Introduction
Modern ADHD diagnostics are facing a crisis, shifting from rigorous clinical analysis toward a superficial matching of symptoms to internet checklists. In her book Bad Influence, Deborah Cohen analyzes how digital culture and the trend of neurorealism are blurring the lines between actual disorders and natural human diversity.
Readers will discover why popular narratives framing ADHD as a "superpower" are risky. The text explains the mechanisms of misinformation and argues that a true diagnosis must be a synthesis of context, rather than a simple sum of symptoms.
Diagnosis as Contextual Synthesis, Not a Sum of Symptoms
Deborah Cohen emphasizes the fundamental difference between a professional diagnosis and online symptom recognition. While internet lists focus on isolated traits, a clinical assessment requires an analysis of developmental history and the degree to which the patient's functioning is impaired.
The author notes that many symptoms have low specificity. For example, difficulty starting a boring task could stem from ADHD, but it could also result from depression, anxiety, or chronic sleep deprivation. Without clinical context and differential diagnostics, a single symptom becomes a misleading signal that leads to incorrect conclusions.
ADHD Diagnosis as a Synthetic Judgment vs. the Checklist Trap
Simply meeting the criteria on a list of symptoms is insufficient for a diagnosis because ADHD is a neurodevelopmental disorder. This means that behavioral patterns must be persistent and present before the age of 12, rather than appearing suddenly in adulthood.
Deborah Cohen warns against the phenomenon of concept creep, or the expansion of psychological terms. When a diagnosis is reduced to a checklist, it functions like a Barnum effect—the recipient finds themselves in the description because it encompasses experiences typical of every human being. A true diagnostic category must not only include certain traits but, more importantly, exclude others.
The Diagnostic Paradox: Underdiagnosis vs. Over-identifiability
The rise in diagnoses is not one-dimensional. Deborah Cohen points out that two processes are occurring simultaneously: addressing previous neglect in overlooked groups (e.g., women) and the risk of over-identifiability resulting from low-quality diagnostics.
The author notes that social media and simplified medical language—such as the "dopamine deficiency" theory—promote neurobiological reductionism. This leads to situations where people mistake environmental influences, such as technological overstimulation, for permanent biological pathology. Consequently, diagnosis ceases to be a medical process and instead becomes an element of constructing an attractive identity.
Summary
In a world where every difficulty with concentration can be labeled a disorder, we risk losing the ability to understand the human being as a whole. Deborah Cohen warns against replacing the healing process with the collection of labels.
The greatest paradox of modern prevention is that the more intensely we search for illness within ourselves using non-specific markers and internet trends, the faster we cease to be simply healthy.
Frequently Asked Questions
What is the difference between a professional ADHD diagnosis and recognizing symptoms in oneself based on online checklists?
A professional diagnosis is based on a full clinical and psychosocial assessment, an analysis of developmental history, and verification of functioning across different environments. Unlike online checklists, it incorporates differential diagnostics and examines whether symptoms are persistent and cause clinically significant functional impairment.
Why is simply meeting the criteria from the symptom list not sufficient to make an ADHD diagnosis?
The symptom list alone can act like a Barnum effect test, as it covers experiences that also occur outside of the disorder. For a diagnosis to be reliable, symptomatic criteria must be supplemented by requirements for persistence, developmental onset, functional impairment, and differential diagnostics.
Is the increase in ADHD diagnoses a result of fashion and the pharmaceutical lobby, or perhaps a way of making up for years of neglect in recognizing certain patient groups?
The increase in diagnoses results from the simultaneous occurrence of underdiagnosis in certain groups (e.g., women and adults) and the risk of over-recognition in other populations. Although there is evidence of conflicts of interest between experts and the pharmaceutical industry, this does not constitute direct proof that changes in ADHD criteria were caused by it.
How do social media and simplified medical language influence the process of ADHD self-diagnosis?
Social media often promote misleading and simplified content that lowers the quality of knowledge about ADHD while increasing users' confidence in the accuracy of their self-diagnosis. Simplified medical language and reductionism (e.g., attributing everything to a lack of dopamine) make the diagnosis an attractive explanatory theory for various aspects of life, which can lead to excessive unification of biographies under a single slogan.
Why are the mere presence of ADHD symptoms or a reaction to medication not sufficient to make a diagnosis?
The mere presence of symptoms is insufficient because inattention and executive function disorders appear in many other conditions, such as depression, anxiety, or sleep deprivation. On the other hand, the response to stimulants is diagnostically non-specific and does not prove that a person suffered from ADHD before taking them.
How do social media and contemporary culture distort the image of ADHD, even if they do not necessarily rely on lies?
Social media distort the image of ADHD by reducing context and promoting simplified fragments of truth that better fit the attention economy. This leads to highlighting attractive traits as 'superpowers,' while serious clinical and functional difficulties remain in the shadow.
Does the increase in ADHD diagnoses result from biology, or from the fact that the modern world and technology exacerbate the symptoms?
The increase in diagnoses results from the interaction of biological vulnerabilities with the environment, rather than a single factor. It may be an effect of better diagnostics and social awareness, but also changes in the demands of the modern world and technology, which intensify symptoms or make certain traits more functionally costly.
Why might the increased availability of diagnostic tools and medical knowledge lead to the misdiagnosis of disorders in healthy people?
The increased availability of tools and knowledge increases the number of detectable anomalies in the body; when searching intensively for a disease in a healthy person, this increases the probability of finding something that allows them to stop being called healthy. Additionally, a wide repertoire of available symptoms makes it easier to interpret one's own experiences through clinical categories, which can lead to the medicalization of normal difficulties.
