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Social History of Medicine Advance Access originally published online on October 20, 2008
Social History of Medicine 2008 21(3):541-559; doi:10.1093/shm/hkn060
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© The Author 2008. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. All rights reserved.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Roy Porter Student Essay Prize Winner

Psychiatry Limited: Hyperactivity and the Evolution of American Psychiatry, 1957–1980

Matthew Smith*

* Department of History, University of Exeter, Amory Building, Rennes Drive, Exeter EX4 4RJ, UK. E-mail: ms302{at}ex.ac.uk


  Abstract

Hyperactivity is the most commonly diagnosed childhood psychiatric disorder in north America. Most physicians believe that the disorder is a neurological dysfunction which is best treated with stimulants, such as ritalin. Accounts of the history of hyperactivity written by physicians, psychologists and even historians suggest that the disorder was always conceived as such. This paper argues that, on the contrary, the notion that hyperactivity was a neurological condition only emerged after vigorous debate during the 1960s between three competing fields within American psychiatry: specifically psychoanalysis, social psychiatry and biological psychiatry. Biological psychiatry won the debate, not because its approach to hyperactivity was more scientifically valid, but rather because its explanations and methods fit the prevailing social context more readily than that of its rivals. American psychiatry's refusal to draw pluralistic conclusions about hyperactivity undermined the development of a deeper understanding of the disorder. The history of hyperactivity provides an ideal lens through which to view the evolution of psychiatry from a field dominated by Freudian psychoanalysis to one rooted in the neurosciences.

Keywords: history of psychiatry; United States; childhood; hyperactivity; psychoanalysis; social psychiatry; biological psychiatry; ADHD; mental health


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