The epistemic status of patient testimony in ADHD diagnostic practice

Abstract

This bachelor’s thesis examines ADHD diagnostic practice as a case study in the epistemology of psychiatry. I argue that the problems produced during ADHD diagnostic practice are structural. ADHD depends heavily on testimony, which in the case of ADHD has a distinctive justificatory structure that cannot be evaluated by the same standards as laboratory evidence. This reveals tensions that arise in the diagnostic process: testimony from the patient and third-party informants is not treated equally, even though the patient is the one who has access to their internal experiences; the patient is not treated as a knower but as a source of data, and this comes from the institutional distribution of epistemic authority, which leads to epistemic and ethical problems within the diagnosis. This also reveals that the problems are not specific to ADHD and point to a broader tension in the epistemology of psychiatry.