Exploring ADHD Understanding and Stigma: Insights from an Online Survey in Lebanon

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Nov 14

PMID 39541296

Authors

Samar Younes

Aline Hajj

Hala Sacre

Nisreen Mourad

Marwan Akel

Chadia Haddad

Fouad Sakr

Rony M Zeenny

Pascale Salameh

Affiliations

Soon will be listed here.

Abstract

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder. Public knowledge of ADHD plays a crucial role in shaping attitudes, reducing stigma, and fostering a supportive environment for individuals with this disease. This study aimed to assess the level of knowledge and stigma of the general Lebanese population regarding ADHD and identify potential factors associated with these variables.

Methods: An online cross-sectional study was conducted between July and August 2023 among adults from all Lebanese regions. The questionnaire was self-administered, available in Arabic and English, and included a sociodemographic section and the validated tools Knowledge of Attention Deficit Disorders Scale (KADDS) and the ADHD Stigma Questionnaire (ASQ).

Results: A total of 647 participants were included. Most participants (n = 483 (74.7%)) lacked prior experience with individuals who have ADHD, and only 12.8% reported having good information about the condition. The participants had a mean knowledge score of 20.49 ±3.23 and a mean ADHD stigma score of 75.71 ±20.58. A significantly higher knowledge score was associated with a university level of education (B = 0.14, p < 0.001), older age (B = 0.14, p = 0.001), using the internet (B = 0.13, p = 0.001) and lecture (B = 0.09, p = 0.015) as a source of ADHD information, having a high monthly income (B = 0.13, p = 0.001), being female (B = 0.08, p = 0.030) and having a health coverage (B = 0.08, p = 0.025). Conversely, a lower knowledge was significantly associated with obtaining ADHD information from television (B = -0.13, p = 0.001) and family (B = -0.08, p = 0.043). A significantly lower score was associated with ever being diagnosed with ADHD (B = -0.18, p < 0.001), having an intermediate monthly income (B = -0.10, p = 0.005), and consuming alcohol (B = -0.11, p = 0.004), while a higher score was significantly associated with a higher KADDS total score (B = 0.12, p = 0.002) and being employed (B = 0.07, p = 0.044).

Conclusion: The present study addressed a gap in the existing literature by examining ADHD knowledge and stigma in the Lebanese population. Surprisingly, a positive correlation between higher ADHD knowledge and increased stigma challenges common assumptions, suggesting a complex relationship between knowledge, misconceptions, and societal attitudes. The findings emphasize the need for targeted education and advocacy to improve knowledge and alleviate misconceptions and stigma within the general population.

References

Godfrey E, Fuermaier A, Tucha L, Butzbach M, Weisbrod M, Aschenbrenner S . Public perceptions of adult ADHD: Indications of stigma?. J Neural Transm (Vienna). 2020; 128(7):993-1008. PMC: 8295125. DOI: 10.1007/s00702-020-02279-8. View

Polanczyk G, Silva de Lima M, Horta B, Biederman J, Rohde L . The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007; 164(6):942-8. DOI: 10.1176/ajp.2007.164.6.942. View

Posner J, Polanczyk G, Sonuga-Barke E . Attention-deficit hyperactivity disorder. Lancet. 2020; 395(10222):450-462. PMC: 7880081. DOI: 10.1016/S0140-6736(19)33004-1. View

Lee Y, Yang H, Chen V, Lee W, Teng M, Lin C . Meta-analysis of quality of life in children and adolescents with ADHD: By both parent proxy-report and child self-report using PedsQL™. Res Dev Disabil. 2016; 51-52:160-72. DOI: 10.1016/j.ridd.2015.11.009. View

Dodangi N, Vameghi R, Habibi N . Evaluation of Knowledge and Attitude of Parents of Attention Deficit/Hyperactivity Disorder Children towards Attention Deficit/Hyperactivity Disorder in Clinical Samples. Iran J Psychiatry. 2017; 12(1):42-48. PMC: 5425351. View

Ahad A, Sanchez-Gonzalez M, Junquera P . Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review. Cureus. 2023; 15(5):e39549. PMC: 10220277. DOI: 10.7759/cureus.39549. View

Fayyad J, Sampson N, Hwang I, Adamowski T, Aguilar-Gaxiola S, Al-Hamzawi A . The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys. Atten Defic Hyperact Disord. 2016; 9(1):47-65. PMC: 5325787. DOI: 10.1007/s12402-016-0208-3. View

Bussing R, Zima B, Mason D, Meyer J, White K, Garvan C . ADHD knowledge, perceptions, and information sources: perspectives from a community sample of adolescents and their parents. J Adolesc Health. 2012; 51(6):593-600. PMC: 3505280. DOI: 10.1016/j.jadohealth.2012.03.004. View

Saad S, Aljanahi F, Coumaravelou S, Agha A, Alsamiri M, Allami S . Knowledge about attention-deficit/hyperactivity disorder among primary schoolteachers in Sharjah, UAE. J Educ Health Promot. 2022; 11:99. PMC: 9093637. DOI: 10.4103/jehp.jehp_957_21. View

10.

Schoeman R, Voges T . Attention-deficit hyperactivity disorder stigma: The silent barrier to care. S Afr J Psychiatr. 2022; 28:1865. PMC: 9772730. DOI: 10.4102/sajpsychiatry.v28i0.1865. View

11.

Fazel M, Patel V, Thomas S, Tol W . Mental health interventions in schools in low-income and middle-income countries. Lancet Psychiatry. 2015; 1(5):388-98. DOI: 10.1016/S2215-0366(14)70357-8. View

12.

Polanczyk G, Willcutt E, Salum G, Kieling C, Rohde L . ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2014; 43(2):434-42. PMC: 4817588. DOI: 10.1093/ije/dyt261. View

13.

Drechsler R, Brem S, Brandeis D, Grunblatt E, Berger G, Walitza S . ADHD: Current Concepts and Treatments in Children and Adolescents. Neuropediatrics. 2020; 51(5):315-335. PMC: 7508636. DOI: 10.1055/s-0040-1701658. View

14.

Richa S, Rohayem J, Chammai R, Kazour F, Haddad R, Hleis S . ADHD prevalence in Lebanese school-age population. J Atten Disord. 2012; 18(3):242-6. DOI: 10.1177/1087054712445065. View

15.

Slobodin O, Davidovitch M . Gender Differences in Objective and Subjective Measures of ADHD Among Clinic-Referred Children. Front Hum Neurosci. 2020; 13:441. PMC: 6923191. DOI: 10.3389/fnhum.2019.00441. View

16.

Moldavsky M, Sayal K . Knowledge and attitudes about attention-deficit/hyperactivity disorder (ADHD) and its treatment: the views of children, adolescents, parents, teachers and healthcare professionals. Curr Psychiatry Rep. 2013; 15(8):377. DOI: 10.1007/s11920-013-0377-0. View

17.

Hamed A, Kauer A, Stevens H . Why the Diagnosis of Attention Deficit Hyperactivity Disorder Matters. Front Psychiatry. 2015; 6:168. PMC: 4659921. DOI: 10.3389/fpsyt.2015.00168. View

18.

See L, Li H, Chao K, Chung C, Li P, Lin S . Knowledge of attention-deficit hyperactivity disorder among the general public, parents, and primary school teachers. Medicine (Baltimore). 2021; 100(12):e25245. PMC: 9282068. DOI: 10.1097/MD.0000000000025245. View

19.

Cabral M, Liu S, Soares N . Attention-deficit/hyperactivity disorder: diagnostic criteria, epidemiology, risk factors and evaluation in youth. Transl Pediatr. 2020; 9(Suppl 1):S104-S113. PMC: 7082246. DOI: 10.21037/tp.2019.09.08. View

20.

Rodrigo M, Perera D, Eranga V, Williams S, Kuruppuarachchi K . The knowledge and attitude of primary school teachers in Sri Lanka towards childhood attention deficit hyperactivity disorder. Ceylon Med J. 2011; 56(2):51-4. DOI: 10.4038/cmj.v56i2.3108. View