Defending 'snake oil': The preservation of contentious knowledge and practices

"Pills Don't Teach Skills": ADHD Coaching, Identity Work, and the Push toward the Liminal Medicalization of ADHD

Despite physicians' near monopoly over medicalization historically, various stakeholder groups shape an increasingly complex process today. This study examines a relatively new initiative, "health coaching," within the context of the changing nature of medicalization. Utilizing 51 in-depth interviews with attention deficit hyperactivity disorder (ADHD) coaches, participant observation from seven ADHD symposia, and ADHD coach publications, I examine coaching's emergence as a partial challenge to medicalization. Findings reveal a field comprised mainly of individuals personally affected by ADHD whose dissatisfaction with institutionalized framings and practices underpins a push for liminal medicalization. Members move between medical and nonmedical discourses to frame ADHD as a paradox of pathology and gift. Additionally, they leverage and commodify personal experience alongside institutional and alternative knowledge into an adjunct or substitute to medication and potential challenge to therapy-one aimed at "self-actualization" versus "treatment." Such efforts highlight (de)medicalization's dimensionality, simultaneous medicalization and demedicalization, and a lay-driven enterprise's role in such processes.

COVID-19 Vaccine Boundary Work: The Case of Facebook Comments in Southeast Georgia

Although much research has considered the worldview of the vaccine hesitant, little attention has been given to the cultural conflict over what it means to be a person who takes vaccines. Through a qualitative content analysis of comments made on the Facebook pages of media outlets serving southeast Georgia, this analysis identifies both motives for rejecting the vaccine and outlines the symbolic boundaries that the vaccine hesitant have erected to distinguish themselves from vaccine advocates. The motives include perfunctory rejections, claims that the vaccine is ineffective, illegitimate, injurious in the short and long term, poisonous, infectious, particularly dangerous for children, and a component of conspiracy theories. These symbolic boundaries include distinguishing vaccine advocates from the vaccine hesitant by personal characteristics such as irrationality and authoritarianism. There are also social boundaries rooted in social locations - namely conservatives vs. liberals and non-elites vs. elites. This study also demonstrates how vaccine proponents engage with these symbolic boundaries. Vaccine proponents both contest and accept these boundaries. Likewise, pro-vaccine comments vary in terms of whether they stigmatize the boundary between vaccine user and non-user. This study adds to the literature on health communication and vaccines by confirming previous reports of the reasons for not taking the COVID-19 vaccine, indicating that public communication on vaccines is not regionally specific, and demonstrating the role that ostensible vaccine advocates might play in contributing to vaccine hesitancy.

Diversity of attitudes towards complementary and alternative medicine (CAM) and vaccines: A representative cross-sectional study in France

How much does endorsement of complementary and alternative medicine (CAM) correlate with negative attitudes towards vaccines? One of the difficulties of analysing the relationship between attitudes to CAM and attitudes towards vaccines rests in the complexity of both. Which form of CAM endorsement is associated with what type of reticence towards vaccines? While the literature on the relationship between CAM and attitudes towards vaccines is growing, this question has not yet been explored. In this study we present the results of a survey conducted in July 2021 among a representative sample of the French mainland adult population (n = 3087). Using cluster analysis, we identified five profiles of CAM attitudes and found that even among the most pro-CAM group, very few respondents disagreed with the idea that CAM should only be used as a complement to conventional medicine. We then compared these CAM attitudes to vaccine attitudes. Attitudes to CAM had a distinct impact as well as a combined effect on attitudes to different vaccines and vaccines in general. However, we also found a) that attitudes to CAM provide a very limited explanation of vaccine hesitancy and b) that, among the hesitant, pro-CAM attitudes are often combined with other traits associated with vaccine hesitancy such as distrust of health agencies, radical political preferences and low income. Indeed, we found that both CAM endorsement and vaccine hesitancy are more prevalent among the socially disadvantaged. Drawing on these results, we argue that, to better understand the relationship between CAM and vaccine hesitancy, it is necessary to look at how both can reflect lack of access and recourse to mainstream medicine and distrust of public institutions.

Testing the talented child: Direct-to-consumer genetic talent tests in China

One controversial area of direct-to-consumer genetic testing in China is "genetic talent testing" for children. In this study, I show that while experts criticize genetic talent testing as unscientific, the persistence of genetic talent testing is not merely a product of parents' scientific illiteracy. Instead, genetic talent testing reflects parents' pragmatic use of technology in response to the parenting pressures in contemporary China. Parents see the results of genetic talent testing as offering an advantage for their children when combined with the intensive parenting strategy of precision education. Drawing on the sociology of testing, I argue how genetic talent testing in China is a product of broader concerns about population quality and can potentially reshape how parents imagine quality children through the theory of multiple intelligences. My study of this "off label" use of direct-to-consumer genetic testing also suggests that scientists need to broaden their imagination of potential misuses of their technologies.