Date of Award

8-22-2025

Date Published

September 2025

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Advisor(s)

Kevin Antshel

Keywords

ADHD;Black Mothers;Complementary and Alternative Methods;Decision Making;Support-Seeking

Subject Categories

Clinical Psychology | Psychology | Social and Behavioral Sciences

Abstract

Background: ADHD, particularly when left untreated, is associated with significant impairment in several domains. Black youth may still be under-diagnosed with ADHD, resulting in symptoms going untreated. Black mothers may determine non-professional delivered supports to be more appropriate and acceptable than medication for their children with ADHD. As they tend to be the primary healthcare decision makers, it is important to develop a greater understanding of Black mothers’ ADHD support-seeking decision making for their youth. Method: The present study used semi-structured interviews guided by Kleinman’s Explanatory Models of Illness to discuss Black mothers’ decision making for their youth with ADHD. Using Interpretative Phenomenological Analysis, the present study explored Black mothers’ (n = 12) (1) experience with and conceptualization of ADHD, and attitudes toward ADHD as a disorder and (2) treatment and support-seeking decisions for their children with ADHD. In addition to participating in semi-structured interviews, participants completed two measures: the Attention-Deficit/Hyperactivity Disorder – Rating Scale – 5th edition (ADHD-RS-5) and the Impairment Rating Scale (IRS) to characterize the symptom severity of their child’s ADHD. Results: ADHD symptom count across participants indicated significant symptoms of both inattention and hyperactivity/impulsivity. Further, the overall functioning rating of the study sample indicated significant overall impairment with the areas of most significant impairment being academic progress, relationship with playmates, and self-esteem. Using Interpretative Phenomenological Analysis, four superordinate themes emerged from the interviews: (a) ADHD as a problem to be solved, (b) an inclination to assign accountability and blame for ADHD, (c) chosen treatment/support must do more good than harm, and (d) understanding and acceptance of ADHD by others would be the ideal support. Discussion: The present findings indicate the importance of understanding and supporting an increase in providers’ willingness to learn from Black mothers as the treatment and support decision makers for their children. The dearth of accurate representation of ADHD and of medical and mental health care providers’ contributions in more accessible spaces may contribute to Black mothers’ lacking feelings of support. The present study provides a starting point for stakeholders to affect change in the area of mental health service provision, specifically support for ADHD, for Black youth.

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Open Access

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