes: (1) the global rise and institutionalization of child-centered cultural perspectives and (2) the global diffusion of narratives that define ADHD as a health condition impairing children’s well-being and development. Our findings do not support alternative explanations such as a nation’s level of development (measured by GDP, poverty, democracy, and tertiary enrollment rates) or healthcare quality and universal access. These findings highlight the substantial influence of global conceptions of childhood and health on ADHD prevalence rates worldwide, while downplaying the importance of national conditions. We contribute to the existing sociological literature on ADHD in two key ways. First, by conducting the first cross-national, longitudinal study of ADHD worldwide we provide novel insights about ADHD prevalence at the world level while identifying the key global factors driving this trend. Second, in merging the existing ADHD literature with the analytical frameworks advanced by world society theory, we introduce a new conceptualization of ADHD as not only a medical disability but also a global cultural phenomenon and institutional priority.