政大機構典藏-National Chengchi University Institutional Repository(NCCUR):Item 140.119/150295

政大機構典藏-National Chengchi University Institutional Repository(NCCUR):Item 140.119/150295

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政大典藏 > College of Social Science > Department of Sociology > Theses > Item 140.119/150295

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Title:	AD/HDer敘事、認同與社會脈絡 AD/HD Narratives, Identities, and Social Contexts
Authors:	李沂潔 Lee, Yi-Chieh
Contributors:	陳人豪 Chen, Jen-Hao 李沂潔 Lee, Yi-Chieh
Keywords:	AD/HD 建構主義生命歷程敘事認同主體性 AD/HD Constructionism Life course Narrative identity Subjectivity
Date:	2024
Issue Date:	2024-03-01 14:25:13 (UTC+8)
Abstract:	近十年來，注意力不足／過動症（AD/HD）議題在台灣社會上被熱烈討論，相關爭議隨之持續在台灣學術界、政治界和公眾之間延燒；但台灣社會學界，仍缺乏對AD/HDer主體經驗的探討。本研究的目的，旨在深入瞭解AD/HDer在日常生活中如何協商醫藥治療、社會常規和自我，並探討他們對於診斷的解讀，以及這種解讀在日常生活中的產生和傳播過程。同時，我們將探究醫療和常民的觀點、常規如何影響AD/HDer對診斷和自我的認知和表達，以及AD/HDer如何回應這些外在觀點。此外，我還將探討AD/HDer如何發展自己的敘事認同，以及社會脈絡對他們敘事和認同發展的影響。為達成上述研究目的，本研究採取滾雪球、主動邀訪和網絡徵求方式，選取年齡20歲以上的成年AD/HD受訪者，共計訪問13人。招募途徑包括研究者人際網絡和AD/HD相關社群網站。訪談方式為深度訪談法，以靈活和彈性的方式捕捉AD/HDer的敘事、主體經驗與認同。理論架構上，本研究使用「建構主義生命歷程」的框架，以便捕捉AD/HDer如何建構自身的生命歷程敘事，而不將他們的生命歷程視為客觀的實體。研究成果的第一部分揭示了醫療院所對AD/HD的類型化，並探討其如何塑造AD/HDer的身分。AD/HDer的就診脈絡往往與偏離生命歷程規範有關，而醫療院所提供的資源（包括物質、身分建構和詮釋資源）成為他們建構AD/HDer身份的重要元素。然而，這些資源仍受制於生物醫療典範，局限了AD/HDer的治療選擇。儘管如此，AD/HDer在這受限制的環境中力圖爭取自己所需的資源。在學術和公眾爭議的背景下，AD/HDer也靈活地引用或抵抗主流醫療觀點，甚至同時採用多個看似衝突的觀點，他們的思考和行動也隨情境改變，而非如專業者遵循嚴格的定義─實踐流程。第二部分揭示了AD/HDer在AD/HD共存的歷程中所面臨的挑戰，以及他們對自我和診斷的主動建構。AD/HDer在社會規範的壓力下，表現出情境化的理性，甚至挑戰現有框架，並主動建構診斷對自身的意義。AD/HDer自我披露行為則不僅是自我的表達，而是高度情境化的行動決策，需要權衡風險和獲得的幫助。敘事認同則是個體主動建構身份的言語行動，同時受到社會規範和文化文本的影響。總之，本研究透過深入探索AD/HDer的主觀視角，並將個人經驗與社會聯繫，填補台灣AD/HD醫療社會學研究的一塊空白，尤其是AD/HDer主體經驗的研究空白，為醫療社會學做出貢獻。藉由突破「疾病／非病」、「用藥／不用藥」等二分法限制，本研究有助於學界和公眾界開拓更為開放的對話和合作空間。其成果對於AD/HDer和其他精神醫學類別或神經發育障礙，都有所幫助。 Over the past decade, discussions surrounding Attention Deficit/Hyperactivity Disorder (AD/HD) have proliferated in Taiwan, spanning academic, political, and public realms. Despite their prevalence, the subjective experiences of individuals with AD/HD have been overlooked in current sociological fields. This study aims to address this gap by examining how AD/HD individuals navigate medical treatment, societal norms, and self-identities, as well as their interpretations of medical diagnoses and their impact on daily life. Additionally, the study explores how both medical and lay perspectives shape the diagnosis and self-perception of AD/HD individuals, and how they respond to external viewpoints. Furthermore, it investigates the development of narrative identities among AD/HD individuals and the influence of social contexts on this development. To achieve these aims, this study employs a combination of snowball sampling, active recruitment, and online solicitation to select adult AD/HD participants aged 20 and above. A total of 13 individuals are interviewed. Recruitment channels includes the researchers' personal networks and AD/HD-related online communities. The interview method employed was in-depth interviewing, aimed at capturing the narratives, subjective experiences, and identities of individuals with AD/HD in a flexible manner. The theoretical framework utilized in this study was “constructionist life course”, allowing for the exploration of how AD/HDers construct their life course narratives without treating their life experiences as objective entities. The first part of the research findings reveals the typification of AD/HD by medical institutions and examines how it shapes the identity of AD/HDers. The context of seeking medical care for AD/HD are often related to deviations from normative life courses, and the resources provided by medical institutions (including material, identity construction, and interpretive resources) become crucial elements in constructing the identity of AD/HDers. However, these resources are still constrained by the biomedical paradigm, limiting the treatment options for AD/HDers. Nevertheless, they strive to obtain the resources they need within this restricted environment. Against the backdrop of academic and public controversies surrounding AD/HD, they also flexibly invoke or resist mainstream medical perspectives, sometimes simultaneously adopting multiple seemingly conflicting viewpoints. Their thoughts and actions vary with the context, rather than following a strict definition-practice process as professionals do. The second part of the research findings reveals the challenges faced by AD/HDers in the course of coexisting with AD/HD, as well as their active construction of self and medical diagnosis. Under the pressure of social norms, AD/HDers demonstrate situated rationality, even challenging existing frameworks, and actively construct the meaning of diagnosis for themselves. Self-disclosure behaviors among AD/HDers are not only a form of self-expressions, but also highly situated action decisions, requiring a balance of risks and benefits. On the other hand, narrative identity, influenced by social norms and cultural contexts, involving individuals actively constructing their identity through verbal actions. In general, this study aims to fill the gap regarding the subjective experiences of AD/HDers in the field of medical sociology in Taiwan by deeply exploring the subjective perspectives of AD/HDers and connecting personal experiences with social contexts. The contribution of this study to medical sociology lies in its ability of breaking through binary classifications such as "illness/non-illness" and "medication/non-medication," fostering more open dialogues and collaborations in academia and the public sphere. The findings of this study will not only be beneficial to AD/HDers but also to other psychiatric categories or neurodevelopmental disorders.
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