Cross-cultural differences in rating hyperactive-disruptive behaviors in children.

Abstract

To determine the extent to which the reported variations across countries in the prevalence of attention-deficit hyperactivity disorder are due to cultural differences among raters, the authors examined the degree to which mental health professionals in four countries differed in their ratings of hyperactive-disruptive behaviors in children. Mental health professionals from China (N = 8), Indonesia (N = 12), Japan (N = 9), and the United States (N = 8) rated the presence and degree of hyperactive-disruptive behaviors in standardized videotape vignettes of four 8-year-old boys participating in individual and group activities. Chinese and Indonesian clinicians gave significantly higher scores for hyperactive-disruptive behaviors than did their Japanese and American colleagues. These findings suggest that perceptions of hyperactivity vary significantly across countries even if uniform rating criteria are applied. Without correction for these perceptual differences, cross-cultural prevalence rates of hyperactivity may not be comparable.