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Front. Psychol. | doi: 10.3389/fpsyg.2018.00244

Biases in Understanding Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder in Japan

  • 1Graduate School of Education, Kyoto University, Japan
  • 2Japan Society for the Promotion of Science, Japan
  • 3Brain Science Institute, Tamagawa University, Japan

Recent research has shown high rates of comorbidity between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) and difficulties regarding differential diagnosis. Unlike those in Western countries, the Japanese ADHD prevalence rate is lower relative to that of ASD. This inconsistency could have occurred because of cultural diversities among professionals such as physicians. However, little is known about attitudes toward ADHD and ASD in non-Western cultural contexts. We conducted two experiments to identify biases in ASD and ADHD assessment. In Study 1, we examined attitudes toward these disorders in medical doctors and mental health professionals, using a web-based questionnaire. In Study 2, medical doctors and clinical psychologists assessed four fictional cases based on criteria for ADHD, ASD, oppositional defiant disorder, and disinhibited social engagement disorder (DSED). Diagnosis of ASD was considered more difficult relative to that of ADHD. Most participants assessed the fictional DSED case as ASD, rather than DSED or ADHD. The results provide evidence that Japanese professionals are more likely to attribute children’s behavioral problems to ASD, relative to other disorders. Therefore, Japanese therapists could be more sensitive to and likely to diagnose ASD, relative to therapists in other countries. These findings suggest that cultural biases could influence clinicians’ diagnosis of ADHD and ASD.

Keywords: Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder, assessment, clinical decision making, Misdiagnosis, Bias

Received: 27 Apr 2017; Accepted: 14 Feb 2018.

Edited by:

Vinai Norasakkunkit, Gonzaga University, United States

Reviewed by:

Andrew G. Ryder, Concordia University, Canada
MASARU Menta, Bukkyo University, Japan  

Copyright: © 2018 Miyasaka, Kajimura and Nomura. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ms. Mami Miyasaka, Kyoto University, Graduate School of Education, Yoshida-honmachi, Sakyo-ku, Kyoto, 606-8501, Kyoto, Japan,