University of Southern California Dissertations and Theses

Understanding the psycho-social and cultural factors that influence the experience of attention-deficit/hyperactivity disorder (ADHD) in Chinese American college students: a systems approach

(USC Thesis Other)

Understanding the psycho-social and cultural factors that influence the experience of attention-deficit/hyperactivity disorder (ADHD) in Chinese American college students: a systems approach

PDF

Download a page range

Download transcript

Copy asset link

Request this asset

Transcript (if available)

Content

UNDERSTANDING THE PSYCHO-SOCIAL AND CULTURAL FACTORS THAT
INFLUENCE THE EXPERIENCE OF ATTENTION-DEFICIT/HYPERACTIVITY
DISORDER (ADHD) IN CHINESE AMERICAN COLLEGE STUDENTS:
A SYSTEMS APPROACH

by

Edmund Wong Din-Mond Young

A Dissertation Presented to the
FACULTY OF THE USC ROSSIER SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF EDUCATION
May 2012

Copyright 2012 Edmund Wong Din-Mond Young
ii

Acknowledgements

I would like to thank my family and friends for their continued love and support
throughout my educational journey and especially with this dissertation project. A special thanks
to my dissertation committee: Dr. Patricia Tobey (Chair), Dr. Pedro Garcia and Dr. Karen Lang.
If it were not for the specific feedback and guidance from my dissertation committee, this project
would not have come to fruition. Additionally, I would like to thank Dr. Peter Ibarra for sharing
his expert knowledge about qualitative methodology and research design.

iii

Table of Contents
Acknowledgements ii
Table of Contents iii
Abstract v
Chapter 1: Introduction and Background of the Problem 1
Background of the Problem 1
Statement of the Problem 2
Purpose of the Study 5
Research Questions 7
Theoretical Perspective 7
Organization of the Study 8
Definition of Terms: Glossary 9

Chapter 2: Literature Review 13
Introduction 13
Establishing ADHD in Adults: How and Why 16
College Success 18
Treatment Methods 19
Malingering 21
Psycho-social and Cultural Factors in the Study of ADHD among 23
College Students
Chinese Americans’ Mental Health and Under-utilization of Mental 24
Health Services
Systems Theory and the Framing of the Present Study 32
Conclusion 34

Chapter 3: Research Design and Methodology 35
Introduction 35
Sample, Population and Research Design 37
Instrumentation: Doing Qualitative Interviews 40
Recruitment and Human Subject Protection 42
Data Analysis 45
Psycho-social Dimensions 46
Cultural and Ethnic Dimensions 46
Academic Institutions 47
Primary and Secondary Supports 48
Service Institutions 48
Limitations of Present Design 49
Conclusion 50

iv

Chapter 4: Data Collection and Findings 51
Introduction 51
Case Study: Mary Ann 52
Case Study: Cecelia (CeCe) 58
Case Study: Jinger 63
Analysis: Themes and Variations in the Three Case Studies 66
Family History and Parental Educational Attainment 67
Familial Dynamics and Support 68
Secondary Supports 72
Culture 76
Academics and Coping Strategies 82
Access to Services 91
Coming to Terms with Treatment: Journey and Struggle 95
Legal Issues 100

Chapter 5: Summary 102
Emergent Themes regarding the Model Minority Stereotype and 102
ADHD: Managing an Illness or a Contradiction
Strengths of the Study 104
Weaknesses of the Study 105
Implications for Practice 106
Conclusion 107
Future Pathways: Areas for Growth and Understanding 107

References 110
Appendix A: PSU IRB Approval 115
Appendix B: Information/Facts Sheet For Non-Medical Research 117
Appendix C: Recruitment Flyer 120
Appendix D: Recruitment Letter 121
Appendix E: Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder from 122
the DSM IV-TR
Appendix F: Commonly used psycho-stimulants adapted from www.PsyD-fx.com 124
Appendix G: Adult Initial Assessment Sample 125
Appendix H: Possible questions to be asked of participants in the study 128
Appendix I: Sample of Data Coding Rubric 130
Appendix J: Research Log 131
Appendix K: Sample of Completed Transcription of Interview #1 & #2 with 135
Cecelia (CeCe)
Appendix L: Sample of CeCe’s Journal Exercise 194
v

Abstract
A review of the extant research literature reveals limited data on college students with
Attention-Deficit/Hyperactivity Disorder (ADHD). Even less information is known in regards to
minority populations living with ADHD, specifically Asian American college student. This
research project was focused on Chinese American college students with ADHD. A qualitative
design using a life history approach allowed the individual case studies to provide a vivid
detailed account into the experiences with ADHD. The project was centered on a systems theory
approach to understanding the psycho-social and cultural factors that influence the experience of
ADHD in Chinese American college students as well as the coping strategies used in order to be
effective learners. This project allows the reader to understand how Chinese American college
students make sense of their ADHD diagnosis, cope with their condition and what this may mean
for these students as they embark on their ADHD journey.
This project aimed to seek answers to these questions: 1) What are the different
pathways to being a Chinese American college student with ADHD? 2) How do psycho-social,
cultural and other factors shape the experiences that Chinese American college students have
with ADHD? 3) How do Chinese American college students with ADHD navigate their
academic environment in order to be successful learners?
The project found that social supports in the form of family and friends help the Chinese
American college student to cope with their ADHD diagnosis, symptoms and academic
struggles. The use of professional services inclusive of psychotherapy, psychopharmacology and
psychological testing helped students to cope and make sense of their condition. The Chinese
American college students found their academic performance improved with the use of the
disability services offered by the university.
1

Chapter 1
Introduction
Background of the Problem
Contemporary research in the field of education studies is concerned to understand the
nature of medical and psychological conditions that can obstruct or hinder efficient learning.
Among these conditions is the diagnosis known as Attention-Deficit/Hyperactivity Disorder
(ADHD), defined as “a developmental neurobehavioral syndrome” (Ramsay, 2007).
Manifestations and symptoms of ADHD include tendencies toward impulsivity, hyperactivity,
and/or inattention (Starcher, 2001). The consequences of ADHD for the student’s educational
career can be serious. ADHD can interfere with the student’s ability to learn and absorb the
curriculum to which he or she is exposed. In addition, a student with ADHD may find him or
herself being singled out as disruptive presence in the classroom, thereby being made an object
of disciplinary action and/or ridicule, which only exacerbates the problem of being able to fully
engage the academic challenges that his or her peers are meeting. The student with ADHD runs
the risk of falling behind academically, possibly becoming psychologically disenfranchised from
their academic environment and suffering a deterioration in their sense of self-efficacy.
Students with ADHD must contend with a variety of demands, both in and out of the
classroom, while also managing their symptoms. Some of this may be addressed by way of
medication therapy and/or psycho-social interventions that can assist these students to manage
their symptoms and improve their ability to perform academically (Rostain and Ramsay, 2006).
However, the nature of the demands on students are likely to change over the course of their
educational careers and their stages of psycho-social development, and whether and how they are
able to manage their symptoms efficiently is likely to be affected accordingly. Despite this
2

longitudinal dimension, the ADHD literature is narrowly focused and primarily centered around
children and adolescents with the illness. This is likely because ADHD is commonly first
diagnosed at younger ages, largely during childhood and adolescence. However, according to
Ramsay (2007), at least 50%-90% of children living with ADHD symptoms will continue to
experience the disorder into adulthood. Although other studies have reported somewhat different
prevalence rates of ADHD into adulthood (Rostain and Ramsey, 2006; Riccio and French, 2004;
McKee, 2008), the research literature has attained a consensus around the idea that childhood
ADHD can persist through an individual’s lifespan from childhood to adolescence and into
adulthood. The question that follows, therefore, is how do adult learners with ADHD differ (if at
all) in their approach to managing their condition while pursuing a higher education?
Statement of the Problem
As the student with ADHD matures and pursues a college education, s/he is increasingly
tasked with the responsibility of balancing life goals against the academic demands entailed by
pursuit of a college degree while also handling her/his ADHD condition. How these competing
demands are handled by adults with ADHD comprises an important question for ADHD
researchers. The research on adults with ADHD is suggestive but limited: Barkley and Murphy
(2010) report that growing evidence indicates that adult ADHD can be associated with various
problems in occupation functioning; that adults with ADHD are at greater risk of absence, are at
higher risk of workplace related injuries, lack sound problem-solving and decision making skills
and exhibit greater work-related anxiety. Safren, Otto, Sprich, Winett, Wilens and Biderman
(2005), agree that adult ADHD is valid and the symptoms continue to cause significant distress
in adults.
3

Important though this work is, its implications for understanding college students with
ADHD are unclear. A fundamental difficulty in relating this research to ADHD at the college
level is that there is a lack of prevalence data for such students, who are not required to disclose
their disability to colleges and universities (DuPaul, Weyandt, O’Dell and Varejao, 2009).
Second, workplace environments do not completely parallel college learning and living
environments. There is, in fact, limited data on the effects of ADHD in college populations, or
how college students with ADHD are navigating the educational environment while also
addressing issues related to their Eriksonian stage of psycho-social development (Berger, 1994).
Students at this stage in the life cycle are addressing an increasingly complex (emotionally,
socially, cognitively) set of demands, ranging from adjusting to a new living environment in
which their parents and siblings are usually absent, identifying a career path and building a
resume that will advance them along it, dating and possibly finding a life partner, starting a
family, attaining psychological and financial independence, and so forth. At the same time that
they find a number of life goals competing for their attention, college students are encountering
academic topics being addressed more subtly and with greater sophistication than previously
encountered, testing the utility and effectiveness of learning techniques and strategies they had
developed in high school for managing their ADHD condition while discharging the student role.
The outcome is that there is a need for research that examines how, specifically, individual
students are managing to get these things accomplished while also pursuing a post-secondary
degree.
The under-investigation of college students with ADHD is even worse when one
considers research pertaining to college students who have minority status; here the research is
minimal, especially with respect to students of Asian-American descent. Now, Asian-Americans
4

have increasingly become a larger share of the student population in the state of California,
including at the collegiate level (for example, at the proposed site of the current research,
students of Asian-American descent are about 22% of the undergraduate population). Despite
their increased prominence, Asian Americans have not been the focus of research that looks at
ADHD in educational settings. This project proposes to address this gap by looking at the
experiences of Asian-Americans of a particular ethnicity -- Chinese -- who have ADHD and who
are in college.
The study will focus on Chinese American college students specifically rather than Asian
American college students more broadly based on the assumption that each sub-culture or ethnic
category within the Asian American grouping collectively have distinct values, customs, beliefs,
linguistic practices, and conceptual understandings of ADHD symptoms and the ADHD
diagnosis, which can thereby shape their experience with ADHD accordingly. Since there is a
significant lack of research data among Asian American students who are living with ADHD
symptoms, it seems wise to narrow the research population to one sub-sector of Asian Americans
rather than assume that all Asian Americans are “alike”. Therefore, this study focuses on
Chinese American students in order to produce a more in-depth understanding of their
experiences of living with, and managing their ADHD symptoms in the college environment
while also attending to other psycho-social demands.
As described in chapter two, a review of the current literature reveals that most studies on
ADHD are based upon quantitative analyses. As a result, the contextual factors that shape the
experience of ADHD for individuals are unclear. ADHD is a mental health disorder with
biological and genetic underpinnings that are shaped by the psycho-social and cultural climate of
the individual. The extent to which these psycho-social and cultural factors exert an influence
5

among Chinese-American college students with ADHD has not been adequately addressed by
education researchers.
Purpose of the Study
A review of the literature (see chapter two) on ADHD reveals a significant gap in current
knowledge regarding college students with the disorder as well as among minority populations.
The particularities of the subjective experiences of adult learners have not been explored, likely
because previous work has not employed qualitative research methods or framed the issues in
terms that are consonant with a holistic sense of what adult learners are actively facing; instead,
current research has favored the use of methods directed toward establishing the prevalence of
the disorder in populations beyond childhood and adolescence, or has focused on the biological
and developmental aspects associated with the illness, consistent with the medical model’s
concern with the etiology of the disease. As a result, a significant gap has emerged in how we
understand the psycho-social (including life-cycle) and cultural (including ethnic background)
factors that shape the experience of the ADHD symptoms. Likewise, there is limited information
on how students with ADHD navigate their academic communities in order to be successful
learners.
Educational systems, and the education researchers who evaluate them, typically employ
various kinds of benchmarks to document “success,” including such standardized measures as
grade point average (GPA), graduation rates, attrition rates, achievement tests, and time toward
degree completion. The extent of one’s ADHD symptoms directly affects a student’s motivation
and self-efficacy, and therefore produces observable effects in ADHD students’ performance on
these benchmarks (Wilmshurst, Peele and Wilmshurst, 2011). Although this research is
important, benchmark-based studies are not able to address directly questions about the
6

processes associated with having ADHD and learning (or not learning). A qualitative approach
focused on the struggles that students with ADHD face is therefore likely to complement these
studies’ focus on benchmarks.
A qualitative approach to the study of college students with ADHD can be grounded in
the work of Clark and Estes (2008), who assert that student motivation to learn is a function of
how they engage three domains: “active choice, persistence and mental effort”. In this view,
ADHD can directly impact how an individual handles each of these three areas critical to
motivation. Therefore, it is important to move beyond benchmarks defined by grades,
graduation rates and so forth as these fail to illuminate the experiences and struggles that ADHD
students encounter in college, their belief systems regarding their academic achievement and
self-efficacy, or the ways in which their “real life” concerns can distract them from their lives as
students.
As indicated above, when studying students it is important to be mindful of cultural
diversity, since the basis for such differences can have an impact on both how students with
ADHD understand their condition and how they are treated by others. ADHD symptoms need
not be understood by laymen in the same way that they are understood by clinicians or
researchers, and this is especially important to keep in mind when considering segments of the
population that may not be as acculturated to Western values and beliefs, including the
diagnostic criteria underpinning ADHD, or the very idea of “mental illness” itself and the
various DSM-IV-TR diagnoses (“ADHD,” “depression,” “schizophrenia,” and so forth).
As per the present study, in the Chinese culture mental illness is considered a taboo
subject. Members of traditional Chinese families believe that individuals who are diagnosed
with mental illness will suffer ostracism, from the extended Chinese community as much as from
7

fellow family members, service providers, employers, classmates, and so forth, and that the other
members of the family will experience this impact vicariously. Mental illness is seen as a defect,
in other words, and carries elements of shame for the family unit. Children who behave “badly”
are therefore the recipients of techniques intended to induce a sense of guilt in the child (Sue and
Sue, 2007) and outward conformity in his or her behavior, but not necessarily treatment of the
underlying condition. Of course, this traditional perspective on mental illness can be offset by
the Chinese-American family’s or student’s exposure to Western values and ideas, suggesting
the importance of exploring how differences in the degree of acculturation can influence the
student’s experience with having and managing ADHD.
In short, a qualitative research design will be implemented in this project to address the
limitations observed in existing research, in the hopes of advancing an understanding of the
subtleties and nuances of the ADHD experience for Chinese American college students.
Research Questions
Given the aforementioned, and as further contextualized in chapter three, the present
study aims to gather information that will address the following questions: 1) What are the
different pathways to being a Chinese American college student with ADHD? 2) How do
psycho-social, cultural and other factors shape the experiences that Chinese American college
students have with ADHD? 3) How do Chinese American college students with ADHD navigate
their academic environment in order to be successful learners?
Theoretical Perspective
This research project will utilize a Systems Theory approach to understand the psycho-
social and cultural dimensions that impact the ADHD experience for Chinese American college
students. Understanding these dimensions through a systems perspective allows for holistic
8

inclusion of multiple themes and factors that organize the experience of ADHD that are generally
not addressed from traditional medical perspectives emphasizing psychopathology. The Systems
Theory perspective is also in-line with the DSM IV Axis IV criteria in that it is centered around
psycho-social factors relevant to mental illness.
Organization of the Study
This research project is based upon a qualitative research design that will entail each
subject’s participating in two in-depth interviews, to be separated by independent journaling by
the participant. The interviews will last approximately between 90 minutes to 120 minutes (1.5
hours to 2 hours). Each session will be spaced roughly between one and two months apart
(pending availability of the participants), which will afford the interviewees the opportunity to
self-reflect upon their experiences with ADHD and how they are adjusting to the university
setting, as well as pondering which issues they wish to discuss with the researcher during the
second interview. Between the first interview and the second interview, a journal will be
provided to the research participant to allow them to free associate on their daily life experiences
and challenges with ADHD as well the coping strategies they use to negotiate their academic
surround. These journals will be collected and reviewed by the researcher approximately one
week before the second interview (pending scheduling availability of the participants), serving as
a bridge between the first and second interviews allowing participants to freely think about their
ADHD experiences as well as a reference point that the researcher can use to elicit follow up
information from the interviewee. These journals will not be coded or analyzed beyond the
intent stated previously. Each interview will be digitally recorded with permission from the
interviewee in order to ensure an accurate portrayal and documentation of their candid
statements. All transcripts will be stripped of identifying information to maintain the
9

confidentiality of the participants. Resulting data will be coded. The interviews will be analyzed
to understand key themes and factors that underpin and shape the experience of ADHD as well
as the coping strategies participants use in pursuit of their education and in the context of the life
cycle issues they are negotiating. Participants will receive $30 compensation at the conclusion
of each interview for their time spent.
Definition of Terms: Glossary
Co-morbidity-Adults with ADHD are more likely to face co-morbidity with alcohol
and/or substance related disorders, other mental health disorders and/or medical conditions.
Ramsey and Rostain (2007) state that the non-specific symptoms of ADHD are common
amongst other DSM IV disorders. Ramsey and Rostain (2007) assert that between 70%-75% of
these individuals have at least one other co-morbid disorder.
Malingering-A review of the literature acknowledges that a sector of individuals with
ADHD had a tendency to misrepresent their symptoms and clinical presentations as a method to
achieve secondary gains or benefits. According to Harrison (2006) and Quinn (2003),
malingering may be a contributing factor that results in the accurate diagnosis of adult ADHD.
Harrison (2006) defines malingering as: a range of behaviors from subconscious exaggeration to
the deliberate and outright fabrication of symptoms. Based upon this definition, an individual
may actually have symptoms that are overly emphasized or an individual may complete make
false claims of symptomatology in the hopes of achieving secondary gains. As a result, Quinn
(2003) believes that adult ADHD should be diagnosed using multiple methods such as: a clinical
interview, medical evaluation, behavioral rating scales, self-reports, and structured tasks to
measure attention and impulsivity. Harrison, Edwards and Parker (2007) state that in-depth bio-
psycho-social histories should obtained pertaining to childhood symptoms, which can be
10

corroborated by reliable sources. Harrison et al. (2007) indicate that students may have a
tendency to malinger in order to benefits from some of the following: acquiring psych-stimulant
medications, obtaining access to an array of disability services, may qualify for potential tax
benefits, be granted access to government-funded services and programs, and/or receive loan
forgiveness due to mental disability. Although this is an important consideration in
understanding the potential for acquiring the ADHD diagnosis, the purpose of this research
project will not focus on this area. It is rather mentioned to allow the reader a more involved
understanding of the rationale of why a student may have a tendency to malinger. Since this is a
voluntary case study with little potential for secondary gains, it is hypothesized that such
individuals will not seek inclusion into the study.
Psychosocial and Cultural factors-Lombardi, Gerdes and Murray (2011) purports that
students with ADHD who have intact social supports have a strong tendency to yield higher rates
of self-efficacy in the academic environment. Starcher (2001) outlines a model of viewing
ADHD symptoms via considering the following factors: Neuropsychological factors, genetic
factors, environmental factors, prenatal and neonatal factors, temperament factors and
psychosocial factors. As with many mental disorders classified in the DSM IV-TR, ADHD has
been found to have biological, genetic and psycho-social factors associated with the illness
(Starcher, 2001). Wilmshurst et al. (2011) state that family support may be a protective factor
against the negative effects of ADHD. Wilmshurst et al. (2011) mention that there are currently
no studies that investigate the nature of college students’ resilience to their symptoms of ADHD.
Frazier, Youngstrom, Glutting and Watkins (2007) state that college students with ADHD face
different stressors that children or young adults who do not attend post-secondary education. In
particular, Frazier et al. (2007) indicate that college students need to acclimate to their academic
11

environment and the numerous demands that are inherent in attending college and therefore may
constitute a separate and distinct sub-population of individuals with ADHD. This is an important
aspect of this research project as the researcher will attempt to understand how Chinese
American college with ADHD learn to navigate their academic environment in order to be
successful learners. Since these Chinese American college students are currently enrolled at the
Pacific Southwest University, it is assumed that these learners have been able to develop a set of
coping strategies to assist them with their daily struggles as students.
Systems Theory-is also commonly referred to as: general systems theory, life model,
ecosystems perspective and ecological perspective. Barker (1995) defines systems theory to be a
reciprocal relationship between the elements or concepts as it constitutes a whole that
emphasizes a relationship among individuals, groups, organizations or communities and
mutually influencing forces in the environment. “Systems theories focus on the
interrelationships of elements in nature, encompassing physics, chemistry, biology and social
relationships.” (Barker, 1995, 375)
Possible need to evaluate DSM-IV criteria in adults - Murphy and Barkley (1996) believe
that the diagnostic criterion for ADHD in adults is not appropriately captured in the DSM-IV.
As a result, Murphy and Barkley (1996) suggest that the diagnostic criteria for ADHD in adults
be evaluated to reflect developmental and age relevant criteria rather than be fixed across the
lifespan as it is currently defined. Riccio, Wolfe, Davis, Romine, George and Lee (2005) also
confirm the need to redefine the diagnostic criteria for adult ADHD as the clinical presentation
and behavioral/symptom profile presents differently than in children and adolescence. This
research project is not intended to debate the necessity for the diagnostic criteria for ADHD to be
augmented to account for the continuance of the disorder into adulthood. Rather this study will
12

focus on the psycho-social and cultural experience of ADHD in a sample of Chinese American
college students. Inferences drawn from this study should take into consideration the narrowed
focus of this project, sample size, population sampling methods and the nature of the study. This
study is not meant to be generalizable but more informative in nature due to the limited amount
of empirical literature related to adult and minority populations with ADHD.

13

Chapter 2: Literature Review
Introduction
Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by developmentally
inappropriate degrees of inattention and/or hyperactivity-impulsivity, and can be exhibited across
the life span of an individual (DuPaul, Weyandt, O’Dell and Varejao, 2009). Although definitive
causes of ADHD have yet to be established, several causes have been speculated about as
accounting for its origins, including genetic predisposition, brain damage during the pre-natal
and post-natal periods, and exposure to cigarettes and alcohol during prenatal development
(Santrock, 2011). Students living with ADHD have a high risk profile across a broad range of
factors and probabilities, including a higher risk of: academic under-performance, stigmatization,
self-medication from alcohol and/or substance use/abuse/dependence, alienation from family
and/or friends, and low levels of self-efficacy in comparison with non-ADHD learners. DuPaul
et al. (2009) believe that students with ADHD face greater risk for grade retention, for
identification for special education services, and for dropping out of secondary schools. Students
with ADHD have been found to have higher rates of academic failure, are at greater risk for poor
academic performance as measured by grade point average (GPA), may face greater risk of
being on academic probation and are less likely that their non-ADHD cohorts to attend college or
attain a college degree, despite the presence of protective factors (DuPaul, 2009).
Most of the research literature is focused upon ADHD in elementary and secondary
education (probably because the disorder is usually first diagnosed in childhood and
adolescence), thus less is known about how the disorder affects college students and adults
(Barkley, Murphy, O’Connell, Anderson and Connor, 2006). Tracking data for ADHD are not
required at the college and university level, whereas these data are reported at the elementary and
14

secondary education levels. Prevalence rates of ADHD among US adults have been estimated at
around 4 to 5 %, with “prevalence among US students being 3.9% and 2.9% for women and
men, respectively” (Ramsay and Rostain, 2007, 339). Current reports by Wilmshurst et al.
(2011) and Barkley et al. (2006) state that roughly one-third to two-thirds of children diagnosed
with ADHD will continue to experience symptoms throughout their life span. Wilmshurst et al.
(2011) estimate that between 2% and 4% of college students will meet the diagnostic criteria for
ADHD. Nevertheless, there is some dispute about the existence of ADHD among college
students and how to best diagnose it among adults, and some researchers and practitioners argue
that the criteria in use to diagnose ADHD among adults cannot be identical to the criteria used to
diagnose it among adolescents (Ramsay and Rostain, 2007; Harrison, Edwards, and Parker,
2007; Murphy and Barkley, 1996).
Epstein et al. (1998) and Solanto et al. (2010) argue that ADHD is no longer to be
considered a disorder of childhood that disappears as an individual ages into adulthood: upwards
of 30% or more continue to display full ADHD symptoms as adults. Riccio, Wolfe, Davis,
Romine, George and Lee (2005) notes that although adult ADHD continues to be an area of
controversy, recent findings suggest evidence that the ADHD disorder continues to hamper
individuals throughout the developmental course (Riccio et al., 2005): ADHD symptoms cause
significant impairment in adults’ educational/academic performance, occupational performance,
and social and emotional functioning, as well as producing greater rates of co-morbidity (mental
health and substance use/abuse/dependency disorders) than are found among non-ADHD adults
(Solanto et al., 2010; Barkley and Murphy, 2010). The controversy over adult ADHD may have
been facilitated because ADHD disorder is easy to substantiate during childhood and early
adolescence as contemporaneous data from parents, teachers, and other observers can assist by
15

providing detailed behavioral observations and histories to assist in the diagnosis of the disorder;
when working with ADHD adults, however, data from parents and teachers become minuscule,
resulting in the disorder being diagnosed in different patterns than are found in children.
Clinicians are forced to rely solely on self-reporting data from “ADHD” adults to validate a
diagnosis because of the lack of observational data as well as third party reporting data. Even if
such third party reporting data were available, Health Insurance Portability and Accountability
Act of 1996 (HIPPA) regulations and consent for release of information must be obtained by the
clinician from the individual that was previously given by parents for younger children. Some
researchers relate the controversy over adult ADHD to the lack of diagnostic criteria that are
developmentally appropriate across the life span of individuals (Ramsay, 2007; Riccio et al.,
2005).
In contrast to the slim amount of research that has been done on ADHD among adult
learners in the US, attention to ADHD among college students of Chinese-American descent has
been even more scant. In fact, the only published work that seems to have been produced that is
of even marginal relevance was done as a cross-cultural study that examined ADHD symptoms
among college students from the U.S. and China (Norvilitis, Ingersoll, Zhang and Jia, 2008).
This study found that 4.4% of American and 7.8% of Chinese students reported significant
current ADHD symptoms; 1.7% of American students and 2.7% of Chinese students reported
symptoms that were 1.5 standard deviations above the mean scales measuring current/past
symptoms (DuPaul et al., 2009). Although the study seemingly validates that ADHD is present
among Chinese college students, the findings are problematic and cannot be generalized to
Chinese-American students. The findings are problematic because China’s secondary education
environment is hyper-competitive and can itself account for mimicry of many of the “symptoms”
16

that are diagnosed as pertinent to the concept of ADHD; furthermore, the tools that were
employed to measure ADHD were of Western origin and not culturally validated with a Chinese
population (although the scale items were translated into Chinese). The findings are not
generalizable because, although Chinese-American and Chinese students share a common
national ancestry, the cultural meanings of presenting “ADHD” symptoms (and the diagnosis
itself) are likely very different, especially as Chinese-American students become progressively
more acculturated into the mainstream of American culture and society.
What follows is a discussion of the empirical and clinical literature on the subject of
ADHD. In addition, the state of knowledge about college students with ADHD, and research on
mental health and illness among Chinese-Americans (including their under-utilization of
services) is reviewed. The chapter concludes with a consideration of the need for inquiry to fill
gaps in the literature regarding the experiences of Chinese American college students with
ADHD, and the potential for insight that a Systems Theory perspective brings to the subject will
be highlighted.
Establishing ADHD in Adults: How and Why

According to Starcher (2001), Attention-Deficit/Hyperactivity Disorder (ADHD) is
usually evaluated (i.e., identified and diagnosed) via three methods: a medical examination, an
in-depth clinical interview and a behavioral rating scale or checklist. Quinn (2003) outlines a
multi-modal approach to ADHD assessment that encompasses the use of a medical examination,
self-report rating scales from the individual and through third party reporters, a structured
clinical interview, as well as structured tasks of attention and impulsivity. The medical
examination is conducted to rule-out possible physical causation that can mimic ADHD
symptoms. In mental health practice, physical health issues are teased out from psycho-social
17

variables in order to ensure that the presenting problems are organic or due to medical reasons.
For example are the symptoms exhibited a direct result of a medical condition or are they
psychosomatic in nature? Mental health practitioners are concerned to address competing
explanations for the existence and persistence of symptoms reporting. This approach allows the
practitioner to tailor specific treatment planning strategies to meet the individualized needs of the
person while taking into consideration alternative sources of possible causation. The clinical
interview or psycho-social evaluation is performed (see Appendix E) in order to substantiate that
the self-reported symptoms constitute ADHD. This diagnosis is achieved by taking into account
the frequency, severity, and chronicity of symptoms reported as well as how these symptoms
impair functioning. Behavioral rating scales or checklists are usually used to assist the
practitioner in measuring the self-reported symptoms of the client. Validating or verifying
mental health related symptoms in this way is important as “symptoms” are subjectively
experienced by the client and may not be fully grasped by a clinician during a face to face
psychiatric interview. Harrison, Edwards and Parker (2007) advocate the use of clinical
interview and self-reporting data alone as neuropsychological testing has not proven consistent at
indicating impairment; they add that no single neuropsychological battery has been developed to
adequately address issues of “diagnostic sensitivity and specificity”.
Establishing ADHD in adult populations is crucial because its nature and existence have
been a subject of controversy (Riccio et al., 2005; Faraone, Biederman, Spencer, Wilens,
Seidman, Mick and Doyle, 2000; Faraone, Biederman and Mick, 2006). Early researchers
believed that children and adolescents with ADHD would “grow out” of their symptoms as they
progressed through the life cycle. On the contrary, adult learners encounter what are arguably
more onerous educational environments, as they not only have to be cognitively engaged in their
18

instruction, but they also face competing demands of work, family, and adult responsibilities that
are unlikely to impact younger learners. “Some students go away to college but continue to live
at home psychologically. Other students live with parents but use the college environment to
define personal goals and values that are truly their own. Older students may have left home
long ago but never developed self-direction. Other mature students have followed career paths,
raised families, and managed their lives with independence but enter college in order to change
directions or start afresh.” (Chickering and Reisser, 1993, 115) In addition, Chickering and
Reisser (1993) believe these adult learners may also face possible backlash from their spouses
and/or partners who may be threatened from their pursuit of higher education. Adults with
ADHD face daunting challenges as they must juggle these social, educational and career
demands while simultaneously managing their ADHD symptoms; however, how they manage
these competing demands has not been systematically examined, either using qualitative or
quantitative means, a deficiency the present study will attempt to address.
College Success
Traditional benchmarks for educational success consist of GPA, graduation rates,
achievement tests, and attrition rates. Students with ADHD are expected to manage their
symptoms while simultaneously performing to satisfy various benchmarks, but such traditional
benchmarks do not account for the difficulties, trials and struggles ADHD learners endure as
they manage their disorder while also meeting these standardized criteria. Individuals with
ADHD have been noted to have higher risk taking behaviors, greater impairment in social
functioning, difficulty focusing on tasks, lower than average grades, self-esteem issues, a higher
propensity to use/abuse/depend upon alcohol and substances, more employment related
dysfunction, and higher rates of failure and drop-out in comparison to their peer group cohorts
19

who do not suffer with ADHD symptoms (Barkley, 1996; Stevenson, Whitmont, Bornholt,
Livesey and Stevenson, 2002). Despite the fact that a slew of negative symptoms and resultant
behaviors have been documented, little is known regarding how ADHD sufferers construct or
define “success” as learners. Kuh (2003) lists alternative benchmarks for evaluating the extent to
which secondary educational institutions foster effective learning environments, including such
items as exposure to cultural diversity and promotion of student-faculty interaction. Such
thinking raises the question of whether traditional benchmarks that measure educational success
pertain most aptly to ADHD learners. Perhaps ADHD individuals conceptualize success in
differing ways that have not been fully explored? These are important points to consider when
examining students with ADHD, for traditional measures of success may be different for learners
who are tasked with juggling completing life demands as well as their ADHD symptoms en route
to an academic degree.
Treatment Methods

Treatment approaches have been developed to address the ADHD disorder (including
among students), approaches that are in the main reflective of a medical understanding of the
condition. Mental health disorders in general have come to be conceptualized through the use of
a medical model, grounded in the bio-physiology of human organisms. This model emphasizes
the etiology of disease as rooted in physical causation. In tune with this medical model, the
psychiatrist is central to the diagnosis and treatment of mental illness; hence the research
literature reports that a combination of psychopharmacology and psychotherapy are the preferred
treatment modality for a variety of mental health disorders.
There are two main types of treatment modalities for ADHD: pharmacotherapy and
psycho-social therapies. Commonly, psycho-pharmacology medications in the form of
20

stimulants are prescribed to individuals living with the ADHD disorder. (See Appendix F for a
list of the commonly used psycho-stimulants that are prescribed to treat ADHD.) Starcher
(2009) states that medication therapy is the leading treatment modality for ADHD. This is not to
say that psycho-social interventions can not be used solely for the treatment of the disorder but
rather that the severity of the symptoms need to be considered. Mild to moderate symptoms can
be successfully managed with psycho-social intervention. However, more severe symptoms
require the use of pharmacotherapy to assist with symptom management. Psycho-stimulants
allow the individual to ignore new stimuli and hold their attention within working memory where
self-reflection, problem-solving, goal-setting and other cognitive processes occur (Starcher,
2001). Riccio and French (2004) assert that cognitive interventions have been recommended for
the treatment of ADHD in children. Solanto et al (2008) acknowledge the limited empirical data
relevant to the effective treatment approaches for adults with ADHD; however, acknowledge that
cognitive-behavioral interventions have yielded positive results in studies.
A majority of psychotropic medications are prescribed each year by general practitioners
who have little formal education in the treatment of mental health issues. In a study based in the
United Kingdom, Baverstock and Finlay (2003) found that general practitioners treating college
students were fairly unfamiliar with the Attention-Deficit/Hyperactivity Disorder. Baverstock
and Finlay (2003) recognize the need for improved collaboration across medical providers
(general practitioners, psychiatrists, psychologists, etc.) so that college student receive the
highest quality of medical assistance in stabilizing their mental health issues and affording them
the opportunity to compete academically. In the field of child and adolescent psychiatry, there is
a great amount of cross-disciplinary consultation. This is the “Standard of Care” or best practice
model in order to ensure more positive outcomes for the patient, client or consumer. Baverstock
21

and Finlay (2003) advocate for the same approach to be utilized in the treatment of college
students with ADHD disorders. Since there is little researched data on the treatment of ADHD
in college populations in comparison with child and adolescent populations, greater
interdisciplinary consultation should occur to better understand and treat the ADHD disorder.
As new non-medical psychotherapies have been developed, there has been an increased
need for non-medical clinicians to provide related services. Included among these innovations is
Cognitive Behavior Therapy (CBT), which has been an effective psycho-social approach to treat
the ADHD disorder (Ramsay, 2007). Ramsay (2007) acknowledges the efficacy of the CBT
approach as this technique acknowledges the neurobiological underpinnings of ADHD
“Cognitive behavioral therapy oriented approaches were appealing options for treating adult
ADHD because this model of psychotherapy already employed structured agendas; a
collaborative, problem-solving focus; and the emphasis on between-session ‘homework’ to
institute the behavior and cognitive modification and skill-building strategies discussed in
sessions. Thus, it was not difficult to adapt these approaches to address the unique needs of
adults with ADHD.” (Ramsay, 2007, 428) Ramsay and Rostain (2007) believe that ADHD
coaching, therapeutic alliance, maintained focus on problem and coping strategies and psycho-
education are effective measures to assist adult learners (among others) with ADHD in coping
with their symptoms.
Malingering
Harrison et al. (2007) state that there has recently been an increase in the number of
adults and post-secondary students complaining of and seeking services for ADHD, which has
caused service professionals to ponder whether these clinical presentations and self-reporting of
symptoms are valid. Harrison et al. (2007) indicate that this skepticism may in part be attributed
22

to the lack of historical (e.g., childhood) data presented to substantiate an ADHD diagnosis.
Mittenberg, Patton, Canyock and Condit (2002) and Quinn (2003) suggest that a multi-modal
approach to diagnosis should be utilized to rule-out malingering inclusive of: a review of the
medical history, self-reporting data, clinical observation (mental status examinations) and a
comprehensive neuropsychological examination. McKee (2008) indicates that ADHD symptoms
in college student populations need to be established prior to deeming them eligible for disability
accommodations. Sack, Gale, Gulati, Gunther, Nesheim, Stoddard and St. John (2008) found
that medical students may also request special accommodations due to the heavy academic
demands of medical school education, indicating that requests for accommodations are not just
seen in undergraduate education, but also occur in specialty schools such as medicine. The
research literature reveals that a portion of students may misrepresent their symptoms in order to
benefit from secondary gains, such as extra time to complete assignments, medication therapy
(psycho-stimulants), access to disability services, additional tutoring services, etc; indeed,
Sireci, Sarpati and Li (2005) found that extended time allotted to students with disabilities to take
examinations yielded improved performance. The academic community has debated whether
these special accommodations extended to disabled students constitute an “unfair” advantage,
and whether the resulting performances are valid and indicative of actual ability and are not due
to the accommodations received.
McKee (2008) does not refute the fact that ADHD exists in college students and adult
populations. However, McKee (2008) acknowledges the criteria used to diagnose ADHD is
normed and based on child and adolescent populations because the disorder is usually first
diagnosed in early phases of one’s life. Therefore, it is crucial to accurately diagnose ADHD in
college students. McKee (2008) states that self-reporting of ADHD symptoms in college are at
23

higher than expected rates and even higher when college-specific normed instruments are
utilized in the screening and diagnosis of ADHD. Therefore, it is vital to correctly diagnose
ADHD in college populations so that appropriate treatment interventions be tailored to address
their specific needs. McKee (2008) acknowledges that college students transitioning to college
life may have higher self-reported symptoms of ADHD that may in fact be due to adjustment to
the college setting vs. actual ADHD symptoms.
Psycho-social and Cultural Factors in the Study of ADHD among College Students

The psycho-social and cultural context in which mental illness presents itself is crucial to
the treatment modality used, the diagnostic formulation and the clinical understanding of the
problem. According to Starcher (2001), psycho-social factors that have been associated in the
development of ADHD symptoms that include the following: marital distress, family
dysfunctions, and lower socioeconomic status (SES). Practitioners need to have a cultural
awareness of or sensitivity to mental illness and how it is viewed within the context of the
individual as well as that of the larger society. Practitioners should understand the transference
and counter-transferential dynamics of their relationship with persons living with mental illness
as these may have underlying significance in how mental illness is viewed and treated.
College students with ADHD symptoms are highly resilient. However, there is little
research on the resiliency of this population (Wilmshurst et al., 2011). Protective factors of
familial and social supports assist these college students in achievement as they mitigate the
negative effects (protective factors) of ADHD, which include improved social
skills/communication and positive mentorship experiences (Wilmshurst et al., 2011). College
students with higher protective factors also have higher levels of self-esteem in comparison to
students without these protective supports. Lower levels of protective factors are also associated
24

with higher levels of co-morbidity such as depression, poorer parent-child relations, academic
difficulty and lower subjective self-reports of quality of life.
Chinese Americans’ Mental Health and Under-utilization of Mental Health Services

An important consideration when dealing with diverse populations is the problem of
cultural competency (i.e., the culturally specific customs that are practiced by bona fide members
of specific ethnic or racial groups). This is especially crucial when trying to understand mental
health and utilization of mental health services among Asian American populations because
mental health and psycho-therapy are largely Western in origins. Asian cultures may view
mental illness and deal with its potentially devastating effects in ways that compete with or
function independently of established Western practices. Asian Americans incorporate their
traditional norms, customs and values while negotiating their host culture (Sue and Sue, 2007).
The level of acculturation into the host culture will influence how Chinese Americans view
mental illness (diagnosis, treatment and psycho-social implications).
Although Asian Americans were once thought to have few mental health issues, upon
review, Asian Americans’ mental issues were found to actually be more severe and chronic than
those of European Americans (Lin and Cheung, 1999). The under utilization of mental health
treatment services led the mental health community to assume that Asian Americans did not have
significant mental illness (Lin and Cheung, 1999; Kung, 2004). Kung’s (2004) review identified
the following research trends in the literature: 1) A focus on comparing mental health service
utilization patterns among Asian Americans versus other races, via archival data compiled by the
Department of Mental Health; 2) Non-representative sampling-based studies of college students
who seek mental health services; 3) Inquiries into Chinese Americans’ attitudes toward, and
perceptions of barriers to, mental health service utilization. Kung (2004) states that the
25

“empirical link between perceived barriers and actual service use was not made in these studies.”
(Kung, 2004, 28) However, Leong and Lau (2001) state that acculturation factors limit the Asian
American population from seeking mental health treatment. A review of the literature did not
indicate that a significant amount of have been conducted specifically with Chinese Americans
with ADHD; instead, it offers prevalency data that indicates that mental health issues exist
among Asian American populations, including Chinese Americans.
Although the epidemiological research has not reached a state of full maturity where
utilization of mental health services by Chinese-Americans is concerned, what limited research
has been done points in a direction that suggests that, contrary to the “model minority”
stereotype, Chinese Americans (and Asian Americans more generally) suffer from a range of
mental health problems that impair functioning (Leong and Lau, 2001), with some groups of
Asians demonstrating higher levels of need for such services, possibly related to recent
immigration status (Abe-Kim et al., 2007) and lower overall SES position (Leong and Lau,
2001), or, as Lee et al., (2009) report, gender: “Among females 15-24 years old, Asian
Americans and Pacific Islanders have the highest rates of suicide deaths” (Lee et al., 2009) as
compared to Whites, Blacks and Hispanics. Lin and Cheung (1999) argue that Asian Americans’
lower rates of psychiatric admission and access to outpatient mental health services falsely
reinforce the “model minority” label for this group: Spencer and Chen (2004) state that only 17%
of Chinese Americans with mental health issues seek treatment services. The use of mental
health treatment services by Chinese Americans (and other Americans of Asian descent) does
not match up with the need documented in such epidemiological studies. Asian Americans are
underrepresented among those using mental health services, and when they do use them, they use
them for briefer periods of time (Leong and Lau, 2001).
26

For educators, understanding the impact of whether and how students with Attention-
Deficit/Hyperactivity Disorder (ADHD) and other mental disorders gain access and utilize
services is important because of the impairments that mental health issues can create for one’s
academic and work performance, ability to attain financial success and independence, degree of
self-esteem and sense of self-efficacy, as well as the development of one’s identity. In order for
learners with psychiatric conditions to receive appropriate diagnosis and treatment of their
disorders, they must be able to access the array of services that are available either through their
school, a general practitioner, or an external mental health practitioner (e.g., mental health
clinicians).
Mental health and mental health treatment services are concepts and practices that are
developed and accepted in Western societies. These constructs are often foreign to persons of
traditional East Asian upbringing. The collective identity of the family unit in the Chinese
community are often questioned when a member is suffering with mental health issues and thus
there may be identity and cognitive dissonance for mentally ill Chinese Americans who struggle
with a desire to seek treatment services to achieve stability at the cost of bringing shame and
embarrassment to their Chinese American kin. Lee et al. (2009) found that cultural norms of
Asian Americans do not promote a view that mental health issues are important; to the contrary,
they result in negative associations with mental illness that work to undermine the probability
that Asian Americans will pursue mental health services. The amount of one’s education
regarding mental illness, one’s level of acculturation and familiarity of mental disorders may
each serve as barriers to accessing needed services.
Kung (2004) documents that Asian Americans have a greater tendency to (a) exhibit
physical manifestations of mental conditions (i.e., psycho-somatization), (b) see mental health
27

issues as a sign of personal weakness or deficits in character (e.g., lack of willpower), and (c)
doubt the effectiveness of mental health treatment; taken collectively, these factors reflect Asian
Americans’ limited acceptance of mental health services and pose obstacles to access, including
program design. Kung (2004) argues that traditional mental health therapies that focus on
assisting the individual to resolve cognitive, affective and behavioral manifestations of
symptoms runs counter to the Chinese cultural tradition under which the normative orientation is
for the individual to repress “negative” thoughts and emotions rather than overtly confront them.
The ability to access the variety of mental health services that might be helpful to people
with relevant conditions is contingent upon a number of factors, including the availability of
mental health services, the ability to afford services, the understanding of the impact of mental
health issues on one’s functioning as well as the stigmatization associated with seeking out
mental health treatment, which can itself be culturally specific (i.e., a greater source of shame or
embarrassment among some groups more than others). Thus, Kung (2004) highlights the
potential cultural barriers that impact Chinese Americans from using mental health services. The
barriers to access of mental health services outlined by Kung (2004) include the following
factors: understanding the relevance and credibility of the mental health system, the possible
denial of mental illness and the need for treatment, fear of being stigmatized by others and trying
to “save face”, lacking knowledge of available resources to treat mental illness, linguistic
barriers and lacking the financial resources to pay for mental health treatment. Similar to Kung’s
(2004) identification of barriers to accessing mental health treatment, Leong and Lau (2001)
acknowledge “barriers to help-seeking” which include the following: cognitive barriers,
affective barriers, value orientation barriers, physical barriers, as well as barriers that
differentially impact specific Asian American sub-populations (e.g., PTSD among Cambodian
28

refugees from the Pol Pot regime). Spencer and Chen (2004) believe that availability and access
are the main barriers to service utilization, while Ying and Miller (1992) believe the degree of
acculturation of the Chinese American into the mainstream society will deter these individuals
from seeking out services. Lin and Cheung (1999) suggest that there may be an element of
cognitive dissonance at work in that Asian traditions will be in direct conflict with European
American traditions, resulting in incompatible beliefs and value orientations that are exceedingly
difficult to surmount. On a more practical level, Spencer and Chen (2004) argue that the lack of
English proficiency, when coupled with the lack of bilingual clinicians, may contribute to the
under-utilization of mental health services among Asian Americans and Pacific Islanders.
Because Chinese Americans express their emotional distress via physical manifestations (Ying
and Miller, 1992), they may seek help from professionals who are not in a position to understand
the psychological bases for their conditions, i.e., medical practitioners, reflexologists and
herbalists. Yang, Law, Chow, Andermann, Steinbery and Sadavoy (2005) found that
acculturation, language, social supports and socio-economic factors played a key role in
immigrants’ conceptualization of mental illness. “Their severe functional impairment is often
compounded by stressors related to migration and acculturation, language difficulties,
socioeconomic disadvantages, inadequate housing, lack of access to services, and discrimination.
Furthermore, many patients may be alone in their new countries—members of their extended
family or other supportive persons may not be available.” (Yang et al., 2005, 1053) In this case,
the issue is not so much that access to services is blocked, but that cultural beliefs and practices
result in the misdirection of help-seeking, or in the viability of competitors to mental health
practitioners who appear to have more sway or authority. Leong and Lau’s (2001) finding that
Asian American tend to terminate their treatment for mental health services earlier than other
29

groups may point to a lack of social support in the Asian American household for receiving such
services, support that is withheld because of value orientations and attitudes that view such
assistance as lacking credibility. Obstacles to access for Chinese Americans therefore concern
not just ability to access but the direction of access and the credibility of the services; each must
be considered when creating targeted programs to increase and enhance service utilization.
Due to the general reluctance of Asian Americans to seek professional mental health
assistance, Spencer and Chen (2004) believe that this group make use of immediate and extended
family, non-traditional (in a Western context) healers, community elders and physicians in the
treatment of mental health issues and will only seek out formal mental health treatment when
these avenues have been exhausted. This approach of seeking out formal treatment services after
accessing other culturally accepted practices is problematic in that the mental health symptoms
of the individual usually become more severe and difficult to treat over time. Perhaps the
resulting resistance to treatment partially accounts for Leong and Lau’s (2001) finding that Asian
Americans have a greater tendency to prematurely terminate services than non-minority clients.
It is essential to understand the problems underlying the limited access to mental health
services for Chinese Americans in order to create viable solutions to remedy the problem.
Chinese Americans and Asian Americans more generally have been referred to as the “model
minority” due to their ability to achieve high rates of academic achievement, high rates of
employment, lower rates of criminal involvement and increased ability to acclimate into
mainstream American society. Chinese Americans with mental health issues face issues of
cognitive dissonance that need to be addressed as they strive to meet this “model minority” ideal
while simultaneously trying to grapple with issues related to mental health. This struggle can
hinder the self-esteem of Chinese American living with mental health issues. Providing
30

education, outreach, support and bilingual/bi-cultural services can serve as interventions to
decrease stigmatization of the mental disease while increasing the likelihood for these
individuals to seek treatment services. It is essential of the mental health practitioner to establish
credibility with the Chinese American community so that he/she will be view as a viable source
of support and assistance.
Leong and Lau (2001) believe that recruiting bilingual and bi-cultural practitioners
coupled with tailoring traditional psycho-therapeutic interventions to meet the cultural specificity
for Chinese Americans may increase the likelihood of their accessing, and persisting in, mental
health treatment. As an example, they point to the face that since the family unit is the primary
source of support for a large portion of Chinese Americans, family therapy and the use of family
support may be crucial to increasing the service utilization for mentally ill Chinese American and
may increase the chances of these individuals’ remaining in and completing treatment. Leong
and Lau (2001) argue that Asian Americans and specifically Chinese Americans have a greater
tendency to report psychosomatic complaints; in line with this, Ying and Miller (1992) believe
that greater interdisciplinary collaboration between mental health and physical health providers
ought to occur in order to provide better mental health education and intervention for this
population. Providing the Chinese American community with targeted outreach services can
serve as a method to bridge service gaps and increase access to services. The use of bilingual
and bi-cultural mental health clinicians and paraprofessionals can assist in de-stigmatizing the
procurement of mental health services by addressing issues of conformity, self-esteem, and
cognitive dissonance.
Understanding some of the controversies and struggles that exist for Chinese Americans
and Asian Americans more generally is necessary in order to pair possible culturally relevant
31

interventions and services to address their needs pertaining to accessing and utilizing mental
health services. The social psychological constructs of self-esteem and cognitive dissonance
must be managed so that Chinese Americans will be likelier to seek out and enter mental health
treatment earlier when their condition can be more readily managed rather than later when the
prognosis of treatment decreases. The use of bilingual and bi-cultural practitioners is necessary
to decrease the negative stigmatization of mental health services and the “loss of face” that many
traditional Chinese Americans may face. Providing education regarding the array of available
treatment services and education regarding mental illness will be necessary in order to reduce the
isolation, shame and guilt that mental ill Chinese Americans and their families may face. The
stereotype threat (Aronson, 2008) Asian Americans face as “model minorities” may result in the
self-fulfilling prophecy whereby they under-utilize needed mental health services, because of the
cognitive dissonance produced by the disjuncture between model minority stereotype and
psychological condition. Asian Americans with mental health issues may be unable to achieve
the elevated performance levels expected of them, causing further isolation, possible depression
and incongruity with traditional Asian American cultural ideals regarding academic and
economic performance and success.
Co-morbidity and ADHD: The research literature report that individuals with ADHD
may also have higher rates of co-morbidity (concurrent mental health diagnoses) such as anxiety,
depression and/or substance-related disorders. For example, Solanto et al. (2008) identify a
significant prevalence of co-morbid depression in ADHD adults. Likewise, Farone et al. (2000)
state that there is a higher frequency of anxiety, depression, anti-social personality and substance
use disorders among adults with ADHD. Since ADHD is characterized by impulsivity,
hyperactivity, poor problem-solving skills, higher risk taking behavior, etc.., these same
32

individuals may have a greater tendency to use and/or have substance related abuse/dependency
in an effort to self-medicate their symptoms.
In general, Asian Americans have lower rates of alcohol and substance use, abuse or
dependency in comparison with mainstream American society. This may not necessarily mean
that Chinese or Asian Americans do not engage in the use of alcohol and illicit substances that
lead to the development of abuse or dependency disorders. Rather the possible under-reporting
of such occurrences can lead to the lower representative data for these minority groups. Luczak,
Wall, Cook, Shea and Carr (2004) believe that genetic variations in Asians can be one causal
explanation of their lower alcohol abuse and dependency rates. According to Luczak et al.
(2004), genetic variations among Asians affect the metabolism of alcohol and may be a
protective factor against Asians’ becoming prone to alcohol abuse or dependency. Luczak et al.
(2004) also state that Chinese and Chinese Americans are less likely to consume and develop
alcohol abuse or dependency issues in comparison with Korean and Korean American groups.
The implication of these findings -- which are yet to be established in the literature -- is that
Chinese American students with ADHD will have higher rates of alcoholism than Chinese
American students who do not have ADHD, but that the former’s rates will be lower than the
alcoholism rates among Asian students who are not of Chinese descent (e.g., Korean
Americans).
Systems Theory and the Framing of the Present Study
Systems Theory is referred to by different names: general systems theory, life model,
ecosystems perspective and ecological perspective. This approach emphasizes the idea of
looking at the “person-in-environment”, revealing how humans and their environments are in
reciprocal relationships and shape one another (Greene, 1999). Systems theory offers a
33

framework for understanding the relationship between individuals, groups and organizations.
These theories are based upon a framework or paradigm that views individuals and their
behaviors from a holistic lens, taking into consideration the variety of contexts that impinge upon
or inform people’s lives, including the social and physical contexts mentioned by Robbins
(2006). In order for an individual, group, organization or system to remain in (or return to)
equilibrium or homeostasis, it must be able to effectively mitigate multiple stresses. According
to Zastrow and Kirst-Ashman (2010), when the balance of a given system is interrupted or
disturbed, the system seeks out avenues for re-establishing equilibrium. Competing demands or
stressors must be managed in order to maintain the integrity of the system. In the field of mental
health, these competing demands are regarded as psycho-social stressors (coded on Axis IV) and
include the following: family and social supports, academic demands, job strain, housing related
issues, economic/financial difficulties, problems with access to health care related services, legal
issues and other psycho-social and environmental challenges (American Psychiatric Association,
2000). System theorists argue that psycho-social interventions ought to be fashioned to best
assist the individual, group, organization and/or system to effectively handle these competing
demands in the interest of optimal functioning. Systems theory helps the practitioner to
understand the interrelatedness or interconnections between various components of individuals’
lives (i.e., involvements) and their presenting behavior; thus, a systems practitioner may assist a
student who is not performing well in school by strengthening their use of family and social
supports as a method of coping. Systems based approaches ought not assume that people are
static, unchanging entities. The best interventions will recognize that people are developing or
evolving over their life course; as Schriver puts it, person-in-environment approaches “must
grasp both process and change if we are to understand Human Behavior and the Social
34

Environment (HBSE).” (Schriver, 2011, 114) A life history-based case study research design
(proposed in Chapter Three) that highlights how people develop and evolve their approach
toward managing their ADHD, in the context of drawing from and interacting with the social and
psychological influences in their environments, is consistent with this view of Systems Theory.
Conclusion
ADHD is a neurobehavioral and developmental disorder that can have profound effects
on the individual throughout his/her lifespan. Gaps in the knowledge base focus on a medical
model of the etiology of the disease rather than the subjective experience of ADHD symptoms
based upon the psycho-social and cultural perspective of the individual. It is imperative to
understand the processes inherent in the disorder as well as factors that contribute to the
experience of ADHD in order to assist individuals and learners deal with their symptoms and
live fruitful lives.
A review of the literature indicates that ADHD has not been widely studied in college
students and/or within minority populations. The extant research data reviewed have deployed
quantitative methods, possibly as a mode to establish with reliability and replicability the
prevalence of the disorder in adult populations. The literature reflects that the ADHD is a
disorder that is usually first diagnosed during childhood or adolescence leading to the limited
amount of data in adult populations. Earlier researchers and practitioners believed that the
ADHD symptoms would dissipate when an individual ages leading early researchers to believe
ADHD to be a developmental disorder. Subsequent studies have noted that between one-third to
two-thirds of children with ADHD will continue to experience ADHD symptoms throughout
their life cycle (Wilmshurst et al., 2011).
35

The present research project will explore how Chinese American college students
conceptualize and deal with their disorder and seek to understand the psycho-social and cultural
factors that shape their experience. A case study approach using in-depth interviews and
supplemental journals will be implemented to acquire a comprehension of the subtleties and
nuances that underpin these factors (Creswell, 2009; Steinberg, 2004). The project will also
examine the coping strategies implemented by these Chinese American college students to
navigate their academic environment in order to be successful learners. Since coping skills
develop longitudinally over a course of an individual’s life, it will be necessary to ascertain how
their understanding and handling of the disorder evolved and changed throughout their
educational careers from K-12 (secondary education) through the present (post-secondary
education).
According to Riccio and French (2004), a review of the literature does not provide
sufficient evidence to formulate sound conclusions regarding the efficacy of various treatment
approaches to ADHD. This in part may be attributed to the way in which ADHD is
conceptualized and the context in which it may present. Therefore, it is crucial to understand
how ADHD is shaped by varying psycho-social and cultural influences. As more information is
understood regarding how ADHD presents within the unique individual, a tailored treatment
approach can be designed and implemented to assist the individual to cope with their symptoms
and become successful learners.

36

Chapter 3
Research Design and Methodology
Introduction
A review of the current literature reveals that Attention-Deficit/Hyperactivity Disorder
has not been widely researched among college populations (Norvilitis, Ingersoll, Zhang and Jia,
2008). In addition, scant research has been conducted with minority students who are diagnosed
with ADHD. The research that has been conducted ordinarily compares Caucasian and African-
American students on various kinds of measures susceptible to quantitative analysis, ranging
from self-report data, to behavioral inventories and performance outcomes. The present effort
diverges from these trends by outlining a qualitative dissertation research project that will
address a specific segment of the college population, students of Chinese American descent.
This research was not comparative in the same sense -- examining differences between Chinese
American and Caucasian American college students, but instead looked at differences and
similarities among Chinese American students per se. This research asked whether there were
variations in the experiences of Chinese American college students, what they were based in, and
how they matter. Using in-depth interviewing techniques as the point of departure for data
collection, this project looked at various domains of practice and influence that may tell us about
the shaping of these variations in experience. Among these domains included the history of
diagnosis, psycho-social factors, cultural immersion and ethnic identity, primary and secondary
supports, access to services, the academic environment, treatment approaches and coping
strategies.
Because this was an initial query into an understudied topic -- the experiences
encountered by Chinese American college students with ADHD -- a qualitative research
37

approach was utilized. Qualitative methods are useful for studying topics in the spirit of
discovery, rather than hypothesis testing (Rubin and Rubin, 2004); they promote the importance
of examining a topic in depth, with a concern to tap into undiscovered subtleties of experience.
Where quantitative methods proceed with testable hypotheses, a fixed research design, and
clearly operationalized variables, qualitative approaches adopt a more inductive stance, and seek
instead to explore and document the range of contexts and meanings that might be relevant to
understanding an underappreciated group, condition, or event (Patton, 2002). The strength of
qualitative methods is that they permit the researcher to be flexible enough to take advantage of
opportunities for the discovery of themes, categories, and meanings that emerge in the course of
fieldwork (Rubin and Rubin, 2004).
Specifically, this study sought to answer the following three questions using qualitative
methods: 1) What are the different pathways to being a Chinese American college student with
ADHD? 2) How do psycho-social, cultural and other factors shape the experiences that Chinese
American college students have with ADHD? 3) How do Chinese American college students
with ADHD navigate their academic environment in order to be successful learners?
Sample, Population and Research Design
Sample and population: The study population was focused on Chinese American college
students with ADHD who attend a private institution of higher learning within an urban setting
(in the Pacific Southwest), to be given the pseudonym of the “Pacific Southwest University”. A
baccalaureate, masters, and doctoral granting institution, the Pacific Southwest University has an
extremely diverse student body, including a sizable international community. Although the
university has a large proportion of undergraduates who are of Asian-American descent (roughly
one out of five students, for the purposes of this study only Chinese American college students
38

were invited to participate. This decision is important to bear in mind because collectively
“Asian American” can refer to any group of individuals with cultural, ethnic or linguistic ties to
any country within the Asian continent or sub-continent. Each Asian country or sub-sector of the
Asian population has distinct customs, beliefs, languages and practices. A strict focus on
Chinese Americans allowed for the specificity of Chinese culture (and acculturation to the US) to
be considered as an influence on how the participants have experienced and managed being a
student with ADHD.
Research Design. Originally, this research project’s sample was to be limited to ten
participants (n=10), each of whom were to be interviewed on two separate occasions, resulting in
twenty in-depth interviews. However, recruitment efforts resulted in only three participants
stepping forward who met the criteria outlined for inclusion in the study, which resulted in a total
of six in-depth interviews. The relatively small number of participants, coupled with the two-
shot study design, allowed for a more in-depth exploration of the research participants’ unique
experiences, and allowed for a more comprehensive account of their life stories than would a
one-shot interview study (Gubrium and Holstein, 2001). The first interview largely covered life
before college, documenting the experience of being diagnosed, the formative years in school
(K-12), and the participants’ decision to attend college; the second interview covered life since
arriving at college, focusing on how participants navigated the academic demands and social life
found in the university setting. In keeping with Rubin and Rubin’s recommendations (2004), the
researcher was flexible about how the interviews went, allowing for fluidity in the research
process that is respectful of the interviewees’ interests and concerns. Thus, on occasion
participants tended to discuss contemporaneous issues relevant to their current ADHD
experience during interview one as well as during interview two.
39

The two interviews were separated in time -- the duration ranging from roughly one to
two months -- during which the participants kept a journal in which they free associated or
reflected on experiences they had that related to the subject of ADHD, or that might have been
stimulated by the initial interview. Before the second interview took place the researcher
planned to review the journal as a way of determining new topics to address, or as a way of
probing experiences documented in the journals, thereby making the second interview an
encounter much more closely tied to the contemporaneous experiences the student was having in
the college environment. However, this was difficult to coordinate with the research participants
as they were in the middle of final exams. The participants reported that this would serve as a
burden to them as they would be distracted from their studies. In order to minimize disruption to
their ebb and flow regarding their study habits, the student researcher agreed to collect the
journals at the time of the second interview to decrease stress and disruption for the research
participants.
The present design, which was essentially a case study approach (Creswell, 2009;
Steinberg, 2004), enabled the researcher to ascertain both the life histories of Chinese American
college students (especially as these relate to the intersection of their educational careers and
their diagnosis), and their current experiences as students with ADHD who may be alternatively
struggling or thriving in the college environment. Since persons with ADHD develop their
idiosyncratic coping strategies over an extended period of time, it was important to bring a
longitudinal mindset to this project, one that saw being a student with ADHD as a process of
negotiating the learning environment and one’s own internal framework. The task was therefore
to erect strategies that would prompt research participants to vividly convey their perspectives,
40

and describe their practices as well as the histories of their practices, such that these could be
documented and analyzed in a systematic and contextually rich manner.
Instrumentation: Doing Qualitative Interviews
Studying ADHD qualitatively. Qualitative interviews were used to inquire into the
subjective experience of ADHD for the research participants. A qualitative approach to
interviewing is essentially one that is “responsive,” i.e., that develops primary and follow-up
questions through listening (Rubin and Rubin, 2004). Although the researcher comes prepared
to do the interview with a sense of which topics to pursue, the researcher also anticipates that the
shape of the individual interview will be emergent, being partially determined by the substantive
statements as well as communicative style (guarded or reticent versus enthusiastic or chatty) of
the interviewee. For purposes of this study, “subjective experiences” essentially refers to the
point of view (understandings, beliefs, ways of making sense) and the practices (techniques and
strategies) of persons with ADHD. Interview topics (see Appendix H) were posed in open-ended
fashion, and responses were probed for nuances that shed light on how participants’ unique
circumstances emerged and were personally navigated by them. Follow up questions are the
heart of qualitative interviewing (Rubin and Rubin, 2004), this enabled the researcher to coax
from the interviewee a full accounting of their perspective. The follow up questions were
contingent on what was said rather than being pre-determined as the latter could interrupt the
flow or fluidity of the interviewee’s emerging discourse.
A focus on unique and idiosyncratic practices is well grounded in the literature.
According to Friedman, Rapport, Lumley, Tzelepis, VanVoorhis, Stettner and Kakaati (2003),
few studies have examined the social and emotional intelligence of individuals with ADHD.
Therefore, questions were posed and phrased in ways that encouraged descriptive accounts and
41

narratives that shed light on participants’ unique subjective experiences, including those that
highlight how they utilized their social and emotional intelligence. In line with Object Relations
Theory, the subjective experience of ADHD was contextualized by the psycho-social and
cultural variables that shape an individual’s sense of self in relation to his or her environment
(Berzoff, Flanagan and Hertz, 1996). According to this approach, each individual experiences
the world differently and uniquely to him or herself. Likewise, individuals with ADHD will
experience their ADHD symptoms in a fashion particular to their unique situation, having been
shaped by their psycho-social and cultural contexts. Therefore, this project sought to document
each participant’s “pathways to ADHD”, meaning the process of being diagnosed with the
condition, incorporating that condition into one’s identity, and developing coping strategies that
were pertinent to succeeding in academic environments. Questions about each participants’
unique histories with being diagnosed as having ADHD and utilizing services related to
managing learning while having ADHD were posed as well, and responses were probed to
produce sufficiently vivid accounts.
As stated above, data collection occurred at two different points in time; each interview
lasted roughly between one to two and a half hours, which resulted in a cumulative interviewing
time of two to four and a half hours per participant. Participants were afforded breaks as needed
during the interview process. In the interim between the two interviews, participants kept
journals in which they free associated and reflected on issues that pertained to their daily life as a
student with ADHD. These journals were collected during the second interview. This allowed
for the incorporation into the second interview of themes and situations mentioned in the
journals, as important areas with which to connect and probe as the interviewees were asked to
provide a summative analysis of the journaling exercise. The first interview posed topics aimed
42

at eliciting accounts highlighting the relevance of psycho-social factors and cultural themes, as
well as descriptions of coping strategies related primarily towards their K-12 education; it also
documented the experience of being diagnosed with ADHD and what that meant for personal
identity and self-efficacy, and had the interviewee discuss the “decision” to apply to and attend
college. The second interview picked up where the first interview left off, primarily focusing on
the participant’s experience with ADHD in the college setting but also allowed the opportunity
for them to share and/or clarify issues that had not been sufficiently addressed previously. This
interview began by asking the interviewee to talk about their early days in college and the kinds
of adjustments that the environment entailed, academically, personally, and socially. The goal
was to depict the kinds of challenges that the student encountered and how they managed or
navigated them. Because the sample included students from all classes, this part of the interview
was designed to be more contemporaneous for some participants than for others. In order to
capture the process-based aspects of living with ADHD as a college student, the interviewer
sought to understand how the participant’s approach to dealing with various challenges
developed over time. The journal highlighted for the interviewer the issues that the participant
continued to wrestle with in the present day and therefore played a vital role in setting the agenda
for the interview as a point of discussion regarding the ADHD experiences for the participants.
Interviews were digitally recorded to ensure that interviewees’ life histories could be accurately
transcribed and allowed for complete analysis.
Recruitment and Human Subject Protection
Recruitment: The researcher recruited participants by having an announcement
describing the project posted to the list-servs of various campus offices and organizations with
which Chinese American and students with disabilities have frequent contact. The researcher
43

outreached to the Asian American Student Services (AASS) and the Chinese Student Association
(CSA). These two university-sanctioned organizations posted the IRB approved flyer to their
list-servs in an effort to assist the student researcher with recruiting potential candidates.
However, no participants were recruited or expressed interest in the study via this method.
Because the researcher did not have access to the list-serv itself, identities of potential
participants were not compromised. In addition, a recruitment flyer was created and widely
posted at different places on campus frequented by students (including at the offices
aforementioned). The student researcher posted over 200 IRB approved flyers throughout the
Pacific Southwest University each week for a period of 1 month as well as left on sign in tables
for various campus events for Chinese American organizations. It was noted by the student
researcher that previous flyers were either taken down or posted over on a weekly bases, which
prompted the student researcher to routinely post flyers in the same locations in order to recruit
potential candidates for inclusion into the study. Potential research subjects self-identified as
having the ADHD diagnosis were asked to contact the student researcher via university email or
via the contact phone number that was listed on the flyer (see Appendix C). The time
commitment and nature of the study was explained to them upon contacting the student
researcher regarding their expressed interest in the study, and they were offered sixty dollars
($30 dollars per interview provided to each participant at the conclusion of each interview) in
return for their time and trouble.
Recruitment was focused at the Pacific Southwest University because of the time
constraints on the project and the practical limitations on outreaching to multiple sites, especially
the problem of receiving site specific Institutional Review Board (IRB) approval at multiple
locations. The student researcher approached two junior colleges in the Pacific Southwest
44

Valley area to recruit possible research participants. These two junior colleges were chosen due
to the high enrollment of Asian American college students. One junior college, fictitiously
named Eastside City College (ECC), did not reply to the researcher’s email inquiry regarding the
possible inclusion in the study. Another location to be named, Northside City College (NCC),
was extremely interested in the study. The Director of Psychological Services at this local junior
college agreed to assist the student researcher by canvassing their existing database of current
students. Unfortunately, none of the junior college students who were identified as fitting the
criteria for inclusion volunteered to participate in the study. All participants in the study,
therefore, were students from the main campus of the Pacific Southwest University. In the case
studies below, the identifying characteristics of participants have been changed in order to
maintain their confidentiality.
As a result of the recruitment procedures used in the present study, three Chinese-
American college students participated in the study, completing each of the two interviews and
writing a journal in the interval between the two interview sessions. All three participating
students were female, two of whom were in their sophomore year and the last of whom was a
senior. The life histories of the students are presented and analyzed in Chapter 4, with special
attention to how they manage their ADHD condition in the midst of meeting the other demands
they face, including their educational careers and social (i.e., personal, familial) life.
Human subjects protections: Participants were required to read an informed consent
document that attested to their voluntary participation in the study and agreement to allow audio
recording of the interview; verbal consent of all participants were obtained in accordance with
the IRB approved procedures. All interviews were conducted in the Learning Library, which
was reserved in advance by the student researcher. This afforded privacy to the interviewees so
45

that they would be able to freely discuss their life histories and experiences with ADHD. Any
personal identifiers mentioned during the interviews (including names of persons, places of
business, states/cities, and streets) were stripped or modified in the transcriptions in order to
maintain the confidentiality of participants’ identities. All interview transcripts were checked for
accuracy and all digitally recorded files will be destroyed after a period of 5 years as specified in
the IRB application. Any participant who required follow-up care or requested information
regarding accessing mental health services was provided with resource information pertaining to
the Student Counseling Center, the Student Health Center, and/or the local county Department of
Mental Health operated and contracted clinics, as appropriate. Only one participant required this
case management linkage as the other two participants were already in treatment via external
providers or already receiving treatment services at the Student Counseling Center.
Data Analysis
Interview transcripts were coded to assist the researcher in recognizing the themes and
patterns that were present in participants’ interview statements. The focus of qualitative analysis
is on understanding the point of view of participants, including how they make meaning of their
experiences and develop practices and perspectives that are responsive to their personal or social
conditions or circumstances. Therefore, the analysis focused on identifying the different “ways”
of the Chinese-American student with ADHD: the different ways in which they managed facing
a diagnosis of ADHD, the different ways in which they navigated the K-12 environment (both
before and after diagnosis), and the different ways in which they confronted and continue to deal
with the challenges found in the college learning environment. The analysis, in other words,
focused on summarizing and comparing common threads as well as moments of divergence in
the lives and practices of interviewees. All interviews were digitally recorded and transcribed by
46

the interviewer. Transcripts were hand coded for themes, especially those pertaining to contexts
that influence ADHD experience. Coding resulted in identification of data that illustrated or
developed key domains of interest to understanding the ADHD experience of Chinese American
college students. Memos were written on the thematically grouped data, which in turn became
the basis for the writing and analysis in Chapter Four. The student research sought consultation
from his dissertation committee as well as sought out expert consultation from a qualitative
expert to ensure fidelity of qualitative discovery.
This project was especially keen on identifying how changes in the life course created
changing demands and introduced new stressors that can compound ADHD symptoms (co-
morbidity), and hence shift the contexts underlying their learning styles, coping strategies, and so
forth (Wilmshurst et al., 2011). In order to ground these shifts in the context of participants’
experiences, the following domains were addressed in producing the data analysis:
Psycho-social Dimensions: Religion, fraternities/sororities, social clubs, organizations, athletics
The focal point for a majority of college students is the social environment and
extracurricular activities that are available at a university campus. Although the priority of
attending an institution of higher learning is focused around learning the requisite knowledge and
skills relevant to a particular domain of interest (college major), the social community of the
university helps the student to learn about themselves in relation to others and is a source of
emotional/psychological respite from the daily academic demands. However, it can also
function as a distraction from one’s studies, and thus raises concerns about how students with
ADHD navigate and balance what can turn out to be competing demands on their focus. This
was evident in the case studies that are presented in Chapter 4.
Cultural and Ethnic Dimensions: Chinese, generation differences, acculturation, beliefs,
47

language, minority status
It is important to understand how cultural beliefs shape the meaning and experience of
ADHD for Chinese Americans, both during their childhood and once in college. Because
ADHD is a western construct through which certain patterns in thinking, acting, and feeling are
categorized as expressing an underlying psychiatric condition, it was clear that more assimilated
Chinese American families reacted to a mental health diagnosis in ways that differ from those
who hold more traditional viewpoints. The negotiation of this cultural overlay is fascinating in
its own right. In addition, because Chinese Americans are a visible ethnic minority, they likely
experience dynamics related to minority status (including the “model minority” myth) that may
create a unique complex of demands that shape how they incorporate a diagnosis of ADHD into
their identity and learning style. Issues relevant to culture, assimilation, “saving face” and social
comparison are highlighted by the case studies presented in Chapter 4.
Academic Institutions: college class (freshman, sophomore, junior, senior,
graduate/professional), GPA, graduation, academic classes, majors, disability services
Over the course of their educational careers, several points of relevance to academic
success are in flux: the cognitive development of the student, the difficulty of the learning
materials, the changing orientation toward understanding how education is personally
meaningful. Consequently, the interview data was analyzed for how the participant adapted to
and managed her academic journey. Perhaps some Chinese American students with ADHD
begin with ambitious goals, but scale them down over time. This was evident in the case studies
presented in Chapter 4 as all participants were high achievers and often were in the top 10% of
their high school graduating classes but report academic struggles once entering their college
programs of study. These questions about academic success, and the meaning of same, provided
48

a context for understanding the adoption, development, and abandonment of various learning and
coping strategies over time as well as resulting in the participants questioning their intellectual
ability and academic self-efficacy.
Primary and Secondary Supports: family and friends
These primary and secondary support systems are important factors to consider as most
individuals find support from family and friends. This is especially true for a majority of
Chinese Americans as well as the larger Asian American community. As a result, data analysis
here was directed toward understanding how the social network of the Chinese American student
with ADHD helps them makes sense of their disorder, provided a basis for support and
acceptance, and may impact their sense of self-efficacy.
Service Institutions: medical and mental health treatment, insurance, student counseling
centers, student health center, hospital, clinics, diagnosis, self-medication
Medical and mental health services are important to consider when viewing an individual
from a holistic lens. An individual’s physical health, psychological and emotional functioning
and their ability to access services to meet their unique needs were important to explore as these
factors can assist an individual’s overall well-being and academic performance. Therefore, the
interview data was analyzed to examine the circumstances under which Chinese American
students avail themselves of such services, differentiating by gender, generational status, and
social class. The kinds of treatment that students sought out or were given, including pharmaco-
therapy and/or psycho-social therapies (Faraone et al., 2000; Riccio et al., 2004) were noted and
compared to findings in the research literature on college students with ADHD more generally as
appropriate.
In addition, ADHD individuals may be found to be associated with higher levels of legal
49

involvement due to their impulsivity, higher risk-taking behaviors, limited insight and judgment,
poor problem-solving skills, and possible self-medication (Murphy and Barkley, 1996). The
interview data were examined for practices that relate to substance use/abuse/dependence that
may affect academic performance in light of Luczak et al. (2004) findings that Chinese
American college students have lower rates of alcohol dependence in comparison with Korean
American and Caucasian American college students.
Limitations of Present Design
The data obtained was restricted to Chinese American college students who were
sampled at the Pacific Southwest University. As a result, the data are not meant to constitute a
representative sample and this limits the generalizability of resulting findings. However, since
the review of the current literature reveals a lack of minority specific data relevant to ADHD,
this study aimed to provide a detailed account of the psycho-social and cultural factors that
shaped the experience of ADHD among Chinese American college students and showed how
these same students negotiated their academic community in order to be successful learners.
The findings from this study may prove useful in offering guidance to future researchers
about key variables to build into larger scale studies utilizing randomized samples drawn from
multiple colleges and universities across the United States. Enlarging the sample to be inclusive
of all Asian Americans could provide a useful comparison in regards to how Chinese Americans
with ADHD in essence function with their ADHD symptoms in comparison with other Asian
Americans and/or in comparison with other racial groups such as Caucasian, African American
and Latino college students.

50

Conclusion
A qualitative approach was implemented to afford the researcher with in-depth detailed
awareness of the psycho-social and cultural factors that shape the experience of ADHD in
Chinese American college students. Questions were asked of the participants that informed the
researcher as to the coping strategies that are implemented by these Chinese American college
students to assist them with navigating their academic environment in order to be successful
learners. Each participant was interviewed twice, for between two and four and a half hours
total. First and second interviews were separated in time by anywhere from one to two months,
during which time participants maintained a journal that documented their experiences from
daily life that were connected to their ADHD condition. Journals were collected at the time of
the second interview as participants felt that meeting for another time to collect the journals
posed to be a barrier to their coursework, exams and pending holiday vacations. All interviews
were digitally recorded with permission and transcribed to ensure accuracy of the data collected.
Any identifying information was stripped in order to maintain the confidentiality of all research
participants. The datum were transcribed, hand coded which allowed the researcher to draft
memos integrating data drawn from diverse interviews and participants into thematically
organized analyses focused on key points of interest and importance, and in line with the
domains of interest outlined above. The analysis allowed the researcher to draw conclusions and
make inferences that may assist programs, services and colleges/universities to enhance and/or
create services to meet the specific needs of the Chinese American college student with ADHD.

51

Chapter 4
Findings
Introduction
This chapter presents findings from the in-depth, life history interviews that were
conducted with the three Asian-American female college students who were recruited using the
procedures described in Chapter 3. This research took a case study design, an approach that
entails treating each individual in a holistic way, examining the diverse influences and
experiences that come to characterize each research participant’s biography. A life history
approach allowed the researcher to extrapolate core domains of interest - including psycho-
social, cultural, primary and secondary supports, access to services, and academic domains - that
contextualize the ADHD experience for the research participants over the course of their past and
present. The characterization of the three research participants offered herein highlights both the
main aspects of their lives, their turning points with ADHD, and their ongoing management of,
and struggle to understand, their ADHD condition in the context of lives that are entering
adulthood in a collegiate environment. Having sketched individual portraits of how each research
participant’s experiences with ADHD are contextualized by the core domains of interest, the
analysis develops common themes and issues in the three participants’ interviews, quoting them
extensively in the interest of preserving their unique histories, voices, and perspectives.
One of the main findings from this research is that these college students continue to
work through issues with their family in the course of managing and making sense of their
ADHD. Issues for the students stem from several sources: from pressures by parents with
expectations for success that are exacting and imposing, or who disagree about whether ADHD
is a true medical condition, or who have concerns about the possibility that ADHD medication
52

can prove addictive. These parental pressures can in turn result in the student feeling as if
though she receives less than ideal parental support as the student faces adverse circumstances.
For two of the three participants, many of the stresses related to ADHD and familial relationships
ultimately seem to center around differences in the extent of acculturation between/among
students and parents. As second generation Chinese Americans, the students are more exposed
to and involved with Western belief systems and values, which can be a point of contention in
disagreements with their parents over the meaning of mental health in general and their ADHD
in particular, and what sort of prominence or importance mental health and ADHD should
therefore be granted.
Case Study: Mary Ann
“Mary Ann” is a 19 years old sophomore from the Bay Area of California. She is
currently studying business at the Pacific Southwest University. Mary Ann was diagnosed with
ADHD over the summer break of her freshman year in college. Mary Ann reports improvements
in concentration, motivation and self-esteem this academic year as compared to her first year in
college. Mary Ann believes that much of this improvement is a direct result of taking the
stimulant medication, Adderall. However despite the improvements in functioning, Mary Ann
reports having conflicted thoughts regarding the need for the medication. Mary Ann mentions
experiencing possible withdrawal-like symptoms, such as lethargy, decreased motivation and
focus, as well as loss of interest, when not taking her medication. She continues to have internal
struggles regarding the necessity of medication therapy despite the positive gains she obtained
during her initial semester on it. Mary Ann stated that she was able to function for the past 18
years of her life without medication and uses that as a baseline comparison and rationalization
against the possible need for medication. Despite her internal conflict regarding the necessity of
53

medications, Mary Ann stated that she will continue with her medication regimen and consult
with her medical provider to further monitor her progress as her academic performance and
overall functional status has improved.
Mary Ann comes from a biracial family of origin. Her father is a first generation Chinese
American and her mother is Caucasian (Jewish). Mary Ann describes her childhood as having
had the best of both worlds. She reports that she never had to choose one culture over the other.
Growing up, Mary Ann was raised in a family where both cultures were openly embarrassed. “I
had the best of both worlds. I was able to celebrate Christmas and Hanukah,” she said. She also
added that many of her friends and same age cohorts during K-12 were also biracial, which
added to her sense of normalcy. From time to time, she was called derogatory names such as
“White washed” but she thought it was comical and did not read much into these harsh
statements made by her other Asian peers. In terms of mental illness, Mary Ann reports that her
family is very supportive of her issues and struggles. This may possibly be due to her father
being a physician and her mother being an attorney, and to her first generation Chinese American
father being well-acculturated into mainstream American society.
Mary Ann cited her parents and siblings as her main sources of support, both in her
current life as well as when she was growing up. Although some of her family members were
reported to have some reservations regarding the need for medications, since then they have
come around to support her taking medicine to treat her symptoms because of Mary Ann’s
noticeable, positive gains in her academic performance, improved focus and organization and
enhanced self-esteem. There is some tension between Mary Ann and her mother, however, over
whether she should continue to take her medications when she returns home during holiday
breaks. The mother questions why Mary Ann should be taking medication that is supposed to
54

help her maintain focused attention on academic pursuits when she is not pursuing academic
activities. The mother tells her that she should be “tapering off” her medication under such
conditions, resulting in Mary Ann having conflicted feelings over whether or not she should
cease or reduce her treatment, especially since she notices what she understands to be
“withdrawal effects” when tapering her dosage independent of medical advice. These trips home
have in turn led Mary Ann to more broadly question whether she is developing an addiction to
Adderall, introducing another source of tension for her that she must manage in her daily life
while back at school.
Mary Ann is the youngest of 3 siblings. Her older brother is approximately 30 years old
and pursuing a Ph.D. from a prestigious university on the west coast. She reports having a good
relationship with him although she feels that they do not have much in common due to their age
differential. Mary Ann has one older sister who is approximately 22 years old and currently
attending medical school. Her sister initially was against Mary Ann taking any psychotropic
medications as her sister believed that the medications would alter Mary Ann’s behavior.
However since that initial reaction, Mary Ann’s sister has had a change of heart due to the
positive gains made by Mary Ann post medication therapy.
At school, Mary Ann’s main sources of support are her best friends, who also happen to
be her roommates. The roommates understand that Mary Ann has been diagnosed with ADHD
and is taking medication for it, and they express acceptance of her situation, especially since
they, too, have noticed positive changes in Mary Ann as a result (including her having become
the cleanest and most organized member of the household, quite a reversal from before).
However, recently Mary Ann’s father has purchased a lock box for Mary Ann to store her
medication safely in her apartment, since it appears that some of her medicine has gone missing.
55

Mary Ann suspects her roommates have been pilfering her medicine, but she refuses to confront
them about it. This has introduced yet another source of strain for Mary Ann, as she wonders
whether her best friends and roommates are taking advantage of her, leading her to question how
truly supportive her friends are.
Before her diagnosis, during her K-12 education, Mary Ann participated in
extracurricular activities such as basketball and volleyball as well as interning for an agency
providing social-media support. During her post-secondary education, Mary Ann participated in
Sorority rush but did not find a house that was compatible with her personality and interests.
Since being diagnosed with ADHD, and as she has tried to focus more on her academic efforts,
she has limited her extracurricular activities to two academic clubs at the Pacific Southwest
University centered around business and has become involved with part-time contractual work
for the agency where she interned during her K-12 education.
Mary Ann is currently under the care of a psychiatrist from the Bay area. She reports that
she was seeing a psychologist sporadically during her K-12 education for family-related
“adjustment” issues, but only briefly. She does not believe that she requires ongoing psycho-
social interventions at this time. Mary Ann feels that her primary concern is adjusting to her
medication regimen as she had been on several different medications before being prescribed
Adderall. She speaks with her provider every few weeks to ensure that the medication is
monitored and adjusted to meet her individualized needs. Mary Ann did not endorse any
medically related problems.
Mary Ann was not diagnosed with ADHD during her K-12 education. As a result, she
did not receive any special accommodations for her disability. Mary Ann did not realize that she
56

had ADHD until the summer of her freshman year of college when she saw a psychologist for
testing through a local educational center in the Bay area. Mary Ann believes that high school
was more structured, the coursework was easier, the classes were shorter in duration and that
teachers were more hands-on in their students learning. Therefore, her ADHD symptoms did not
seem to impair her academic performance to the extent it did during her freshman year of
college. Comparatively in college, students are expected to demonstrate the use of more self-
regulated learning and exercise self-discipline and time management skills which are related to
executive functioning. These executive functioning tasks are largely impacted by ADHD
symptoms as mentioned in Chapter 2.
While in college, Mary Ann reports that she has received special accommodations for her
disability in the form of a note taker to assist with taking notes during lectures, having time and a
half on exams, having the ability to utilize computerized texts to assist with her academic career,
all of which were arranged through the Office of Disability Services. These services appear to
have greatly assisted Mary Ann to improve in her academic performance as demonstrated in her
improved GPA during the Fall semester of her sophomore year (Fall 2011). As a result of these
accommodations, Mary Ann reports that her friends/roommates are somewhat envious that she
receives these services to minimize her disability. Some of her friends and acquaintances
attribute her improved academic achievement to her having extra time to complete exams as
opposed to her innate intellectual ability. Mary Ann reports that this minimization of her
academic performance has caused her internal conflict and created self-doubt regarding the
fairness of receiving these additional support services. Despite having this internal struggle,
Mary Ann is excited about her overall functional ability and mental clarity when on medications
and is committed to continuing with her medication regimen as prescribed by her treating
57

provider, as well as availing herself of the accommodations facilitated by the Office of Disability
Services, which she has come to greatly value.
The academic transition to college proved to be quite a challenge for Mary Ann. During
her K-12 education, Mary Ann would read, highlight, re-read and create flashcards on various
subjects to assist in her learning. However when she entered college, Mary Ann found it difficult
to continue in this way as the amount of reading was overwhelming, and she found her
development of self-regulated learning skills to be greatly impacted by her inability to focus,
read and retain information. As a result, her grades were below what she was accustomed to and
she lost faith in her abilities. Mary Ann was frustrated in that she was spending a lot of time
trying to study but not getting much of a return for her effort. Furthermore, Mary Ann found the
classroom environment in college to be a challenge: lectures could be hard to follow and her
peers were often on their computers, surfing the internet (e.g., Facebook or Twitter), or playing
computer games. Although she has been able to focus more since taking her medication, the
classroom environment itself continues to be a challenge. When asked why she doesn’t simply
reposition herself in the classroom, for example, by sitting in the front row where nothing will
interfere with her view of the professor or chalk board, she replies that she doesn’t want to feel
like an outcast. Thankfully, many of the professors have caught onto the fact that students are
using their computers and smart phones in class for subversive purposes and have banned the use
of gadgets in class, which Mary Ann finds a source of relief from the distractions that professors
previously unknowingly allowed.

58

Case Study: Cecelia (CeCe)
“Cecelia,” or CeCe, is a 21 years old senior (graduating Spring 2012) who relocated from
the east coast to the Pacific Southwest in order to pursue her studies in Bio-Medical engineering
at the Pacific Southwest University. She receives a partial scholarship (half paid tuition) in
recognition of her strong academic performance. Despite the recognition, CeCe was recently
diagnosed with ADHD (in her junior year). Her interest in the research project seemed to stem
from a genuine interest in making sense of her own experience with, and relationship to, ADHD,
a condition she is still becoming acquainted with and which she is not entirely sure she
understands or believes in. CeCe reports having conflicted relations with her family, which
appear to have been folded into the process of making sense of her new ADHD diagnosis. CeCe
is ambivalent about her recent ADHD diagnosis, and about mental illness more generally, as
ADHD and mental illness are obscure concepts for her, not being grounded in the “hard” data
that she is accustomed to in the natural sciences. This desire to make sense of her ADHD
condition, coupled with her familiarity with the rigorous methods of the natural sciences, drives
her interest in seeking and receiving psychological testing to validate her recent diagnosis.
CeCe is a Chinese American female from an intact family of origin with one younger
sister. Her parents were both immigrants from the southern region of mainland China and
emigrated to the United States primarily to pursue an advanced education. CeCe’s parents are
highly educated: both parents have obtained their graduate degrees (her father has a Ph.D. in a
science field and her mother has a Master’s degree in the engineering field). CeCe’s family is
very traditional by most measures -- holding beliefs and observing customs and practices found
among those who have not left mainland China. Accordingly, CeCe’s parents have little
understanding of the Western conception of mental illness or its potential consequences. CeCe
59

does not openly discuss her ADHD diagnosis with her parents, in particular her father, whom she
characterizes as the family patriarch, and with whom her relationship is strained. Her mother is
aware of Cece’s ADHD diagnosis, but doesn’t take it seriously; Cece has refrained from
informing her father altogether. CeCe considers her father to be rigid and inflexible in his ways
of thinking and overbearing in his manner toward her, especially in his strongly expressed
inclination to map out her life (confusingly so, since his ideas about what CeCe should do with
her life are constantly being revised, leaving CeCe confused about what he wants her to do or
what is acceptable to him). CeCe feels that her father’s strong subscription to traditional Chinese
ideals and values leaves little room for her to diverge from his perceived notion of “success”. As
an example, CeCe’s father did not want to attend her high school graduation because he viewed
this occasion as a “given”, a transition that was to be expected and not extraordinary, such that
celebratory praise and festivities were unjustified.
CeCe believes that her father’s rigid Chinese beliefs and values have impacted her
academic and career goals as well as inhibited her from pursuing her true interest, which is in
various kinds of design, due to fear of failure and uncertain probability of socio-economic
success. As CeCe sees it, her father’s belief in the Chinese notion of “saving face” ends up being
used against her, as he pressures her to perform well, lest she embarrass him by being a failure
and reflecting poorly on him. However, because the father’s plans and expectations for CeCe are
always evolving, CeCe becomes confused, frustrated, and angry, to the point of exclaiming that
she “hates” Chinese culture.
Further marginalizing CeCe’s perspective and viewpoint, CeCe’s father expresses the
view that mental illness is a social construct created by Americans to rationalize or camouflage
their “laziness” and inadequacies. This is one reason that CeCe has refrained from informing her
60

father of her recent ADHD diagnosis: CeCe believes that her father, upon learning of her
diagnosis, would reply that CeCe was making excuses for her lackluster performance and that
she was in fact being “lazy”. CeCe’s father is clearly the dominant figure in her household, so
much so that CeCe’s mother, CeCe’s sister and CeCe herself often bond together as a method of
coping with the strained familial environment her father promotes, providing her with a source of
support (commiseration) formed under duress.
CeCe mentioned that she did not encounter any acculturation issues growing up, which
she attributed to the fact that most of her peer cohorts were also the offspring of Chinese
immigrants. Born and raised in the United States, CeCe considers herself to be Chinese
American and has been fully acculturated into American society, without any sense of
“adjustment issues.” If anything, her issues are with Chinese culture (as expressed through her
father’s rendition of it), which she finds to be problematic in many ways and less a source of
comfort than a set of stressors and obstacles to her well-being.
Because of the strained family dynamics, CeCe rarely goes home to visit her parents and
has instead tried to distance herself in an effort to be “happy” and live her life without being
overly parented. Further illustrating this distancing, CeCe is considering a summer internship
program in Germany after graduation to gain practical experience while simultaneously
precluding face-to-face interaction with her father. For CeCe, the true motive behind her
decision to go to Germany is to have an “excuse to travel” as well as for being “far, far away”
from her father. “Having fun” is unacceptable to her father, but masking the fun by saying that
what you are doing is in pursuit of knowledge makes it acceptable to him, so long as the pursuit
of knowledge is not done solely for pure enjoyment or for its own sake. (By the time of the
second interview, CeCe was becoming more reflective about her ADHD and her relationship
61

with her father, saying that she had come to the realization that she had chosen to go to school in
California in order to get away from her father.)
Having grown up in a privileged household, accessing services presumably would not
have been a problem for CeCe during her K-12 education had she sought to receive them, but it
is important to understand that CeCe was not diagnosed with ADHD until her college years. In
fact, CeCe did not initially seek out an ADHD diagnosis, nor was she aware that she presented
any symptoms associated with the condition. In the course of a conversation with a psychologist
at the Student Counseling Center, she was asked if she was willing to see a psychiatrist. The
psychiatrist to whom she was referred mentioned to CeCe at their first meeting that her
psychologist had referred her for an ADHD evaluation, stunning CeCe. The psychiatrist did not
think that CeCe had ADHD, because her grade point average (GPA) was too high (3.7), far
higher than most of her patients. The psychiatrist did not see any impairment requiring medical
treatment. However, after consulting with a second psychologist, the ADHD diagnosis was
confirmed. Despite psychological testing that confirmed the ADHD disorder, the treating
psychiatrist did not prescribe any stimulant medication to treat CeCe’s ADHD symptoms. CeCe
reports that her psychologist was puzzled by the reluctance of the psychiatrist to prescribe
medications. However, CeCe’s treating psychologist was able to validate the ADHD diagnosis
and assist her with accessing the disability services offered by the university.
In retrospect, CeCe thinks that her ADHD symptoms may have always been present.
However during her K-12 education, she believes that she was able to better mask her symptoms
as the class sessions were shorter, the course materials were easier, taught in a more regulated
environment, and the subject of scrutiny by her parents (“Have you done your homework?”),
resulting in a more externally structured engagement with learning, probably allowing her
62

symptoms to be contained. In college however, CeCe found learning to be more of a challenge,
getting swept up in the minutiae of her curricular instruction, failing to see the broader picture in
what she was being taught. After being diagnosed, CeCe had an “a ha!” moment, her learning
issues crystallized in a new light, and the diagnosis was in a certain sense comforting and
cathartic. Thus, although CeCe is ambivalent about the ADHD label, and is not sure she gives it
scientific credence, she has found that it has provided her with a source of insight into how she
processes and absorbs instructional material.
Since being diagnosed, CeCe has been receiving special accommodations from the
university. She feels that the extra time to complete assignments and extra time during exams
has been a primary reason for her academic improvement. Since CeCe is not medicated, she
finds it very difficult to focus and stay goal oriented to meet timelines and project due dates. She
is easily distracted, which exacerbates her frustration with herself. This was clearly apparent in
her journaling exercise as she discussed how easily frustrated she gets when she can not focus
and is tempted to play video games (i.e. Angry Birds) in lieu of studying for her courses that later
leads to heightened anxiety. With regards to studying, CeCe reports that she is not able to have
the TV on or any lyrical music playing in the background as she will shift focus from studying to
try to decipher the gist of the TV show or to understand the lyrics of the music. CeCe stated that
even surfing the Internet for class related research is difficult as she will have multiple web
browsers open simultaneously yet be unable to complete one web search in its entirety without
being distracted. CeCe reports that her lack of focus and organization make it difficult for her to
sufficiently plan ahead which often results in her “cramming” for tests and projects a couple of
days before the due date despite being given ample time to prepare for the tasks.

63

Case Study: Jinger
Jinger is a nineteen year old Chinese American woman from the Pacific Northwest. She
was born in China but raised in the United States, where she arrived when she was six years old.
Although her early years in the U.S. were somewhat challenging because she had to learn the
culture and language in an environment (the Southern U.S.) where she was the only visible Asian
in her classes, she felt more at ease once the family permanently settled in the Pacific Northwest,
mostly because there was quite a sizable number of Asians there, but also because the family
became more rooted in one place. Jinger’s parents immigrated to the U.S. from mainland China,
and Jinger is the only child in her primary family of origin. She says that her parents are
understanding of her ADHD symptoms and do not “push” her to excel, although Jinger’s parents
are both highly educated with graduate degrees. Her father has a Ph.D. in a science field and her
mother has a Master’s degree (unknown discipline). Jinger did not indicate that her parents
benchmarked her success by use of social comparison with others. Jinger is currently a
sophomore at the Pacific Southwest University majoring in architecture. She is on a partial
tuition scholarship based upon her high school achievement. However more recently, she has
been placed on academic probation as her grade point average (GPA) is currently 2.5, which is
below the 3.0 requirement.
Although she was more at ease in the Pacific Northwest, Jinger didn’t necessarily “fit in”
at school. She developed a reputation for being a “space cadet,” and she is still somewhat aloof
from others, having few friends (none of whom at the time of the interview were of Asian
descent). Jinger considered herself to be “strange” in high school, but she was very private about
how she felt - alone and different from others. Because she was unwilling to share with others
how she felt about herself, she did not have the opportunity to discover others who felt the same
64

way, or learn about a possible medical basis for her condition. She assumed that this was just the
way she was. She did have problems focusing on, and staying interested in, her studies when in
high school, but before her diagnosis, these problems were not an issue because her grades were
strong (she reports having a 3.75 GPA in high school). In fact, Jinger came across her ADHD
diagnosis by accident, while still in high school. She was surfing the internet and came across an
ADHD checklist of symptoms as a method of self-assessment. She was able to endorse most if
not all the criteria for ADHD on the self-assessment. Next, Jinger provided that same self-
assessment inventory to her friend to rate Jinger from her friend’s viewpoint. The results were
similar to those obtained by Jinger. This provided Jinger with the necessary data to approach her
parents about her findings.
Jinger’s parents responded initially in a supportive way. Her parents “always knew
something was wrong with” her, and now Jinger’s parents sought out mental health services to
address her ADHD symptoms, namely, medication therapy. Despite their initial support,
however, Jinger’s parents eventually stopped her medication therapy due to possible side effects
she was experiencing, including feeling slowed down in her thinking. In addition, Jinger’s
parents do not believe in mental health, which may also account for their discontinuing psycho-
pharmacological intervention. She quotes her parents as saying that ADHD “didn’t exist in
China, it was made up just to sell drugs in America.” However, since Jinger is their only child,
her parents may have wanted to provide her with the best opportunity to perform well
academically, hence were initially open to allowing Jinger to be given medication therapy,
despite being dubious about the applicability of the ADHD label to Chinese nationals.
Jinger’s condition appears to have “spilled over” beyond her academic pursuits to affect
her daily routines and personal relationships. Jinger reports that she has lost both her apartment
65

keys on several occasions and also lost her cellphone five times. She loses track of time. She
talks about having difficulty successfully interpreting social cues, such as those expressed non-
verbally. Jinger often forgets to perform housework chores, such as forgetting to take out the
trash, even though she notices that the trash bin is completely full with garbage spewing out of
the top-- it just doesn’t cross her mind to empty the trash container. This lack of consideration
infuriates her roommate and causes tension in the apartment. Jinger feels that the relationship
with her roommate and her is strained, so much so that her roommate has on occasion refused to
open the apartment door so that Jinger can enter the premises.
Jinger is not currently in any treatment services. However, Jinger acknowledges that she
was performing better academically in high school when she was taking stimulant medication
than she is now in college without medication therapy. Therefore, Jinger is considering
restarting her medical regime at the Pacific Southwest University and has also inquired about
how to access mental health treatment services from the Student Counseling Center. Jinger
acknowledged her parents’ beliefs regarding medication, but notes that since she is now of
“legal” age, she can consent for treatment services on her own.
Based on her statements, it seems that Jinger is willing to do anything that she thinks will
assist her in performing at a higher caliber, lest she lose continue on a path that will endanger her
scholarship. Jinger stated that if she did not raise her grade point average (GPA) by the end of
her Fall Semester (2011) that she would need to consider leaving the Pacific Southwest
University and transferring to a local junior college in the Pacific Northwest. She has notified
her parents that she is on academic probation, but she has not been explicit about the threat to her
continued status as a funded student at the university in good standing.
66

Analysis: Themes and Variations in the Three Case Studies
Overview

Many common themes were found among the three case studies. First, it was apparent that in
each case, the family is an important source of support and coping, but that this relationship can
be tense and a source of strain for the student. The degree of acculturation into mainstream
American customs, beliefs and traditions as well as the level of understanding of mental illness
directly affects parental viewpoints, which is evident in variations in how families viewed and
responded to the participants’ ADHD diagnosis and treatment. All the participants were high
achievers in high school but faced challenges upon entering their college studies. Each
participant reported similar difficulties adjusting to academic coursework in college, as
compared to their experiences in high school, where the course materials did not pose a serious
challenge. It was a shared sentiment among all “conversational partners” (Rubin and Rubin,
2004) that their respective ADHD symptoms were easily masked in high school due to the
shorter class duration, extensive teacher involvement and parental oversight coupled with less
challenging course material. While in college their ADHD symptoms became more pronounced
as class sessions were significantly longer in duration, coursework was more difficult, and there
was less oversight by professors, since students are expected to be mature self-regulated learners;
furthermore, they were living away from home and away from daily parental influence. Finally,
each of the women seemed to be going through a process of making sense of what their ADHD
meant to them, including how they felt about the diagnosis itself as well as their treatment
options, although in each case it seems that the diagnosis did help them make sense of their past
behavior, troubles in school, or personal choices.
What follows is a presentation of prominent themes from the interviews, with an
emphasis on allowing the voices of the research participants to come through clearly.
67

Family History and Parental Educational Attainment
It was noted in all the case studies that these participants were raised by parents who had
high levels of educational attainment. In all three cases, each participant’s father held a doctoral
level degree (Ph.D. or M.D.) and each participant’s mother held either a Masters level degree or
Juris Doctorate (J.D.).
Mary Ann: “Well, my dad’s a dermatologist and he like went to Med School. He’s
pretty knowledgeable about a lot of that. My mom was actually an attorney. Umm… so
both of them know about mental illness and I think they understand it and I think that
they… umm… I don’t know. I think they think it’s a problem but they are supportive of
me taking medication for it. Umm… yeah.”
CeCe: “Oh, umm… they’re both like graduate degreed. My dad has a Ph.D. (in the
sciences) and so he thinks that Physics is like the ultimate meter of intelligence because
everyone hates Physics and only like Physicists are able to do Physics. And I never
learned Physics properly so I was never… Well, he’s really not a Physicist. He ended up
doing like software consulting work just like most Chinese parents that I know ended up
doing some kind of software computer OCS stuff because it’s easy to get a job
comparatively It’s like easy at least when they were coming out of school, it was easy. It
was the ‘Big Boom’, that’s why every single one of them is doing computer stuff. And
my mom got a Masters in an engineering field too but I don’t think she’s really suited to
it at all. She just did what was practical.”

Jinger: “Um. My dad has a Ph.D. and my mom has a masters.”
The parental level of educational attainment may have a direct impact on the family’s emphasis
on having the children perform well academically. On the one hand, this seems to have made the
families supportive, at least initially, in terms of being agreeable with the idea of their daughters’
receiving assistance for the ADHD condition, where this was disclosed. However, at times it
may be that the family’s emphasis on superior academic performance created demanding
expectations for the children that were their own source of stress. In that sense, it may be that in
the case of high achieving parents, parental support for children with ADHD can be a double
edged sword. Furthermore, the support that is offered may not be entirely authentic to the extent
68

that first generation Chinese American parents do not give credence to the idea of ADHD itself,
or have issues with the medication therapies that are often part of its treatment.
Familial Dynamics and Support
One participant reported that her father’s expectations for her were often unrealistic and
constantly fluctuated, resulting in her feeling inadequate at meeting his seemingly contrived
benchmarks for success. This uncertainty led to a strained relationship between her father and
the rest of the family. The other two interviewees endorsed positive and supportive relationships
with their fathers, which resulted in their feeling a greater sense of self confidence, support and
validation. Respondents reported that the level of parental understanding of mental illness had
ultimately impacted their own internal belief in mental illness and their diagnosis as a student
with ADHD. For instance, CeCe stated:
I think my dad doesn’t believe in it. And I think my mom doesn’t really know what to
think. I think her unconscious inclination is to not believe in it because it’s foreign to
them and I understand because I wasn’t raised with mental illness being a thing. So I
don’t, I don’t have a real deep inclination towards believing in it. So it’s kind of a
process right now or I believe in some mental illness and then like some mild versions
I’m not really sure what that is anymore because it’s like in the spectrum of being really
like dysfunction and being functional and then once you get toward the functional, I don’t
know any more what it is or if it’s just their personality. Maybe it’s just their personality.
It seems like assigning a dysfunction to just a certain type of person and I don’t know
what to think any more but I think (my mother) definitely believes in extreme mental
illness like people who literally hallucinate and things like that. I think Asians are pretty
okay with that and realize that those people are actually insane and like they need help
and stuff. But once you’re… seen to be coherent and especially if you’re smart than they
like to ignore the mental illness is like a thing because. I remember in Chinese school I
would see lots of boys who had… there was one boy who I thought had some serious
problems. I don’t know. He seemed pretty anti-social to me but he was 10. I was like,
that kid is pretty evil and I don’t even understand what he’s going to be like when he
grows up. My mom was like it’s okay, he’s a genius at math. I’m like how does that
change anything? Why does that even matter? Why is it okay that he’s like… I think
there’s something really wrong with him but like because he’s so smart it doesn’t matter.
Like it’s okay that he’s like, might need help with something else but because he’s good
at math, it’s okay.

69

On the one hand, CeCe feels unsupported by her father, who has stringent demands on her and
who does not believe in mental illness; accordingly, he doesn’t take ADHD seriously. Thus,
CeCe has yet to disclose her diagnosis to him, and in fact believes “it will go very badly” when
she finally does disclose her condition to him, since he does not believe in “conditions” requiring
specialist treatment or medical intervention, whether physical or mental. On the other hand,
CeCe is perplexed by how her mother thinks about mental illness, as she apparently believes that
being proficient at certain intellectual tasks in some sense invalidates the possibility that that
person has mental health issues: the intellectual ability voids out the mental illness. The result,
then, is that CeCe feels she cannot count on her parents to support her through her journey in
managing a life as a woman with ADHD. These concerns about the parents’ views on mental
health occur against a particular backdrop provided by her earlier years in school: although
CeCe was always a high performing student, regularly pulling down a 3.7 GPA, she never felt
she had performed well enough to please them. Her father, for example, would always point to
peers who had outperformed her, surpassing a 4.0 GPA. In this sense, the discovery that she had
ADHD likely reawakened a number of conflicting feelings in her about her adequacy and also
her ability, feelings she is exploring with a therapist, rather than her family.
Comparisons to others, in her case to her sister, were also important to Mary Ann’s
experience, but the process and dynamic were different: less competitive, perhaps, though the
discovery of her ADHD allowed Mary Ann to have an aha! moment, one that clarified why she
learned differently than her sister, as seen in the following excerpt:
(Interviewer: And how did you do in high school? What was your GPA like then?)

I think 3.8 unweighted. Umm… but another thing my family realized was a kind of sign
was that my older sister just has no signs of ADHD and she’s very very smart and there
has always been a difference between us. She’s the type of person who hears things in
class and doesn’t do the reading but she does the reading even though she doesn’t have to
70

and just… it’s not that she’s smarter than me it’s just how she remembers things and
processes things is very different than for me and for other people in other ways besides
that.

(Interviewer: And how does that make you feel that there’s a difference?)

Umm… well it didn’t make me feel great but now that I know that it’s natural problem
that I have ADD, it makes me feel better about it. It’s not that I’m not as smart as she is
it’s that I process things differently than she does…

(Interviewer: So it sounds cathartic for you when you found out that you had ADHD?)

Yeah… it was just a relief but when he told me, ‘how do you feel are you okay with
this? Are you upset?’ I told my friends and they said, ‘I’m sorry.’ I said, ‘no, it’s a good
thing cause I can get help that I need and I’m gonna do better.’ I wasn’t that I couldn’t
read or pay attention. Like it wasn’t my fault I guess… yeah…

Unlike Cece, Jinger feels that her parents have been really supportive of her from the time of her
diagnosis and have always recognized the effort that she has put forth in her academic studies:
(Interviewer: How did your parents respond to the diagnosis?)
They were happy for me… especially, I’m really close with my mom and she knew that I
was just really struggling last year and it wasn’t that I wasn’t putting effort in. Like I was
putting in all the time that I had to study but I was putting in so much time and then not
getting good results. Like I don’t mind putting in lots of time studying if I’m going to get
an A then I’m happy about it but it was to the point where (I thought), why am I even
studying?
(Interviewer: What is your parents’ philosophy regarding mental illness?)
Well, my dad’s a dermatologist and he like went to Med School. He’s pretty
knowledgeable about a lot of that. My mom was actually an attorney. Umm… so both
of them know about mental illness and I think they understand it and I think that they…
umm… I don’t know. I think they think it’s a problem but they are supportive of me
taking medication for it. Umm… yeah.
Mary Ann also stated that her sister, who’s a medical student, was initially against her taking
stimulant medication, but was later supportive when she noted an improvement in Mary Ann’s
self-esteem that coincided with an improved academic performance:
My sister is actually in her 2
nd
year of Medical School so she keeps giving me her
opinion. At first she was really opposed to… she said she doesn’t like behavioral
altering drugs because she doesn’t think it’s right. She thinks that I should just adjust my
71

habits kind of but then she saw how much better I’m doing this year and it’s not just
doing better in school, it’s like a confidence thing as well like I’m putting in effort and
doing well. Umm… Now she’s actually supportive of it. She definitely thinks I have it
but she just doesn’t think I should take a pill to fix the problem and my brother because
he’s so much older than me. We have a good relationship and he’s really friendly and I
enjoy talking to him but we’re not like super close. We’re at very different parts of our
lives.
This support from her family has been a great source of comfort for Mary Ann as she reported
feeling heard and validated. This support can also be witnessed in how the family reacts to the
possibility that Mary Ann is experiencing side effects from her medications:
(Interviewer: Do you think there are any underlying depressive issues going on?)
I don’t think so... There was one instance over Thanksgiving where I didn’t take the
Adderall and I was really tired and really emotional a day. I just wasn’t social and I
wasn’t seeing my friends out. And then I was talking with my family and my sister and
then they confronted me and wanted me to talk about it. They thought I was depressed.
They wanted me to see a psychologist and change my medication. I didn’t really want to
do all that and I didn’t really understand. And it scared me too but I felt really bad for
scaring them. It never happened before and it hasn’t happened since. It’s not depression
because it’s not long-term but I think that the week before Thanksgiving, I was just
getting 3 or 4 hours of sleep and then 3 or 4 hours of sleep so I just needed to crash and
like restart. And I just felt comfortable enough to have a break down at home instead of
like having it in front of my roommates. That was the only instance where I thought that
or my parents thought that because it was scary for me too.
Issues related to parental support were also reported by Jinger, shaped somewhat by a
limited understanding of mental illness and ADHD by her family. Jinger reported that once she
was diagnosed with the ADHD disorder that her mother became proactive to learn more about
the disorder via purchasing books on the subject:
Umm… my parents are really concerned. They weren’t really sure that (ADHD) actually
existed. I mean I’m still not sure if it actually exists. I’m not sure if it’s like a mental
illness. I just think it’s a set of symptoms that are just found. There’s really not a way to
fix it. I’ve been on medication… umm.. it worked but it also would make me feel like
kind of odd because it’s just not my personality and I’m just known for being impulsive
and like I just do weird things that’s just who I am. So like… My mom bought a ton of
books when she found out I had it.
72

(Interviewer: So she was trying to keep abreast of the literature. Oh great. How did that
make you feel to have your mom on your side?)
They didn’t mind that. They were supportive or whatever of any illnesses that I had. They
just didn’t want me to be on medication was their main concern…
(Interviewer: After you mother read some of the literature on ADHD did she say
anything relevant to the cultural experience being Chinese or Chinese American with
ADHD or did it not jive well with her?)
She said that it didn’t exist in China. Like, it was just made up to sell drugs in America.
In Jinger’s case, parental support had its limits. They had her taken off the medication therapy
she was receiving, despite Jinger’s belief that her medication was helping her in her studies.
Although the parents felt it was important to help Jinger achieve academically, they also did not
have faith in the ADHD diagnosis or the medical treatments that are used to control it, resulting
in effectively undermining their daughter’s efforts to successfully manage her condition through
medication therapy.
Secondary Supports
Secondary social supports are a large source of coping for individuals, especially when
they are away at college, where parents are unlikely to be immediately present and when students
are likely to be in the course of establishing stronger, independent selves. This was not any
different with regards to these three participants. Some of the interviewees reported feeling
supported and validated by their peers, while other were reluctant to share their diagnosis with
their friends, or had conflicting experiences with peers with whom they had shared their
diagnosis. Mary Ann stated that her friends were mostly supportive of her need to take
psychotropic medications to treat her symptoms and diagnosis, but were dismissive of her need
for reasonable accommodations for her disability. She says that her roommates are supportive:
73

Definitely with the organizational aspect. I lived with one (roommate) in the dorms last
year and the other two were our neighbors in the dorms. Last year, I was the messiest,
but this year I’m the cleanest and they see how much better I’m focusing and doing in
school. The only thing I have with them is that all 3 of them have taken Adderall for like
finals and stuff and I had never given it to them. I had gotten to the point and I think I
said this last time, I told my parents that I felt uncomfortable leaving my medications at
home so I got a lock box and I think that was kind of weird with them at first but I don’t
know. My dad told me to blame it on him so I did. They kind of left it alone…
(Interviewer: Do you think they have stolen your medication before?)
I don’t know. I don’t want to start thinking like that but it came to a point where I was
keeping track of the days that I took it. I felt like things were running out too quickly.
Umm… those are not only my roommates here but they’re also my best friends here and
I don’t want to think that they did that or that any of my friends did that really. So having
a lock box really helps to eliminate the suspicion and question.
(Interviewer: Do they look at you differently?)
I think at first it annoyed one of them, Carla (fictitious name), the one I lived with last
year and this year who is literally my best friend, just because it seemed like I didn’t trust
her but I didn’t say that…
(Interviewer: How did they know that you had a lockbox unless they were looking for
something?)
I mean... I told them too. It came in the mail. It was big and at first, I really didn’t have
a system for it. I was taking something out every day but now, I have one of those pill
boxes and I do the lockbox like once a week and put the pills into the pillbox. So this way
if Wednesday is gone, then I’ll know and I can keep track of it a lot better. The only time
I felt pressure was when they asked me for it and I had to say ‘no’ and then I felt like they
may have taken it. That would be it.
(Interviewer: Do they still ask you for it now?)
No. But they still get it. I don’t know. It’s just weird. I just really didn’t understand
how people do that. Umm… There’s no point in getting upset. I just think it’s
unnecessary. Carla, she’s one of my roommates who would pull two one-nighters all in a
row, cram, pull out two papers and then not do anything for two weeks and then for the
next couple days after, she’s like my body hates me. I was like up all night. And I’m
like why did you do that? And I don’t think it’s more effective. Last year we had a class
together and I did better but she took the Adderall too and she didn’t do better. I don’t
know. It’s kind of a waste of their own money.
The topic of college students abusing prescription medications as a study aid has been widely
reported in the media and on the Internet, including social networking sites. This passage
illustrates the issue through a real-life experience as accounted for by someone with ADHD.
74

Friends and roommates may perceive the Adderall as providing a student with a leg up on her
studying and test-taking, and hence invoke claims of friendship to pressure her to share her
medication. As a result, the student with ADHD may be torn about whether her illness or her
friendships should assume priority.
Mary Ann stated that her friends are a large part of her support system and she relies on
them to assist her in coping with daily struggles. Mary Ann feels that it has been challenging for
her in dealing with “normal” developmental issues while simultaneously trying to cope with and
make sense of her ADHD diagnosis. However, she reported that they sometimes are dismissive
of her diagnosis, or minimize its importance in her specific case, as shown in this excerpt:
Another thing that one of my friends say is that everyone has ADD to some extent and
it’s just a matter of getting tested and diagnosed but I disagree with that and I’ve told her
that. Yeah, I think they lose track of understanding why I get the accommodations that I
do and why I have the prescriptions I do.
(Interviewer: Do you think in their mind that you’re lying?)
I don’t think they think I’m lying. They may be thinking that I’m taking advantage of
that but I don’t understand that. I don’t think they think I’m lying. I think they know I
have it. I got tested all summer for it. I know I have it. But I don’t think they think it’s
necessary.
(Interviewer: Does it really matter what your friends think?)
No it doesn’t but at the same time it does because my friends are very important to me.
And I’m someone who needs balance. I need to be social and be happy and I think that I
may be making them sound a little worse that they really are.
(Interviewer: They don’t sound bad. They just sound like normal teenagers or young
adults.)
Yeah. They are and they’re immature but I’m immature, too, to some extent. One thing
that teenagers do is that we assign blame to things. Like, oh the teacher was bad or it
wasn’t really fair and this is just another way for them to do that. Sometimes, I’m just the
scapegoat for that.
(Interviewer: I think you hit it right on the nail. You’re the scapegoat and sometimes it’s
hard to take ownership of some of your deficiencies.)
75

Yeah. But when that happens, they’re just wasting their own time. They’re not making it
any better for themselves.
By contrast, Jinger reported that she did not inform her friends of her ADHD diagnosis
because she did not want to be perceived to be “weirder” than her friends think she is already.
This reluctance to tell even her closest friends illustrates the internal conflict that Jinger may be
experiencing. In this excerpt, Jinger has been asked to elaborate on what she means after she has
said she “does weird things”:
Like… I don’t know. I would just like (do) weird hand motions. Umm.. I would just
ask things that were totally out of the blue. I would say things that don’t make sense to
other people. Well, I don’t know if that has anything to do with ADHD. And then like I
sometimes don’t listen to people. I am usually dismissing sometimes.
(Interviewer: You said earlier that your family doesn’t really believe in mental illness or
ADHD. What caused you to feel like that?)
Well they told me so…
(Interviewer: They just told you straight out?)
Yeah. Yeah…
(Interviewer: How did that make you feel?)
Umm… it was just like, I think I was just going through a weird identity crisis because a
lot of my friends don’t believe in it so I didn’t tell a lot of people. Umm. It’s just like a
weird like, what’s the word… what a weird thing to be attached with. You don’t want
people to think of me and think of that. Umm…
(Interviewer: What did your friends think about that? That you had ADHD?)
I only told like 2 or 3 people. And then some people didn’t believe me. And other people
would be like that’s weird or that’s interesting or like I can see that. Yeah.
CeCe, on the other hand, was able to discuss her ADHD condition with a friend who was
also diagnosed. Their discussion turned into an effort to have a better understanding of the
symptoms and how to manage them. Their talk helped CeCe have a different perspective on her
ADHD condition, since her friend was also diagnosed later in his life.
76

CeCe: I guess I’ve tried to talk to the people I’m friends with who I know are ADHD
and talking to them about if they think this is an ADHD thing or is it just me or
something because I have a friend who got diagnosed really late in his life and he has a
lot of the habits that are really similar. Random things that I didn’t think… just waking
up in the morning or getting to morning appointments on time is a big problem because I
can’t wake up properly in the morning and I thought that was just a “me” thing and I just
couldn’t understand why there’s a lot of people who can just wake up in the morning and
like come to class on time or like go somewhere on time and not just wake up half asleep
and just feel like you just have to go back to sleep like resisting the urges. Like maybe
they’re just really good at resisting urges or do they not get them. He said that he has that
problem too and I was like, really! I thought that was just me who couldn’t get out of bed.
He said nope ADHD all the way.
Having a friend who is also diagnosed with ADHD, and who is also on the path of discovering
what it mean, can be profoundly helpful to the student with ADHD. Suddenly, a whole series of
habits and practices may come to be viewed as symptomatic of the medical condition, and not
just a problem of personality. Some solace may in turn be taken, because the problem is not one
of personal limitations, but of the “ADHD thing” that the student is trying to get treated or
manage. Interestingly, CeCe makes a firm distinction between herself and the ADHD condition,
implying that she has yet to integrate her condition into her core identity.
Culture
This section highlights the importance of Chinese ethnicity in how ADHD is
contextualized in the experience of the research participants. All participants in this study are
female and self-identify as Chinese American. Two of the participants reported that both
biological parents are of Chinese descent. One of the participants is biracial: her father is
Chinese American and her mother is Caucasian. The degree of parental acculturation into
mainstream American society appears to play a large factor in how mental illness is
conceptualized as well as the parents’ willingness to access treatment services for their
diagnosed family members.
77

CeCe reports that she has much resentment towards Chinese ideology, tradition and
culture. CeCe believes that she is often judged by how she measures up against an idealized
other, a social comparison that she resents. She stated that her father benchmarks her success in
relation to how she performs as compared to peers in her age cohort. CeCe reports resentment
over this stereotypical Chinese mentality, saying it has caused her to feel inadequate in her skill
set, knowledge base and caused her to be unable to fully pursue her intrinsic interests:
I think I know that (my mother is) not trying to make me feel bad, but she just can’t help
comparing me and like I (can’t) help comparing myself either, honestly, but so it’s just
like saddening. I feel inadequate because I’m not… I don’t have like ‘wow’ things as
much as those other people so. Like they’re all going to… I guess this is also related to
why I was stalking people I knew in high school on Facebook to see where they are now.
All the Asians have gone on to very predictably Asian places like umm… medical
school or doing Ph.D. or umm… investment banker. I was never that type of person like
I wasn’t really interested in doing the things that are really valued to the Asian culture so
I feel a lot of pressure to prove myself in those respects but at the same time I have no
interest in (them). So then I generally feel kind of like pulled in multiple directions and
am constantly comparing myself and (it) makes me feel like I’m doing less all the time.
Like I’m not as good as all these people I grew up with or went to high school with who
are also Chinese and (who) my parents know about. And then… my mom always said
like, ‘oh, our family is just not that good at school like we just aren’t so good at school
because we know all these…’

(Interviewer: Despite the fact that your parents are highly educated, she thinks you are
not good at school?)

Yeah. Yeah. It’s just a matter of how many ‘wow’ schools you have, like, you have in
your history. You know. Cause I don’t think we hung out with too many parents who
had like kids who ended up going to regular places. I guess in general that people did go
to college because we are from the wave of immigration were all the parents were already
college educated and they came here for grad school and so they met a lot of their friends
and they ended up settling in the similar areas. Like affluent, upper middle class areas
and they’re all college educated Asian Americans. They’re the first generation, then they
have their kids and so their kids are of course going to go to college because like they’re
highly educated already so like the baseline is that they are going to go to college but
‘where?’ is the question. Where, and what after that, and what kind of job they get, and
what industry? That proves to them how smart they are. It is probably the biggest respect
point. And then the intelligence is measured by like you know, the name of the school
you went to and whether you got into medical school, whether you got into a PhD
program and whether or not you have any other high paying job.

78

During the second interview as well as in her journaling exercise, CeCe described herself in
polarized terms, unable to reconcile her American and Chinese selves. On the one hand she feels
as if she is doing well academically, succeeding in acculturating and performing ably in her high
school and collegiate environments, and yet on the other hand she feels that she is not doing well
enough, because of what she attributes to the Chinese emphasis on outperforming peers in her
age cohort. This split then amounts to an inability to integrate her dual identity as a Chinese
American. Furthermore, the American emphasis on pursuing a career or area of study based on
what one loves to do is in tension with her parents’ emphasis on pursuing a course of study that
will give her a comfortable lifestyle, one saturated with the trappings of success. CeCe singles
out her father as the source of her internal conflict. She believes that her father’s vision of what
she should and should not be has overpowered her life and caused her to pursue courses of study
and career pathways that are possibly incompatible with her personal interests. She blames her
father’s rigid viewpoints on his Chinese cultural beliefs for forcing her into making choices that
are not suited to her true academic talents or abilities, though she also admits that the ADHD
may in some ways “kick in” and become relevant, too. Thus, in talking about her current course
of study, biomedical engineering, and whether she finds it “too easy,” and hence a source of
boredom, or too challenging, and hence not something she can easily absorb, she says:
Oh, no. It’s not too easy. It’s definitely not too interesting for me and umm… I think the
ADD part might cause me to not follow through on stuff for myself. The not interesting
part also does it. Even when things are interesting for me, I put it off just because it’s
easier to watch TV or something so… like, I never make time for the things I want to do.
It’s still stuff that I haven’t done before so it’s like a work in progress, but it requires you
to kind of keep focused on it, but sometimes I’m like, oh I’m gonna do this, and I get all
inspired, but that only lasts for like a day because then the next day I don’t want to get
up, because there’s too many things to do. And then I just lay there and think of all the
things that I need to do over and over and I’m like, I should get up now. And when I do
do the to-do-list, I get distracted and only do like 30% of my list done which is terrible.
79

Nevertheless, it is apparent that CeCe redirects her problems away from her ADHD condition as
such, and focuses it more on Chinese culture in general. The sense of alienation and resentment
that CeCe feels toward her ancestral culture can express itself suddenly, but especially when in
the midst of participating in a Chinese event or when surrounded by other Chinese, when the
impact of the culture can seem overwhelming to her:
I went to a Chinese New Year gala which was run by the regional Chinese school
association and I was just surrounded by Chinese people and I was talking about when
that happens that I feel like I’m in Chinese mode. And It’s like I have 2 modes in my
head and I feel like the Chinese American mode is kind of the me one but when I’m in
the Chinese mode, I feel like an alien and at the same time a child because it’s mainly
made up of my childhood stuff so I’m in this sea of Chinese people and I generally sit
there and sulk with resentment because I kind of blame a lot of my family problems on us
being Chinese because I see the introvertedness and the lack of being able to understand
that people are different. It’s the individual’s responsibility to live up to society’s
expectation and there’s not kind of the American culture where you should try to
understand different people and it often doesn’t happen but I like the encouragement that
you should culturally want to understand other people and not judge them. In Chinese
culture, I don’t see that. I have built up all the resentment towards that social culture
where it works fine if you’re a “normal” person because you can hide your skeletons or
whatever but if you have a family like mine when there’s all these mental problems then
you can’t, you can’t go out with it, you can’t do anything with it. It just bottles up and
multiplies on itself and I just really resented that, and when I’m in that sea of Chinese
people, I just resent all these people being okay with all of this. And generally, I get this
sense that I’m more inadequate in that sense because I’m definitely not good enough (by)
the Chinese bar or ruler of social expectation. And that really gets brought out when I’m
in a Chinese situation. And there will be like adults of… parents of people that I went to
high school with who are on paper much more successful than I am and there are some
adults who will only ask you about what your school is or what you want to be and it
seems like your identity is only wrapped up in how you can function as a successful
person, by their monetary success or whatever value that they have, and it’s so narrow
about what is valued about a person so I resent them for that too, because not everyone is
like that but there’s a good chunk of them who are literally… will only value me if I have
success or if I have this functionality for society and so it’s not like they care about your
whole person. They only care about whether they can compare themselves to you and
feel good about themselves and I resent them for having that kind of society as well and
everyone seems to be okay with that. They don’t seem to see that there’s a problem with
that. So I talked about how I was just sitting there for most of the time like sulking.

80

Jinger, by contrast, has a less clearly articulated critique of her Chinese cultural
background as a basis for understanding her current difficulties. Jinger stated that she has
become fully acclimated into mainstream American society, having assimilated into American
culture at a young age; however, it is also the case that Jinger’s family often relocated throughout
the United States during her K-12 education as a result of her father’s employment. Thus, she
was often disconnected from the all-White social environments that she inhabited, and failed to
make close connections to others as the sole Chinese in her classes, until the family finally
settled permanently in the Pacific Northwest, when she encountered other Chinese in her age
cohort with whom she could form bonds:
I don’t know if my troubles are because I’m Chinese or because I have ADHD. You
know… I’m sure like, White people who don’t have any illnesses or mental illness also
go through the same trouble that I do. So yeah… I can’t pinpoint anything. I do feel that
sometimes socially it can be difficult just because people are hard to read and I tend to
like focus on like certain things and not other things.
(Interviewer: What kinds of things do you tend to gravitate to or focus on?)
Umm… like I just don’t notice a lot of things. Like my best friend in high school would
just be like, “Yeah, I was in a really bad mood and you were just being really bitchy.”
And I was like, “I didn’t know you were in a bad mood and I didn’t know I was being
bitchy.” And another thing, it’s sometimes really hard to read people and then things that
I focus on are just like whatever seems important at the time. You know. Yeah and a lot
of time I have a really narrow focus so I can’t pay attention to too many people at once.
Jinger stated that her parents do not want her to be on ADHD medication, but she does not
attribute their reluctance to have her undergo medication therapy to their Chinese backgrounds.
Mary Ann reports that she was often teased by her Asian peers for being “White
washed”. She did not feel that they were trying to be derogatory in their comments. She added
that because she was biracial that others doubted her academic performance in relation to other
81

similar age cohorts who were mono-racial. She says that her dual identity as White and Chinese
was “never a huge struggle,” adding:
My high school was pretty Asian and there’s definitely like the stereotypical Asian group.
I don’t know. Umm… I remember once I think my freshman year someone told me I
was “White washed” and most of my friends are either half Asian or White and I don’t
really know why that is. Umm… but it’s never really been a struggle I guess. The
biggest struggle would be that I am really motivated academically the same with my
sister. We just do pretty well, we make ourselves do well in school and I think that
people sometimes get surprised about how smart I am and that was kind of weird for me
because I took it kind of offensively also. Umm… like people told me and I think
they’re trying to be nice, they’re like, ‘I didn’t think you’d be so good at this AP Stats or
Accounting now.’ And I’m like well, ‘why’? I think that’s the only struggle I have
with…
(Interviewer: What would cause them to say that?)
I don’t know. Umm… I don’t think it was because I’m White because there are
definitely smart White kids. I think it could have been the group I was in. Umm…
because some of my friends were not that smart. Or I don’t know. I say like a lot
(giggling). Maybe it’s just how I came off. The only people who ever said that to me
were like kids in my high school who were Asian. And I haven’t had that problem really
the other way around. I don’t know if that is coincidental or not. Umm…
(Interviewer: So the Asian kids when you were growing up were surprised about how
intellectual you were.)
It was a little hard for me because I was a little offended when they said that to me but
then they also meant it in a nice way. Like no one ever said it to be mean I think.
Umm… but yeah. It was never the other way.
(Interviewer: How did that make you feel though?)
Just kind of umm… I think that if I had more of an internal struggle between identifying
with either being Chinese or White it would have affected me more but (I) just kind of
shook it off and thought it was weird. And when someone calls me “White washed”, I
thought it was funny like what does that even mean, really?
It appears that because Mary Ann’s family is grounded in the American culture and fully
embraces its heritage that adjusting to mainstream society has not posed a challenge. This is
evident in the response given by Mary Ann in reference to her peers making racially based
comments to her and her ability to not personalize these attacks. She doesn’t seem to make a
82

connection between her ADHD and her Chinese ancestry, either as exacerbating her condition or
as preventing her from managing it. Finally, it may be that having a father who is a physician
provided Mary Ann with a firmer basis for confronting her medical/mental health issues head on.
Academics and Coping Strategies
The majority of the participants stated that it was easier for them to mask their ADHD
symptoms during their K-12 education. They attributed this to the smaller class size, easier
course material, greater parental oversight, increased teacher involvement, and smaller class
sessions. Therefore, these interviewees, although symptomatic in hindsight, were able to
perform at a high caliber as demonstrated in their high GPAs. Mary Ann and CeCe were not
diagnosed with ADHD until they entered college. Mary Ann stated that she was diagnosed
during the summer break of her freshman year because she felt a disconnect between the amount
of time she was spending on her academic studies the course grades she was receiving. CeCe on
the other hand has consistently maintained high academic markings but found it puzzling that she
was experiencing a high degree of difficulty in relation to her peers as well as noticing a lot of
wasted time when trying to prepare for projects and examinations. These cumulative effects
prompted CeCe to seek assistance for symptoms and confirmatory psychological testing during
her junior year of college. Jinger was the only participant in the study who had been diagnosed
with ADHD during her K-12 education. Jinger is not receiving any mental health services at this
time. Although Jinger was a high achieving high school student, she is currently on academic
probation and at risk of losing her academic scholarship. Jinger reported that losing her
academic support would be financially devastating and would more probably cause her to
relocate back to the Pacific Northwest, where she would have to enroll in the local junior college.
83

CeCe reports that she attended a magnet high school on the East coast that was noted for
having students who were extremely bright. These same students reportedly were often admitted
into and attended Ivy League colleges and/or other top universities in the United States. She
stated several times that her performance, as compared to these students of similar or higher
caliber, was essentially unimpressive, for they were smarter than she considered herself to be.
Although CeCe has moved across the country in large part to avoid her parents, primarily her
father, she continues to assess her performance by comparing it to other students in her major,
not just in terms of how well they do, but in terms of the passion that the subject matter evokes in
them.
People in my major are pretty smart, so I’m kind of a middle of the road GPA, I think,
because there’s a whole bunch of people who do the professional club and they’re on the
E Board and they have like a 3.78 or something. Because my early GPAs were pretty
low and now they’re okay high and so it’s like a 3.5 so it’s a very very decent GPA but
still in my bubble, I’m still like... because there are still more people who are responsible
with time management than I am…
(Interviewer: But you must be pretty smart because you have like a 3.75.)
I’m like responsible because my standards are high but I’m not responsible otherwise.
Like it’s not just me because my boyfriend knows, too, and he’s like “your work ethic is
pretty bad” -- because I work, because I’m afraid of failing, but I’m naturally kind of a
chill person. I’m definitely not a workaholic, I might be if I were doing the thing that I
would be a perfectionist about, a perfectionalist about visual ascetics. Theoretically, I
would be working more consistently because I can’t stand the non-perfection of this
product that I was making if I was doing something visual, but engineering is all mathy
stuff, so it’s just work. So in order to get grades that I think are acceptable to me, I freak
out when it’s crunch time, but as a normal person, I’m just lying there. I’m not like a
workaholic type of person because a lot of other people that I see are organized are
basically, I think, are workaholics and they just like being busy. They like working on
these things and they like engineering more than I do… Comparing myself with other
people in my major, the difference is that they really do learn something in class. They
don’t zone out and they can keep up in class…
CeCe is essentially saying that she is less interested in her major than are her fellow students, but
she attributes their better performance in class to their being smarter and more focused. In this
84

case, the comparisons that she is making may be unfair to herself in that it is possible that her
peers might not do as well as she was doing if they were studying subjects that are of greater
interest to CeCe. (And yet, CeCe still manages to muster a respectable GPA, despite her relative
disinterest in the subject.) We see here how comparisons focused on outcome measures like
GPA, fostered by her parents, undermine how CeCe interprets differences in the ways that
varying individuals engage distinctive disciplines, some of which are suited more to the aptitudes
or their personal interests (passion for the subject). CeCe divulged during the interviews that she
had interests in design due to the aesthetic/visual element but has not pursued these interests due
to an internal need to “please” her father, to the detriment of her own happiness. As a method of
emotional defense (defense mechanism), CeCe rationalizes her lack of initiative or drive in
pursuing these passions by noting that the probability of being able to economically sustain
herself (i.e. as an artist or industrial designer) is slim in comparison to being a biomedical
engineer. Although this is a conscious decision that CeCe is making for herself, she blames her
father for not “allowing” her to pursue her passions. Her failure to pursue her passion, in other
words, is an indirect way of receiving approval from her father.
The following extended passage depicts vividly how CeCe experiences the classroom,
and gives the reader a sense of how the flow or process of receiving instruction in a lecture can
be difficult for her to manage.
I really don’t organize I just have a pretty good memory so I’ve like never have been able
to keep a like a calendar. No, I’ve never been able to keep a calendar because I’m like
too… cause I don’t like calendars I don’t like having to write down everything. It’s
really bad because standardly speaking people say you should write things done but in up
to like in middle school and high school they would give you free planner and they want
to encourage students to be organized and I would try to use them in the beginning of the
semester but once like things started going and like like someone the teacher mentioned
the assignment or something I would like just remember or if it’s a date, I’ll write it down
on whatever sheet of paper I have in front of me or my hand or something but I can’t
85

like… I’m too lazy to go into my bag and rummage for it and go to the page… I manage
to write in the calendar and that will help me remember it so that if I remember the date if
I sit there thinking about what homework I have I’ll make a mental list and I don’t even
bother getting my calendar out so usually speaking I remember assignments but
sometimes I’ll forget what day it is generally like I don’t have a problem remembering
appointments or assignments it’s that I lose track of the dates and I don’t remember like
say there’s an appointment at on October 1
st
at 2 PM, I don’t realize that today is October
1
st
or I don’t realize that it is 2 PM right now so then that’s when I forget that something
was due which occasionally happens and so I never really got straight A’s after middle
school or after I got straight A’s for the most part in elementary school but I would get
B’s in like organization or like talking in class so and I couldn’t really explain the talking
to my parents because I remember umm… like sometimes my teachers would think I was
talking and they would talk about it in teacher-parent conferences and then my dad would
be very angry but I can’t tell you that like I talk all the time.

(Interviewer: So in your K-12 education, you would be easily distracted too and have
sidebar conversations?)

I have a lot of sidebar conversations because I tend to comment on things a lot or just
everything going on I like to make comments about it and then I would find the nearest
person to like tell the comment to and I like did it less when I got older but I would still
not realize sometimes. If we were already in a conversation and then like the teacher
says pay attention now and I would have something to say, I would just keep going. I
wouldn’t keep going straight away, I would try to pay attention but my attention would
still be on the conversation we were having and I would still do that.

(Interviewer: Because in your head the conversation hasn’t ended?)

Yeah and then that would be like still happened up until 5
th
grade and I tended to be shy
and quiet which is kind of strange because I thought there was something funny so I
would have to tell so moving me around from friends really didn’t help because I would
find someone to tell. But for the most part I was pretty shy so I guess still I’m like that
once I find someone I feel comfortable with I keep talking a lot but with strangers, I’m
still really shy around so I don’t break ice and things like that so than I’m pretty
reserved. That’s when I’m not in the process of talking but and so…

CeCe’s description of her classroom experience depicts the point of view of someone with
ADHD who is not under medication and is struggling both with the process of engaging the
learning environment as well as engaging in corrective actions for her displays of distractedness
that she understands is disruptive to the learning environment for others. Hence, CeCe is
simultaneously managing problems of learning as well as of violating implicit rules of classroom
86

conduct, resulting in yet more things to be distracted by and feel stressed out about. On a
positive note, while in college, CeCe has been receiving accommodations for her ADHD
disability in the form of extra time on examinations and having a note taker. CeCe reports that
the extra time has made the biggest difference as she is now able to complete her examinations.
In terms of coping with the academic surround beyond the classroom, CeCe regrets not
being more active in student life at the Pacific Southwest University. Her primary concern since
arriving on campus has been on her academic studies, especially with trying to manage issues
related to ADHD (pre- and post-diagnosis). Now that she is slated to graduate in Spring 2012,
however, CeCe expresses disappointment with herself for not being more outgoing and socially
well-rounded. In thinking about possible post degree employment prospects, she has realized
that employers may seek out applicants who are not only academically oriented but who are able
to represent their business and fit within the organizational structure (teamwork), parts of a skill
set not cultivated by academic excellence alone. As CeCe puts it:
I’ve been kind of shy, so like only this semester I’m like, I must go do some
organizations because it really didn’t hit me until senior year that it was the end. I’m like
there’s so many things I could have been doing. So many opportunities and then I was
just hermitting because I think a lot of it was being afraid that I wouldn’t get my work
done so… I wasn’t confident enough that I could do all that so… I just ignored it. But
theres all these things that I now know that I wanted to do. ‘I did want to volunteer but,
sorry, guys, I don’t have any volunteering experience to talk to you guys about. But hire
me as your volunteer.’ Actually that’s really a time commitment I just applied for,
recently, and turned it down because I looked at my schedule and said, ‘no.’
(Interviewer: So you were actually accepted into it?)
Yeah. I applied for service learning for like the Center for Asian Pacific Family. It’s like
the battered women shelter basically. And so I personally identified with that, like Asian
Americans really needing help, but not knowing where to go for it because they have like
all Asian languages or someone who speaks it for the hotline. But they have a huge time
commitment and also I don’t have a car and I’m thinking that this would probably be bad,
that I would just get burnt out and slip up on everything. I would try to do everything and
I would be like too tired to do anything properly. So, I turned it down and I felt really
87

bad but now I’m like I should have done that early, like when I didn’t have so many hard
classes or projects that I had to do, but there are lots of things I could have been doing.
CeCe refers to her way of engaging the collegiate environment as “hermitting,” by which she
appears to me burrowing away and focusing on her studies, to the neglect of other pursuits that
ultimately are also important to being “well rounded.” It appears that her efforts to compensate
for her ADHD by studying extra amounts of time have an “opportunity cost,” namely, they have
diminished her ability to seize opportunities to extend herself in ways that would have
strengthened her marketability to prospective employers.
High school was pretty easy for Mary Ann in an academic sense (her high school GPA
was 3.8), as compared to her experience with college coursework (she accumulated quite a
number of C’s before undergoing medication therapy this year). Mary Ann was unaware of her
ADHD symptoms in high school, as the learning and supervision environment allowed her issues
to be masked. Mary Ann stated that in high school, she started to utilize a flashcard system to
help her memorize the information needed for classes. She would read, highlight text, and create
flashcards. Mary Ann stated that this method of learning was effective for her until she entered
college. While in college, this method of acquiring information became ineffective due to the
large volume of reading material and the need for students to exercise more self-regulated
learning strategies. Mary Ann became overly consumed with applying her previous regimented
learning style and become frustrated over her academic performance in comparison with the time
spent studying (inverse relationship). This prompted her to seek consultation, evaluation and
treatment for ADHD during the summer semester of her freshman year, primarily at the
prompting of a friend who stated that he was diagnosed with ADHD and could identify with her
symptoms. Mary Ann is currently receiving accommodations for her disability in the form of
extra time on exams and provision of a note taker. The following passage highlights the routine
88

study practices that Mary Ann used during her K-12 schooling; it ends with her account of how
she approaches learning, now that she is on stimulant medication.
I actually wasn’t diagnosed until last summer. Umm… it’s unclear if I’ve always had it
or if it emerged but umm… K-12 (I) had really good grades. Umm… but I also worked
really hard too and umm… I’ve always been a slow reader, just when I read things also it
wouldn’t stick in my mind so I would read, take notes, highlight notes, make flash cards,
so I just had like a really umm… disciplined system but it was also really time consuming
and then, umm last year when I got to school, the amount of college reading… I just had
so much more reading than I did when I was in high school so it was impossible. Either I
wouldn’t even get through half of my work, or I would try to do it all and not remember
anything I read, so I never struggled so hard as I did last year, and it was really
frustrating, but there were other things too like, I’ve always been kind of disorganized
and a little bit like impulsive... (Now) I’m taking Adderall, but there’s like a shortage
right now... so I maybe switching it, but I take it in the morning. I take an extended one
so it lasts like 8 hours but then I take like an instant one later on when I have to study
outside of class…
(Interviewer: Do you notice any difference when you’re on the meds?)
Yeah. Definitely and umm… all my roommates notice it too and I live with 3 other girls
and we were all neighbors last year so we all know each other very well and then as soon
as I came to school this year, I just started taking it and I’m so much more organized and
just really clean. They can just always tell in 10 minutes if I’m taking it or not. Just in
how I talk like, how focused I am. I was always someone who would lose things or
forget what I was saying. Umm… they definitely noticed…
(Interviewer: You mentioned that when you would be reading, you would highlight and
use flash cards. Is that a technique you developed?)
Yeah. Umm… I just developed cause I knew that when I read it that I didn’t remember
it so I’d write it down and then I think I just developed it over time. Umm… but I knew
it was pretty tedious but it worked for me and I just had enough time in high school and
like I was in AP classes but they weren’t that hard. Umm… so I just came up with it on
my own and it worked and I was doing really well with it. But it was impossible to do
last year… I really don’t do the flashcards this semester. This year [i.e., since beginning
medication therapy] I can read faster and comprehend it better and then I have to write
down less and I stop with the writing down. I don’t highlight and do flashcards and also
in lectures, I’ve noticed that I’ve been able to pay attention better and then it goes hand in
hand, like when you learn better in class, it makes more sense outside of class. And then
it’s just really nice. I’ve been doing very well this year. I think I’m gonna get a 4.0 this
semester and like last semester I didn’t do horribly. I got all B’s, B- and B+, umm… but
I’ve never gotten all B’s before (in high school) and it was definitely kind of a blow.
89

As the transition from high school to college was a significant change for Mary Ann, it was
necessary for her to also adapt her method of acquiring knowledge. Prior learning strategies
implemented during her K-12 schooling were no longer effective in her college coursework. In
contrast to CeCe’s case, Mary Ann adapted better to her ADHD diagnosis and was able to
augment her practices to meet the challenging course material. Her adaptive strategies have
likely been buttressed by a family support system that is more supportive of her academic
pursuits and believes in the necessity of mental health treatment and endorses her choice of
academic major.
Finally, Jinger reports that she was medicated while in high school but was taken off the
medications by her parents, since they were afraid of her possibly becoming addicted to the
medication. Jinger reports that the medications were effective in enhancing her ability to focus
during her studies, but since coming of the medications, she has struggled to develop a
consistently effective approach to studying, as exemplified in this quote:
Umm… for my oceanography final the problem was I studied the wrong stuff. I studied
everything we learn the whole year and I thought I did a pretty good job and then it turns
out that (the professor) just focused on stuff that we learned in the past 3 weeks, which I
didn’t focus as much on, so… all of the test was just on the last 3 weeks and I studied the
whole semester so like I spread myself out. And then for my history test, I didn’t study
as much because I had my project due and I had done nothing right, so I don’t think that
went that well... Oh, then I had my structures final which was on the same day as my
history test and then I studied like 10 hours and got a “B” which is pretty good.
(Interviewer: In hindsight, would you do anything differently in the course of studying for
your finals, or for the semester?)
Maybe not studying, but for architecture I would have started my projects earlier…
(Interviewer: So after you find out that you have a project due because it is on the
syllabus, how would you prepare for it?)
Umm… it’s kind of like a cumulative process. It’s like every week you have due dates
but they’re kind of lenient so it’s like how much work can you really get done and then I
90

always but in the very minimal amount of work so at the very end, I have a lot more work
just so I can catch up and finish the project.
(Interviewer: So just waited until the end just to get it done.)
Yeah, I wished I put in more effort into the beginning because it’s hard to put effort into
the beginning because your design is not finalized.
(Interviewer: How about the concept? Is it finalized in your mind?)
No because the concept is being developed throughout the 4 weeks for the project so it’s
hard to make drawings because you know they’re going to get scrapped. But when you
do make drawings it just makes the rest of the project easier but I just don’t because I’m
like whatever, I’m not going to use them anyways but in reality you should because it
makes you better in the end. Yeah.
(Interviewer: So do you think you learned from the mistakes you made?)
Yeah, definitely, definitely… also to do my homework. Umm… some of the reasons
that my grades aren’t as great as they should be because I’ll have like a “B” or “B+”
average in tests but then I’ll have a “C-“ in my homework average because I don’t do
homework a lot of the times. So I need to start doing these things.
(Interviewer: So, it sounds like you know what you need to do.)
Yeah but I just don’t do it. That’s why I’m thinking that medication would probably be a
good idea.
(Interviewer: You sound very intelligent and you did very well in school. In high school,
you did very well and then last year, it sounds like it was very devastating for you last
year.)
Yeah. Yeah. I just… It’s just hard sometimes. I just get distracted.
(Interviewer: So how do you cope with that since you are not medicated and you’re not
getting any type of treatment services?)
I just try as hard as I can. Sometimes I can do it. Sometimes I can study and sometimes I
just can’t so… I feel like my life is kind of unstable at times.
Jinger did not endorse any particular coping strategies that she utilized in order to be an effective
learner. Jinger was able to recognize her poor planning skills and stated that she wished that she
would have started assignments earlier rather waiting. However despite understanding that she
requires more time to complete assignments and having difficulty planning assignments, Jinger
is not receiving any accommodations for her disability.
91

Access to Services
Mary Ann and CeCe are currently receiving services for their disabilities. Mary Ann is
seeing a private psychiatrist while CeCe is seeking mental health services through the Student
Counseling Center at the Pacific Southwest University. Mary Ann and CeCe did not receive any
mental health services during their high school careers as they were both diagnosed while in
college. Jinger was the only participant who had been diagnosed during her high school
education. Jinger is not receiving any treatment services while in college, although she did
inquire about the process of linking up with treatment services because she is contemplating
restarting medication therapy.
Mary Ann is currently receiving medication therapy from her psychiatrist who is located
in the Bay area. She speaks with him intermittently in order to monitor her medication therapy
but has regular follow ups with him when she is back at home. In the past, Mary Ann saw a
therapist for adjustment related issues but has not seen a provider for her ADHD
diagnosis/symptoms. She stated that she is not opposed to seeing a therapist for psychotherapy,
but feels that the medication therapy has been effective in managing her ADHD condition. Her
therapist is based in another part of the state, so most of her conversations with him occur over
the telephone, which she refers to as “check-ins.” During these calls he would inquire about how
she is doing, essentially checking on how she is doing on her medication. She will also visit with
him in person when she is back home during breaks. The kind of information that he provides
her with is evident in her discussion about possible side effects of Adderall.
I know that sleeping can be an issue. I also know that appetite can be an issue and that
actually had been an issue because it doesn’t make you feel that hungry but my doctor
warned me about that. He said to make sure that I take it will a meal because when it
wears off, you can be really hungry and that has actually happened to me and then it’s
92

really hard to control what you eat afterwards. It can be really hard after you haven’t
eaten for a day. I think those are the main side effects we talked about. There’s other
smaller things that can happen like you mouth can get dry… umm... I don’t know.
CeCe is currently seeing a psychologist through the Pacific Southwest University Student
Counseling Center. She is receiving psychotherapeutic services but was deemed an
inappropriate candidate for medication therapy at this time. She has just started therapy so is not
sure how effective this treatment approach has been, since her primary psychologist recently has
been on leave and her treatment has not been consistent. CeCe looks forward to receiving
psychological testing in January, because of the generation of concrete data that may definitively
verify her ADHD condition, after having been in a kind of limbo for quite a while.
Ah last year.... I started going to counseling and he didn’t diagnose me with anything. We
were just kind of talking and then he was like ‘do you want to possibly go see the school
psychiatrist also if you have problems with like distraction or whatever. You can go
check it out.’ I went and she was the first person who was like, “so he referred you to me
for ADHD’ and he never actually said that before and I was like, I mean I kind of get the
idea from the distraction that that was what it was going to be, but he never tried to
diagnose me or anything, but when I went to the psychiatrist she said like ‘he wants me to
evaluate you for that’ and she didn’t feel that I had it because my GPA is too high for that
or something…

(Interviewer: How high is your GPA?)

It’s a 3.5-ish. She said like, ‘I can’t diagnose you because you don’t have impairment
clearly,’ or something.” Cause she said like the person who I medicate for is like, he gets
a 1.9 and on medication he’ll have a 2.8 and that’s like the real big difference and… and
so then I was very unsure. I just figured like, “well no but and then I go back to this
psychologist and he says, ‘I don’t understand why she’s not wanting to diagnose you,
because like I’m pretty sure you do and I’ve met people who are like really good at
compensating for it and they can do really well and like it doesn’t necessarily mean. And
I was just like mmmrrhh, just kind of like I just kind of brushed it off. I didn’t take it too
seriously because as it is, like I was just…

(Interviewer: Sure, you’re confused. “Do I have it? Do I not have it?”)

Yeah, and so like but then recently I went… more recently I went to a primary
psychologist who specializes in child and adolescents, school problems and ADHD to get
a second opinion and she felt that she agreed with my psychologist that it makes sense
93

because of like how I talk and stuff or the way I describe the way I learn and kind of how
I get really fixated on certain things that seem to not matter for other people. Um like,
small discrepancies in my knowledge really bother me and I can’t step away from it and
keep on studying. I have to figure it out what it is and it’s very difficult because I’m
grasping at it and I’m really bad at asking questions so it’s hard to get the answers for it.
For my questions for it because also no one knows what I’m asking and so like I have
that kind of issue when I kind of described how me and my mother, like I think my
mother is probably the same way cause we’re very similar and how it’s impossible for us
to like do any kind of quick stop anywhere like we like… there’s a joke where we’ll be
driving past this grocery store and we’re like, ‘oh we need to pick up eggs or something,’
and ‘quick stop’ and then an hour later it’s like basically when we come out and we know
it’s impossible to just like have a ‘quick stop.’ And like so she said like from all those
things that it made a lot of sense for a psychologist to diagnose me so then like now I’m
more like, I guess I have it but I’m still like confused and I guess I’m umm scheduled for
a psycho-educational testing at school here in January so then that’s like another thing
that my psychologist says, just in case for more edification purposes.

Jinger is not in any treatment services for her ADHD condition. She is also the only
participant who is not receiving any disability accommodations. Jinger is the only participant
who was diagnosed during her K-12 education. Although Jinger’s parents were initially
supportive of her being on medication therapy, they soon after discontinued her on that treatment
regimen for fear of Jinger becoming addicted to the psycho-stimulant medication. As the
following excerpt shows, Jinger was unaware of how to access treatment services while at the
university and was directed by the present researcher to both the Student Counseling Center and
the Student Health Center, consistent with the ethical obligations associated with research with
human subjects:
Well I was diagnosed a while ago and probably lost the paperwork. I’ve been thinking
about going back of medication again. Just because there have been times like I just
can’t focus and I’m trying so hard to. And there’s days when I just can’t get out of bed.
(Interviewer: Oh, wow! What do you think is going on there?)
I don’t know, it’s just like me being lazy and not being interested in my school work so I
just don’t want to do it. And I want to be on medication as least for part of the time so I
can get my work done when I need to.
94

(Interviewer: So in a given week, how many days do you think you just don’t want to get
out of bed?)
I mean, it depends on the season you know. It depends on how much work I have on my
plate. Sometimes the more work I have the less I want to get up…
(Interviewer: How many classes did you take?)
I took 4 classes…
(Interviewer: Is that a lot for you? Do you think you need to take so many?)
No, I mean that’s average and it also very necessary…
(Interviewer: But you are also contending with different factors that other people don’t
have to compete with.)
Yeah but in order for me to get my degree, I have to do 4. So that’s what I mean that I
want to try the medication again…
(Interviewer: What happens if your family is opposed to it again?)
Well, they can’t really because I’m of legal age. So you know…
(Interviewer: Okay, do you know how to access services like that here at school or …)
I don’t. How do I go about finding a doctor?..
(Interviewer: Okay, have you tried the student counseling center here?)
Mmm Mmm…
(Interviewer: Okay, the student counseling center is right next to the bookstore in the
back. You could start that route or you could even go to the health center… the student
health center.)
Okay. Okay… Okay.
(Interviewer: Yeah and just let them know what issues are going on with you.)
Do you think they have someone there who can prescribe medication?
(Interviewer: Mmhmm. Sure.)
So I don’t have to go outside of school…
(Interviewer: Yeah. And then you are covered with the student insurance.)
Oh really. Well, does that mean they will still pay for medication or?

95

(Interviewer: I’m not sure how that would work but talk with the provider when you go
to see them.)
Okay.
The three case studies appear to demonstrate that accessing treatment services is highly
influenced by the social support systems that these women are involved with, primarily family
support. For Jinger and Mary Ann, parental support was key in their validation of the illness,
feeling supported, and encouragement to access services. CeCe, on the other hand, does not
endorse a close relationship with her parents, which ultimately seemed to misdirect her away
from accessing services, except inadvertently, which has in term prompted serious soul searching
as she has sought to come to terms with her diagnosis by way of deciphering her family’s
dynamics.
Coming to Terms with Treatment: Journey and Struggle
ADHD has been a journey for the three women who agreed to participate in this study.
ADHD has forced each of them to make sense of their past,, and it has also been something
through which they have to make sense of themselves moving forward. Unquestionably, there
has been a sense of struggle for each of these women around their ADHD and education, as well
as the maturation process, and that struggle continues to go on. Of coming to learn about her
diagnosis, and describing her initial exposure to stimulant medication, Jinger stated:
I felt alone. It’s hard. I don’t know if I really believe in mental illness or ADHD. I didn’t
talk to anyone about it really. I just thought it was how I am. I’m strange (slightly sad
affect)… I was on Adderall and something that started with the letter ‘V’ or something.
It made me feel really slow and I thought, ‘boy is this how normal people feel?’
Jinger added that she is currently of legal age and can consent for treatment services on her own
behalf. Jinger is willing to start medication therapy again even if her parents are against it due to
the benefits derived from treatment (cost/benefit). Jinger reported that the medications were
96

effective in allowing her to focus more as it “slowed her down” and made her feel “normal”.
However since entering college, Jinger’s academic performance has not been sufficient at
meeting the academic standards required by the university to maintain her academic scholarship.
As a result, Jinger is reconsidering the possibility of restarting medication therapy as it was
previously effective in assisting her to manage her symptoms of ADHD.
Mary Ann is currently taking the stimulant medication Adderall and checking with her
psychiatrist every few weeks to ensure appropriate monitoring of symptoms and dosing of
medications. Mary Ann has tried a few different medications in the past and she is happy with
her performance on Adderall. Despite her overall improved performance on medication therapy,
Mary Ann is contemplating possibility discontinuing medication therapy or at least decreasing
the frequency of taking the medications, because she fears having an unfair advantage in regards
to her peers and also being concerned with developing a dependency or withdrawal-like
symptoms:
I think I know that I have (ADHD). I think I’m trying to come to terms with the
medications and I’m trying to come to terms with me being on medications just because
of the little comments here and there and from my friends saying, “oh, if I had Adderall.”
“If I did this.” I think that’s the only thing I’m coming to terms with. I know that I have
it. I know that I need it and to even the playing field. Over time, it’s still making me
start to question if it’s fair or not and before, I wasn’t questioning it at all. I’m not
questioning if I have it, I’m questioning if it’s fair. Or it just makes me feel bad…
(Interviewer: So when you have those thoughts what do you do? How do you handle
that?)
I kind of push it aside. I have to. I’m not trying to fight with my friends about it and for
the most part, I think that it’s an excuse for them for the way they did but I try to push it
aside. I know that I have it and I know that it works for me and I know that I’m not
taking too much and I’m not like tweaked out or twitching or anything weird…
(Interviewer: Do you ever share those things with your parents or your support system?)
A little bit but it’s never really been a big issue. I think the only thing I really talked to
my mom about was the physical dependence or mental dependency. I think it’s a mental
97

dependency. And she saw it when I was home too. And she didn’t like it really so she
had me start taking it less. I think I started taking it 5 or 4 times a week then 3 or 4…
(Interviewer: And how does your doctor want you to take it?)
He’s relaxed about it but here at school, I should take it 6 or 7 times a week because I
have to go to class, pay attention in class and do homework outside of class. Unless I’m
having a day when I have no classes and no homework than I shouldn’t not take it. But
when I was home, he said you can take it, it’s up to you. When I was home, I had a small
contracting job for a company that my friend used to intern for and none of my… it
wasn’t really challenging work, it was just analyzing you-tube channels and categorizing
things and my mom was like there’s no reason you need to take it for that. It was so
boring. It wasn’t really my job, it was hers but I was helping her. I was just a small
contractor helping her on the side. I would sit there with my computer and literally try to
find something else to do. I would go to my neighbors, I would go see my friends, I
would go take a hike, I would go paint my nails, I would go watch TV… I just didn’t
want to do it. But if I took Adderall, I would just make myself do it…
(Interviewer: So that is something you’re going to have to come to terms with in terms of
the cost/benefit of the medication.)
Yeah. I think when things settle down in the next week or so, I just need to sit down and
start to do things without Adderall. Things that I think I need Adderall for but I don’t.
That would just reassure me and make me feel better but right now, I just don’t have time
for that. I can’t just waste a day...
(Interviewer: Do you think it would help you to talk to somebody about some of the
issues that you’re having.)
Not really. It’s not like I’m up all night thinking about it. If it gets worse, I would. I’m
not the type of person who’s against talking or seeing a therapist. I just don’t think that
it’s at the point where I need to right now.
College has been a constant struggle for Mary Ann. Initially, Mary Ann was struggling with the
challenging course work demands, adjusting to a new social environment, making sense of her
ADHD symptoms and diagnosis and getting appropriately titrated on her ADHD medications.
Now that she has started medication therapy and her academic performance has markedly
improved, Mary Ann continues to struggle regarding the fairness of receiving accommodations
for her disability and the possibility of becoming addicted to the very medication that has
improved her performance. This internal dialogue is something that Mary Ann will likely
continue to grapple with throughout her college career.
98

The third research participant, CeCe, has a self-reflective personality. She clearly is
capable of reflecting on her purpose in life, on where she’s been and where she’s going, even if
she isn’t always capable of executing or performing in ways that measure up to her or other’s
expectations, especially her father’s. At the time of the interview, it appears that ADHD has
introduced into her self-reflections a new way of making sense of her past and her prospects
moving forward. In addition to thinking that many of her difficulties are attributable to her
family’s attachment to traditional Chinese culture, the ADHD diagnosis has allowed CeCe to
revisit her personal and academic history, as well as her personality, and reinterpret things
through an ADHD lens:
I have similar pressures to the other Chinese kids, that’s the thing. Maybe my dad is
more alarming then theirs, but they also have a lot of pressure, but a lot of them are what
they are supposed to be. Because statistically, I’m doing well, right, but in my
community, actually, they’re a lot of people who actually ended up going to Ivy leagues
and like MIT and Stanford like the top 5 like universities. There are quite a few people
who went there and I personally know who make me mediocre and my parents know so
based on comparison… the Chinese tendency towards comparison -- I am mediocre,
because they do tend to achieve things because they were able to stick with something --
because I was never able to stick with anything when I was younger. I still tend to do
that because they’re not lessons, because I don’t pay for much but I like trying everything
and in my childhood, I was just trying everything but I would never get committed and
start like getting somewhere with that. So that frustrated me because I really wanted to
get somewhere but I didn’t want… I couldn’t stay motivated enough to work through it
and so I think that may have been the ADD or I think in school it came out because I
would complain to other people that I couldn’t stay about and I didn’t find anyone who
seemed to have that same problem as me. And they didn’t seem to have the same
problem of not completely being up in class because I would just zone out completely.
And they were like, ‘yeah sometimes I don’t pay attention,’ so it was like lackadaisical
but at the same time, they were on top of the material. So I didn’t understand what was
going on, what was I doing that they weren’t because these were just Asian Americans
that I was friends with so I’d be like, “oh, can you explain this to me because I have no
idea what’s going on in class right now”. But they would say that they didn’t either and
they were able to explain things to me so I wasn’t sure what was going on. I didn’t feel
that I was unintelligent, I just felt like I was always unorganized and I was always not on
99

top of things and I was always not paying attention and so now looking back with the
idea of maybe I was ADD then that makes more sense. So it was a constant sense of oh I
was not on top of things but other people seemed to be on top of things and if I could just
be on top of things like they are than I could be where they are because I felt that my
intelligence was not too different from theirs, I just couldn’t work hard and I was a lazier
person and inconsistent and flaky so…
(Interviewer: So it sounds like you have internalized what other people like your parents
think -- that you’re subpar or mediocre because it’s coming out in how you define
yourself.)
I think it’s internalized just because when I grew up, that was just the normal thing. I
didn’t equalize my scale of what is good or bad like across the whole state or the whole
county as you’re okay or something…
(Interviewer: Well, it’s harder for you because you’re competing with something else
that other people don’t have to deal with. So that’s why you’re trying harder, you’re
putting in more effort.)
I’m still trying to figure that out I guess…
(Interviewer: Because you’re running at a deficit compared to other people who don’t
have ADHD.)
Yeah. I’m still trying to make sure that I do have it because it’s new like completely
new. After 20 years of my life not thinking about that… this is a new thing that I still
don’t know how it fits in so I’m trying to confirm it because I’m doing the psycho-
educational testing at school right now. It’s kind of fun. We’re doing this stuff for…
(Interviewer: So you’re doing psych testing? What else have you tried? Are you in
therapy?)
I guess I tried to recently start therapy. I had one appointment last week. I’m not sure I
like her that much yet but we’ll see…
(Interviewer: So you just started therapy last week.)
Because my other psychologist is out on leave. He’s kind of elderly and I’m not sure
he’s ever gonna come back soon. He got sick and then he’s kind of weakened and not
ready for work and that was where I was starting therapy and he’s like an elderly Chinese
man so he would kind of get the background. So now I’m starting a new one because all
of his cases have been transferred to other people because he’s been out. I’m not sure
where that’s gonna go because I feel like it’s still all in my own head so I’m still not sure
100

how other people are going to help me to decide what’s going on. I kind of look forward
to the testing because… I don’t know. I like having the data. I like having data…
(Interviewer: You want some concrete evidence.)
Yeah…
(Interviewer: Understandable. So let’s say that it comes back and it confirms it, what is
going to be the next step for you?)
Umm… being relieved that I have a label I guess or that I have an actual thing and I’m
not…
(Interviewer: It sounds like you already have the label but you want to confirm the
label.)
Oh yeah. So now I have a confirmed label and maybe now I can figure out how to deal
with it.
Cece wants to have concrete data to prove her mental health diagnosis, which is why she looks
forward to psychological testing to validate her condition. If confirmed, the ADHD diagnosis
promises to provide CeCe with answers, explaining to her that certain behaviors and tendencies
“may have been the ADD” and hence prevented her from becoming what her peers became:
“what they are supposed to be.” In short, figuring out how her new ADHD “fits in” is CeCe’s
next phase in her journey.
Legal Issues
Coding of the data did not reveal that legal issues related to ADHD were a source of
difficulty for any of the participants in this study. All participants denied involvement with the
legal system and did not endorse any significant alcohol and/or drug related issues. Two
participants did endorse under-age drinking but it was not problematic for them. These reports
appeared to be in line with common reports of under-age drinking at university campuses across
the United States. When queried regarding the extent of their drinking, the participants stated
101

that it was more socially related, as a method of bonding with their social circles, but they did not
feel pressured to participate in this activity. No participant endorsed the use of alcohol or drugs
as a method of self-medication for their ADHD symptoms.
102

Chapter 5
Summary
Emergent Themes regarding the Model Minority Stereotype and ADHD:
Managing an Illness or a Contradiction?
This research project was focused around the experiences and coping strategies of
Chinese American college students with ADHD. Since little information is known of this
increasingly prominent group, it was fascinating to learn of the participants’ lives, their cultural
experiences, their academic performance, and career aspirations, as well as how they make sense
of their ADHD condition. Using a life history approach with semi-structured interviewing, the
student researcher was able to obtain vivid details regarding the bio-psycho-social experiences of
these Chinese American college students with ADHD as seen in the various case studies.
Generally speaking, the participants were high achievers in high school, as demonstrated
by their academic performance. Each student was at or near the top of her graduating high
school class. Despite their ADHD symptoms (that were present although may or may not have
been diagnosed), they were all able to perform at a high caliber, which they attribute to the tight
pedagogical structure found in high school education, the short class periods of roughly 50
minutes, the easier coursework, & having closer monitoring by teachers and parents, all of which
eased the path for them to excel, as compared to the learning environment they encountered at
college. Two of the three participants were not formally diagnosed with ADHD until entering
college. Despite being diagnosed later in their academic careers, in retrospect, these participants
were still able to see how their symptomatology impacted their daily functioning. These
participants believe that it was simply easier to disguise their impairment during their K-12
103

education. However during their college careers, the coursework became more difficult and
rigorous, which required them to utilize self-regulated learning strategies that is extremely taxing
on their limited working memory. Since ADHD affects an individual’s executive functioning (in
areas such as organizing and planning), the new demands and requirements of college
coursework further exacerbates their condition. This makes it extremely difficult for the ADHD
college student to focus and complete assignments as required, especially when their coping
strategies are not functioning optimally to meet this demand. The higher degree of autonomy
and lack of teacher containment/oversight can pose to be an obstacle to maintaining focus and
fidelity to coursework material and timelines. Transitioning from high school to college is a
challenging period for most students. This challenge may be amplified in the ADHD student as
they are navigating their new academic surround and trying to develop new sources of support.
There is much overlap in the social and cultural backgrounds of the participants. All
participants were from intact families of origin and were raised in affluent households (middle to
upper SES). The participants’ parents were highly educated professionals, with both parents
holding graduate degrees (MS, Ph.D., M.D. or J.D.). The range of familial support differed on a
case-by-case basis, depending on the parents’ level of sophistication in understanding the ADHD
diagnosis coupled with their level of acculturation with mainstream “American” ideals, values
and traditions. The more traditional Chinese parents were reported to lack sensitivity about
mental illness and view their children with ADHD as being lazy or unmotivated and “less than”
in comparison with peer cohorts (social comparison), and were also concerned with trying to
“save face” in front of their Chinese friends; meaning that these traditional Chinese parents did
not want to be viewed as inadequate in comparison to their friends because of the academic
performance or career decisions of their offspring. Through these in-depth interviews, the
104

participants were able to share how their parents’ values and beliefs shaped their internal
framework regarding their identity, performance ability, and conceptualization of mental illness.
Strengths of the Study
A life history approach was implemented in this research project in order to understand
the psycho-social and cultural factors that influence the experience of ADHD in Chinese
American college students as well as to understand the coping strategies utilized in order to be
effective learners, as these develop or are cultivated over time. This project utilized a 2-shot
interview designed coupled with a month long journaling exercise that afforded participants the
ability to reveal their ADHD experiences, the subtleties of experience (unconscious and
subconscious) and coping strategies utilized in order to be effective learners over a period of
several weeks. As conversational partners in the interviews, they were able to freely discuss
their efforts to deal with ADHD and how their psycho-social surround helped to shape their
experience and develop their coping strategies, and contributed to their overall sense of being. A
holistic person-in-environment approach to understanding the unique experiences for these
Chinese American college students with ADHD was implemented that allowed the researcher to
decipher how their individual contexts helped shape their learning environment (reciprocal
relationship). Since there was roughly a one month gap between interview# one and interview#
two, participant were sensitized to the topic and able to give a detailed account of how ADHD
affected their personal and academic lives. Rather than interviewing participants at a single
fixed point that only provides a snapshot of their experiences at one point in time, this 2 shot
interview design allows one to see the fluidity of the ADHD impairment that may not otherwise
be fully comprehended. Since data were collected on participants ADHD experience during K-
12 and Postsecondary education, the evolution of the ADHD symptoms, impairments and the
105

modified coping strategies utilized during differing stages of the interviewees’ developmental
stage were documented.
Weaknesses of the Study
There are several weaknesses and limitations of this research study, derived from the
project design and implementation. Since this study was only conducted at one university
location, the findings would make it extremely difficult to generalize to larger populations or to
the broader Chinese American college student population more generally. The data collected
from this research project should be viewed as isolated case studies with overarching themes of
similarity (points of intersection). A larger data set coupled with randomized sampling might
have yielded a greater wealth and diversity of information. Although the student researcher
attempted to outreach to various post-secondary institutions (junior colleges) within the Pacific
Southwest area, research participants did not materialize as potential qualified recruits did not
volunteer or had already transferred to other institutions of higher learning. As a result, only
three participants were interviewed for this research project making it difficult to generalize
findings. The lack of Chinese American male college students with ADHD also limits the
understanding of the collective experience as all three participants were females.
Since the sample only included undergraduate Chinese American college students, the
data do not address how Chinese American graduate and professional students with ADHD
experience and manage their ADHD symptoms, or offer insight into how they develop coping
strategies during a more advanced educational career. All research participants were 2
nd

generation college students, thus neglecting how 1
st
generation Chinese American college
106

students with ADHD might experience and navigate their academic surround in differing
pathways.
Implications for Practice
It is important to understand and recognize the impact of mental health and physical
health related symptoms of disease in order to assist learners to be successful. Educators and
practitioners need to be aware of how mental health disabilities impact a student’s ability to
perform academically. Understanding the symptoms of mental illness will allow the student to
be screened and treated for their condition in order to reasonably accommodate their disability.
Issues of race, ethnicity, gender, culture/acculturation, identity issues, SES and primary and
secondary supports systems are necessary to understand in order to be able to better intervene to
assist the student. This study was centered around Chinese American college students with
ADHD. However, this study can be further expanded to other minority populations in order to
decrease the knowledge gap regarding ADHD in post-secondary settings and the even larger gap
that exists in knowledge about ADHD in minority groups within the post-secondary educational
setting.
Reasonable accommodations can be made for students with proven mental and/or
physical disabilities. However as evident in this study, members of minority groups, such as
Asian Americans are often reluctant to step forward and admit to issues related to disability for
fear of “loosing face” within their social circles, and possibly for fear of being perceived as being
lazy or making excuses for a possibly lackluster performance that may be connected to their
disability. It may be that, at times, educational interventions for the Asian American will also
have to include their familial and social support network, as this is usually a large source of
107

support and coping. As noted in this study, the participants’ primary support system was a huge
contributing factor in regards to their conceptualization of mental illness, the treatment
approaches utilized, and the participants’ sense of identity and self-efficacy.
Educators, practitioners and policy makers need to have some understanding of the
struggles that members of racial and ethnic minorities with mental and/or physical disabilities
face so that more culturally competent services can be targeted to this population, assisting them
both academically and socially. Failure to develop and apply these culturally sensitive services
may prove to be a detriment to society, inhibiting these individuals from maximizing their
potential, and hence depriving society of the contributions they are capable of.
Conclusion
Future Pathways: Areas for Growth and Understanding
Ideally, this study will be replicated at various university settings located throughout the
United States, with research participants representing various levels of socio-economic status,
and differing degrees of acculturation, allowing for a fuller grasp of the complexity of ADHD
among Chinese American college students. Future research comparing Chinese American
college students with ADHD to Chinese college students with ADHD in China would help
establish how culture and various psycho-social constructs shape the experiences of these
groups, identifying points of congruence and divergence. The literature on Chinese American
college students with ADHD is limited, but so is the literature on other groups of Asian
backgrounds. Hence, it would be useful to compare and contrast Chinese American students’
experiences with those of other Asian American subgroups such as Koreans, Vietnamese,
Cambodians, Japanese, etc… to further expand the knowledge base regarding this disorder in
108

U.S. Asian populations as well as to allow for comparisons with non-Asian populations. Due to
the knowledge gap regarding Chinese American college students with ADHD, it was necessary
to take an in-depth life history approach to understanding participants’ unique experiences, for
members of this group are often marginalized and overlooked. Once more is known about this
minority group’s experiences with ADHD, it would be beneficial to utilize alternative research
designs that further enhance the discipline’s understanding of this, up to now, “invisible” sector.
Research has revealed that Asian Americans are reluctant to seek out mental health
treatment services for a variety of reasons stemming from the denial of mental illness, the lack of
financial resources, the lack of culturally competent services, the lack of understanding of mental
health issues, trying to “save face” in the eyes of others and the tendency to somatize mental
health symptoms. Further research, education and outreach/advocacy services may assist to
further dispel the negative stereotype of mental health services and breakdown the cultural
“wall” that hinder Asian Americans in seeking out treatment services in comparison with other
populations.
Chinese American college students living with mental and/or physical disabilities may
have a greater challenge trying to navigate their academic environment in comparison with
others who do not have these issues, as they are trying to manage their symptoms while
simultaneously coming to terms with how their disability relates to the “model minority”
reputation that they are often sensitized to.
Finally, given the importance of the family to how Chinese American college students
with ADHD perceive and cope with their diagnosis and treatment, it is important for future
researchers to be mindful of the need to develop research projects that will allow for a better
109

glimpse into the family situation. Such research might benefit from involving family members
as research participants, allowing for a better understanding of how the perceptions of students
with ADHD are filtered through assumptions, fears, and beliefs about mental illness and ADHD.

110

References
Abe-Kim, J., Takeuchi, D. T., Hong, S., Zane, N., Sue, S., Spencer, M. S., Appel, H., Nicdao, E.,
& Alegria, M. (2007). Use of Mental Health-Related Services Among Immigrant and
US-Born Asian Americans: Results From the National Latino and Asian American
Study. American Journal of Public Health, 97(1), 91-98.
American Psychiatric Association. (2000). Quick Reference to the diagnostic criteria from
DSM-IV-TR. Arlington, VA.: American Psychiatric Association.
Aronson, E. (2008). The Social Animal (10th ed). New York, NY: Worth Publishers.
Barker, R. L. (1995). The Social Work Dictionary (3
rd
ed). Washington, DC: National
Association of Social Workers (NASW) Press.
Barkley, R. A., & Murphy, K. R. (2010). Impairment in occupational functioning and adult
ADHD: the predictive utility of executive function (EF) ratings versus EF tests. Achives
of Clinical Neuropsychology, 25, 157-173.
Barkley, R. A., Murphy, K. R., O’Connell, T., Anderson, D. & Connor, D. F. (2006). Effects of
two doses of alcohol on simulator driving performance in adults with attention-
deficit/hyperactivity disorder. Neuropsychology, 20(1), 77-87.
Baverstock, A. C., & Finlay, F. (2003). Who manages the care of students with Attention
Deficit Hyperactivity Disorder (ADHD) in higher education? Child: Care, Health and
Development, 29(3), 163-166.
Berger, K. S. (1994). The developing person through the life span (3
rd
ed). New York, NY:
Worth Publishers.
Berzoff, J., Flanagan, L. M., & Hertz, P. (1996). Inside out and outside in: Psychodynamic
clinical theory and practice in contemporary multicultural contexts. Northvale, NJ:
Jason Aronson, Inc.
Chickering, A. W. & Reisser, L. (1993). Education and identity, (2
nd
ed). San Francisco, CA:
Jossey-Bass, Inc.
Clark, R. E., & Estes, F. (2008). Turning research into results: a guide to selecting the right
performance solutions. Charlotte, NC: Information Age Publishing, Inc.
Creswell, J. W. (2009). Research design: qualitative, quantitative, and mixed methods
approaches (3
rd
ed). Thousand Oaks, CA: Sage Publications, Inc.
DuPaul, G. J., Weyandt, L. L., O’Dell, S. M. & Varejao, M. (2009). College students with
ADHD: Current status and future directions. Journal of attention disorders 13(3), 234-
250.
Epstein, J. N., Conners, C. K., Sitarenios, G., & Erhardt, D. (1998). Continuous Performance
Test Results of Adults with Attention Deficit Hyperactivity Disorder. The Clinical
Neuropsychologist, 12(2), 155-168.
111

Faraone, S. V., Biederman, J., & Mick, E. (2006). The age-dependent decline of attention
deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychological
Medicine, 36, 159-165.
Faraone, S. V., Biederman, J., Spencer, T., Wilens, T., Seidman, L. J., Mick, E., & Doyle, A. E.
(2000). Attention-Deficit/Hyperactivity Disorder in adults: An overview. Society of
Biological Psychiatry, 9-20.
Frazier, T. W., Youngstrom, E. A., Glutting, J. J., and Watkins, M. W. (2007). ADHD and
achievement: Meta-analysis of the child, adolescent, and adult literatures and a
concomitant study with college students. Journal of Learning Disabilities, 40(1), 49-65.
Friedman, S. R., Rapport, L. J., Lumley, M., Tzelepis, A., VanVoorhis, A., Stettner, L., &
Kakaati, L. (2003). Aspects of social and emotional competence in adult Attention-
Deficit/Hyperactivity Disorder. Neuropsychology, 17(1), 50-58.
Greene, B. (1997). Psychotherapy with African American women: Integrating feminist and
psychodynamic models. Smith College Studies in Social Work: Special Issue,
Theoretical, Policy, Research and Clinical Perspectives for Social Work Practice with
American Americans, 67, 299-322.
Greene, R. R. (1999). Ecological perspective: an eclectic theoretical framework for social work
practice (2
nd
ed.), 259-308. New York, NY: Aldine DeGruyyer.
Gubrium, J., & Holstein, J. (2001). Handbook of interview research. Beverly Hills, CA: Sage
Publications.
Harrison, A. G. (2006). Adults faking ADHD: you must be kidding! The ADHD Report 14(4),
1-7.
Harrison, A. G., Edwards, M. J., & Parker, K. C. H. (2007). Identifying students faking ADHD:
Preliminary findings and strategies for detection. Archives of Clinical Neuropsychology,
22, 577-588.
Kuh, G. D. (2003). What we’re learning about student engagement from NSSE: Benchmarks
for effective educational practices. Change, 35(2), 24-32.
Kung, W. W. (2004). Cultural and practical barriers to seeking mental health treatment for
Chinese Americans. Journal of Community Psychology, 32(1), 27-43.
Lee, S., Juon, H., Martinez, G., Hsu, C. E., Robinson, S., Bawa, J., & Ma, G. X. (2009). Model
Minority at Risk: Expressed Needs of Mental Health by Asian American Young Adults.
Journal of Community Health, 34(2), 144-152.
Leong, F. T. L. & Lau, A. S. L. (2001). Barriers to providing effective mental health services to
Asian Americans. Mental Health Services Research, 3(4), 201-214.
Lin, K., & Cheung, F. (1999). Mental health issues for Asian Americans. Psychiatric Services,
50(6), 774-780.
112

Lombardi, A., Gerdes, H., & Murray, C. (2011). Validating an assessment of individual actions,
postsecondary supports, and social supports of college students with disabilities. Journal
of Student Affairs Research and Practice, 48(1), 107-126.
Los Angeles County Department of Mental Health. (2011). Adult Initial Assessment. Retrieved
from http://file.lacounty.gov/dmh/cms1_159897.pdf.
Luczak, S. E., Wall, T. L., Cook, T. A. R., Shea, S. H., & Carr, L. G. (2004). ALDH2 status and
conduct disorder mediate the relationship between ethnicity and alcohol dependence in
Chinese, Korean, and White American college students. Journal of Abnormal
Psychology, 113(2), 271-278.
McKee, T. E. (2007). Comparison of a norm-based versus criterion-based approach to
measuring ADHD symptomatology in college students. Journal of Attention Disorders,
11(6), 677-688.
Mittenberg, W., Patton, C., Canyock, E. M., & Condit, D. C. (2002). Base rates of malingering
and symptom exaggeration. Journal of Clinical and Experimental Neuropsychology,
24(8), 1094-1102.
Murphy, K., & Barkley, R. A. (1996). Prevalence of DSM-IV symptoms of ADHD in adult
licensed drivers: Implications for clinical diagnosis. Journal of Attention Disorders,
1(3), 147-161.
Norvilitis, J. M., Ingersoll, T., Zhang, J., & Jia, S. (2008). Self-reported symptoms of ADHD
among college students in China and the United States. Journal of attention disorders,
11(5), 558-567.
Patton, M. Q. (2002). Qualitative research and evaluation methods, (3
rd
ed.). Thousand Oaks,
CA: Sage Publications.
Preston, J. (2012). Quick reference medication chart. Retrieved from http://www.PsyD-
fx.com/.
Quinn, C. A. (2003). Detention of malingering in assessment of adult ADHD. Achives of
Clinical Neuropsychology, 18, 379-395.
Ramsay, J. R. (2007). Current status of cognitive-behavioral therapy as a psychosocial
treatment for adult Attention-deficit/Hyperactivity Disorder. Current Psychiatric
Reports, 9, 427-433.
Ramsay, J. R., & Rostain, A. L. (2007). Psychosocial treatments for Attention-
Deficit/Hyperactivity Disorder in adults: Current evidence and future directions.
Professional Psychology: Research and Practice, 38(4), 338-346.
Riccio, C. A., & French, C. L. (2004). The status of empirical support for treatments of
attention deficits. The Clinical Neuropsychologist,18, 528-558.
113

Riccio, C. A., Wolfe, M., Davis, B., Romine, C., George, C., & Lee, D. (2005). Attention
deficit hyperactivity disorder: manifestation in adulthood. Achives of Clinical
Neuropsychology, 20, 249-269.
Robbins, S. P., Chatterjee, P., & Canda, E. R. (2006). Contemporary human behavior theory: A
critical perspective for social work. (2
nd
ed). San Francisco, CA: Pearson Education, Inc.
Rostain, A. L., & Ramsay, J. R. (2006). A combined treatment approach for adults with
ADHD-results of an open study of 43 patients. Journal of Attention Disorders, 10(2),
150-159.
Rubin, H. J., & Rubin, I. S. (2004). Qualitative interviewing: the art of hearing data. (2
nd
ed).
Beverly Hills, CA: Sage Publications.
Sack, W., Gale, J., Gulati, S., Gunther, M., Nesheim, R., Stoddard, F., & St. John, R. (2008).
Requesting accommodation for a disability: A telephone survey of American medical
schools. Journal of Postsecondary Education and Disability, 20(2), 93-99.
Safren, S. A., Otto, M. W., Sprich, S., Winett, C. L., Wilens, T. E., & Biderman, J. (2005).
Cognitive-behavioral therapy for ADHD in medication-treated adults with continued
symptoms. Behaviour Research and Therapy, 43, 831-842.
Santrock, J. W. (2011). Life-span development (13
th
ed.). New York, NY: McGraw-Hill
Companies, Inc.
Schriver, J. M. (2011). Human behavior and the social environment: Shifting paradigms in
essential knowledge for social work practice. (5
th
ed). Boston, MA: Pearson Education,
Inc.
Sireci, S. G., Sarpati, S. E., & Li, S. (2005). Test accommodations for students with disabilities:
An analysis of the interaction hypothesis. Review of Educational Research, 75(4), 457-
490.
Solanto, M. V., Marks, D. J., Wasserstein, J., Mitchell, K., Abikoff, H., Alvir, J. M. J., &
Kofman, M. D. (2010). Efficacy of Meta-Cognitive Therapy for Adult ADHD.
American Journal of Psychiatry, 167(8), 958-968.
Spencer, M. S. & Chen, J. (2004). Effect of discrimination on mental health service utilization
among Chinese Americans. American Journal of Public Health, 94(5), 809-814.
Starcher, D. (2001). Biopsychosocial aspects of Attention-Deficit/Hyperactivity Disorder:
Toward a self-regulated behavior paradigm. The New Jersey Journal of Professional
Counseling, 56, 42-51.
Steinberg, D. M. (2004). The social work student’s research handbook. Binghamton, NY: The
Haworth Press, Inc.
Stevenson, C. S., Whitmont, S., Bornholt, L., Livesey, D., & Stevenson, R. J. (2002). A
cognitive remediation programme for adults with Attention Deficit Hyperactivity
Disorder. Australian and New Zealand Journal of Psychiatry, 36, 610-616.
114

Sue, S., & Sue, D. W. (2007) Chinese-American Personality and Mental Health, in A
Companion to Asian American Studies (ed K. A. Ono), Blackwell Publishing Ltd,
Oxford, UK.
Wilmshurst, L., Peele, M., & Wilmshurst, L . (2011). Resilience and well-being in college
students with and without a diagnosis of ADHD. Journal of attention disorders, 15(1),
11-17.
Yang, J., Law, S., Chow, W., Andermann, L., Steinberg, R., & Sadavoy, J. (2005). Assertive
Community Treatment for Persons with Severe and Persistent Mental Illness in Ethnic
Minority Groups. Psychiatric Services, 56(9), 1053-1055.
Ying, Y. & Miller, L. S. (1992). Help-seeking behavior and attitude of Chinese Americans
regarding psychological problems. American Journal of Community Psychology, 20(4),
549-556.
Zastrow, C. H. & Kirst-Ashman, K. K. (2010). Understanding human behavior and the social
environment, (8
th
ed). Belmont, CA: Brooks/Cole.
115

Appendix A: PSU IRB Approval
(Modified to maintain the confidentiality of participants)
Date: September 25, 2011, 11:34am
Principal Investigator: Edmund W. Young
Faculty Advisor: Patricia Tobey
Co-Investigators:
Project Title: Chinese American college students with ADHD
PSU UPIRB# UP-11-00389
Pacific Southwest University
PSU INSTITUTIONAL REVIEW BOARD
FWA 00007099

Exempt Review

The iStar application and attachments were reviewed by PSUIRB staff on 9/28/2011.

The project was APPROVED.

Based on the information provided for review, this study meets the requirements outlined in 45
CFR 46.101(b)(2) and qualifies for exemption from IRB review. The study is not subject to
further IRB review, IRB exemption of this study was granted on 9/28/2011.

The following documents were reviewed and approved:
Certified Information Sheet, dated 09-28-2011
Certified Recruitment Flyer, dated 09-28-2011
Certified Recruitment Letter, dated 09-28-2011
Minor revisions were made to the recruitment and consent documents by the IRB Administrator
(IRBA). The IRBA revised documents have been uploaded into the relevant iStar sections.
116

Please see the IRBA revised documents if an amendment is submitted and future revisions are
required.

To access IRB-approved documents, click on the “Approved Documents” link in the study
workplace. These are also available under the “Documents” tab.

Sincerely,
RoseAnn Fleming, CIP

Funding Source(s): N/A-no funding source listed
117

Appendix B: Information/Facts Sheet For Non-Medical Research
Version: 9-24-2010 Page 1 of 2
Pacific Southwest University
School of Education

INFORMATION/FACTS SHEET FOR NON-MEDICAL RESEARCH
(Modified to maintain the confidentiality of participants)

A systems approach to understanding the psycho-social and cultural factors that influence
the experience of ADHD in Chinese American college students as well as the coping
strategies utilized in order to be effective learners.

PURPOSE OF THE STUDY
The purpose of this study is to highlight the experiences as well as the subtleties of the
experience of ADHD in Chinese American college students. It is hoped that this will add to the
limited knowledge base regarding Chinese American college students with ADHD.

Participation is voluntary. You must be aged 18 or older to participate.

PARTICIPANT INVOLVEMENT
If you agree to participate, you will be asked to participate in 2 interviews coupled with a
journaling exercise. The interviews will be approximately 1 month apart. At the end of the first
interview, you will be given a journal to complete regarding your ADHD experiences. The
journals will be collected approximately 1 week before the second interview for review and as a
method of bridging interview #1 and interview #2. The interviews will be tape recorded with
your permission to ensure accuracy of information. You can decline being audiotaped and still
be included in the study.

Date of Preparation: September 28, 2011
PSUIRB#: PSU-11-00389

118

PAYMENT/COMPENSATION FOR PARTICIPATION
At the end of each interview, you will be given $30 cash. You do not have to answer all of the
questions to receive the cash.

CONFIDENTIALITY
Any identifiable information obtained in connection with this study will remain confidential and
will be disclosed only with your permission or as required by law.

You will be asked to choose a pseudonym (false name) name by which you will be referred. The
data will not be directly linked to your responses. All data will be kept in a locked box, which
will be kept at the student researcher’s home. The data will be maintained for 5 years after the
study has been completed and then destroyed.

Your grades or relationship with PSU will not be affected whether or not you participate in this
study.

The members of the research team and the Pacific Southwest University’s Human Subjects
Protection Program (HSPP) may access the data. The HSPP reviews and monitors research
studies to protect the rights and welfare of research subjects.

When the results of the research are published or discussed in conferences, no identifiable
information will be used.

INVESTIGATOR CONTACT INFORMATION
Edmund W. Young, Student Researcher, e-mail: edmundyo@psu.edu or phone number: 323-
270-XXXX or Dr. Patricia Tobey, Faculty Advisor, e-mail: tobey@psu.edu

IRB CONTACT INFORMATION
Pacific Southwest University IRB, Office of the Vice Provost for Research Advancement, (213)
821-XXXX or irb@psu.edu

119

Date of Preparation: September 28, 2011
PSUIRB#: PSU-11-00389
120

Appendix C: Recruitment Flyer
(Modified to maintain the confidentiality of participants)
Date of Preparation: September 28, 2011

*Are you a Chinese American college student aged 18 or
older with ADHD?

You are invited to participate in a
research study.
Participation is voluntary.
You will be compensated for your time.

Principal Investigator: Edmund Young, Ed.D. Candidate
Email: edmundyo@psu.edu
Phone: 323-270-XXXX

Faculty Advisor: Patricia Tobey, Ph.D.

PSU School of Education
121

Appendix D: Recruitment Letter
(Modified to maintain the confidentiality of participants)
Dear (Name),

My name is Edmund Young, and I am a doctoral candidate in the School of Education at the
Pacific Southwest University. I am conducting a research study as part of my dissertation,
focusing on Chinese American college students with ADHD. You are invited to participate in
the study. If you agree, you will be asked to participate in 2 interviews, approximately one
month apart; you will also be asked to keep a journal. Each interview is anticipated to last
approximately 1.5 to 2 hours and will be audio-taped with you permission.

Participation in this study is voluntary. Your identity as a participant will remain confidential at
all times. Your relationship with PSU will not be affected whether or not you participate in this
study.

If you have questions or would like to participate, please contact me at (323)270-XXXX or via
email edmundyo@psu.edu.

Thank you for your participation,

Edmund W. Young, Ed.D. Candidate
Pacific Southwest University
School of Education

Date of Preparation: September 28, 2011
PSUIRB#: PSU-11-00389
122

Appendix E: Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder
from the DSM IV-TR
A. Either (1) or (2):
1. Six (or more) of the following symptoms of inattention have persisted for at least 6
months to a degree that is maladaptive and inconsistent with developmental level:
Inattention:
a. Often fails to give close attention to details or makes careless mistakes in
schoolwork, work, or other activities
b. Often has difficulty sustaining attention in tasks or play activities
c. Often does not seem to listen when spoken to directly
d. Often does not follow through on instructions and fails to finish schoolwork, chores,
or duties in the workplace (not due to oppositional behavior or failure to understand
instructions)
e. Often has difficulty organizing tasks and activities
f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental
effort (such as schoolwork or homework)
g. Often loses things necessary for tasks of activities (e.g. toys, school assignments,
pencils, books, or tools)
h. If often easily distracted by extraneous stimuli
i. If often forgetful in daily activities

2. Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted
for at least 6 months to a degree that is maladaptive and inconsistent with
developmental level:
Hyperactivity
a. Often fidgets with hands or feet or squirms in seat
b. Often leaves seat in classroom or in other situations in which remaining seated is
expected
c. Often runs about or climbs excessively in situations in which it is inappropriate (in
adolescents or adults, may be limited to subjective feelings of restlessness)
d. Often has difficulty playing or engaging in leisure activities quietly
e. Is often “on the go” or often acts as if “driven by a motor”
f. Often talks excessively
Impulsivity
g. Often blurts out answer before questions have been completed
h. Often has difficulty awaiting turn
i. Often interrupts or intrudes on others (e.g. butts into conversations or games)

B. Some hyperactive impulsive or inattentive symptoms that caused impairment were
present before age 7 years.

123

C. Some impairment from the symptoms is present in two or more settings (e.g. at school (or
work) and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or
occupational functioning.

E. The symptoms do not occur exclusively during the course of a Pervasive Developmental
Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by
another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder,
or a Personality Disorder).

Codes based on type:
314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type: If both Criteria A1 and
A2 are met for the past 6 months.
314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: If
Criterion A1 is met but Criterion A2 is not met for the past 6 months.
314.01 Attention-Deficits/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive
Type: If Criterion A2 is met but Criterion A1 is not met for the past 6 months.

Coding note: For individuals (especially adolescents and adults) who currently have symptoms
that no longer meet full criteria, “In Partial Remission” should be specified.

314.9 Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified
This category is for disorders with prominent symptoms of inattention or hyperactivity-
impulsivity that do not meet criteria for Attention-Deficit/Hyperactivity Disorder.
Examples include:
1. Individuals whose symptoms are impairment meet the criteria for Attention-
Deficit/Hyperactivity Disorder, Predominantly Inattentive Type but whose age at onset is
7 years or after.
2. Individuals with clinically significant impairment who present with inattention and whose
symptom pattern does not meet the full criteria for the disorder but have a behavioral
pattern marked by sluggishness, daydreaming, and hypoactivity.

124

Appendix F: Commonly used psycho-stimulants adapted from www.PsyD-fx.com
Generic Name Brand Name Daily Dosage
Methylphenidate Ritalin 5-50 mg
Methylphenidate Concerta 18-54mg
Methylphenidate Metadate 5-40mg
Methylphenidate Methylin 10-60mg
Methylphenidate Daytrana (patch) 15-30mg
Dexmethylphenidate Focalin 5-40mg
Dexmethylphenidate Dexedrine 5-40mg
Lisdexamphetamine Vyvanse 30-70mg
Pemoline Cylert 37.5-112.5mg
D- and L-amphetamine Adderall 5-40mg
Modafinil Provigil, Sparlon 100-400mg

125

Appendix G: Adult Initial Assessment Sample
(adapted from the Los Angeles County Department of Mental Health)
http://dmh.lacounty.gov/ToolsForClinicians/Clinical_Forms/documents/MH_532_Adult_Init_As
sess_02_08_09.pdf

1. Demographic Data:
*Age:
*Gender:
*Ethnicity:
*Marital Status:
*Preferred Language:
*Referral Source:
2. Reason for Referral/Chief Complaint (presenting problem):
*Precipitating factors, current symptoms and functional impairments, including intensity and
duration, from the perspective of the client as well as significant others as appropriate.
3. Psychiatric History: History and onset of current symptoms/manifestations/precipitating
events. Treated/non-treated history.
*Hospitalizations (dates and locations)
*Outpatient treatment (date and locations)
*Impact of treatment and/or non-treatment on the client’s level of functioning
*Family history of mental illness
4. Medical History
126

*MD Name/Address/Date of last physical exam:
*List of major medical problems (treated/non-treated/family history of medical problems)
*Hospitalizations (date/reason for admission)
5. Medications
*Medication name/dose/frequency/period taken/effectiveness or response
6. Substance use/abuse/dependence
*Inventory of substances (frequency/amount/precipitating factors)
*Substance treatment programs
*Support groups (AA, NA, CA, Dual DX, etc…)
7. Psycho-social History
*Family and relationships (family constellation, relationships, origins, family dynamics,
cultural factors, domestic violence, physical/sexual abuse, safety issues)
*Dependent care issues(number of dependent adults/children, school attendance/behavioral
problems, learning problems, special needs, discipline issues, juvenile court history,
dependent care needs, any unattended needs, child support, child custody, guardianship
issues, foster care/group home placement)
*Current living arrangement and Social Support system (type of setting and associated
problems, community supports, religion, government agency involvement, and other
community resources/agencies)
*Education (highest grade level completed, educational goals, skill level, school related
problems, motivation, learning barriers, general knowledge)
*Employment History/Means of Financial Support(Longest period of employment, current
income, employment history, military service, work related difficulties, money management
issues, sources of income, areas of strength)
*Legal History and Current Legal Status (Parole/probation status, arrests, convictions,
divorce, child custody issues, conservatorship status/issues)
8. Mental Status Exam
*Grooming and hygiene
*Eye contact
*Motor activity
*Speech
127

*Interactional style
*Orientation
*Intellectual functioning
*Memory
*Fund of knowledge
*Mood and affect
*Perceptual disturbance (hallucinations and/or self-perceptions)
*Thought process disturbance (associations, concentration, abstractions, judgment, insight,
serial 7s)
*Thought content disturbance (delusions, ideations, behavioral disturbances,
suicidal/homicidal, passive, other)
9. Diagnostic Summary (ego strengths and weaknesses, observations, descriptions,
symptoms/impairments in functioning)
10. Admission Diagnosis
*Axis I (Primary
*Axis II (Personality disorders and/or Mental Retardation)
*Axis III (Medical problems as effecting clients’ mental health)
*Axis IV (Psycho-social stressors)
*Avis V (Global Assessment of Functioning (GAF) score)
11. Disposition and treatment recommendations/plan
128

Appendix H: Possible questions to be asked of participants in the study
Legend: Psycho-social dimensions (PS); Cultural dimensions (C); Primary and secondary
supports (FF); Access to services (A); Academic (Ed)

The questions to be asked to designed to tap into the certain domains of interest as it helps to
inform the psycho-social and cultural experience of ADHD for the Chinese American college
student and the coping strategies that have been created and implemented to negotiate their
academic environment.

1. What has been your experience of ADHD? (PS), (C), (FF), (A)
2. When did you find out that you had ADHD? (A)
3. How old were you when you were diagnosed with ADHD? (A), (C), (FF)
4. What is your understanding of ADHD? (A), (C), (PS), (FF)
5. How does ADHD impact your life? (PS), (C), (FF), (A)
6. How have you been able to cope with your ADHD symptoms? (A), (PS), (C), (FF)
7. What does your family or significant others think about you having ADHD? (F), (C)
8. What things have they done to make you believe this (family’s perception)? (F), (C)
9. What do your friends think about you having ADHD? (FF), (C)
10. What things have they done to make you believe this (friend’s perception)? (FF); (C)
11. What are your family and friends understanding of the ADHD diagnosis? (FF), (C), (A)
12. What are your cultural beliefs regarding ADHD? (C)
13. What are your cultural beliefs regarding mental illness? (C)
14. Are there any culturally related practices used to treat ADHD or mental illness? (C)
15. What has been the experience for you as a Chinese American with ADHD been like?
(C), (FF), (PS)
16. How have your ADHD symptoms affected your sense of self-efficacy? (PS), (C), (FF),
(A)
17. How does your family view individuals who have mental illness? (FF), (C), (A)
18. How does your family’s response affect the way you think about yourself? (FF), (C),
(A)
19. How do your friends view individuals who have mental illness? (FF), (C), (PS), (A)
20. How do your friends viewpoints affect the way you think about yourself? (FF), (C),
(PS), (A)
21. Did you have any friends or acquaintances with ADHD during your K-12 education? If
so, how did this make you feel? Did you learn anything from their experience of ADHD?
(Ed), (PS), (FF), (C), (A)
22. Tell me about your academic history. How has ADHD impacted you academically?
(Ed), (A)
23. Are you utilizing any disability services or receiving accommodations for your
disability? If so, how do you think this has enhanced your academic performance? (A),
(Ed), (FF)
24. When did you start to utilize these disability services? (A), (Ed), (FF)
25. Are you currently in treatment for your ADHD? (A), (C), (FF)
129

26. If so, where are you receiving treatment (psychiatrist, mental health professional,
general practitioner, etc…)? Did you receive any treatment services during your K-12
education? If so, how do you believe this impacted your academic studies or
performance? (A), (C), (FF)
27. What type of treatment approach are you receiving (medication only, psychotherapy
only, combination of medication and psychotherapy)? (A), (C), (FF)
28. How has ADHD affected your academic performance? (Ed), (FF), (PS)
29. What types of coping skills have you used to offset the negative effects of your ADHD
symptoms? (A), (FF), (PS), (C)
30. How has your approach to managing your ADHD symptoms changes from when you
were younger to now? (A), (FF), (PS), (C)
31. Tell me about your experience with alcohol and/or drugs? If you experimented with
these substances, what promoted you to use these substances? How did it impact your
ADHD symptoms and overall functioning? (PS), (FF), (C), (Ed), (A)
32. Do you belong to or participate in any clubs, organizations, sports or extracurricular
activities on or off campus? (PS), (Ed), (FF), (C)
33. If so, how does this impact your ADHD symptoms? (A), (PS),
34. Did you participate in these same activities during your K-12 education? What was the
experience like for you? (Ed), (PS), (FF), (C)
35. Are there any questions or issues that I did not ask you about that you feel may help
further explain how ADHD has impacted your life? (PS), (C), (FF), (A), (Ed)

130

Appendix I: Sample of Data Coding Rubric
Domains of Interest Theory Example of Words
Psycho-social Dimensions Systems Theory Religion
Fraternities/sororities
Social clubs
Organizations
Athletics

Cultural and Ethnic Dimensions Systems Theory Chinese
Generation differences
Acculturation
Beliefs
Language
Minority status

Academic Institutions Systems Theory College class
GPA
Graduation
Academic classes
Majors
Disability services

Primary and Secondary Supports Systems Theory Family
Friends

Service Institutions Systems Theory Medical treatment
Mental health treatment
Insurance
Student counseling centers
Student health centers
Hospital
Clinics
Diagnosis
Self-medication

131

Appendix J: Research Log

9/28/2011-IRB approved study.
10/3/2011-Outreach to Asian American Student Services (AASS) and Chinese American Student
Association (CASA).
10/5/2011-Posted 60 flyers at the Pacific Southwest University campus.
10/6/2011-Received 1 response via email. Respondent didn’t read flyer and needed to verify if
study was for Chinese American college students with ADHD.
10/7/2011-Responded to email inquiry above.
10/11/2011-Posted additional 60 flyers at the Pacific Southwest University campus. It was
noticed that most flyers were removed or posted over.
10/12/2011-Received 2 inquiries via email. Provided email response to both inquires.
10/13/2011-Received 1 inquiry via email. Provided email response regarding inclusion criteria.
10/14/2011 & 10/15/2011-Coordinated interview time w/ Jinger and reserved interview room in
Learning Library 201C. Emailed Dr. Patricia Tobey regarding update of study.
10/17/2011-Purchased digital recorder for the interviews.
10/18/2011-Purchased journal log for Jinger.
10/19/2011-Interview #1 Part 1 with Jinger conducted in Learning Library 201C. Emailed Jinger
to confirm meeting.
10/20/2011-Sent email follow-up to AASS & CASA. Emailed Jinger to confirm Interview #1
Part 2. Meeting with Jinger to complete Interview #1 Part 2. Transcribed interview. Received
and responded to 1 email inquiry regarding study.
10/21/2011-Completed transcription of Interview #1 Part 1 & 2 with Jinger. Posted more flyers
at the Pacific Southwest University campus.
10/25/2011-Emailed Dr. Patricia Tobey, Dissertation Chair, regarding status update.
10/26/2011-Emailed Jinger to remind her to complete ADHD journal. Emailed School of
Education IRB Coordinator regarding possible expanding the study to local junior colleges.
10/27/2011-Continued to plan with School of Education IRB Coordinator regarding the
expansion of the study.
11/1/2011-Continued to plan with School of Education IRB Coordinator regarding the expansion
of the study.
132

11/3/2011-Internet search of the Pacific Southwest University organizations to expand outreach
of study. Email reminder to Jinger to complete ADHD journal. Drafted email to Northside City
College (NCC)- Business Services Director & Disabled Student Programs and Services for
possible expansion of study. Drafted email to Eastside City College (ECC) Disabled Student
Programs and Services.
11/4/2011-Email correspondence with Dean of Special Services at NCC who stated that he
would forward my contact data to the Department of Psychological Services for review and
consideration.
11/9/2011-Spoke with Director of Psychological Services at NCC who will assist with the
research project via canvassing through existing open cases and contacting potential participants
for interest in the study. Will allow student researcher to utilize office space in their department
for the interviews.
11/10/2011-Received email correspondence re: inquiry into the study. Provided information re:
inclusion criteria. Wrote email to School of Education IRB coordinator and Dissertation Chair
re: addition of junior college sites. Ed.D. student colleague forwarded data re: a potential
research subject.
11/14/2011-Contacted potential research subject that was forwarded by another Ed.D. student.
Interview scheduled for 11/18/2011 @ 5:30PM.
11/15/2011-Reserved interview room in Learning Library for 11/18/2011 @ 6:00PM. Received
email confirmation from research participant (CeCe) for 11/18/2011.
11/16/2011-Spoke with Director of Psychological Services at NCC who stated that he has
identified 3 students who meet the inclusion criteria and will contact them regarding interest in
the study.
11/17/2011-Received voicemail message from Director of Psychological Services at NCC who
stated that 2 of the students have transferred to other universities. He has left a message for the
current student but has identified 2 other students who meet the criteria and is in the process of
testing them. He will pass my data along to them.
11/18/2011-Interview with research participant in Learning Library Rm. 201B. Began to
transcribe part of the interview. Received an email inquiry re: the study. Provided email
response to clarify the study and inclusion criteria.
11/21/2011-Received email inquiry into the study and provide response (Mary Ann).
11/22/2011-Received email response and trying to coordinate an interview for this participant
(Mary Ann). Emailed Jinger regarding her journal and confirmation of interview #2.
11/25/2011-Received email response from potential participant who continues to express interest
in study and provided me with interview times.
11/28/2011-Responded to email from participant and will schedule interview for this Thursday,
12/1/2011. Interview room reserved in Learning Library Rm. 201B for 12/1/2011 @ 6PM.
133

Emailed Jinger to inquire re: the journal and to schedule interview #2. Emailed CeCe to inquire
re: the journal.
12/1/2011-Received email message from Jinger re: scheduling of interview #2. Room was
reserved in Learning Library Room 201F for Tuesday, 12/5/2011 @ 6PM.
12/5/2011-Received email from Mary Ann re: confirmation of interview #2. Provided response
to coordinate interview #2 for 1/18/2012 @ 5 or 6PM. Mary Ann confirmed for 1/18/2012 @
5PM. Will schedule an interview room as the date nears.
12/6/2011-Jinger canceled interview #2 via email stating that she had a study session with her
TA. Wrote email back to reschedule interview as she indicated that she would be in the Pacific
Southwest until 12/15/2011.
12/7/2011-Jinger wrote email to schedule tentative date for interview #2 for Tuesday or
Wednesday of next week. She will confirm later.
12/8/2011-12/12/2011-Transcribing interviews to ensure coding accuracy.
12/10/2011-Dissertation group meeting w/ Dr. Patricia Tobey.
12/13/2011-Received email from Jinger to coordinate 2
nd
interview. Responding and trying to
coordinate for 12/14/2011. Room reserved for Learning Library between 6-8:00 PM.
12/14/2011-Jinger responded via email stating that she will be there at 7:15 PM. Interview #2
completed with Jinger this evening.
12/16/2011-Received email from CeCe re: the journaling process. Responded to email and tried
to coordinate schedule for interview #2.
12/29/2011-Received email from CeCe re: the journaling assignment. Provided email response
to clarify journaling exercise.
1/13/2012-Emailed CeCe and Mary Ann re: scheduling of interview #2. Reserved interview
room at Learning Library for 1/18/2012 @ 5PM with Mary Ann.
1/17/2012-Received email from CeCe re: times available for the 2
nd
interview this week. Trying
to coordinate time for meeting. Wrote follow up email to Mary Ann to confirm meeting for
tomorrow but realized that she has 2 different email addresses that she has been corresponding
with. Confirmed 2
nd
interview with CeCe and room was reserved in Learning Library for
1/20/2012 @ 5PM.
1/18/2012-Received email response from Mary Ann requesting the 2
nd
interview to be
rescheduled as her roommate’s mother is gravely ill and will be leaving school this semester.
Replied to email to coordinate a tentative interview for next week. Mary Ann confirms
scheduled 2
nd
interview for 1/25/2012 @ 5PM in Learning Library and a room was reserved.
1/20/2012-Completed 2
nd
interview with CeCe in Learning Library Rm. 201C.
134

1/21/2012-Met with dissertation chair to discuss progress and solidify date for dissertation
defense. Continued to transcribe and analyze interviews.
1/22/2012-Continued to transcribe and analyze interviews.
1/23/2012-Continued to transcribe and analyze interviews.
1/24/2012-Sent email reminder to Mary Ann to confirm interview time for tomorrow. Continue
to transcribe and analyze interviews.
1/25/2012-Interview #2 with Mary Ann in Learning Library. Continue to transcribe and analyze
interviews.
1/26/2012-Continue to transcribe and analyze data. Drafting Ch. 4 & 5.
1/27/2012-3/7/2012-Continue to edit Ch. 1 through 5.
3/8/2012-Dissertation Defense

135

Appendix K: Sample of Completed Transcription of Interview #1 & #2
with Cecelia (CeCe)
Interview #1
Me: So CeCe how old are you?
CeCe: I’m 21.
Me: Ok. And what are you studying here?
CeCe: Biomedical engineering.
Me: Great. Wow. Sounds difficult.
CeCe: Ahh. Well… Yeah, I guess but yeah.
Me: What year in school are you?
CeCe: I’m a senior.
Me: You’re a senior? Great. And what do you plan to do with that degree?

CeCe: I don’t know. Um like I’m not really sure right now about where I want to try to go into
BME industry or try to switch over a little bit um cause I guess I have different options of going
into a different kind of engineering, which would be more grad school or like design maybe
which would be more grad school or like, I don’t know. I don’t really like but I’m supposed to
decide soon and I don’t want to.

Me: You don’t want to? You’re procrastinating?
CeCe: I don’t wanna. I don’t know. It’s like a big decision and like I’m a super indecisive
person even for just little things like what should I eat is…

Me: Nice. Where were you born?
CeCe: Um, I was born in um the East coast.
Me: Ok, great. And what brought you out here to L.A.?
CeCe: Um school and like um mainly school and I guess I like the idea of adventures in big
cities except I generally don’t even go out. Also I didn’t want to be too close to home so um like
it seemed boring also because I didn’t want like my dad to have an excuse to go see me but I
don’t even think he’s like that type so he doesn’t even come see me out here.

Me: So what’s that like for you?
136

CeCe: It’s okay for me because I can’t see too much of my dad.
Me: Oh.
CeCe: Yeah it’s just like, he’s very alarming to be around.
Me: In what way?
CeCe: Well like if he’s in a bad mood then it’s like… he tends to easily be in a bad mood and
then he’s highly critical. And you have to kind of guess what he wants to hear and tell him that
so it’s like very stressful to be around him but like sometimes if he’s in a nice mood it’s okay but
I really don’t now so.

Me: Wow. So sounds like some issues are going on with father? Where’s your mother in the
picture?

CeCe: Um she’s like the same too or she’s like living in the same house and stuff. It’s just like I
don’t have a problem with my mom but like so I don’t mind whatever with my mom but my dad
is the scary one. And they don’t get along either. It’s like me, my sister and my mom is like a
unit and my dad is like the other unit. (Laughing)

Me: Wow. So sounds really stressful in the household.
CeCe: Yeah.
Me: Is it like that for your sister as well? Is she stressed out?
CeCe: I’m sure she does but I like was never I not close enough with her that we’ve talked about
this or anything.

Me: Are you the oldest?
CeCe: Yeah, I’m the oldest. But um when I left home she was 13ish so I didn’t like I didn’t
really get to that point where I talked to my sister and stuff like that it was just the kid-annoying
sister type relationship.

Me: Even currently?
CeCe: Even currently I don’t even actually call them that often. Like they call me usually. I like
think about call my mom and then I forget again and go on to another piece of work. Or I don’t
remember til I get home at night and so there’s a 3 hours difference so I’m like oh it’s 9 and like
whatever and then… so.. so... (laughter)

Me: How convenient?
CeCe: Yeah so.
137

Me: Ok great. How the study is broken up is actually a 2-shot interview design so the 1
st

interview today we’re gonna talk a little more about K-12 education. You have your journal the
time between the next time I see you will roughly be between 3 weeks and 1 month and the
journal is really for you to free associate about any experience you have regarding your ADHD.
I don’t want to tell you parameters about how to structure it I really want you to be able to do
what you feel is relevant.

CeCe: So just like ramble in it a bit about stuff?
Me: Yeah. Well anything that is relevant to your ADHD experience.
CeCe: So like a day to day?
Me: Or a weekly basis whatever won’t be too taxing for you because I know you’re a full-time
student.

CeCe: Oh yeah, right.
Me: And I don’t want this to be too much of a burden for you in terms of cognitive overload. I
just want you to be able to have time feel it’s appropriate to journal.

CeCe: So, you just want to record stuff on a daily basis kind of like things that…

Me: Things that pop up that you think are related to your ADHD symptoms.
CeCe: Oh symptoms, oh okay.
Me: Or anything regarding your ADHD. Let’s say that you’re in class or what not. Are you in
class next week? Or are you guys..

CeCe: Oh, I’m in class for like half the week and then it’s Thanksgiving.
Me: Okay, let’s say you’re in class and you’re like oh my God that kind of triggered something
for me. Well when you go home or whenever you have time and write a little blurb about it.

CeCe: Okay.
Me: And I’ll collect that around 3 weeks 4 weeks out.
CeCe: It’s like really weird cause like I only recently got diagnosed with ADHD so it’s like hard
for me to even understand what is what is not ADHD stuff. I haven’t had it for like a long time
so I have things like I say, ‘is this supposed to be what ADHD is or is that just like me and I’m
just like that?”

Me: So when did you get diagnosed with ADHD?
138

CeCe: Ah last year. And then I kind of… well like back then I was just kind of like. I started
going to counseling and he didn’t diagnose me with anything. We were just kind of talking and
then he was like ‘do you want to possibly go see the school psychiatrist also if you have
problems with like distraction or whatever. You can go check it out. I went and she was the first
person who was like, “so he referred you to me for ADHD and he never actually said that before
and I was like. I mean I was kind of get the idea from the distraction that that was what it was
going to be but he never tried to diagnose me or anything but when I went to the psychiatrist she
said like ‘he wants me to evaluate you for that’ and she didn’t feel that I had it because my GPA
is too high for that or something.

Me: How high is your GPA?
CeCe: It’s a 3.5ish. She said like, “I can’t diagnose you because you don’t have impairment
clearly or something.” Cause she said like the person who I medicate for is like, he gets a 1.9 and
on medication he’ll have a 2.8 and that like the real big difference and like… and so then I was
very unsure. I just figured like, “well no but and then I go back to this psychologist and he says I
don’t understand why she’s not wanting to diagnose you because like I’m pretty sure you do and
I’ve met people who are like really good at compensating for it and they can do really well and
like it doesn’t necessarily mean. And I was just like mmmrrhh, just kind of like I just kind of
brushed it off. I didn’t take it too seriously because as it is like I was just…

Me: Sure, you’re confused. “Do I have it? Do I not have it?”
CeCe: Yeah, and so like but then recently I went… more recently I went to a primary
psychologist who specializes in child and adolescents, school problems and ADHD to get a
second opinion and she felt that she agreed with my psychologist that it makes sense because of
like how I talk and stuff or the way I describe the way I learn and kind of how I get really fixated
on certain things that seem to not matter for other people. Um like, small discrepancies in my
knowledge really bother me and I can’t step away from it and keep on studying. I have to figure
it out what it is and it’s very difficult because I’m grasping at it and I’m really bad at asking
questions so it’s hard to get the answers for it. For my questions for it because also no one
knows what I’m asking and so like I have that kind of issue when I kind of described how me
and my mother like think my mother is probably the same way cause we’re very similar and how
it’s impossible for us to like do any kind of quick stop anywhere like we like… there’s a joke
where we’ll be driving past this grocery store and we’re like oh we need to pick up eggs or
something and “quick stop” and then an hour later it’s like basically when we come out and we
know it’s impossible to just like have a “quick stop”. And like so she said like from all those
things that it made a lot of sense for a psychologist to diagnose me so then like now I’m more
like, I guess I have it but I’m still like confused and I guess I’m umm scheduled for a psycho-
educational testing at school here in January so then that’s like another thing that my
psychologist says just in case for more edification purposes. Yeah and so…

Me: Test, they can give you a TOVA or any other psychometric measures to try to quantify it.
And I think for you as a biomedical engineer, you’re always looking for concrete evidence.

139

CeCe: Yeah. Ha ha ha. (laughing) And also I think because of the Chinese American. Like I
told my mom umm and she of like grasped on to it but I feel like she doesn’t take it seriously
because she… I don’t know. It’s hard to take it seriously cause all of sudden you have a
condition and there’s a name on it and my mom doesn’t even like she not from a culture where
people understand like understands what conditions mean.

Me: Sure.
CeCe: Yeah, so she still doesn’t exactly get what is ADHD either or I’ve tried to explain some of
things that I read and stuff and she’s like so is it this and I’m like no… I don’t know. Or she’ll
say are you doing this because you’re ADHD or she’ll be like that. Umm… obviously I haven’t
told my dad at all and I don’t plan to for a while because there’s really no point in that. It would
probably go very badly. Umm… because he doesn’t even believe like he doesn’t even believe
in other parts of the body doctors much less mental doctors so… yeah so. Yeah.

Me: So how is it for you? It feels invalidating of your experience.
CeCe: Yeah. I guess but it’s like I haven’t even validated it myself so it’s I’m not really
surprised. Like I don’t take them too seriously so I know where they’re coming from but umm…
I guess I’ve tried to talk to the people I’m friends with who I know are ADHD and talking to
them about if they think this is a ADHD thing or it just me or something because I have a friend
who got diagnosed really late in his life and he has a lot of the habits that are really similar.
Random things that I didn’t think… just waking up in the morning or getting to morning
appointments on time is a big problem because I can’t wake up properly in the morning and I
thought that was just a “me” thing and I just couldn’t understand why there’s a lot of people who
can just wake up in the morning and like come to class on time or like go somewhere on time
and not just wake up half asleep and just feel like you just have to go back to sleep like resisting
the urges. Like maybe they’re just really good at resisting urges or do they not get them. He said
that he has that problem too and I was like really, I thought that was just me who couldn’t get out
of bed. He said nope ADHD all the way.

Me: Have you ever looked at the DSM IV?
CeCe: Yeah, I’ve look at that but I thought those were just things that people do so I don’t know
to what degree they’re talking about.

Me: When you’re looking at the profile of ADHD of course there are specifiers but when you’re
looking at mental illness because I’m also a clinician, you’re looking at the 5 axis. Axis I looks
at the mental health or substance abuse issues. Axis II is about personality problems or mental
retardation. Axis III is about medically related problems such as looking a diabetes that can
cause impairment on your mental functioning or mental health. Axis IV is looking more at your
psycho-social functioning and that’s where your psychiatrist is saying that your functioning
pretty well in your daily life. She’s not seeing the impairment because when you’re looking at
mental illness from a Medi-Cal standpoint, you’re looking at functional disabilities or functional
impairments and she think she sees a fully functioning and highly intelligent person so what
could be wrong?
140

CeCe: (giggling)
Me: And Axis V relates to global functioning is scored from 0 to 100. 100 being totally perfect
functioning and 0 being totally unable to function… possibly in the hospital or what have you.
There’s a gamut when talking about mental illness it’s not so straightforward it’s very abstract.
Even now that’s why it’s really more of an art vs. a science it’s not so concrete as going to see a
cardiologist.

CeCe: Yeah… going to get an echocardiogram.
Me: A lot is based on self-reporting or using psychometrics. So that probably more likely what
they’re going to be doing with you to put you at ease and to validate your issues that are
presented which is not a bad thing. Like I said, when you’re look at mental health, there’s a
gamut of functioning. There are doctors who are schizophrenic but you think that schizophrenics
are not able to function. That’s not the case so it’s really a case by case basis. I’m really more
interested in the experience of it for you and how you actually cope with the day to day issues.
It’s a little spin on what’s going on. I know from what you’re saying that you were recently
diagnosed when you were a junior, so are you getting counseling?

CeCe: Yeah. I have dropped the ball lately because umm… cause he was sick a couple of
weeks back when I had an appointment and I’ve been meaning to make an appointment for like 2
weeks now. Yeah, so it’s on my to-do-list but things same on my to-do-list for a really long time
especially if there’s not a deadline so umm… we’ll do that soon so I am getting counseling here
but I actually haven’t completely fully gotten into counseling. Umm because we were
counseling for a while and it was mainly family focused until going to the psychiatrist business.

Me: Was it through the Student Counseling Center?
CeCe: Yeah. Then when I came back it was just a general like trying to get the accommodate
for exams that and also trying to discuss getting testing because he really wanted to get it tested.
Get me tested and that really took up the rest of the appointments last year and then this fall, I’ve
had a couple of interviews just discussing second options and we haven’t really gotten back to
the whole counseling thing yet and so I still don’t know what counseling actually does but umm
my roommate is getting counseling so I’m kind of learning about that kind of. She has like
massive depression problems and currently going through her stuff. She’s also Chinese
American. I suspect that she has major ADHD too. She is mainly depressed so I don’t think it’s
like a priority right now for her psychiatrist so yeah. Anyways, then was there another question
in there in the beginning?

Me: So I know that you saw the psychiatrist the person who felt that you were not a candidate
for medication therapy or psychopharmacology.

CeCe: She didn’t feel that she could even diagnose me because she was talking about maybe
getting the exam accommodations. In the end, my psychologist wrote the letter because she
wasn’t comfortable in diagnosing me even just for exam accommodation and not just medication
141

so like she tried to ask disability services if they would allow for something that wasn’t
diagnoses and they were like “no sorry” so I felt like umm whatever oh well, I guess I can just
keep going on with whatever I’ve been doing but then my psychologist was like no I can support
the documentation for you with my diagnosis so he was like I don’t know why she doesn’t even
feel comfortable diagnosing you. So it was like not even qualified for medication but like not
even for ADHD so I then was at that point like oh well I am just what I am and we’ll just keep
going on with whatever I’ve been doing and I guess…

Me: Well, it seems to be working well whatever you’ve been doing. What have you been
doing?

CeCe: Well, I think I just learn things relatively not too bad. Learning things isn’t too too bad
for me. I just have bad time management issues that is basically my problem for school for me
because umm…. Like I can.. I can’t be one of those organized students that I know who are
always on top of things or start their homework and still doing it. I feel like as time goes on and
the more stressed I get umm… I start not finishing assignments. I finish them technically when I
have time and then when time comes up it like whatever I get out I get out and then umm I never
finish studying and I know about of people don’t finish studying but I feel like I could have
finished studying if I could have started earlier but I tend to like procrastinate for like along time
and it also depends on cycles of stress levels. If I’m really stressed, I tend to be more discipline
and I’m like no I must go lock myself in a room or something but…

Me: Do you physically do that?
CeCe: Well, I don’t go lock myself in a room by myself because the apartment I live in is like is
lively I guess and in some ways it’s okay along as it’s not too lively because there’s some
background noise. I noticed that I can’t have words going on in the background even if its very
soft like because I’m going to start tuning towards it so along as its some kind of video game
noise or umm like umm not lyrical music or something like that it’s kind of helpful in that I don’t
get too bored and start thinking about something else you know what I mean?

Me: Do you actually have TV on and music on or?
CeCe: No like… I might have music on but it can have no words in it because I’ll start listening
to the words or like try to sing it or I’ll like have urges to sing it and pay attention to the words to
see if there’s meaning or something or anything with meaning going on, I’m going to be
listening to it.

Me: So it diverts your attention over to the music?
CeCe: Yeah or like I can go back to it but once it gets boring the music will be way more
interesting or if there’s like stuff going on in the music and then TV’s no good because there’s a
lot of stuff going on in TV. Even if I mute it, I don’t know. It’s like too much stuff going on in
there that like I’m gonna watch it.

Me: So how do you get organized now than?
142

CeCe: I really don’t organize I just have a pretty good memory so I’ve like never have been able
to keep a like a calendar. No, I’ve never been able to keep a calendar because I’m like too…
cause I don’t like calendars I don’t like having to write down everything. It’s really bad because
standardly speaking people say you should write things done but in up to like in middle school
and high school they would give you free planner and they want to encourage students to be
organized and I would try to use them in the beginning of the semester but once like things
started going and like like someone the teacher mentioned the assignment or something I would
like just remember or if it’s a date, I’ll write it down on whatever sheet of paper I have in front of
me or my hand or something but I can’t like… I’m too lazy to go into my bag and rummage for
it and go to the page… I manage to write in the calendar and that will help me remember it so
that if I remember the date if I sit there thinking about what homework I have I’ll make a mental
list and I don’t even bother getting my calendar out so usually speaking I remember assignments
but sometimes I’ll forget what day it is generally like I don’t have a problem remembering
appointments or assignments it’s that I lose track of the dates and I don’t remember like say
there’s an appointment at on October 1
st
at 2 PM, I don’t realize that today is October 1
st
or I
don’t realize that it is 2 PM right now so then that’s when I forget that something was due which
occasionally happens and so I never really got straight A’s after middle school or after I got
straight A’s for the most part in elementary school but I would get B’s in like organization or like
talking in class so and I couldn’t really explain the talking to my parents because I remember
umm… like sometimes my teachers would think I was talking and they would talk about it in
teacher-parent conferences and then my dad would be very angry but I can’t tell you that like I
talk all the time.

Me: So in your K-12 education, you would be easily distracted too and have sidebar
conversations?

CeCe: I have a lot of sidebar conversations because I tend to comment on things a lot or just
everything going on I like to make comments about it and then I would find the nearest person to
like tell the comment to and I like did it less when I got older but I would still not realize
sometimes. If we were already in a conversation and then like the teacher says pay attention now
and I would have something to say, I would just keep going. I wouldn’t keep going straight
away, I would try to pay attention but my attention would still be on the conversation we were
having and I would still do that.

Me: Because in your head the conversation hasn’t ended?
CeCe: Yeah (laughter). Yeah and then that would be like still happened up until 5
th
grade and I
tended to be shy and quiet which is kind of strange because I though t there was something funny
so I would have to tell so moving me around from friends really didn’t help because I would find
someone to tell. But for the most part I was pretty shy so I guess still I’m like that once I find
someone I feel comfortable with I keep talking a lot but with strangers, I’m still really shy
around so I don’t break ice and things like that so than I’m pretty reserved. That’s when I’m not
in the process of talking but and so…

Me: When you were in your K-12 education, what was your academic career like? Were you
pretty successful in planning for assignments? Is it similar to what you do now?
143

CeCe: I didn’t really plan for umm… elementary school I don’t really remember. I just
remember that elementary school was so easy that I didn’t make much effort like I didn’t have to
study for anything. Studying was pretty foreign I think I may have studied for some history test
because there are dates that you have to know and studying… for the most part it was
memorization tests not for math tests. Having an Asian family, I learned math way before like a
year or two before I had to learn it in school so it was a non-factor because I already knew it and
umm… for memorization tests I was just really good at memorizing things. I just am… as long
as they are not symbol based things like math or chemistry umm… I pick it up super quickly if
its language if it’s in English and the teacher is saying it… It’s easy to understand and I can just
hear people talk well so I the teacher is discussing something that is interesting than I’m going to
remember it. Like I remember her saying this and kind of have a video of her.

Me: So if it’s boring, you totally forget about it?
CeCe: I don’t forget about it. If I’m paying attention at the time than I’ll probably remember it.
But if I’m not paying attention at the time then I didn’t even input it like I was engaged at the
time so it didn’t even come in long enough to stay it was just kind of passing so umm… There’s
weren’t a lot of assignments but I tend to work really slowly like I’m a perfectionist so if like
my… I just realized recently that I didn’t need to take too many notes because when I try to take
notes I get really obsessive about how the notes look and umm like trying to organize it nicely
and getting every detail and umm… they started trying to have us start taking notes in 5
th
or 6
th

grade and it was really bad for me because I would just write down everything. I would be
reading a textbook, I would read the history textbook and would like summarize everything or
just slog through the chapter cause I was like what if don’t remember this, I better write it down
and then so I spend so much time writing stuff down that it might have been better to just read
the chapter and not worry about it. And so I spent many years taking notes and not really getting
anything from the taking notes but really spending so much time. Every time I do something, I
spend a really long time. I’ve always been pretty slow about stuff and like it never occurred to
me that I had ADHD until I was in college but I already knew I was slow. Like I was a slow
worker and I think kind of slow. When I do class work next to people doing the same class
work, I do it slower and even if I do understand all the material, I just do it slower and I don’t
know why.

Me: It sound like you are looking at it from different angles vs. someone who maybe
haphazardly reading it. You’re trying to analyze it, deconstruct it.

CeCe: Yeah. Pretty much every time I do a problem, I basically have to connect it to some other
problem I’ve done or if it reminds me of something else, I freak out and I’m like, I don’t
remember that. I have to remind myself that it makes a connection so I know everything. Like I
know that I remember everything.

Me: Actually from an educational standpoint that is not a bad idea because you’re trying to
incorporate prior knowledge. The goal is to have automated knowledge so it doesn’t take you so
long. But the thing is you’re also a perfectionist so you’re integrating and synthesizing
information a little different. You can’t just take things at face value. You’re always trying to
144

bring a historical context into it but you’re trying to deconstruct it to understand exactly what it’s
trying to say.

CeCe: I’m thinking what if this happened then what would happen? Do I understand that? And
that’s really bad for Physics because I never learned Physics properly so they have very general
laws or umm… like theorems or equations and like they only have like very simple examples
usually. Then they tell you to do different problems, that how you usually apply those. But I’m
sitting there going, ‘wait. What if it’’s like this and it’s not a…’ I’m not sure of what this law is
applying to. Is this allowed? What is something this or this happens? I do that for Chemistry
and my Chem T.A. was like, ‘you don’t worry about what if this happens. If these 2 things react,
what happens?” She’s like you just need to learn the reactions you’re taught in class and you’re
not going to have to know other stuff and on the test.

Me: So how does that make you feel? Once again that invalidates your experience of how you
construct knowledge.

CeCe: Well, I don’t know if it invalidates. I just feel different and then I… cause… It’s
generally for me because I get very anxious if I don’t know what’s gonna… like cause then it
suggests to me that I really don’t know what this means. And I probably don’t if I don’t know if
this happens or even applies. Or is this something you even need to worry about. Is this a
reasonable thing I will like have to know? Like to me, if I’m wondering that and I don’t get an
answer from someone or they’re like just don’t worry about it. Then I feel anxious that I just
don’t know it. I don’t think that that’s like an ADD thing and I’m thinking differently and their
saying like you’re thinking is bad. They’re just saying that oh you’re worrying about it too
much.

Me: It sounds like you’re trying to take the problem to a different level.

CeCe: Oh yeah. Maybe. I guess sometimes I do.

Me: It’s not bad. It just means that you are trying to really understand the full nature of what the
problem is saying to you. You could easily say: A+B=C but you’re say now then what else
could happen?

CeCe: Yeah.

Me: That doesn’t sound like a bad way of looking at problems because they’re not just uni-
dimensional. They’re multifaceted.

CeCe: I think that after I learn things properly, I know it pretty well and I remember it. If I’ve
gone all through the annalysation, I will remember the material for quite a long time
comparatively I think to other students. But if I don’t learn it properly that way then I don’t
remember any of it because it’s just a ball of confusion and anxiety in my head. I can’t be tested
on it. I can’t remember. So it’s a good way for me to learn things but the problem is when I
have to… I do inconsistently on tests because if I wasn’t fully prepared and there are all these
little things that have bothered me then I feel that I don’t really understand what’s going on. And
145

then on the tests, I’m gonna have all of those questions come back because I never resolved
them. So if there’s something like that, I’m like wait but what if I’m doing or thinking wrong
right now cause I don’t know for sure all this time I’ve been studying is the correct material.
What if I was mistaken and… because I don’t feel like I have a hold on this material so I kind of
know it but once you ask me like, ‘when does this plus this equal that?’ then I’m like I’ve been
doing problems and my inclination is to do this but since I never got a good hold on this I’m… I
have no idea if I know how to do this right now. And so I just… I’m able to let go and just do
something cause it’s kind of like a crap shoot when I take tests. Was I thinking correctly at the
time? I don’t know. Cause sometimes, I can’t even count on tests. Like… sometimes, I count
things incorrectly on tests. I can’t explain that to anyone. There’s no conscious mistake going
on there it’s just like stuff going on. Like… and that was a problem I guess in high school
because things started getting harder. Umm… I started learning things that I hadn’t learned
before in school. I was hitting things that I needed to study for but I had trouble studying for. I
procrastinated so long that I didn’t end up studying for anything or I tried…

Me: Do you think you procrastinated because it was too easy for you?

CeCe: No. Like I procrastinated… well, I guess there’s two different kinds of procrastination.
Procrastinating where I feel comfortable in knowing what I have to study then I procrastinate
because I know that I can do this so I’m not stressed out. So I’m just gonna… like, I can take the
time to do whatever. I can take this time to start reading this book or something. It’s okay, I’ll
just do it later. It will be okay and I feel like secure. But then there’s they type of studying
where it’s like stuff that I don’t know and so I’ll start looking at it and just freaking out because I
don’t even know what’s going on here and then I start doing something else. The stress builds
because I keep distracting myself and then I come back and realize I still have the same amount
of studying and I still don’t know what it means and I have wasted like 2 hours now and I’m in
worst straits. It snowballs that way. When I have stress, I try to talk to my friends constantly but
then that turns into long conversations and I waste most of the night and then I start studying but
really I’m just like trying to get as much done as possible but then the next day, I’m just sleep
deprived and like whatever happens happens. I started doing badly in certain classes. It’s harder
to me to learn mathy things. Learning math is easy. Just like K-12 math is very math based. It’s
not very application based. It tends to be here’s how you do this kind of problem and I’m like
okay. Then I’ll do a couple problems and I’m good. I can do that quickly or I can learn that
quickly but on the test I can’t get As after a certain point. Like after a certain point of
complexity, I can’t do it without screwing up somehow so that a couple points go off here and
there so it goes down from an A. So even if I know how to do all those problems for the test,
like I can’t do it perfectly like there’s always something I forgot there and because I’m slow, I
can’t go back and check either because I always finish close to the end and then I have like 5
minutes to flip through and not just know where to look to check.

Me: So in the moment of taking the test, do you realize this? Or do you fixate on this from the
beginning and it snowballs as the time goes down?

CeCe: Umm.. I don’t fixate. I just try to do the test but I work, I think slowly. So it just
happens that I’m always at the… I’m always running out of time or barely finish. When tests
are really easy, I’ll finish earlyish but not like super early. I never… I guess that would be the
146

problem of making an answer and sticking with it. Just like every step of the way, I’m
questioning it. And making sure I’m doing this write and I’m not thinking weird. Even so like
something always goes off and like that always really frustrated my dad. He’s like I don’t
understand why you can’t. You just need to study more. It just means that you’re not
understanding the material if you’re not getting an A. You know. You don’t understand it fully
but I studied as hard as I could. I know I can do all these problems but I can’t add randomly. I
can’t add some simple thing like… I look at something like 2+ -1 and I think 3. I can’t stop that
because I’ve known how to add negative numbers since like 10 years ago. How am I… I can’t
explain to you why it won’t work out. So that was constantly frustrating for him. He can’t
understand that. He’s like you just need to do more problems.

Me: So does your dad think that, in terms of what’s going on, that you’re not putting forth the
effort? That you’re being a little lazy?

CeCe: Well, he thinks I’m lazy for sure but he’s like, I don’t know how to really tell other
people what my dad’s opinions are because on the one hand over time it does affect you that like
I definitely do have lowered self-esteem because of his criticalness but at the same time I don’t
know how much of it is true because he is really critical so compared to other people of my
similar potential which I don’t even know how to quantify. I don’t know how I compare in
terms of laziness or whatever. I went to a magnet high school so I knew lots of smart people
who just were very lazy but managed to keep doing well because they’re just awesome. And
umm… I wasn’t one of those and then there are people who are organized and awesome also. I
knew that laziness wasn’t exactly the case. Like I know when I do bad because I didn’t study.
Like I didn’t time manage and then it’s more frustrating when I did know what I was doing and I
still got a B or something. I just can’t help like I can’t do anything about it.

Me: In terms of your parents schooling, can you tell me a little bit about that? In terms of your
mom and dad’s educational background.

CeCe: Oh, umm… they’re both like graduate degreed. My dad has a Ph.D. in the sciences and
so he thinks that Physics is like the ultimate meter of intelligence because everyone hates Physics
and only like Physicists are able to do Physics. And I never learned Physics properly so I was
never…

Me: Your dad never gave you any assistance?

CeCe: Well, he’s really not a Physicist. He ended up doing like software consulting work just
like most Chinese parents that I know ended up doing some kind of software computer OCS stuff
because it’s easy to get a job comparatively It’s like easy at least when they were coming out of
school, it was easy. It was the ‘Big Boom’, that’s why every single one of them is doing
computer stuff. And my mom got a Masters in the engineering field too but I don’t think she’s
really suited to it at all. She just did what was practical.

Me: You mentioned that your mom kind of jokes around with you and says, ‘Whatever happens
is that because of your ADHD?’

147

CeCe: Well, she’s like half joking because she wonders if like that counts. “Is that what it is?”
She’s like still trying to figure it out and I guess I’m still trying to figure it out too but she is ever
further back because there’s so many things that are mental diseases that she doesn’t understand.
Like I’ve tried to explain depression to her and she just totally doesn’t get it. The same like my
roommate’s parents also don’t get it. They don’t get that it’s a disease. They’ll still call her up
and be like so how are you feeling? And she’ll be like, ‘mmmmhhh.” Then her mom will ask is
there a particular reason why you are sad and she’ll be like, we already went over this. There’s
like no reason… so, like there’s that kind of disconnect where it’s really hard for her to
understand what it is.

Me: It sounds cultural?

CeCe: Yeah. I think she has it too so like she’s always wondered how come it is that other
moms can keep up with housework and stuff because she is completely unable to have time to
clean. Like our house is just in shambles. And like that is a constant source of conflict because
my dad wants to have this like the nice idealic home where the wife does all the cleaning and
stuff and he’s like all the other moms have jobs, and children and like their houses look nice and
why can’t my house look nice? The funny thing is, his room is just as bad so it’s like maybe he
is too because it is possible he just has a different type of ADD. My mom says that she was
always better at studying beforehand than he did. He was always studying at the very last minute
and he tends to like… but she’s always late and he tends to be more paranoid about not being
late but he still ends up procrastinating til like the last minute until he usually leaves the house
but he tends to get to places on time more. But he tends to still like… I don’t know what he is
doing but he tends to dilly dally too.

Me: So where are your parents from?

CeCe: They’re from different cities in China. Generally from the Southish but they met in
America so they didn’t really meet in China.

Me: So do they really not have an idea of what mental illness is or do they not believe in mental
illness?

CeCe: I think my dad doesn’t believe in it. And I think my mom doesn’t really know what to
think. I think her unconscious inclination is to not believe in it because it’s foreign to them and I
understand because I wasn’t raised with mental illness being a thing. So I don’t, I don’t have a
real deep inclination towards believing in it. So it’s kind of a process right now or I believe in
some mental illness and then like some mild versions I’m not really sure what that is anymore
because it’s like in the spectrum of being really like dysfunction and being functional and then
once you get toward the functional, I don’t know any more what it is or if it’s just their
personality. Maybe it’s just their personality. It seems like assigning a dysfunction to just a
certain type of person and I don’t know what to think any more but I think she definitely believes
in extreme mental illness like people who literally hallucinate and things like that I think Asians
are pretty okay with that and realize that those people are actually insane and like they need help
and stuff. But once you’re… you seen to be coherent and especially if your smart than they like
to ignore the mental illness is like a thing because. I remember in Chinese school I would see
148

lots of boys who had… there was one boy who I thought had some serious problems. I don’t
know. He seemed pretty anti-social to me but he was 10. I was like that kid is pretty evil and I
don’t even understand what he’s going to be like when he grows up. My mom was like it’s
okay, he’s a genius at math. I’m like how does that change anything. Why does that even
matter? Why is it okay that he’s like… I think there’s something really wrong with him but like
because he’s so smart it doesn’t matter. Like it’s okay that he’s like might need help with
something else but because he’s good at math, it’s okay.

Me: Or could it be a gender role difference?

CeCe: Yeah. It could be a gender role but he was really abnormal amongst the boys. He tended
to enjoy exploding things like or messing up things of other people and just running away and
laughing about it. And his parents would be like, ‘oh hehe haha he’s so mischevious’. I like,
‘no’. He’s kind of beyond there a little bit… I don’t know how he’s doing now but like her only
friend for the most part his son has been diagnosed with Asperger’s and so that has been a thing
like I guess when we were younger, we never really talked about mental illness but now that I’m
older we talk a little more just about general stuff cause the more like ‘friend’ relationship we
develop between the parents and the kids… like it seems like his mom is kind of just like, I don’t
know maybe she’s in denial about it. Like I think she accepts the fact that he has been diagnosed
but she definitely is in the Chinese way… just doesn’t kind of believe in it or at least before she
didn’t because I always thought that kid was like seriously socially stagnant but like it never
came up with the other Chinese parents who are like in their group. They never mentioned that
he was like different or like he’s really smart at like all the numerical type things you know like
science and math and stuff but he wasn’t so good at language stuff but that’s pretty standard and
acceptable for Asian boys. You know, it was never really a problem but as he got turned into
now… I think he’s a teenager now and he’s not functioning so well socially and it’s really
extreme now because you know when you’re younger and get picked on it’s pretty standard.
Kids are mean but once you get older and you are definitely aren’t working well with the other
people it becomes really obvious. Now it’s really becoming out and I think that she believes it
that but she doesn’t really understand what is going on with him or why it’s like that or like what
really is like his impairments. She just knows that he’s been diagnosed with something and
like…

Me: Did you ever feel when growing up with that kid that your mom was comparing you in any
way to him?

CeCe: No. Well maybe a little but he wasn’t close to my age. He’s closer to my sister’s age so
we weren’t really growing up at the same time that she could compare our development. Umm..
I felt like compared to all the other like other Chinese kids who grew up the same age as me or
around the same age. Even now when she calls me, she tells me about gossip. “Oh, I ran into so
and so’s mother the other day and they just graduated from Stanford or something. I’m like…
all these over achieving Asian kid things and …

Me: How does it make you feel when she does that?

149

CeCe: Umm… I think I know that she’s not trying to make me feel bad but she just can’t help
comparing me and like I help comparing myself either honestly but so it’s just like saddening. I
feel inadequate because I’m not… I don’t have like ‘wow’ things as much as those other people
so. Like they’re all going to… I guess this is also related to why I was stalking people I knew in
high school on Facebook to see where they are now. All the Asians have gone on to very
predictably Asian places like umm… medical school or doing Ph.D. or umm… investment
banker. I was never that type of person like I wasn’t really interested in doing the things that are
really valued to the Asian culture so I feel a lot of pressure to prove myself in those respects but
at the same time I have no interest in those. So then I generally feel kind of like pulled in
multiple directions and constantly comparing myself and like makes me feel like I’m doing less
all the time. Like I’m not as good as all these people I grew up with or like I went to high school
with who are also Chinese and my parents know about. And then, so then like… my mom
always said like, ‘oh our family is just not that good at school like we just aren’t so good at
school because we know all these…’

Me: Despite the fact that your parents are highly educated, she thinks you all are not good at
school?

CeCe: Yeah. Yeah. It’s just a matter of how many ‘wow’ schools you have like you have in
your history. You know. Cause I don’t think we hung out with too many parents who had like
kids who ended up going to regular places. I guess in general that people did go to college
because we are from the wave of immigration were all the parents were already college educated
and they came here for grad school and so they met a lot of their friends and they ended up
settling in the similar areas. Like affluent, upper middle class areas so and they’re all college
educated Asian Americans. They’re the first generation, then they have their kids and so their
kids are of course going to go to college because like their highly educated already so like the
baseline is that they are going to go to college but ‘where?’ is the question. Where and what
after that and what kind of job they get and what industry? That proves to them how smart they
are is probably the biggest respect points and then the intelligence is measured by like you know,
the name of the school you went to and whether you got into medical school, whether you got
into a PhD program and whether or not you have any other high paying job.

Me: So, when you got into the Pacific Southwest University. What was your parents’ reaction?
Were they happy?

CeCe: They were luke warm. I think my dad was like this is way too expensive but I had…
when I got in, I didn’t have a scholarship but then I got the National Merit thing. I applied for a
scholarship just as is but I got rejected because my grades were no like top grades like other
people. They were that same as they are right now actually maybe a little bit higher like a 3.68
when I applied for stuff. It got a little bit higher at the end of senior year but like umm…
because I went to the high school with really high achievers, it was actually about average of a
GPA. There were so many people getting over 4.0s that it was just like… there were so many
people getting close to 4.0 that I was almost at the below average for my school. Even now, they
instituted a new rule that if you get a GPA below 3.0 that you’re not allowed to go there anymore
so they have to move you out to your regular school because it was a magnet school that drew
from different districts so you have to go back to your regular district school. And so that goes
150

to show the range of GPAs that people really have like it’s from the 3.0 to over 4.0 and half of
my class was above 3.5 and so it was like… comparatively, I was never on top of stuff. And so
like my grades were never… like I had a couple scares in high school which was the 1
st
time I
got any below a B so my parents were freaking out and my mom would be like, ‘oh well’. She’s
more of a resigned person. She doesn’t get angry she says, ‘oh well. I guess we’re just not that
good at school. She just goes off. She says that you should just do better next time but in
general, she just thinks that we’re not as good as some of these other kids that she knows in
school because clearly they can get A’s and B’s constantly on their tests. And at the end, they
generally get A’s for their final grade and I’m like… there were a couple of classes in high
school where I was barely… like I was getting D’s sometimes and like I didn’t tell my parents.
But like in freshman year, I took my 1
st
like computer science class and I could not pay attention.
I can’t pay attention to anything math or like math but not math related but like were they
communicate in math or the language is kind of math. With humanities and other kinds of
things, the way they communicate the information is in words so it hits your brain like you
understand it. With CS, it’s kind of like a new logic like you communicate through like math
and like symbols. So once there’s a little bit of a delay of some kind of information transferring
to my brain, I can’t pay attention and like so… I don’t understand math equations and symbols
very well. Like I have to actively think about equations to know they’re describing and how they
describe the situation it doesn’t just hit me. So when everything starts being described in math or
in physics class and to a degree in chemistry but I got used to chemistry but the 1
st
time I took
chemistry, it was really bad. It took me a long time to learn those things because I couldn’t learn
in class. I had to learn it myself.

Me: So it sounds like your symptoms were present back then?

CeCe: It didn’t occur to me that that was ADD. I just couldn’t pay attention and become
narcoleptic.

Me: In retrospect, do you think it was because of your ADHD? Or were you just not interested?

CeCe: Maybe. I don’t know because other people like… you tend to discuss with other people
like how you can’t pay attention in this class and they would agree with you so but at the same
time a lot of those people are just very critical of themselves and also they’re not too worried or
they’re not seriously not paying attention or they pay attention mildly and they don’t think they
were really on it the whole time so they’re like, yeah, I can’t really pay attention. It’s just
boring. He’s so boring. I will literate fight sleep the whole time that was just my class activity,
to fight sleep to not look bad falling asleep. Like in certain classes where I just didn’t understand
anything because … I tend to pay attention in the beginning of the course and as things go up on
the board like equations or something like that that doesn’t hit my brain really quickly, then I
start getting slower and slower and I fall behind and I don’t know what the next thing is anymore
because I’m still on the last thing and make sure that I understand it but they’ve moved on. And
then when that happens, I’m basically behind and then always lost because after that everything
they say, I don’t understand and I just start falling asleep and… the 1
st
time where it was really
terrible was when I took summer chemistry in sophomore year. All my friends were taking it
and it freed up space so you could take AP chemistry then next school year during the school
year. During the summer, me and all my friends were taking chemistry over the summer and
151

like that was most terrible because the schedule was 3 hours of lecture in the morning and then
you did a lab and there was 3 hours more of lecture and like I realized that I just could not pay
attention to things that were not interesting in the lecture. I just started doing really badly
because you learn so much in a certain day than I’d just be fighting sleep for like 2 hours at a
time and it was awful and I didn’t learn anything then I would go home and try to read the book
and learn it. I could not keep up and like… I really didn’t see anyone who had serious issues
with sleep. All my friends could definitely stay awake and I couldn’t understand why it was so
hard for me to stay awake but I think I got like called out once because the teacher was noticing I
was asleep. I was like, I can’t do anything about it. I was like really sleepy right now, I can’t do
anything much less understand what was going on. I was trying to not be asleep and that was my
whole activity for that class. I was getting C’s and I ended up with like a B but barely with
homework and labs and stuff like point padding so it worked out.

Me: When you were having problems were you able to ask your parents for help because they
are highly intellectual when it comes to the sciences?

CeCe: Ahh, no because my mom doesn’t remember things and my dad mildly remembers things
but he tends to remember extremely advanced things and then he tries to teach you that. And so
I learned to never ask my dad for help because he then gets fixated on helping you but then he
needs to actually review what you’re learning and then he injects all this advanced stuff because
he thinks it’s fun and I just start falling asleep. He rambles a lot kind of like me and he just gets
going and all this stuff comes out and he goes over what you need. He like, he like… over
expects things. My mom tends to tell him when I need help because I complain to her so I
stopped complaining to her because once I complain to her she goes and tells him that I need
help and he comes after me. It’s like more trouble than it’s worth for the most part. He doesn’t
really know Chem or Bio and then he knows Physics but he doesn’t remember how basic things
are. He tries to overcomplicate it so it’s really more trouble than it’s worth asking him for help.
He tends to expect way more out of you than you need to and then it wastes your time because
you need to learn all this other stuff that…

Me: So it stresses you out more?

CeCe: Yeah. Basically. And so I never really got into the habit of asking my parents for help.
It’s not a thing for me. I don’t ask my parents for help with school work.

Me: Do you think that asking your parents for help impacted your self-esteem at all because
they are highly intellectual?

CeCe: My mom never felt intellectual to me. She doesn’t seem to be like an intellectual person.
And my dad just… I don’t know him too well to like know that he’s an intellectual. I think of
an intellectual as someone who’s really curious about things and enjoys learning stuff and
discussing random things about the world. That’s how I define it. And my parents never felt
like to me to be really intellectual people. They’re highly educated people but I never felt like
they were intellectuals. I didn’t feel inferior in that way. Amongst Physics I felt bad that I
couldn’t get Physics compared to my day but umm… I never… I don’t think that was ever a
thing with me in terms of me not feeling like I was measuring up to my parents.
152

Me: It sounds like they have a lot of expectations of you?

CeCe: Yeah but I don’t think they’re any different from any other people I grew up with or their
parents expectation so umm… but like half of those other people were able to meet their
expectations as far as I could see because I’m not in their family but as far as I could tell. They
seem to meet or come pretty close to their parents’ expectations. A lot of the Asian kids that I
grew up with did go to Ivy League school and major in something suitable and …

Me: What do you think your parents would say about your accomplishments to this point?

CeCe: I personally have a difficult time trying to figure out what I’ve accomplished which is a
problem now that I have to interview for things. I’m kind of at a loss for what I need to say
when people ask me what I’ve accomplished or obstacles you’ve overcome. To me it’s a very
everyday thing… that’s just how you live. You have to overcome things and finish things. It’s
not an accomplishment for me because it feels so pedestrian. So I think it’s the same way with
my parents. They feel that everything I’ve done is like pretty… I think it just happens that they
know a lot of other special kids because I went to the high school that I did and so maybe they’re
like mildly proud that I got into the high school that I did.

Me: And that you’re doing pretty well in college. You’re about to graduate soon.

CeCe: Graduating is not an accomplishment to my parents. Especially my dad, he didn’t even
really want to go to my high school graduation because it’s so standard because if you don’t
graduate from high school than you are a failure but if you graduate from high school that you’re
a normal person.

Me: So what happens if you finish your degree and you don’t go on to grad school? What do
you think their viewpoints of you will be do you think?

CeCe: I don’t know if they care about grad school too much because there are other things that
are equally as prestigious like as long as you turn out to be successful by their definition you
don’t need to have a grad degree.

Me: So what is their meaning of successful? A good job?

CeCe: A good job and quite rich. Yeah. Pretty much. Very comfortably rich and secure
basically. Security is basically really important in the job. It can’t have a social stigma of some
sort like gambling or other things that are kind of shady. So it’s limited to being like a lawyer or
a doctor or CEO of a business. Something that’s kind of permanent in a way like you can’t
really go into terrible straights unless you’re on the statistically low side like being a lawyer or
doctor. Even if you’re not a rich one, you’re guaranteed to have a job.

Me: So they have set the bar pretty high for you. I’m wondering if you don’t meet that
expectation, what would happen?

153

CeCe: I have slowly not met their expectations and so they have slowly started to resign
themselves to like not have amazing amazing kids so I think my mom is easier to reside herself
whereas my dad tends to do this thing where he tends to hope for things because he thinks it’s
possible that… because his kids aren’t dumb or anything but if it doesn’t happen, then he’ll have
a break. Where he will have a tantrum basically because this is not happening because he can’t
have… like he also gets disappointed with my mom but it’s just easier for her to be like oh well
and then she tends to turn it inwards. It’s like a resign ‘oh well’ kind of feeling. So then she
accepts it more and she overly accepts it and tends to expect less of you and that makes you feel
a little less… it makes you feel like oh that’s all to be expected of me now. With my dad, he
kind of… he’s really critical and yet he doesn’t tell you. He doesn’t tell you that he expects all
these things of you but you find out when he’s angry that it didn’t happen because he doesn’t tell
you that he believes you can totally do this. You just find out that he didn’t believe in it because
when it didn’t happen he’s like super angry with the disappointment because he’s been let down
and thought that this would happen even if it doesn’t happen. So…

Me: How does that it turn feel?

CeCe: Umm… immediately speaking, I just try to get away because there is epic stress going
on. He like attacks you from all sides. When he’s mad, he tends to bring things that don’t
belong or connect. All the things that bother him about you, he brings it out by criticizing you
even if it’s not related to the situation but it’s like… it changes his view of you because he has
this nice cloudy view of you as his kid as you being like umm… super successful because you
kind of have promise or whatever. You don’t seem to have serious issues. You don’t have signs
of being like seriously dumb. He has this nice cloud bubble in his head. Once it doesn’t turn out
like he thinks, then he has to revise his view of you and then he kind of like swings to the
opposite side of things like these are all the bad things I’ve noticed and they make me secretly
believe that you’re going to turn out to be a non-functional person. So now, he has a whole
panic attack about like… you may actually be the worse that he thought and so he can’t think
that you didn’t meet his expectations. He swings from either side.

Me: It sounds like a pendulum.

CeCe: Yeah. He swings from either side. I think that over time, he starts to accept things like
you’re kind of just in the middle and that’s okay. He thinks that being average is kind of a
failure in itself so like in that way, it’s already polarized.

Me: Do you think he is projecting his own insecurities on to you?

CeCe: Yeah. Probably. I didn’t really think too hard about it before I left home from high
school because I would just try to analyze what type of thought processes he was but now like
when I’m distanced more, I can think more about ….

Me: You went across the country?

CeCe: (laughing).

154

Me: So what do you think was going on there? Was the plan to leave and go away as far as
possible?

CeCe: Well, I didn’t plan… like I didn’t need to be across the country far but I wanted to be in a
big city. I kind of wanted to go to New York. I just wanted to not be in the same state because I
did not want them to easily come visit. Like… like without warning.

Me: So what’s gonna happen for Thanksgiving? Are you going to go home?

CeCe: Oh, I never go home for Thanksgiving but I go home for Winter break. I always make
sure to have some kind of job for the summer because I can’t be home for 3 months at a time but
I go home for a couple of weeks at a time. Like 2 or 3 and I’m like… that’s enough of like… or
like it’s gotten nicer over time because I think that he sees less of me so he sees less of the
worrying habits that I have. So I think lately… my mom’s been mentioning things about how
he’s like CeCe’s doing okay. That worries me because it means that he’s got a lot of time to
think about making this bubble in his head of what I’m like. I’ve grown up but I definitely have
not changed that much. There are still things that…

Me: How do you know that he’s not thinking that CeCe’s doing okay? Not that he’s lowered his
standards for you but that she’s just doing really well.

CeCe: Oh. No no! He would never think that I’m doing really well. But like the the good kind
of … the good outcome of that would be that he’s starting to accept that I’m different and that’s
okay. Like I’m not achieving these like standardized achievements that other people are getting
and maybe that’s okay. Like… she’s not completely average but she’s not completely super
super awesome. But it’s okay, I’m okay with it now. But the bad thing is that he’s been away
from me so he doesn’t see me not waking up early in the morning. He doesn’t see me like
staying up all night. He doesn’t see me like doing all the things that I still do like I used to do
that too and to him, that ‘s a sign of laziness. Like… like… not waking up early in the morning.
He thinks that truly successful people or organized people have to wake up at the same time
every day. They have a schedule and follow the schedule. I’m like… cause this signifies that
every time he finds out about a bad grade, he tends to… we tend to distance ourselves on a daily
basis so he doesn’t see my daily struggles or whatever. Nothing outside of waking me up or
taking me to school and he would occasionally see me at night and I’ll be doing homework like
looking like I’m doing homework but really I’m distracted doing something else. But like for
the most part he starts like he goes into complacency. He’s like they’re okay they’re keeping up
with schoolwork and all of a sudden, he may find out about a grade that I go that might have
been a C or something and he’s like, ‘oh my God. It’s not what I thought. I thought was doing
okay but a C’s like failing.”

Me: So what would happen in your K-12 education if you came back with something less than
an A? What would happen to you in terms of counseling you or parenting you?

CeCe: My mom would be like oh well. She has a much lower threshold for like freaking out
and when she freaks out, it’s not like very alarming. It’s just her being upset. She gets upset
when it’s like a C or a D and then she’s like “oh no. Why?” But she’s not going to attack you
155

for it. She just kinds of starts to lower her expectations and like being disappointed and it makes
you feel like guilty but you’re not like stressed out. With my dad…

Me: Does she really lower her expectations or is she just a mellow and chill person?

CeCe: She’s kind of a mellow and chill person but she’s also kind of like… she is a very
resigning person like… she just resigns herself to things. So if things aren’t going well, she just
kind of resigns herself to it. And like, and like she gets a very pessimistic point of view so she
doesn’t stress you out, she’s just pessimistic and if you fail, she’ll just be like oh well. I guess
it’s to be expected because based on statistical data; you haven’t been getting A’s all the time
anyways. Sigh. Like my children are not as good as others.

Me: And how did that make you feel?

CeCe: I kind of mirror her and lower my expectations and then I’m like, oh yeah, that makes
sense. I’m not like a straight A student. That has been basically proven. Like, I’m not a straight
A student for whatever reason. I’m just not that type. Like I’m disorganized… I try to figure
out why but…

Me: So why do grades define the person vs. the attributes or the characteristics that you have?

CeCe: I always thought it was like a cultural thing. I like have developed much resentment for
the social culture of Chinese people because I see it as highly unhealthy for people who aren’t
achieving what they wanted to. Like, it’s all like, it’s super awesome for people who fit into the
mold and people who fit into the expectations for them. They do really well. You know. They
get the bragging rights. They get all the adoration. For people who don’t fit in, or like, umm…
don’t meet the expectations, or just aren’t interested in things that people find prestigious like…
it’s really unhealthy because you just get all this like… so much pressure to do certain things.
And that’s what you’re defined by. Everyone in society is only defined by their job and like
their material stuff.

Me: But that’s if you allow yourself to be defined like that.

CeCe: Yeah. Definitely but I think that it’s much more prevalent with the immigrants especially
who feel like they have to prove something. They have to… I’m never lived in China so I don’t
know if it’s still prevalent in China… like people still have that and I’ve talked to other
umm…types of Asians. Like I know this Korean guy who says that in Korea there’s this
universal social ladder with points. Like you get 10 points for becoming a Ph.D. and you get
another 10 points for becoming a professor. He’s like, I haven’t met too many happy professors
who like really liked their job until I came here. So that just tells you that in Asian, it’s pretty
prevalent that people literally, they are very compelled to define themselves by certain things and
it’s really hard for them to separate themselves when you’re raised in that type of environment
when like they have no emphasis on the emotional health really. I felt that that was a really big
issue because my parents also have a really bad relationship and they don’t know how to fix it
or… in my opinion, they should have never gotten married at all because they’re too different.
They’re just way too different. And like they just don’t know how to deal with that at all. It’s so
156

no in their field of knowledge to deal with problems. They just… I don’t know. My dad handles
problems by yelling and threatening people. That’s like the only thing…

Me: So does your mom become passive and meek about it?

CeCe: Not meek but she tries to get out. We all try to get out of the way and give him what he
wants to make him go away and then go on with our lives.

Me: Sounds kind of explosive.

CeCe: Yeah. Umm… I’ve concluded that he really doesn’t know of any other way. He only
know the way of taking advantage of other people before they take advantage of you and I think
that’s still a Chinese thing.

Me: Your talking about with family now not about with a stranger.

CeCe: Yeah. I just think that he’s an extreme case that it has spilled over into his personal life
and relationships just because he got like a … he never learned to function properly in a regular
social sense.

Me: So is he pretty aggressive personality wise?

CeCe: I think he… like I think he wasn’t never felt totally socially comfortable and so in order
to get what he wants, he just somehow learned in his life that you just have to go out and get it
and do whatever it takes and do things that aren’t kind of acceptable to me. To be really
aggressive and not like threaten people to get what you want. There are some moral barriers that
don’t exist because it’s just in the process of getting what you want and there’s no other real
way. If you really want to get what you want then…

Me: So is it like Malcolm X… by any means necessary?

CeCe: (laughing) Yeah. Maybe. He doesn’t… he doesn’t like… he’s really paranoid that
other people are trying to do what he’s trying to do basically. He kinds of judges people by his
own self. But the problem is, I think we all do that but problem is that he doesn’t really think
like other people especially in this country. So the way that he applies people’s motivations is
completely wrong. He’ll be afraid of people having certain ulterior motives that don’t make any
sense. He thinks that he understands people really well but he really doesn’t. He just fears that..
he thinks that they think certain things but from my point of view, that would be unreasonable. I
would never expect them to be having that far out of a ulterior motive for whatever they’re
doing. He’s really paranoid that people are always taking advantage of him.

Me: So does he try to teach that to you to? To be on the lookout for people?

CeCe: He has pretty standardized lectures that he gives about like you have to be competitive
and you have to get out there before they get out there and you have to do more problems than
everybody else so. But he never really gave me life advice about that. He just… I learned that
157

from the way he acts and the way he gets angry at my mother for being too nice. He’s like
without me you would probably be dead cause you don’t… you don’t pay attention to stuff and
you just let people take advantage of you but really for me… in that situation, there’s really no
point in fighting it. It’s not a big deal you know but with him every little thing has to be fought
and he has to prove that he’s not a pansy that he’s not getting taken advantage of. Then my mom
is like just… she’s a very passive person and just like kind of nice and normal but generally on
the passive side so she’s not going to confront people about things and so… my dad will be
angry at her for backing off because you know, she should have pursued that. She should have
made sure that she wasn’t being taken advantage of and to him that a big… it’s just stupid. It’s
stupidity of being like I don’t know… like it really bothers him.

Me: They’re trying to teach you all these Chinese ideals, means of life, customs and values but
now you’re also an American so at some point, there is a conflict between traditional Chinese
values and norms and American culture. So I want to know what was that like for you because
you want to go out and be social and fit in? You want to be a normal average Joe but it’s also
not okay because you’re Chinese and you need to excel and be different.

CeCe: At the same time like I always felt like I was different. I was always a little strange and
like quirky or like awkward. I think it was awkward for the most part. I didn’t think… but I
was like kind of strange also at first I was afraid of people so then I really didn’t know what
other people like… normal average Joes were like so I was… I just had like one best friend ever.
In like elementary school that’s how I operated until like 6
th
grade I just had like 1 or 2 like
“best” friends and then I would only hang out with them. And I would avoid having to like deal
with other people because I just instinctively knew that we didn’t really have too much in
common.

Me: So what happened in middle school and high school, did you have a lot of friends?

CeCe: I would start like having a group of friends but I only really felt close to one or two
people. And then I would have a group of friends that I would kind of hang out, eat lunch with
in school.

Me: Were they all Asian too?

CeCe: Yeah. For the most part, they were Asian but there would be like some other nerdy like
kids. In general, I would identify my friends as more being nerdy rather than being Asian
because Asian do tend to be more nerdy but I had White friends who were the nerdy ones and so
I was just like a nerdy kid. I didn’t like… I.. currently, I identify myself as being more “White
washed” then most… a lot of Asians but in the like nerdy sub-type hipster type like maybe.

Me: So what do you parents think about that then because if you’re more Americanized?

CeCe: They really haven’t talked to me about it because they don’t have too many friends. Like
they… they’re able to compare me to kids in academic senses and accomplishments but they
don’t know those kids well enough to know what type of kid they are and how Americanized
they are other than their level of Chinese proficiency or something. They don’t know any of
158

these other kids well enough to know that I’m more Americanized then them. That’s not a thing
for them because they don’t know what levels of Americanized there is out there. But my mom
tends to just… she tends to have comments like, ‘oh that’s because you’re American that you
don’t get this or why I don’t get this’. And sometimes it’s not even applicable. She just uses it
when we disagree. She’ll say, ‘that’s because you’re American.’ But umm, yeah… I don’t think
I had too much problem with the clashing of trying to be normal and fit in. Me as a person, I
think if I were ‘White American’ I would still not fit in because I’m not like a really regular
person. Maybe that’s an ADHD thing but like I’m not like a normal person. And I generally find
most people boring so then it didn’t bother me too much because as a child, I kind of distanced
myself from the popular people and found a way to look down on them. I guess in a sense, you
still have the jealousy of like, they’re the popular and socially active people and I’m always in
the corner afraid of them but at the same time, I look down on them because they’re not
interesting to me so I wouldn’t want to be their friend anyway.

Me: Do you think you’re afraid of them because of the way your dad socialized you?

CeCe: I don’t know about that. Like… maybe. Maybe I’m not sure of what kind of response I
would get out of people. If they would understand. I think I had a lot of… I guess something
from middle school and elementary is that I had a group of friends and then that was the time I
started talking to people about my family and then it was kind of spewing out of me constantly. I
would constantly be negative. Like stuff didn’t go well for the most part. I remember that one
of my friends who’s like American but I don’t think that had anything to do about it. She was
just that kind of people like… like… it’s not fun to be around you if you’re always talking bad.
Like negative things and then like I started not talking about my family or I tried not to talk
about my family as much except to like one or two people that I knew would like understand and
then so that was something that I remember just from like elementary and middle school. Once I
got a group of friends, I started like learning to talk about stuff because before that I didn’t like
talking about stuff. I felt like people wouldn’t get it. Or maybe I was too young to want to talk
to other kids about stuff. But as I started getting older, I really liked… learned that it felt a lot
better to just constantly complain about stuff if it was… like, so it didn’t just creep around in my
mind so then I would just spew it out constantly. But at the same time, I tried to not talk about it
all the time because then it gets old and I don’t know. I don’t know whether people want to hear
it or not because I don’t think they do. Back then, it was a constant thing. It wasn’t that I talked
about the same event. It was constantly events happening just from like family like so I always
felt awkward.

Me: Going back to when you said you had a few close friends when you were growing up. Did
they ever notice anything being different about you in terms of ADHD or did they just think that
was part of you persona?

CeCe: I usually had the friend who was just as crazy as I was so it’s possible that I sought out
other people who were ADHD but didn’t know about it.

Me: Sure.

159

CeCe: Cause like in the last year or so I thought that maybe… I took inventory and I feel like
that pretty much all of my friends have some kind of thing or another… some kind of thing going
on with their brain. Like, they’re either depressed or ADHD or have ADHD tendencies. The
people I felt really close to tended to be kind of loose and not too organized and like… umm…
silly. Extremely silly is probably what I like most about people so …

Me: Did that make you feel more comfortable?

CeCe: More comfortable and also that’s the kind of humor that I like. Just like absurd silly…
my really good friend in high school… she hasn’t been diagnosed with anything besides maybe
like depression. Like… she’s … she’s… constantly every 5 minutes she’ll just come up with
something really ridiculous to say. A ridiculous way to describe something that’s pedestrian so
that’ what I appreciate in people. Them just being to make everything funny because it’s just so
absurd and you don’t even know where it comes from because like there’s no logical thing but at
the same time, it kind of fits and it’s hilarious because it ridiculous. So I always had friends who
were… who I could have ridiculous events with. Not events but if we went out to recess, we
would come up with something ridiculous to do at recess and like laugh about it. So it’s possible
that like… I think I always sought out people who were different. I did have some friends who
were like ‘normal’ but I couldn’t be friends with them for too long because we would stop
having things to do. I would be at a loss as to what to do.

Me: Did you participate in any extracurricular activities while in high school… K-12?

CeCe: Generally piano, which is like a very standard Asian thing. And then I went through a
series of lessons of various kinds. Like my mom tried taking me to ballet, gymnastics and then
like diving for a very short time and then like wooshoo for like a couple years. Sports never
stood very well with me because I’m pretty bad at them so…

Me: I was more wondering if you were able to use any of the extracurricular activities to help
you cope with some of the symptoms that were going on with you?

CeCe: I don’t think that extracurriculars were coping. If anything, I didn’t practice piano very
much because I would get bored. Like my mom says, ‘everything becomes itchy’.

Me: Were there any issues going on with drugs or alcohol in K-12?

CeCe: No. No. It was like… I wasn’t even in a position where it was like… I would hang out
with too many people who would even did that or had access to that or even occurred to them to
do that. There was a relatively low number of people who did that in my high school so it wasn’t
like… I was never someone who liked to do substance things because it doesn’t interest me to
be drunk too much. Like I don’t like the feeling of not being in control. I’m not a thrill seeker.
So…

Me: So in K-12, you didn’t use any type of disability services because you apparently didn’t
know anything.

160

CeCe: I didn’t know anything. I was just a disorganized, somewhat lazy dirpy person.

Me: Is that still the case now or has it changed because the psychologist wrote you a letter?

CeCe: Oh! I recently got more time on tests. So, yeah.

Me: Have you ever heard of the Korshach Center? It’s a new center that started at the Pacific
Southwest University in the Student Union 3
rd
Floor. They have a computer lab and different
things in there to support students. They received a $10 million dollar grant to start a facility to
assist ADHD students.

CeCe: Oh! Next to the disability services?

Me: Yeah. That could be extra services that you would qualify for. I would encourage you to
look for the different services they have on campus to help you with some of the learning issues
that you think are going on with you. They can give you different preps or tutorials on how to
study, time management. When you have ADHD, your executive functioning and planning
skills decrease.

CeCe: I actually plan okay. I just can’t follow through. Like I can’t actually follow a schedule
because I’m gonna want to do something else. And then I can’t resist urges to do other things
and then I’ll end up doing that for 2 hours instead of half an hour like I planned. Like when I
look back now at all the possible things that might have been a symptom… like I remember
back in high school, I had an internship were I worked in a lab and we had to do self-evaluations
or something and my mentor… because there was a question like, “ rate their ability to plan
things.” And “rate their ability to follow through”. I was like clearly, I can’t get things done so I
must not… I don’t know. And he was like, there’s nothing wrong with your planning. You
make nice plans. You just don’t ever finish them. Like you don’t ever actually get everything
done like you were planning to do. And that’s generally my issue with life because I can’t ever
get things done. I’m okay with doing plans.

Me: I definitely know that you have some symptoms of ADHD but I’m also wondering on some
level because of you internalized guilt if you self-sabotage yourself?

CeCe: Probably yes.

Me: Like a self-fulfilling prophecy. For example, you think I’m going to do bad so I’ll show
you I’ll do bad. And if you do badly, then this reinforces their feelings about me that there’s
really nothing special about me to begin with.

CeCe: Umm… I guess. But then I still have competitiveness at the same time so I still keep
trying. I go in cycles. After I do badly on a test, I’m like depressed for like a day and then the
next day, I just kind of forget about it. Like… I tend to forget emotions easily that’s probably an
unconscious coping mechanism from my house. Where… like a shot to the system and then
goes back to normal and like then like a fuzzy baseline stage and then like… oh crap. I just tend
to not remember when I’m angry. I don’t remember what it feels like to be angry after I’m
161

angry. If I’m angry with someone, it’s easy for me to forgive people because I just don’t
remember how I feel about them. I just remember what they did but it doesn’t… it doesn’t
make me angry anymore so and then… it doesn’t bother me too much. I don’t hold grudges. I
am just weary around people after that. It’s not really a grudge. So… like for me, there’s
probably self-defeating going on if it is it’s more unconscious maybe. But consciously
sometimes yeah… but I thinks it’s more overshadowed by fear of doing the work or not being
able to… I just don’t want to do the work. It’s like painful.

Me: Well, you’re at the home stretch. You have 1 more semester, right?

CeCe: Yeah. But them what about graduate school. And I have to decide what I want but I
don’t know what I want.

Me: Sound this sounds like a really exciting part of your life right now? This is an exciting
time. Yes, there’s some uncertainty going on and I’m sure that’s arousing some type of anxiety
but look where you’re at. You’re going to be graduating and starting your life.

CeCe: Mmmm.

Me: It’s like a reframe. Reframe it for yourself.

CeCe: (soft tone) But I don’t know where I’m going. Like… I don’t have the like.. I don’t
know. I’m afraid of what’s going to happen and I have to know what the consequences of things
are.

Me: If you look at it from a social comparison standpoint, many of your friends are probably in
the same boat where they don’t know what they are doing.

CeCe: I know. Well, I guess I don’t have too many friends but the people who are not my
friends do know. My classmates tend to kind of know what they want. They know that they
want to go to grad school or want to go into industry or something. I think it’s the mainly the
problem I have is that I have interests that are not engineering. So right now, I have a lot of
anxiety about where I should try to pursue the other interests and so I don’t feel like I have other
classmates who understand because they’re invested in the engineering and they’re okay with it.
Umm.. they may not be super interested in it but they have nothing that they think they would
rather do and so…

Me: What is your alternative?

CeCe: Alternatively, I would like to get a design degree which is scary because this would be
the 1
st
time I try to pay for something. And it’s also something I haven’t tried to work on. I
don’t have a portfolio and I don’t know if I could do it. It pays less and I would have debt and I
don’t know if I’m gonna like it as much as I think I do because I tend to flip-flop around
different things.

Me: So what kind of design? Like interior design?
162

CeCe: Industrial design. Like product design. Umm.. in general, I’ve always liked artsy stuff
but I never stuck to one thing and so my mom felt that I wasn’t so interested in art because artists
don’t make a lot and I’m not obsessed with it or anything. So I didn’t go to art school. I didn’t
go to design school like coming out of high school. I had all these activities which allowed me
to… I got all this background in engineering so I should just continue with engineering. And
it’s like comfortable.

Me: So did you dad choose your major?

CeCe: Definitely. Definitely.

Me: Do you have any resentment?

CeCe: I have resentment but it’s not really completely on them because I know in general that
they grew up in a society that valued these practical things. Like that gets you jobs and stuff and
show that you’re smart were as if you do artist things it doesn’t prove that you’re smart to people
in the way that Chinese people think that you should be smart. It’s kind of like an analytical
smart you know and so I got conditioned to think that you’re only really smart if you’re good at
science and math. And you’re only really like… you’re only really going to be able to find a job
if you do these things. Umm… the kids that I grew up with that were Asian also continued to do
these things and the kids who went to high school with me, it’s like a science and math high
school and that was… there was a lot of emphasis on science and math. I have all this
background in science and then it seemed like I would just be throwing it away. It’s a comfort
zone. At this point I know how to do this now. I’ve done it for a while but at the same time, I
never really felt like it was me. I never really liked it. It was interesting at times just because
I’m a curious person but it wasn’t really interesting. Things like… things that people do that
impress me tend to be artistic in some way. I definitely don’t like art just pure like fine arts but
I’ve always like crafts and doing things with your hands… making concrete things. I’ve always
slipped around to all different types of crafts and different types of drawing then not drawing
then making this and not finishing it and then going on to something else and not having time to
finish it. So, I never really produced anything. I never really stuck to something so my mom
didn’t really... Even now, I’ve mentioned to her that I’m at a different turning point that I can
decide if I’m going to stay with doing the safe thing or whether I want to branch out of
something. I guess I didn’t know… I really didn’t know too many other Asian kids who were
able… who were interested enough in something that wasn’t Asian and went out and got it. So
it was like, it was what everyone else was doing… engineering or finance or something but I
really didn’t want to do business.

Me: So what would have happened if you came to the Pacific Southwest University and studied
theatre?

CeCe: That would have been not good because they would not have paid for that and I don’t
think I would feel comfortable in having them pay for that because I know the job prospects are
not good. They would totally not…

163

Me: Are you on scholarship here?

CeCe: I’m on a half scholarship. But it’s still quite a bit.. it’s still more than the state school
so… in a way, engineering was something I thought was worth the money as an investment.
Even now, it’s like should I invest the money in another degree to do something that will pay
less than I will be doing now so the invest…

Me: There’s some incongruence with the story. I’m thinking your dad and mom are saying that
we want you to be successful and we benchmark that by monetary attainment but artists can
make tons of money.

CeCe: They generally don’t though. There’s so much more risk in it.

Me: So they’re looking at the probability factor?

CeCe: Yeah. Even my dad isn’t completely happy with the engineering. He was trying… he
was like, oh, I have a job for you. Maybe you could go work at the patent office because once
you get into the Federal government, it’s really hard to get fired and it’s super stable. So, he’s
thinking… you know, you could just cruise the rest of your life because you’re like just in there.
Even engineering wasn’t stable enough for him because he wasn’t sure that engineers… they
want it like you constantly have a job. You don’t have to worry about not having a job. I
understand that because I’m afraid too because I’m still here.

Me: So how do you think that makes you feel that he tells you to get Federal employment
because you can cruise by and skate by.

CeCe: And have a comfortable living basically.

Me: But he also has these high attainment values for you.

CeCe: I think that before he wanted me to be a doctor or something or a business person because
that’s…. the doctor, lawyer is just obvious… pretty standard Asian. You’re highly educated and
you proved to everyone that you’re pretty smart. You generally make a lot of money all the
time. You don’t stop working and so I think that was his original benchmark but now he’s like
she didn’t go that path so what next. What is the next best thing I can think of for her? And it’s
super stable and it’s possible that they can get paid pretty well if they move up in the pay grade.
And so… he’s like, it pretty easy so if you’re good at it in a couple years you can rise to like
GS13 or like something.

Me: So they would never just come out and say, “CeCe whatever makes you happy will make us
happy.”

CeCe: No.

Me: You said that pretty quickly.

164

CeCe: Yeah (laughing). Because I don’t know what’s good for me.

Me: So, you’re doubting yourself and your abilities and what you want to do.

CeCe: Yeah, but I’m not sure if it’s more unsure than any other persons who’s like a very not
risky person or anyone who’s raised in the Chinese household tends to have a bit of practicality
thing going on where they fear non-security. They’re not going to go out and not make lots of
money. So, it goes back to… I don’t know too many people who became artists that were from
my background and who were able to make it. There’s only these stories that my mother knows
of people who were graphic designers or something and now they don’t have a job and because
of this one antidote she thinks that the job market is super bad that you just can’t do it. You can’t
do it. You have to be super good and she’s like, are you sure you’re good enough at it because I
don’t know. You didn’t spend your whole childhood drawing or whatever. Maybe you’re not
good enough. And like, I don’t think it’s the… it’s a field that she doesn’t even know about.
Like industrial design, it’s not really art either and I try to keep explaining that but she keeps
coming back to, “what if you really don’t draw that well.” You don’t really need to draw that
well. You just doesn’t get it. But like, I’m not sure if my fears are any more than a person
who’s a fearful person. In general, I’m a fearful person and that may have roots in my family
background but right now my personal fears are kind of… I think I’ve done a decent job of like
convincing myself out of influences from my parents even though conscious habits of my mind
that are ingrained in me so the comparison with others… like using others as a yard stick
basically. And basically, I’ve put myself in a place where no one else has done what I want to do
so I don’t feel encouraged that I can happen I guess and I really can’t talk to them about it.
They’ll think it’s cool that, oh, that sounds cool but they don’t understand how to do it or like
they’re not trying to do that or go there. They’re going in relatively easy transition… going
from an engineering degree to getting a job. There’s a lot of resources for that because the
engineering school expects you to do that. They’re prepared to help you find an engineering job
or something or a consulting job maybe.

Me: But would you be happy with that?

CeCe: Mmm. Probably not. I would be happy with the money because I think that my coping
drug at this point is probably shopping because I can’t resist impulses to buy things and so I tend
to spend money as I earn it. So money would be good. Right now, I’m not sure if I would be
happier if I was doing design or be happier having a nice job. Because I proven to myself that I
can deal with doing jobs where I don’t particularly like and like as long as it’s not too stressful, I
can do it and life is okay. And I find more like… I’ll just hang out with friends or something
and especially since I haven’t done design, I don’t know exactly how much I would like it
because I don’t feel as strongly about it as some other people do. My mom’s like what if it’s just
your ADD and like in several years, you’ll realize that you want something else? What then?
I’m like oh no, what if I sink all this investment in it and it’s not a practical investment and what
if I change mind later. I don’t want to particularly deal with the debt at that point.

Me: Well, things happen. People on average have maybe 2 or 3 careers. Things happen in life
and you take a fork in the road. You go somewhere else and your interests change. But to be so
rigid, that life is linear can be difficult.
165

CeCe: I think that’s particularly an Asian thing. Like in Asian society it is literally like that. At
least may be it isn’t today but in their time, it was literally like that. You literally had one career.
They came here and had no choice. They had to have 1 career. So they can’t understand to have
the mobility to have careers. They’ve ingrained into me the fear of not having 1 career. And so I
don’t know anything else. I consciously know that people change careers because I hear it all the
time but career centers tell you and teachers tell you but unconsciously it is ingrained fears that
are Chinese. So that’s the pulling in the different directions. I guess I never really had a lot of
trouble trying to fit into “normal” White or like “normal” Joes because I was never a popular
person. Hopefully, I was above average in my ability in a teenager to be like… “That’s okay.
They’re boring anyway”. And so I was not able to feel bad about not fitting in.

Me: So you tried to rationalize it?

CeCe: Yeah. And I was okay with it. I didn’t have too much to stress with. You know trying to
fit in with normal people as well as trying to meet expectations as well as trying to… I was okay
with being different but at the same time, I was okay with being the “bad” different which is like
the disorganized and not able to get straight A’s like these other Asian kids and that was the
stress. Not being able to measure up academically to these other kids. I was okay with just
being strange and just finding other people who were also strange. They were a lot more fun that
trying to fit into people who didn’t even interest me to begin with so for the sake of fitting in so
yeah. I think I decently good at getting over but not completely because everyone wants to be
loved by everyone but I was okay with that.

Me: The main thing is that you’re content with yourself whatever that means for you. I really
appreciate your time. Is there anything that we didn’t cover that you think I should know about
relevant to K-12 and ADHD? I think you covered a lot of territory.

CeCe: Oh, really.

Me: Yeah. You really did.

CeCe: I wasn’t sure if I just started rambling about a lot of stuff that didn’t like… that didn’t fit
into the thing.

Me: That’s okay.

CeCe: Oh. Mmm.

Me: Do you have any questions or anything I can address for you?

CeCe: I’m actually curious about what kind of high achieving Asian people that you… whether
there’s kind of the image of that subtype because like what I found out about whether I had
ADHD or not, I went online and kind of read about it and it like… people definitely tended to
focus on the impulsive one because that the more general ADHD and so that doen’t fit me much.
The hyperactive kind so… then they went into inattentive but then there’s inattentive people who
166

have it really bad I guess and they do really badly in school and so I wasn’t doing that badly in
school and that didn’t match me either. I have trouble identifying with like… yes, I am ADHD
because that person is ADHD and we are also similar and like… we’re high functioning.

Me: There’s a whole gamut within the diagnosis. There are 3 subcategories of ADHD,
inattentive, impulsive and combined type. It sounds like you’re more inattentive. You’re
definitely not impulsive from what it sounds but the things is… despite your disorder, to feel
comfortable within yourself and think of this a normal phenomenon for yourself. I think for a lot
of people when they think they have a mental disorder or mental health issues… they feel
abnormal because they have a label. Sometimes it’s therapeutic for some people because all my
symptoms or what’s going on with me, someone knows about it.

CeCe: I definitely think that happens a lot with people when they get diagnosed when they’re
older because you get to grow up feeling like you don’t have a disability. You may feel different
maybe and so I don’t know how much of that is because I’m ADHD or because I’m just a
different kind of person. Not fitting in with what Asians value just with the science and math
thing because I wasn’t truly interested in science and math but I was always doing it. I was
always doing it. That’s just something that I do. I felt different in that way but I’m not sure if
that counts but… I don’t feel bad for being weird and quirky but it’s just that when I feel
different in terms of not being able to keep up with my life and not keeping up with obligations
than I feel that the different is bad. Like I actually have… I’m happy with the weird stuff and
just being weird but like I kind of enjoy that so if that’s part of the ADHD then it’s good in a
way. And so…

Me: Or could it be just part of your personality?

CeCe: Exactly, I don’t know where that stops and once I got the ADHD diagnosis, it was relief
like someone knows about this and it’s not a thing and it’s not just that I suck at everything…
like time management. But umm… in that way, I don’t think it’s a disability because I found
out later on that… when… if I feel different, when I feel different and I’ll say because it’s
because I’m ADHD and like I have a disability and I’m like, oh God. So as I’m different, I’m
just different and it’s cool and now I find out that I’m also ADHD so then I have already a
person and I don’t know how ADHD fits into that except it’s a disability and makes it harder for
me to get things done. Even so, it doesn’t seem like a disability for me. It seems like something
I have a problem with.

Me: But you’re living with it. You are able to cope with it. You’re really high functioning and
you’re doing well in school.

CeCe: I’m definitely forced to though. I’m wondering how much that factors into it because
like because there’s so much expectation and there’s so many standards and so many high
functioning people around me. It want a question of… and I never felt like I couldn’t… like I
wasn’t smart enough. Like up until I met like genius people, I didn’t think I was smart enough
so then I didn’t feel… like I felt that actually being smart was the seed of your identity and like
the disorganization and not being able to keep up in school and not being able to control your
grades that was separate and because underneath, I didn’t feel too stupid and then like then I
167

must not be that bad and I don’t feel disabled I guess. I got this impression that if I’m disabled
than I would physically not be able to do certain things… like I can’t physically do things. But I
feel that I could do it if I wanted to but then I can’t. Or I can’t get it done. I don’t have the time
or I never have time until other people who know… there are certain people who I know are
very organized and think, how do they do that?

Me: Do you ever ask them?

CeCe: I thought it was just their personality. They’re just really focused people. They don’t
have problems with like…

Me: In terms of educational psychology, we look a lot at motivation and learning and how the 2
fits together and the use of different techniques called scaffolds or ways of doing things like
prompting yourself… if would encourage you if you see your friends who are doing well to ask
them what they’re doing and give you some pointers.

CeCe: There’s one example for you. A friend who’s Chinese American she does well all the
time. I’ve known her since middle school or elementary school… since 6
th
grade and like
organization comes easy to her. Like she has never woken up like late ever. She’ll say things
like… she’ll kind of try to commiserate about other people by say that, ‘well today, I slept in but
I woke up and told my mother that I was sleeping in and went back to bed.” I’m like, that’s not
sleeping in. That’s not like the ‘oh crack, I over slept’. She’s never ever over slept and I ask her
how do you even do that? It’s in fathomable to me. I can’t stop sleeping in and so it’s not a
thing she’s doing on purpose. She just literally has control of her urges to do some whatever.

Me: It could be biological that your circadian rhythm is different.

CeCe: Well, not just that I mean but when she does things. She makes schedules. She doesn’t
do things the last minute because she’s like… she has a list of her assignments which I also
have. I know that I should do this now and do this next. I can prioritize them. I just can’t guess
how long it will take me because it will take me way longer then whatever time I give myself.
But she can set a schedule and follow a schedule and get her work done before hand and so like
without major procrastination. What she calls her procrastination is not… is like a break for me
basically. Where I procrastinate so much that I can’t control my procrastination. She can control
herself and explain to someone else…

Me: It’s part of her make-up or her personality profile.

CeCe: It’s easy for her because that’s just how she is so I see it that way. That’s people I know,
that’s just how they work. Like they can keep a calendar and follow it. Like, they don’t get
bother by having to follow it and they don’t get bother by how they haven’t done this yet… like,
must do this now before I forget.

Me: I know that it’s Chinese custom to always try to “compete with the Jones”.

CeCe: I have so much resent for that.
168

Me: But at some point, you’re going to need to look at how are you going to be able to compare
yourself to yourself.

CeCe: I’m starting to get a lot of input from like outside of my family sources and outside of
that kind of Chinese subtypes or society thing… so it’s on the surface now and it really hasn’t
sunk in. I know all these things that I should be doing but in retrospect, it’s starting to sink in but
it’s not completely in there yet.

Me: So when do you think we can meet next? I want to give you time to do the journal. You’re
going to be going home for the holidays. When do you come back?

CeCe: Umm…oh, January.

Me: When are you coming back from winter break? Do you have any idea?

CeCe: January 6
th
. I think it’s a Friday.

Me: I would like to plan to meet how about the week after that to give you time to settle back in.

CeCe: Okay.

***Occurred after the tape recorded Interview #1 outside of Leavey Library, as research
participant wanted to inquire about the process of become a therapist.
CeCe: “I was curious about how to become a therapist. Can you tell me?”
Me: “Yes, I can do that but maybe we can talk outside for a few minutes as this room appears to
be reserved by someone else.”
CeCe: “Great. I really want to know.”
Me: “No problem.”
CeCe: “So how do you become a therapist? I always wanted to know.”
Me: “Well, there are different pathways to become a therapist. In the field of mental health, you
can be a Licensed Clinical Social Worker, Psychologist, Marriage and Family Therapist, Mental
Health Nurse (RN) or Psychiatrist.”
CeCe: “Oh that’s really interesting. I’m concerned with making money and being able to do
something that I like. I always wanted to use my artistic side but my parents are always telling
me that I need to do something where I can have a stable job and income. I’m worried about not
being able to pay bills, support myself and the cost of schooling.”
Me: “Well, there are different financial aid options and you can apply for scholarships. We are
fortunate that we are at a school that has money to provide assistance to students. The key really
169

is for you to find something that you are interested in doing. Money will come later but the key
is are you going to be happy with what you’re doing?”
CeCe: “I’m really scared to venture out and do something that would go against what my
parents think. I wouldn’t mind being an artist but there’s no jobs for that. My mom would also
say well, ‘why would you be an artist is I don’t even see you drawing or doing art? I guess she
has a point.”
Me: “At some point, you are going to come to a fork in the road where you will need to make
these decisions for yourself and do what’s going to make you happy. Part of life is taking
chances and learning from mistakes.”
CeCe: “Yeah I know but that’s not the Chinese way. They expect you to do certain things and
become either a doctor or lawyer. It’s difficult. I’m really scared about my future and what will
happen next. I guess I’m studying Bio-Medical Engineering so I’ll have something to fall back
on. That’s really not what I want to do I don’t think. It’s a job though.”
Me: “Taking chances are difficult. You’re gonna have to eventually make decisions for yourself
to make you happy even if it may not be what your parents want for you.”
CeCe: “Being Chinese American is difficult. They have so many expectations for you.”
Me: “What was helpful for me was to review all my classes that I took in my undergrad and
really evaluate the classes that I like and trying to pair that with something that would
incorporate that.”
CeCe: “That sounds like a good plan. I could do that. I’m afraid if I did something else and I’m
not good at it, I would have wasted a lot of money.”
Me: “It depends on how you look at things. On average, most people change career paths
around 2-3 times during their adult life. Life circumstances change, your outlook of life may be
different… these affect you and cause you to re-evaluate things. The key is to be open to change
and how to deal with it. You will need to make decisions for yourself and what you want to do
with your life.”
CeCe: “That’s really helpful. I’m just kind of stressed out because I don’t know what to do. My
friends and classmates are looking for jobs or graduate school and here I am not knowing what I
want to do with myself. I feel like I’m behind. Chinese are supposed to be focused and know
what they want to do. I guess that’s why my parents keep lowering their expectations for me.”
Me: “Give yourself some time and talk with different people and allow yourself to make
mistakes. It’s part of learning and growing. I never thought I would be a therapist or coming
back to school now. Things happen and life events change.”
CeCe: “That’s true. So I’ll do the journal and see you after the break.”
Me: “Great. If you have any questions, please feel free to call me or email me. I’m planning on
picking up the journal around the week of January 9
th
and the 2
nd
interview the week after that.”
CeCe: “Sounds great. It’s been really nice to meet you. Take care.”
170

Interview #2
Me: Hey CeCe how’s it going?
CeCe: Good so far. (Ambivalent)
Me: Oh, what does that mean?
CeCe: There hasn’t been enough work for me to snowball. So..
Me: How was your holiday?
CeCe: Mmm. Annn?
Me: It wasn’t all that exciting?
CeCe: It was just full of dad.
Me: What is that like?
CeCe: Terrible. I wrote about it.
Me: I know that you were concerned about the journaling experience and how your father
played a big part of it.
CeCe: My winter break was full of father anxiety.
Me: Well, good. At least you got to spend time with your family.
CeCe: That’s bad. (Giggling)
Me: So how has it been going for you so far this semester?
CeCe: Good. I’ve just been applying for stuff I guess. I’m kind of all over the place. I applied
for a fellowship to a Master’s program that I don’t know if I want. So , it was hard because I had
to tell them why I wanted it. And I still don’t really know.
Me: What’s the fellowship in?
CeCe: It’s just like to help fund people who are trying to get Master’s degrees in engineering…
women in engineering basically. I have this vague feeling that engineering is not that great
somehow. I know that it’s not that interesting for me but sometimes It’s okay and maybe I shy
away from it because it is so Chinese and I don’t want that. I’m not sure what is really going on.
I’m also applying for something in Germany like a German internship thing for sciences,
engineering and stuff… some kind of exchange internship program. It’s an excuse to travel
basically. I’m not sure if I’m gonna get that but it would be pretty awesome.
Me: Wow. So what would you do if you got into both of them?
CeCe: I don’t know. I would just have to decline one of them. I think the German one can just
be over the summer so… if I can come back before school starts than that would be good. Even
with the fellowship, it’s still not quite enough for the Pacific Southwest University. It’s kind of
171

difficult because I didn’t want to ask my parents for too money for the Master’s program
especially not my dad because he just holds it over my head. My mom said that she would
contribute but I don’t know if I want to do that yet. I should work some and see if I want it
because it is a big chunk of money that I maybe could have used for something else that I wanted
to do. And that’s unclear too because everything I like changes all the time.
Me: Do you think it’s because of your ADHD or do you think it’s because you have different
interests?
CeCe: I don’t even know. For me, I didn’t think anything was ADHD until recently. I just can’t
pick something that I like because what I like can change and why should I… I don’t know.
Why don’t I just do something that is just nice and Chinese… I minus well. Now, I thinking
that I might regret not trying a whole bunch of different things because it does that a lot of
motivation to try things that I even like because I get inspired for short periods of time. And then
most times, I kind of unmotivated to do anything. Or if I do something that I want, I just can’t
stay in the motivation thing or finish the project so I never finish anything for myself ever. And
that’s really frustrating for me now because I just don’t know what I should do. I don’t know. I
don’t really have motivation to pursue my own goals. It’s much more familiar to do what other
people’s goals are or like what I think I should be doing because that‘s more of an external thing.
I realize that I can’t do anything for myself so I don’t know what I want and whether I should do
what I want because I really can’t make myself do what I want anyways so it would be kind of
useless if I just went off and tried to do something else.
Me: So what are some of your goals?
CeCe: I guess in the big picture to not a big train wreck 4 years from now and just financially
and emotionally and not be in a family like my family and hopefully… big shiny like cloud
dream would be do to something that is more fun for me or that I intrinsically value more just the
daily work and being a little more stable. In the best case scenario, I would be like successful
enough to show all of them… like my parents type of person… I don’t want to use the word
parents because my mom is generally okay. She’s worried about stuff but she doesn’t try to do
anything. My dad is like the one who says, “no, this is how the world works”.
Me: So what happens if you deviate from that path?
CeCe: Well. He was actually on a mission this break to force me to come up with career goals
except that was like really stressing me out because I don’t have clear ones. He wants clear one.
Ones that are back up by how I have already done part of it. And they can’t just be like a goal.
There has to be like a clear plan and like flow chart crap and I can’t give that. Like I can’t
produce something like that.
Me: Do you think he really wants that or do you perceive him in wanting?
CeCe: Maybe both but he really wanted something detailed because if I just say something that
was true, he would say that that was just an idea. Like that’s just garbage and maybe I should
just talk to him because people say that but trying to just reminds me of my childhood because I
tried to and I just failed and I just stopped doing it. It reminds me of why I stopped. And I have
a good reason for stopping because I just get cut off. Like my mind starts getting warped and
172

I’m not sure like what’s going on like what I want and what he wants is like getting mixed up.
I’m like up and then I don’t even know what I’m saying anymore. So it’s kind of useless to
figure out what he wants. He’s worried in the Chinese way that if you don’t have a formula then
you’re not going to get there. You can’t… you can’t …
Me: There’s not different paths at getting to the same goal?
CeCe: You have to pick one or you have to pick a plan that you think is a path.
Me: What happens if you pick a path and it’s wrong and you choose another path and it’s right?
Is that acceptable? Or do you have to be right the 1
st
time?
CeCe: I think theoretically, he wants you to be right the 1
st
time. But he thinks that I’m
indecisive and it’s true, I haven’t really followed through on anything. So he’s worried that I’m
gonna just wonder about life, which is highly possible. But for him, it’s like a major crisis. Like
I’m gonna end up like a homeless person. It’s like… I’m gonna be a nobody because he kind of
looks down at people who are just employees even though he is because if I’m coming from a
middle-class background, judging from where he came from the proportional rate of success
should be much greater and so I can’t end up like in his general location. He has like really
skewed views of how people have gotten there. He as an extreme Chinese way of thinking about
stuff. When they see someone that’s successful, they just want to go out and by their biography
and follow their life basically. They take from it what they want to see. You know. He likes to
idolize people who are really successful entrepreneurs like Bill Gates and the Wal-mart people or
the Wal-mart person and Steve Jobs at least for the Facebook people it was something that they
done out of their own fun kind of…
Me: It sounds like some contradiction in that. Even if he were to idolize Bill Gates, yeah he’s a
billionaire but I don’t even think he finished college did he? I think he dropped out.
CeCe: But he’s okay with that. His new thing is like, you’re still nothing because you went to
college and you wasted time in college and there’s all these other successful people who were
too smart for college that they just dropped out. And so they were smarter than you, they didn’t
just follow the in-the-box stuff and they weren’t satisfied with their future success. His views
like they wanted to be rich and successful so they dropped out of college but like he doesn’t
actually know the details of their lives he just thinks that they don’t it this way. Like he thinks
that Obama because when he graduated college, he literally set his sights on the presidency but I
highly doubt that. He was probably going to law school and then hoping to be a successful
attorney and then turned to politics. I don’t know. He literally thinks that they set the goal early
on just one and they set out to be a lawyer but that’s not how it works.
Me: Maybe his concept of a goal and a dream are identical vs. being separate? You can aspire
to be something but your goal can be something different.
CeCe: Maybe but at the same time, he has a very warped view of how they got there. They
didn’t get there because they wanted to be rich and successful which is what he sees their goal as
being. I think their goal was being rich and successful at doing this thing that they wanted to do.
He leaves that part out. He doesn’t get that you work hard at a goal that is not personal. You
can’t just come every day with this goal that I want to be rich and successful… I’m gonna try
173

this version of being successful so like I’m gonna start a company so I’ll just pick something like
that I think the market needs. That’s not how they usually started those really big companies.
They kind of had an interest in the tech and they wanted to be successful doing the tech and they
weren’t focused on the money. But that’s not how you get there but he focuses on the money
and the desire to be better than everyone else is what got them there. He ignores the part where
they have a personal passion for that field of whatever that was.
Me: Do you think that he does that to arouse a response out of you because it sounds like he’s
putting you in a catch 22? Where when you chose one path you’re wrong and if you chose
another path you’re wrong? So at what point are you going to be right?
CeCe: I grew up in constant catch 22s. I don’t think he gets that. I don’t think he’s clear about
what he wants and like recently, he realized as part of his own growth through life that you don’t
need to be in the box. So over break, he was say that actually I would have supported you if you
like for example wanted to be a designer but you would have to say how you already tried it.
Like or you have shown that you’ve already done something like that instead of just dreaming
about it like, oh, I sold a couple of things like in high school. But he also sees it like everything
becomes a business you can’t just do something for the sake of wanting to do it because doing
what you like doesn’t get you anywhere. I think it’s a requirement for a lot of those people but
he thinks that what you want is really like just a hobby. And so unless you turn it into an
entrepreneur thing than and unless you’re an entrepreneur than you’re not going to be successful.
That would be the out of the box way to do things but if you’re going to be in the box then you
have to be a certain… the standard Asian thing. You have to do all the school because that’s a
requirement because you can’t just drop out of school. That’s like the highest level of success
for in the box, the standard paths of life. So he wants me to either do that which I’m not because
I’m just kind of wandering along. Or if I want to do something completely weird, than I have to
start a business. I can’t just do that.
Me: Well, you not just wandering along. You’re about to graduate soon.
CeCe: I’m an wandering because I don’t have a goal.
Me: Well, you goal is to finish school.
CeCe: That’s not a goal.
Me: That’s not a goal?
CeCe: Nnnmm.
Me: What does he consider it?
CeCe: That’s a given.
Me: But he was talking that it would be okay if you were a fashion designer.
CeCe: Yeah, but only if I had started a … he means the business of it. But what I like about it
is not the business of it. I’m not like a business person. I’m pretty sure I’m not a business
person. I’m just not that type of person. So if I were a fashion designer, I would be actually a
designer. People who are successful in that start out as designers and end up like business people
174

because they have to be and you get like less of the designing part but I’m more interested in the
more intrinsic less monetary part of it which is the hands on work which society generally tends
to not pay you lots for because they generally find a business person who they pay lots for.
But… cause if I could give you all the examples I’ve given him for that, say I’ve been doing this
on the side occasionally like I can’t show him that I actually produced this. He actually wants a
production of something and like some begins of business growth already. It’s just a train-wreck
so it’s not… I can only just leave and stay away as far as possible. I don’t know.
Me: I’m wondering if he actually means what he’s saying or is there a deep meaning? Maybe
it’s symbolic because Chinese people tend to use a lot of symbolism and metaphors.
CeCe: He’s really not that symbolic. The only thing is how does this reflect what is actual fears
are because he can’t articulate. He’s just ranting and spewing out all this name calling and stuff.
Generally, he has this kind of a warped sense of reality. And you really don’t know what the
details are like in his head but every time things don’t work out like he thought they would, he
has kind of a break down. He starts lashing out and that’s what you feel. And you kind of have
to work around that but it’s hard because it’s always a catch 22. You’re not sure what’s going on
in his head and that’s basically it. He has a very different view of the world that most people and
it’s not really a Chinese thing. He’s very extreme like a very extreme person. I think he took the
Chinese values and went way too far with it. I think he also has some kind of social disorder
because I’ve seen him in some social situations where he is just not getting the signals at all.
And so it’s impossible to communicate with him and so you don’t know what’s going on in his
head very well and you can’t mollify him at all. It’s kind of a constant struggle.
Me: And it sounds like how he perceives the world impacts the whole family. Your mother,
your sister?
CeCe: He just has a really twisted perception. Like sometimes, it’s normal and you start
thinking that he’s normal because he starts with a really normal premise like a good premise than
he just goes. He just diverts off the normal track of logic and you’re not sure when it happened
and then you’re there wondering like if he’s going crazy because you can’t tell when he’s going
crazy or not.
Me: So do you think there are some mental health issues going on with him?
CeCe: Every time I go back, I realize that both my parents have mental health issues. But I just
don’t know what they are. I find it fun to google them actually but obviously, I’m not educated
about these things. I feel that wow that’s great because maybe it’s like a narcissistic parent issue
here and I’m like… my mom is definitely a hoarder now that I’ve realized. She definitely is not
as bad as the people on TV. I feel like I’ve put some of these things in my journal because I just
kept writing. She’s definitely a hoarder and I didn’t realize that she was actually a hoarder until
like recently when I just started watching this show and when I try to get her out of it, I realize
that she has a compulsive need to collect things and like she can’t stop. She can’t throw things
away. She keeps buying things on sale that she might need some day and she can’t break out of
the cycle of like, I’ve had this thing for 5 years and I haven’t used it so I should probably get rid
of it. But she can’t. She just can’t let go of things. And my dad’s response is to scream at her
24/7 about it because he can’t understand it so he makes up reasons of why it might be
175

happening. He’ll like say that she’s doing it on purpose… it’s just like a giant thing going on.
Yeah.
Me: Well part of that identifies who they are as a person though, right? If you took away some
of his issues and you took away some of her issues then they wouldn’t be the same people.
CeCe: Yeah. I know. It’s just in general, it’s a train wreck to be around. My dad is really the
only stressful one because like my mom’s a hoarder and it’s annoying at best but I really don’t
mind. It just aggravates my dad. So he’s like a constant issue because he can’t stand all the
mess. Because he’s a pretty messy person so I don’t respect is objection that oh, I’m a neat
person that I just can’t stand this. It’s more like a Chinese saving face thing. He says that he
doesn’t have any friends because he can’t invite them over to our house but I feel that it’s just a
misunderstanding of what friendship is because if you have friends, it wouldn’t really be a matter
of where you can invite them over or not or whether you’re too ashamed of your house to invite
them over. That’s not how your friends drift away exactly.
Me: So when he says that to your mother or you guys, how does that make you feel? That I’m
ashamed to bring over my friends because of the mess or could it be other things?
CeCe: Well, because I’m like very Americanized, I don’t buy into that at all. Cause I know that
he has a lot of very warped ideas and I do understand that it is kind of embarrassing like when I
do bring people over but I’m not like extremely embarrassed but that could be because I’m not
like extremely traditional Chinese where I have all this face stuff going on. But it is
embarrassing but I think that most people don’t mind as long as they don’t have to live with you.
Like they really don’t care and I think that unless they are… like if my dad had a friend who was
just like you, I don’t think they’re going to judge you for it too hard because they’ll know that
you’re a messy person. Unless they have to live with you, they really don’t care. Especially if
they’re your friend, they won’t care. So it doesn’t make me feel bad about my house. It just
makes me feel bad that my father can’t understand that that’s not how relationships work. And
that he’s taking it too far and he doesn’t need to be throwing a tantrum like all the time like
weekly about the state of the house. Like being upset and when he’s upset he becomes verbally
abusive and like just terrible. So…
Me: So it sounds like that’s what caused you to move across the country.
CeCe: Yeah. I guess I didn’t realize it so much. Like I keep saying to you that each time I go
back, it just gets worse. I just start growing as a person and when I go back it’s like further
regression… like a bigger gap of regression.
Me: So what’s gonna happen after you graduate? Post degree, are you going to move back or
are you going to stay here?
CeCe: No! I’m gonna avoid moving back as much as possible. I really want to get a job out
here so I can be like, “nope, I can’t come home”. He was pressuring me to apply to the patent
office because it’s a nice cushy government type job but unfortunately, I think it’s kind of like a
white collar sweat shop. Like you’re supposed to pass patents through as quickly as possible
because you have a quota every month and that would not work well with me. I just applied for
it because why not and I wanted to get him off my back. Apparently, he was later saying that,
176

“don’t do it if it’s not your idea” and I’m like there’s no point of not doing it because it is a job.
That place is like only half an hour from my house so like I really don’t want to work there. I
don’t want to be within visiting distance or “oh, you can just live at home distance”; so it’s kind
of terrifying for me. Umm, because I might actually get that job because I am qualified for it but
I don’t want to go down that path because his grand plans for me is, “if you go to the patent
office, you might actually become a patent lawyer and make lots of money and all you have to
do is get over the hate of reading like giant stacks of paperwork”. It’s like don’t be afraid of hard
work and I’m like “no” I don’t want to put in the effort to get something that I don’t want. Like I
don’t mind putting in the work, it’s just that I would be putting in the work for something that I
don’t want. That seems kind of ridiculous and tiring but…
Me: Does he ever ask you what you want for yourself?
CeCe: Yeah. He does but I don’t think he actually wants to know because it’s not very concrete
and it would make him more afraid. Like he did make me tell him what I wanted but I just told
him that I’m not really sure.
Me: But does he know the experience of most people graduating with a Bachelor’s? Most
people don’t know what they want.

CeCe: I’m not sure that he knows but I think that he might know that Amercans do but
Americans don’t count for anything so… They’re just average because for the most part, they’re
just dumb minus the people who have companies already like in their garage.
Me: It sounds like a hard ideal or standard to live up to? You also don’t know what the standard
is because it changes all the time.
CeCe: Yeah. He doesn’t get that at all. He’s like in an emotional state that he has never felt
before so… it’s pretty impossible to explain to him. He’s only going to hear that you’re unsure.
He’s not going to get all this other stuff and he also changes and he doesn’t realize that it
changed a lot or his expectations and how it affects you. He wants me to be a risk taker,
entrepreneur type of person but I was raised as an obedient Asian child. I don’t know why he
doesn’t see the discontent of being an obedient person and he wants me to be an obedient person
who follows authority and then becoming an entrepreneur which the whole point is that you
don’t want to follow authority and you have the guts to take risks but on the other hand, you’re
not supposed to do that at home. He wants you to become 2 different people but he doesn’t get
that also.
Me: But what happens if you fail? He’ll say, “I told you so.”
CeCe: By that point, he may have been disillusioned already and then he’ll be on a different
mindset. Like he used to be like learning Chinese is useless until like everyone started saying the
China was the new financial giant, then he was like “you must learn Chinese”. He’s just always
like of changing and he always thinks that he’s kind of right.
Me: So it sounds like he’s influenced a lot by his surrounding?
CeCe: Yeah. He thinks he’s not. Like I can understand why he’s the way he is because there
was a point to it. There was something to lecture me about. He told me about his career story
177

after like … I don’t know, I’m 21 and I’ve never really heard his whole career story. But it
makes sense the way he thinks but his inflexibility is his own… his inability to see the world as
being different now. I really haven’t met too many people like that. He had a hard time going
from the Communist like the Cultural revolution he had to really work hard at now having school
for the lik7 years and then going to college after not going learning all those years but there were
1000s of people as well as although not everyone followed his path that there are people his age
who are my parents age who are like my friend’s parents age and they seem a lot more
reasonable than he is so… so I think it’s a very hidden thing. He wasn’t able to bounce back
emotionally. He kind of has a lot of unhappiness that he doesn’t know how to deal with because
he doesn’t even know how to deal with other people’s unhappiness and then dealing with his
own unhappiness kinds of warps him too. He doesn’t… he’s like on this thing where he should
be happy.
Me: But aren’t you happy now doing what you’re doing?
CeCe: Well you can’t be because you’re not where everyone thinks that you’re supposed to be
happy. If you’re not happy not you know, you’re not going to be happy later. Once you get
what you think you’re supposed to get and like, he doesn’t have that kind of a concept either
so…
Me: It sounds really difficult for you having to go to school, worry about school, going from the
East coast to the West coast, trying to find new friends, trying to do all this with ADHD and now
having family issues… adding another layer too.
CeCe: I think that the family issues make everything easier too like I think it was harder during
the 1
st
and 2
nd
year because he felt like he needed to call me every week or else I would slack off
or something. If he wasn’t pressuring me than I would slack off and everything would go bad
because my 1
st
semester grades were pretty bad but it really wasn’t related to my parents. It was
just like me transitioning I guess but he like flipped out and made me call him every week for the
2
nd
and 3
rd
semester. I look backwards now and see this transformation going on. From being at
my parents’ house to like being separate but when I go back I tend to regress to kind of like an
adolescent side like someone who’s oppressed and can’t think. I think in the last 2 years, he kind
of just tapered out and stopped caring so much about grades because he discovered new plans for
me to be an entrepreneur so he stopped caring about grades and he stopped making me call him
and then I was just free for a very long time.
Me: It sounds beneficial to you.
CeCe: Yeah. I know. I know that I can get certain grades and if it’s not those grades then
there’s something wrong and not in a terrible wrong way but it’s kind of a given for me that
these are kind of the grades that I get. And they’re not as good as I want them to be and I kind of
talked about that because I never finished anything satisfactory. I’m always up to the last minute
so I just barely finish it. There are parts of it that are not well thought through. Things like that.
And so I’m frustrated that I’m not doing as well as I know that I can do. If I was on time with
things and actually motivated to do work in a systematic manner instead of at last minute.
Me: It sounds like your parents, primarily your father has put a lot of pressure on you that when
it’s off, you’re just kind of resting.
178

CeCe: Yeah. I’m in chill mode.
Me: So what do you think it will be like on graduation day? I’m sure he’s coming out.
CeCe: I don’t know. I’m kind of hoping that he doesn’t because he might not but I think that
my mom might try to prod him because he might say that he has to work. I’m like, “yes, he has
to work”. (happy)
Me: You won’t be sad at all?
CeCe: Like stay away please. Because I really haven’t had a relationship with him so there’s no
relationship to be saving or trying to salvage or like trying to keep alive or something. It’s just
like all building from zero here. It’s kind of a big project that I don’t want to embark on so… I
feel like it’s not worth all the issues that I would have to undertake. He has his own problems
and I can’t deal with that as well as dealing with our relationship that’s not really there. Like it’s
not just something I can do because they all have their own problems. I can’t help them with that
so… because he really didn’t want to come to my high school graduation either because… even
for me, high school graduation was kind of a given because everyone I knew graduated high
school. It’s just kind of like a fact of life. Like I’m going to be 25 and I’m going to graduate
high school… I’m going to go to the movies. It’s kind of like on that part. It was kind of hard
for me to get congratulations from American parents because it just seemed strange for me. It’s
not something that big to me so I guess…
Me: So, what would happened when you graduate and don’t go to grad school would that be
devastating for him?
CeCe: No. He doesn’t want me to go to grad school because it’s a waste of time and money.
Me: So how are you going to be the patent attorney he wants you to be?
CeCe: Because when you go to the patent office and become a patent examiner because if
you’re good at cranking those patents through that they might actually fund your law school.
Me: So as long as he’s not financing it.
CeCe: Mmmhmm. Because then it’s not your risk, it’s their risk. And like if you’re that good at
cranking those patents through by that point, you’ll be really familiar with the process and you
can become super sought after because you have all this experience with actual patents after you
graduate from law school with a patent law degree. Now you can work with paperwork for the
rest of your life so… because it’s really terrible. When I have to read dry stuff, I just can’t do it.
I can’t read dry material. I would read a paragraph and then need to read the same paragraph like
10 times. I just can’t do it because like nothing is going in. it’s just a slow slow process.
Me: Well, it’s also part of your ADHD. What does your dad thing about that?
CeCe: Oh. He does not know. That would completely be out of his realm of comprehension.
Me: So he has no idea.
CeCe: Nnnmmmhhh.
179

Me: Does your mother know?
CeCe: Yeah. She does. But she still doesn’t get it. She still kinds of makes fun of me for my
therapy adventures. Umm… she’s not familiar with that kind of thing so she’s not hard on me
about it. She just thinks that it’s kind of somewhat not serious. I honestly thinks that she has
ADD too so I try to tell her too because we have the same… before all this happened, before I
went to college she was always complaining about how all these other people can keep their
houses clean, like they can do the cooking and the cleaning too after work and take their kids to
their lessons or whatever because I can only take the kids to their lessons and then we eat dinner
like at 10 pm at night and then I don’t even have the energy to wash the dishes because it takes
me like 2 hours to make dinner. Apparently, it takes other peoples mom only half an hour to
make dinner because she kind of asked someone else and it’s like that, people just do things
faster. They don’t distracted. And when we’re at the mall, she’s like “ooww, we should just pop
in there” and I’m like “no” because it will take like a half an hour. And this is why we are slow
again because other people don’t get these urges all the time to pop in there and check it out, pop
in there and check it out. She’s like, “really”. I don’t know either but I think so pretty much.
Like so that’s the thing with that, but my dad I will never really tell him because that would just
be really terrible.
Me: You think he would just lay off of you if you tell him.
CeCe: No because that would prove to him that I’m just trying to make excuses for myself and
that I’m going into the lazy American way of having mental problems because when I was in
high school, I had some friends with depression. One of my friends kind of took leave from
school, I’m still not really sure what was going on with him because I only had a couple of
conversations with him when he was out. After that, he only kind of sporadically came back and
I drifted away from him but when I did talk with him, it seemed like he might have panic attack
like issues. And he had like a sleep disorder where he can’t fall asleep at a normal time and he
had like no schedule and they had to put him on a schedule by taking sleeping pills and taking it
at a certain time of the day and putting him on a schedule. He was like out for months and
months. I wasn’t really sure what was going on but I mentioned that so and so is not in school
right now because he’s taking time off for like, I think he’s depressed maybe. But my dad was
like, “I’m sure he’s depressed if like he’s failing”. He’s like you shouldn’t associate with people
like that as if the depression is contagious because depression is caused by failure which is
caused by not having any motivation. It’s caused by someone who’s a slacker. And if you hang
out with slackers then, “oh my God.” Clearly, I don’t think he will be capable of understanding
any type of mental condition because he doesn’t even really understand bodily conditions. And
he still gets mad at me if he notices that I have a cold because it’s my fault for not dressing
warmly enough. But I’m like no, every one on campus is sick. My teacher is sick and like my
lab partner is sick. It’s like dodging a bullet here because he’s like, “no” just to keep warm and
exercise and you won’t get sick. And I’m like, “no, dad it’s a virus. You know it’s a virus
right?’ These are things that go from one person into the other person and then you get sick. But
I don’t know, he has like a traditional background so I think he has that kind of slightly
backward medical ideas or old wise tales based medical knowledge from one of his parents. One
of his parents was like a country person and that kind of colored their culture a little bit I think.
And I heard that they also have pretty bad tempers. So that may be where that comes from so…
180

Me: Your dad has a Ph.D. correct?
CeCe: Yeah.
Me: So, he should be able to think outside of the box.
CeCe: I don’t know though. I think that only applies to really non-people related things like
math. He has no people logic because I’ve never seen him have really good empathy perception.
He just doesn’t realize social signals, people signals, …
Me: So it sounds more like him vs. it being cultural.
CeCe: Yes. He’s just a really extreme person. He is a Chinese person but he took it to the
extreme. It’s kind of like if you have and American… Have you ever read some of the literature
about the American dream? Because I haven’t read too much in college so my GE classes there
were some American studies. There’s like, “What makes Sammy run?” which is like a Jewish
boy who had like a really poor Jewish family on the lower east side of New York and his dad
was really religious like a really good person. He just went totally away from that because he
was like my parents are useless because they spent their whole lives selling hotdogs in the streets
or something and working hard for nothing and so I’m just gonna cheat and lie and step on
everyone all the way to Hollywood. He actually steals people’s scripts and he absolutely has no
qualms about it. That’s just the way he thinks. He kind of took that American dream and he
went extreme with it and that’s kind of how my dad is. He took his Chinese background but he
is an extreme person and he just went way far on the really superficial ones that are really
obvious to him that the nuances of people are lost on him. He doesn’t really appreciate them.
Me: So going to the journal CeCe. What are some of the highlights of the journal?
CeCe: Highlights (giggling). I don’t even know. I feel like I got redundant at some point
because I keep having the same things going on. I wasn’t really sure how to do it so I…
Me: There’s really no right or wrong way to do it.
CeCe: I just kind of diaried.
Me: What do you think some of the themes or content were?
CeCe: Before my break, it was finals and procrastination, frustration with self and then my study
habits and the cycle that I go on. Being anxious so I start early but that just means having the
work next to me while I’m being distracted by my computer, which I can’t resist. So when I
actually get scared, then I force myself to leave my computer and everything and I lock myself
into a blank room kind of like something like this and then 48 hours of like cramming is what
always happens. Then there’s a vicious cycle of that…
Me: 48 hours of studying straight?
CeCe: Not straight but I go there and then when I need to take a break to eat food, I’ll get food
then I’ll end up going back and sitting there.
Me: So you’re basically up the whole time for finals.
181

CeCe: The day before like the 48 hours I actually sleep and I can’t generally wake myself up
unless I have an external appointment so I generally sleep a lot like 9, 10 and then from then on
whenever I get the motivation to go to the room then I just stay there forever because I’m really
not done. Because I have learned nothing over the course of a several weeks before the test
because I can’t listen in class and so I’m learning everything on my own. So I end up doing stuff
on my own because I have homework and I have this mini cycle where I don’t learn anything
before the test and I try to start earlier when I do have time but I can’t really push myself. I’m
kind of like in a chill or chill out mode until like 48 hours before a test and start freaking out
because like I have to do it now and then I’m just worried that I’m not going to finish. And if I
don’t finish, not even cursory finish sometimes and like the last day…
Me: It sounds like it’s your learning style. This has been going on for a while though.
CeCe: Yeah. It’s how my life works (laughing).
Me: So you wait until the last 3 or 4 weeks then it goes into anxiety mode.
CeCe: It’s like a couple of days. I can’t even umm… and I can’t work fast unless I have
anxiety. If I’m in a normal sane mind, I work really slowly. I like thinking things through and
like taking breaks and zoning out and day dreaming. I don’t know but it doesn’t even stop when
I am in anxiety mode. I still have periods where I just sit in the room and I’m like I don’t have
that much anxiety right now but I know that I should. So whenever I realize that I’m
daydreaming again than I’m like, “oh no bad… study.” And like it’s scary that I’m not even like
urgent right before it will be like 3 am at night and I’ll be like I want to sleep and I’m like if I
really want to sleep than I need to study because I’m really zoning out right now and it’s really
weird that I can’t make myself study right now. And that was mainly all of that… just stuff. It
ended up being kind of like I was writing to you slash the book and also just going over some
other habits and types of assignments. I think I got redundant… more details about what I
procrastinated on exactly. like I started for 10 minutes than I decided I need to get up to get this
other notebook because there’s other information in there and when I got up, I go distracted for
half an hour because I saw this other thing that I was interested in. I’m like oh that thing, I
should do that thing now so… I just do that thing and like an hour and a half later I realize that I
was originally going to do something else. It’s really terrible.
Me: Well, that’s how your life is though.
CeCe: Yeah but I want to get more done though. Especially at night, I get cycles of where I see
all this cool stuff and I see what other people do and it gives me ideas of projects that I could do
on my own. But I never never do those. I just get really excited at night and I don’t want to
sleep because sleep is like boring and then I just get tired the next day because I know I’m gonna
be tired and I should go to bed but I just want to finish reading this one thing on the internet and
this other thing. This just speaks of how many tabs I open up all the time, I have like 20 different
tabs open at any given time on my computer because there is stuff that I want to read but I don’t
get around to it. So I just leave it open but then I just open up other tabs of things I want to read
but then I forget. Awful… and then winter break starts and then it’s like oh god dad. Like I’m
feeling suffocated all the time and then oh my God, regressing and I think I had this because my
ADD stuff happened before this break. I didn’t go home last summer so I had a whole year of
forgetting how bad home was so it was an extra shock this break to go home and remember. He
182

was on a mission this break because in past breaks, I wasn’t graduating yet. So I’m like what
does he want to get out of me and that made it much worse also because I started thinking about
ADD and how it affected my life and doing all this thinking about other stuff and when I went
home a lot of things became more clear like my mom’s hoarding, my dad’s stuff and like
possible mild PTSD going on in my life that acts out when I have to talk with my dad and when I
don’t feel like myself. It’s like everything is anxious.
Me: Are you anxious and startle easily?
CeCe: Anxious but I don’t know about startle easily. It’s just like constant worry and on guard
and I get like slightly religious or superstitious where like if he’s in a bad mood, I cross my
fingers that he’s not going to come and bother me or something. Even though that I don’t
actually belief in stuff, when I go home it like umm… and I think that I’m kind of an anxiety
person because even when I’m not at home I get really worried about the next thing that I have to
do and whether I’m gonna get it done because I know that I need to start getting out of my cycle
of stuff.
Me: So have you developed anything to prompt you like a notebook?
CeCe: Prompt?
Me: You said that you want to do a lot of things but you seem to forget.
CeCe: It’s not exactly forget, it’s just that I don’t make the time for it. Because everything
externally that I have to do umm… I can do easily because there’s a set deadline but I can’t set
deadlines for myself and I can’t follow deadlines. I just motivate myself enough to finish what I
need to do for other people like for school I can’t finish early so I’ll have time for other stuff.
Cause when I have school work, I spend all my extra time procrastinating on it by doing non-
productive or other productive things… I read the internet.
Me: Do you think it’s because of your ADHD or are you not interested in it or is it too easy for
you?
CeCe: Oh, no. It’s not too easy. It’s definitely not too interesting for me and umm… I think the
ADD part might cause me to not follow through on stuff for myself. The not interesting part also
does it. Even when things are interesting for me, I put it off just because It’s easier to watch TV
or something so… like I never make time for the things I want to do. It’s still stuff that I
haven’t done before so it’s like a work in progress but requires you to kind of keep focused on it
but sometimes I’m like, “oh I’m gonna do this” and I get all inspired but that only lasts for like a
day because then the next day I don’t want to get up because there’s too many things to do. And
then I just lay there and think of all the things that I need to do over and over and I’m like I
should get up now. And when I do do the to-do-list, I get distracted and only do like 30% of my
list done which is terrible. That’s my procrastination because I put a lot of things on my to-do-
list like I need to go over my notebook for this… like I start with assignments it fills up the time
with whatever I have cause then I don’t go over my notes. Going over notes just goes onto the
48 hours before the test part. And umm…. So the last part, I kind of started to procrastinate on
this too. Umm… the last part was before I left school so my resentment toward Chinese culture
and my identity like with the new found possibility of ADHD and how that might have affected
183

it or maybe that was why I felt like this. I don’t know. It kind of fell into the ranting because I
went to a Chinese New Year gala which was run by the regional Chinese school association and
I was just surrounded by Chinese people and I was talking about when that happens that I feel
like I’m in Chinese mode. And It’s like I have 2 modes in my head and I feel like the Chinese
American mode is kind of the me one but when I’m in the Chinese mode, I feel like an alien and
at the same time a child because it’s mainly made up of my childhood stuff so I’m in this sea of
Chinese people and I generally sit there and sulk with resentment because I kind of blame a lot of
my family problems on us being Chinese because I see the introvertedness and the lack of being
able to understand that people are different. It’s the individuals responsibility to live up to
society’s expectation and there’s not kind of the American culture where you should try to
understand different people and it often doesn’t happen but I like the encouragement that you
should culturally want to understand other people and not judge them. In Chinese culture, I
don’t see that. I have built up all the resentment towards that social culture where it works find if
you’re a “normal” person because you can hide your skeletons or whatever but if you have a
family like mine when there’s all this mental problems then you can’t you can’t go out with it,
you can’t do anything with it. It just bottles up and multiples on itself and I just really resented
that and when I’m in that sea of Chinese people, I just resent all these people with being okay
with all of this. And generally, I get this sense that I’m more inadequate in that sense because
I’m definitely not good enough in the Chinese bar or ruler of social expectation. And that really
gets brought out when I’m in a Chinese situation. And there will be like adults of… parents of
people that I went to high school with who are on paper much more successful than I am and
there are some adults who will only ask you about what your school is or what you want to be
and it seems like your identity is only wrap up in how you can function as a successful person by
their monetary success or whatever value that they have and it’s so narrow about what is value
about a person so I resent them for that too because not everyone is like that but there’s a good
chunk of them who are literally will only… will only value me if I have success of if I have this
functionality for society and so it’s not like they care about your whole person. They only care
about whether they can compare themselves to you and feel good about themselves and I resent
them for having that kind of society as well and everyone seems to be okay with that. They don’t
seem to see that there’s a problem with that. So I talked about how I was just sitting there for
most of the time like sulking.
Me: Well, it sounds like you have a lot of issues going on?
CeCe: (laughing) Yeah.
Me: Getting back to the concept of success, it’s really what you make of it. Some people think
of social capital as success and some people think economically. It just depends on what you
value.
CeCe: I just feel like it’s so narrow for the Chinese people who immigrated here. I may
understand why they are but it’s so terrible that they all generally have the same value of what is
successful and I wonder whether I was always off because I was ADD. It wasn’t something that
they could grab onto and say, “oh, you’re mediocre intelligence or you’re mediocre this.” But on
paper, I was just mediocre but it wasn’t something that you could work on or it was kind of
intangible.
Me: What happens if you were mediocre, does it mean that you’re less of a person?
184

CeCe: Yeah, I feel like it does for them like in that kind of community… cause I don’t know
about China because I never lived there but I get the sense of roots that are there but in the
community in the suburbs of where I grew up, the Asian parents who immigrated worked really
hard to get there and they were hand selected as the academic types who came here. You know.
So they’re a certain type of upper middle class background Chinese people and they just have
this definition of success which is kind of a weird version of the American dream. And so it’s
kind of narrow and I was felt that I couldn’t explain to people why I wasn’t super obedient or
diligent. Like I wasn’t consistent… like consistency is what they like because it’s stable. Like
sometimes, I was doing well on my test scores but then my grades were kind of mediocre. Like I
would do piano and my piano teacher supposedly… like my piano teacher told me I was
talented but I couldn’t focus on practicing a lot and I never got anywhere with that so it’s all this
umm… kind of stuff that’s hard to describe for me but they kind of categorized as you’re just a
slacker or like you’re a mediocre person and so that…
Me: In hindsight, do you really think it was because you were ADHD that you couldn’t focus on
piano or other things?
CeCe: I feel like the ADHD made me really not… not…
Me: It sounds like too much pressure. It sounds like you have a lot of pressure.
CeCe: But I have similar pressures to the other Chinese kids that’s the thing. May be my dad is
more alarming then theirs but they also have a lot of pressure but a lot of them are what they are
supposed to be. Because statistically, I’m do well right but in my community, actually, they’re a
lot of people who actually ended up going to Ivy leagues and like MIT and Stanford like the top
5 like universities. There are quite a few people who went there and I personally know who
make me mediocre and my parents know so based on comparison… the Chinese tendency
towards comparison, I am mediocre because they do tend to achieve things because they were
able to stick with something because I was never able to stick with anything when I was younger.
I still tend to do that because they’re not lessons because I don’t pay for much but I like trying
everything and in my childhood, I was just trying everything but I would never get committed
and start like getting somewhere with that. So that frustrated me because I really wanted to get
somewhere but I didn’t want… I couldn’t stay motivated enough to work through it and so I
think that may have been the ADD or I think in school it came out because I would complain to
other people that I couldn’t stay about and I didn’t find anyone who seemed to have that same
problem as me. And they didn’t seem to have the same problem of not completely being up in
class because I would just zone out completely. And they were like, yeah sometimes I don’t pay
attention so it was like lackadaisical but at the same time, they were on top of the material. So I
didn’t understand what was going on, what was I doing that they weren’t because these were just
Asian Americans that I was friends with so I’d be like, “oh, can you explain this to me because I
have no idea what’s going on in class right now”. But they would say that they didn’t either and
they were able to explain things to me so I wasn’t sure what was going on. I didn’t feel that I
was unintelligent, I just felt like I was always unorganized and I was always not on top of things
and I was always not paying attention and so now looking back with the idea of maybe I was
ADD then that makes more sense. So it was a constant sense of oh I was not on top of things but
other people seemed to be on top of things and if I could just be on top of things like they are
185

than I could be where they are because I felt that my intelligence was not too different from
theirs, I just couldn’t work hard and I was a lazier person and inconsistent and flaky so…
Me: So it sounds like you have internalize what other people like your parents think that you’re
subpar or mediocre because it’s coming out in how you define yourself.
CeCe: I think it’s internalized just because when I grew up, that was just the normal thing. I
didn’t equalize my scale of what is good or bad like across the whole state or the whole county
as you’re okay or something.
Me: Well, it’s harder for you because you’re competing with something else that other people
don’t have to deal with. So that’s why you’re trying harder, you’re putting in more effort.
CeCe: I’m still trying to figure that out I guess.
Me: Because you’re running at a deficit compared to other people who don’t have ADHD.
CeCe: Yeah. I’m still trying to make sure that I do have it because it’s new like completely
new. After 20 years of my life not thinking about that… this is a new thing that I still don’t
know how it fits in so I’m trying to confirm it because I’m doing the psycho-educational testing
at school right now. It’s kind of fun. We’re doing this stuff for…
Me: So you’re doing psych testing? What else have you tried? Are you in therapy?
CeCe: I guess I tried to recently start therapy. I had one appointment last week. I’m not sure I
like her that much yet but we’ll see.
Me: So you just started therapy last week.
CeCe: Because my other psychologist is out on leave. He’s kind of elderly and I’m not sure
he’s ever gonna come back soon. He got sick and then he’s kind of weakened and not ready for
work and that was where I was starting therapy and he’s like an elderly Chinese man so he would
kind of get the background. So now I’m starting a new one because all of his cases have been
transferred to other people because he’s been out. I’m not sure where that’s gonna go because I
feel like it’s still all in my own head so I’m still not sure how other people are going to help me
to decide what’s going on. I kind of look forward to the testing because… I don’t know. I like
having the data. I like having data.
Me: You want some concrete evidence.
CeCe: Yeah.
Me: Understandable. So let’s say that it comes back and it confirms it, what is going to be the
next step for you?
CeCe: Umm… being relieved that I have a label I guess or that I have an actual thing and I’m
not…
Me: It sounds like you already have the label but you want to confirm the label.
186

CeCe: Oh yeah. So now I have a confirmed label and maybe now I can figure out how to deal
with it.
Me: So let’s say it comes back confirmed through psych testing which is using validated
measures, do you think you’ll share that with father?
CeCe: No! This is just for me and for future people that I meet that are normal. I don’t think
that my dad is actually ever gonna know unless I have like a massive… “but I’m okay now so I
can actually tell you that I have problems and they pale in comparison to my success and then he
won’t freak out.” Because if I told him now, it would be me just making excuses for not
working hard basically the same way that depression is an excuse for being sad that you didn’t
work hard enough.
Me: So, how did you do last semester in school?
CeCe: Umm… like a 3.6 or 7.
Me: That’s pretty good. What did you dad say about that?
CeCe: Umm… I don’t even think he’s looked at it. I don’t even want to go there.
Me: In your mind, do you think he would say why isn’t it a 4.0?
CeCe: Yup. People in my major are pretty smart so I’m kind of a middle of the road GPA I think
because there’s a whole bunch of people who do the professional club and they’re on the E
Board and they have like a 3.78 or something. Because my early GPAs were pretty low and now
they’re okay high and so it’s like a 3.5 so it’s a very very decent GPA but still in my bubble, I’m
still like aannn because there are still more people who are responsible with time management
than I am.
Me: But you must be pretty because you have like a 3.75.
CeCe: I’m like responsible because my standards are high but I’m not responsible otherwise.
Like it’s not just me because my boyfriend knows too and he’s like you’re work ethic is pretty
bad because I work because I’m afraid of failing but I’m naturally kind of a chill person. I’m
definitely not a workaholic, I might be if I were doing the thing that I would be a perfectionist
about a perfectionalist about visual ascetics. Theoretically, I would be working more
consistently because I can’t stand the non-perfection of this product that I was making if I was
doing something visual but engineering is all mathy stuff so it’s just work. So in order to get
grades that I think are acceptable to me, I freak out when it’s crunch time but as a normal person,
I’m just lying there. I’m not like a workaholic type of person because a lot of other people that I
see are organized are basically I think are workaholics and they just like being busy. They like
working on these things and they like engineering more than I do.
Me: So you boyfriend is he also an engineer?
CeCe: Mmmhhmm. He’s not… he’s pretty lazy but he’s better than me at math. He’s kind of a
natural problem-solver so he’s kind of an overachiever. But at the same time, he still doesn’t
work that hard. He had like a 3.7 or 3.8 but then it slipped a little more because his classes got a
187

little bit more involved but now it’s like a 3.78 or something but he plays videogames all the
time.
Me: But CeCe, yours is right there and you’re competing with something that he doesn’t have
to.
CeCe: I suspect that…
Me: He could probably play his videogames blindfolded.
CeCe: Actually, I’m pretty terrible at playing videogames. He’s also in generally just better at
math. He’s better at being an engineering major than I am so I’m at a disadvantage there.
Comparing myself with other people in my major, the difference is that they really do learn
something in class. They don’t zone out and they can keep up in class.
Me: Because they’re not competing with something that you have to.
CeCe: Yeah.
Me: It’s like asking an amputee to run a race.
CeCe: It’s like hurp durp.
Me: It’s not a fair comparison.
CeCe: Yeah. But it’s still frustrating that I can’t do the things that I want to do. Like, I want to
do this project but really I’ve just been procrastinating on my actual work and you don’t have
time to do this project.
Me: In the real world which you’ll see is really the quality of the relationship sometimes that
will get you the job and not necessarily what you look like on paper.
CeCe: Yeah. Even that is scary to me because I’ve been kind of shy so like only this semester
I’m like, I must go do some organizations because it really didn’t hit me until senior year that it
was the end. I’m like theres so many things I could have been doing. So many opportunities and
then I was just hermitting because I think a lot of it was being afraid that I wouldn’t get my work
done so… I wasn’t confident enough that I could do all that so… I just ignored it. But theres all
these things that I now know that I wanted to do. I did want to volunteer but sorry guys, I don’t
have any volunteering experience to talk to you guys about. But hire me as your volunteer.
Actually that’s really a time commitment I just applied for recently and turned it down because I
looked at my schedule and said, “no”.
Me: So you were actually accepted into it?
CeCe: Yeah. I applied for service learning for like the Center for Asian Pacific Family. It’s like
the battered women shelter basically. And so I personally identified with that like Asian
Americans really needing help but not knowing where to go for it because they have like all
Asian languages or someone who speaks it for the hotline. But they have a huge time
commitment and also I don’t have a car and I’m thinking that this would probably be bad that I
would just get burnt out and slip up on everything. I would try to do everything and I would be
188

like too tire to do anything properly. So, I turned it down and I felt really bad but now I’m like I
should have done that early like when I didn’t have so many hard classes or projects that I had to
do but there are lots of things I could have been doing.
Me: Well, you’re winding down. 4 more months?
CeCe: 4 more months to get a job… get a job.
Me: Well, you’ll be graduating in 4 years but the average now is like 5.
CeCe: Yeah. I would be nice if it were 5. I sometimes wonder what it was like for people 20
years ago in college. Why is it that we’re always… I feel like all I do is work but like how was
school for them back then? Did they have less classes that they had to take?
Me: It depends on the school that people went to. Everyone maybe competing for the same
types of classes, GEs were usually the problem. So as a result, it kept putting people back
because you couldn’t get into certain classes.
CeCe: Uhhuh.
Me: It was a problem especially with the State universities because you have everyone compete
for the same classes and you have 4 or 5 thousand people competing for like a 100 spots.
CeCe: I wonder for professors like how hard was it for them to get done with undergrad because
it seems like were stressed all the time. One time I’ve heard one professor saying the, “oh, you
guys are learning things so fast now a days that you can’t even learn things properly and you
students have to take some many classes now.” It sounded vaguely like he was required to take
less classes or something. Maybe the standard course load wasn’t as big. They had a little bit
more time to absorb everything.
Me: It used to be 128 units that you needed to complete.
CeCe: Yeah. It still is. I know that in a different county, I had this physics professor who was
German and he was saying how they would have weekly homework sessions. They would have
extra sessions outside of class. I’m like how do they have all this time to do this extra homework
and they had way more homework than us. Does it mean that they have less class? I can’t
imagine having more homework per class. I’m kind of curious how they had it structured
because a lot of people don’t learn things properly anymore so… you just get it done and then
when you leave the class, you forget everything. I’m wondering if they learned more so it stuck
better.
Me: It could be that the classes were a year long. Instead of semesters or quarters, they had year
long classes.
CeCe: Oh yeah. That’s interesting.
Me: For example some schools have qualitative and quantitate classes that are a year long not
just one semester long. It just depends on the school. This is something to think about if you go
onto grad school.
189

CeCe: I’m really hoping to get into the German internship because I really want to travel travel.
Me: Congratulations on the internship.
CeCe: Well, I don’t know if I’m gonna get in yet. It’s just like any other internship but it’s in
Germany. So you still have to apply and resume… it’s the same as getting a job.
Me: And it’s a whole year long?
CeCe: No, it’s anywhere from just a summer to a few months like 6 to 10 months. It really
depends on like the company.
Me: So, if you complete the internship, does it give you a job afterwards.
CeCe: No, it’s just like an exchange thing. I think it makes it easier for you to come back if you
use the same program later or if they like you enough they might but even internships… like it’s
like internships here. Most internships here do not end up in a job. It just makes you more
attractive if you do apply for a job. I wouldn’t be speaking fluent German anyways. There are a
lot of German internships that don’t require you to know German but I assume that if you were a
full-time employee that you would have to be German. I doubt that their economy will allow
them to hire foreign people. They’re probably reserving it for their own citizens so… that’s
probably not a big thing but I just want to be there so I can travel and see stuff.
Me: That sounds like a plan.
CeCe: Yeah.
Me: Well, you’ll be a new graduate. What do you think your parents will say about that?
CeCe: I’m not going to tell them unless I actually get it.
Me: So what happens if your parents say no.
CeCe: Well they can’t really. Most of it is paid for by the… I think my mom would be like
“oh, cool”. But my dad, I’m not going to ask him for money so he really can’t say no. I did tell
him that I was going to try out for a Fulbright Scholarship and he kind of freaked out because he
doesn’t know what that is. He’s like, “you’re going to ruin a whole year of your career building
time. You’re going to ruin your career by like teaching English in some foreign place.” He
thought it was the Peace Corp or something. I mean it’s not exactly the Peace Corp but he’ll say,
“okay it’s not the Peace Corp but… and then you want to go to Peace Corp.” He thinks that I’m
like going everywhere. I’m just going around like gambling my life away or something. He
doesn’t have a concept of experiences being a… because you never know what’s gonna happen.
You need to go for the experiences that you think are going to help your career and that’s the
only thing you should be doing.
Me: But that’s what you’re doing.
CeCe: But you’re wasting your time.
Me: But you’re following your goals.
190

CeCe: Yeah. But I need to pick one and just go with one. The only things that lead down that
path.
Me: So what would happen if you have more than one path?
CeCe: He will say that you need to just pick a path… only one. And if you’re halfway there
and you decide it’s not a good one than you need to pick another one. You can’t keep like your
options open and sit back. Like he thinks that I’m sitting back because I like options and I don’t
like picking one. I mean he has a point but he’s on the extreme end of that point… and like I
really don’t have a plan.
Me: It sounds more like he’s worried about you wasting your time.
CeCe: Yeah. I think it’s because I’m getting too much fun expectation out of this. He thinks
I’m doing things for fun and fun is a terrible thing because fun wastes time. Like when I was
growing up, me and my mom would joke around that he was allergic to fun. He kind of like has
a satellite dish on his head where he can detect if someone’s having too much fun out there.
Cause like, you can’t have too much fun. You can tell him like I’m going out with friends but if
it’s like more than 4 hours per month than he’ll start freaking out or something. When you have
2 outings in the same week, he’ll say that you’re wasting life and that you have no priorities and
stuff. He’s worried that you have no priorities because you’re having too much fun. Fun is
always a waste of time and everyone always wants to have fun. And they are all mediocre.
Me: That’s really interesting.
CeCe: And he doesn’t really know any of these overachiever kids really because he would then
find out that they go out and party. They’re just better at school than I am but that’s just what he
sees on the outside.
Me: So what would happen if you end up as a pharmaceutical rep because of your biomedical
engineering background and part of your job is to go out there and have fun because that’s part
of the business?
CeCe: But if I make a lot of money, then it can’t be that much fun because work isn’t fun. But
applying for things like yeah, I want to have an experience that sounds like fun. If I were like
there are no good jobs here so I have to go abroad because they have good jobs, and it might be
fun along the way but I don’t mention that because it’s mainly for a job than he’ll say that’s not
fun, you’re trying to find a job. Because your goal is to get a job and maybe later turn it into a
business so in order to get a job because there are no jobs, you have to go there for a job and
that’s getting a job, it’s not getting fun. But if you want to travel to see where things bring you
and to see new things than that’s fun and so it’s terrible.
Me: Well, it sounds like it’s going to be an ongoing struggle.
CeCe: Yeah. I just kind of hope to mentally separate myself from it because when I’m too close
to it, I don’t know what’s me anymore. And even me is pretty confused normally.
Me: Does he tell you, he misses you?
191

CeCe: No. He’s not a touchy feeling person to say, “oh I miss you”. He’s not like that. He’ll
only call me to find out how I’m doing as in like, “where are you in your goals. Tell me about
your goals and what have you done this week to achieve your goals.”
Me: It sounds like his underlying intentions are good. It sounds like his presentation of things
that you’re having the problem with.
CeCe: In general, he’s just kind of creepy so.
Me: Well, is there anything in terms of your ADHD that we didn’t cover that you think would
be meaningful that we haven’t talked about?
CeCe: Umm… I think what would be important to you is just more of the identity stuff. More
like, there’s no such thing as mental illness for Chinese people so it’s really hard to figure out
what it means when you do have ADD. Like for people who haven’t even grown up in America
like my mom, she can’t even understand what that means and whether it’s a disability or not
because she defaults to saying… she defaults on saying that it’s a bad thing when it’s not or that
it’s an excuse. She still can’t really comprehend it. I think it’s hard as a Chinese American to
figure out if you have something like the mental thing, to find out what it is and to get support
for it. It’s really kind of hard.
Me: Some of it has to do with the reframe. Mental illness already means that something is
wrong with you… maybe issues? Because we all have issues.
CeCe: Yeah. But the mental issues, it’s not really a thing it’s like you’re coming up with a
whole new idea for yourself and that’s kind of hard. And it’s hard to make it your own because
you have not community support for it. You have no community support and it’s hard to tell
people.
Me: It’s the cultural idea of not shaming or losing face for the family.
CeCe: Yeah.
Me: Part of the problem it sounds like that’s going on is if something is wrong with me than
how will others view them (family)?
CeCe: And I really don’t like that. At the same time that I’ve been instilled with that kind of
value because it’s what I’ve known, I… it’s hard for me because I have a tendency to compare
myself but at the same time, I reject that because I see it as a really unproductive way to be
thinking maybe because I have the input from the American culture that people do have mental
issues and it’s more productive to try to help people. People don’t just bottle it up inside and
multiply it within themselves. So in dealing with relationships, feeling and emotions, I just tend
to go with it… the American or western way of viewing things like mental health because I see
absolutely no benefit from the Chinese way of viewing it. A new thing for me is going to mental
health and finding out things about it and trying on this new thing of having mental health and
that being an issue whereas before, only physical health is an issue mental health is not an issue.
So now, it’s really more concrete and I think about it a lot and I see it a lot more and I talk about
it with my roommate who has her own mental health issues. For the both of us being Chinese,
it’s like a whole new discovery or buckets of ourselves and how the past things that happen
192

really mean. And things that were completely blocked out because that’s not even a category.
So now there are more things that we can explore about in our identity. Now that we are going
to naming or labeling what our thing is… for her, she’s going through a similar thing but she’s
going through the depression. So we talk about that but we kind of bounce things about the both
of us, we bounce things back and forth.
Me: It sounds interesting. Do you ever google search under cultural issues and mental health?
You will find out that mental health has away been there but it comes out more in somatic
compliants.
CeCe: Somatic?
Me: Somatic. Like physical ailments. So for instance, instead of me saying I’m depressed
because there’s really no word in Chinese for saying I’m depressed, you usually describe the
feeling of what’s going on…
CeCe: Did they ever come up with a medical term?
Me: They might say are you happy or are you not happy. There’s really no word to mean
depression. It’s really more trying to describe their affective states or their physical state of
being. It’s very similar to Latino culture especially if you’re interested in looking at mental
health issues in different cultures like psychiatric anthropology. Different societies and cultures
will view mental health in different ways. By viewing mental health in the way that we
(Americans) do is more related to western culture. Like psychotherapy doesn’t really exist in
Chinese culture.
CeCe: It just boggles my mind how people deal with their different mental problems. My only
conclusion is that It just explains a lot of these crazy people because when you except it as like a
matter of course, it’s hard and especially when you’re in an introverted culture where you’re not
reaching out to a lot of people. You don’t get the checking with other people who are different
to contrast with the way you think about things and to let you know that there’s another way that
you could be thinking about this. It doesn’t have to be this way or it doesn’t have to be that way.
I thought like that when I was living at home. There wasn’t an option, that wasn’t an option.
This is actually a thing and that you can deal with it. You can do something about it. It doesn’t
have to be this way. That kind of possibility wasn’t really there and looking back at it when I
consider things… more things are clear and not living in a place where you can’t discover these
things and you can’t deal with them. You can just like cover them up and not realize that you
could be living differently and it can’t be like this. I can’t imagine like entire continents of
people because like I feel like there are a lot things that happen because of political upheaval.
I’m sure the culture was like okay before that or in times of peace you know and then after any
type of revolution there’s like… I see a generation of Chinese people who are like really messed
up and they have no idea that they are. They have like… kind of like my dad, they just can’t
comprehend another way of being and the way their being is not… it sometimes makes them
unhappy but they don’t see that and it’s really unfortunate because it boggles my mind. How
there’s so many people like that and they just can’t change themselves and they don’t see a
problem and see that something could be changed about it.
193

Me: Well, that’s part of the problem. If you never see that there’s a problem, you won’t be able
to see when things are wrong.
CeCe: Yeah.
Me: Sometimes things only go one way, you don’t see other ways.
CeCe: Yeah.
Me: A lot of it sounds cultural for your dad, he escaped from China because he had intellectual
abilities and that was one of the ways that you could leave.
CeCe: Yeah.
Me: Because they thought that you would come back with this intellectual knowledge. They
didn’t know that people would just stay but that’s what happened for the fraction of people who
were able to escape. So it is different for your dad vs. other generations of people who are able
to come over now. But it sounds like a whole bunch of issues going on. It’s not just one issue.
CeCe: Yeah.
Me: Well, I’m dying to see what your journal looks like. I saw part of it already.
CeCe: It’s pretty looking from afar.
Me: I’m really impressed with your penmanship.
CeCe: I did one of the CARS things this week and one of the questions was, “do you have
terrible penmanship?” I was like, “never”.
Me: Well, I appreciate all your help with this.

194

Appendix L: Sample of CeCe’s Journal Exercise
(Modified to maintain the confidentiality of participants)
November 19, 2011
I recently started keeping my appointments recorded in my phone’s calendar;
theoretically, I can keep track of them and also not have to worry about what time it is because
my phone will alert me when I have an appointment. Unfortunately, I still am not done
overbooking myself. Plus, every time I am in the process of deciding on and planning a new
event/appointment, I fail to check my calendar. Appointments manage to creep up on me
anyway, because I usually have not planned my life around having that appointment that day;
merely waiting passively for my phone to remind of things. Today, I realized again that I can’t
go to two of the appointments on my calendar because of poor planning and procrastination.
One was pushed out because I have more important work.
Apparently, I can’t structure my life properly unless I have all my obligations held in my
head. And if I have more obligations that I can fit in my head at once? Well, then I obviously
can’t handle the number of events/obligations I have signed up for. I think this might improve if
I got really good at using a calendar, but that won’t be happening too soon. Having to deal with
too many things (like an external calendar rather than a mental) is still an overwhelming thought.
It’s really bothering me that I haven’t been to any career/networking type events because
finding a job is looming. Every time there is one (like today), I end up not going because I have
work (that I should have finished already but I procrastinated) or I am lacking the energy because
I’ve just come out of an overwhelming night of post-procrastination Crunch Time. My like
already revolves around schoolwork and procrastination on schoolwork that I can’t imagine
being able to properly look for a job…
I procrastinated/wasted 6 hours today on the internet compulsively Googling things and
reading blogs. I have had a particularly bad string of the compulsively surfing the net this week.
I have very little work in the last 2 weeks compared to the most of this semester (which was at
least 8 straight weeks of 1 test per week) and I compulsively surfed the net through all of these 2
weeks. Today is beginning to be Crunch Time because I have a chemistry test on Monday. I
was planning to study starting last weekend, but I did zero chemistry. Today was/is one of the
days when I feel powerless against urges to surf the internet and organize my iTunes, etc… I’ve
worked myself into a frenzy avoiding the studying. Once I got myself half settled into
chemistry, I realized, very consciously, that I have utterly screwed myself over. I’m so frustrated
that I had so much time to prepare for this exam (last out of 4) compared to the previous ones,
and I squandered it all. Once again, I am left learning everything 48 hours before the test. (I
don’t learn much in class, either) I can only hope I make it, but I have a lot of repressed anxiety
right now because I don’t think I will do so well with focusing this weekend. This ADD spell
doesn’t seem to be under much control, still. The anxiety is only amplifying my difficulty with
focus. I feel pretty powerless against my procrastination and urges to not think about chemistry
and the overwhelming amount of material that I have to internalize. Using HW playlist to prep
myself up as much as I can/improve my mood. Hair picking is pretty frenzied today from the
anxiety (trichotillomania).
195

November 25, 2011
So I actually did really well on my chemistry test. I don’t think I altogether finished
studying and had everything on quick recall, but I did really well-I think mostly because the test
wasn’t too hard and I now have enough time to comfortably think (with new test time
accommodations). This is the 2
nd
time I’ve done really well on an organic chemistry test (out of
9 organic chemistry tests) and both times were in the last two tests, when I had 1.5 time. On the
last test where I did pretty well, I’m not sure how to read the experience with more time because
I was also out of my mind with sleep deprivation and exhaustion. I found it impossible to focus
on the questions, memories, and the material, and I didn’t figure out the last problem. My score
was about equal to what I usually get, only on this test, the average was a 43%, so I ended up
doing really well after the grade adjustment. So, I guess, theoretically, I was able to do ok with
te help of more time wade through my addled brains, a result of not managing myself well and
learning things before the 48 hour pre-test point. Technically this is the first time I’ve ever
gotten a good score on an organic chemistry test! It wasn’t that hard, granted, but apparently
some others in my class didn’t have as nice of a time; the average was a 60, with as big standard
deviation. I can’t help but wonder, if they had as much time as I had-wouldn’t they have done
better too? I’m not sure I deserve the exam accommodation. I could theoretically prepare
better… right?
I still am wrestling with my ADHD diagnosis and whether or not I am actually disabled
or not. I don’t even know what “disabled” means anymore. I have never thought of myself as
disabled, and yet I’ve had all this trouble in high school and college performing on tests and
schoolwork like I want to/wanted to. As I lost control of managing my time and mind, I lost
faith in my performance-my self-esteem now isn’t too good and I have a lot of test anxiety and
fear of failure. I stopped believing that I could show my knowledge and analytical skills in
testing and pressure timed situations. It seemed I always succumbed to silly mistakes and
temporary “slips” in reasoning, and I didn’t feel like I could control any of it or fix it by working
harder. I also had problems finishing difficult tests due to slowness. I saw signs that I simply
processed problems too slowly to finish tests involving a lot of analytical problem solving.
I think it really affected me over time, because I was in an environment of very intelligent
people and my parents raised me to think (despite teenage resentment of Asian systems of people
valuation) of my value in terms of my intelligence and achievements. So far in my life, the big
achievements and gauges of my intelligence have been grades and test performance. I was God-
awful at getting work done, and I occasionally forgot about smaller assignments altogether.
Though I feel that realistically, most people aren’t necessarily able to manage their time, stay on
a schedule, and get tests assignments done. I was in an environment where I felt like I was the
only one-or at least, the others who forgot or weren’t on top of assignments and tests were the
several who I felt were generally not grasping the material as well as I was, or were cavalier
about school. I’m not sure if I was reading myself wrong, but I always felt that I was good
enough to achieve great things but I was always too slow, too inconsistent, and unable to
discipline myself. Whenever I talk to people who I am peers with, more often than not I reach a
point where I realize that they don’t share my magnitude of lack of self-control, focus, and
efficiency. It’s easy for them to tell me to just focus and get my work done before the last
minute, and they say they are able to because they just “have to if they want to do well”. So, do I
not want to do well? Do they just care more than I do? Do I not have to do well in school too?
196

How come they don’t spend 6 hours doing nothing productive without being able to rein
everything in? How come they work fast enough to finish assignments when they want to,
leaving room for starting the next due assignment so that they don’t force themselves into the
position of doing the assignment at the last minute? I am told my silly mistakes and slow testing
speed can be fixed by just doing more practice problems; this is true, however, I barely am able
to finish the assignments that are due, much less be able to have time for practice problems. It’s
a vicious cycle. Furthermore, I see others around me who know the material about as well as I
do but they’re faster ant getting to the point where they can recall and use it quickly. Meanwhile,
I feel I understand the material and could solve problems if given a lot of time, but I never have
enough time to slowly think. Does that count as a testing disability? Blanking out randomly and
thinking too slow? Shouldn’t that all go away if I managed my time and learned things not at the
last minute and was able to do way more practice problems? I till fell like I would make those
silly mistakes nonetheless… from experience. Maybe I am not all of these people who can learn
the stuff and then think it out on the test (I know many of these). Maybe I should stop whining
and accept that I am not as smart as these people just because I can understand most of the things
they are able to –just at a slower more inconsistent pace. I also have to learn it from a different
approach, I have learned, as well. It must seem so silly to people outside of my bubble of high
achievers that I feel inadequate, but I never felt that I simply wasn’t equipped to achieve
“Greatness” (like I have accepted totally in the realm of anything athletic)… is that what a
disability feels like? Sorry about the rambling and babbling.
About this last chemistry test, I felt so much more comfortable during the test-I could
look around the room and blank our and stare at the test question or a minute while thinking
about something unrelated-without building a mountain of panic and adrenaline. I never realized
how much I dilly-dallied in my brain until I had the relaxation of all this time. I probably was
also thinking pretty clearly because I did so well and only made one mistake that I didn’t see
coming. I’m kind of feeling better about school right now, but I’ve already done no work over
Thanksgiving break so far and it is making me nervous. I know I need a lot of
procrastination/distractions padding time to do every little thing, so I cannot afford to “let”
myself have too much planned non-productive time. Yet, I haven’t wanted to take inventory of
my assignments until today. Quite appalling and overwhelming-I wish wish wish that I could
just sit down, get a whole bunch of things done, focused and awesome, but I can’t. I don’t know
why but I just can’t. Linear focused thinking wears me out so quick. I do one or two small
things, like send an email or download study notes, and I’m already wanting to take a break.
Something that’s definitely ADD that I did today-not particularly unique to today, but
today is an ex.-I was on my computer shopping, checking email, setting up for bio lab report (not
too involved of an assignment), and watching TV. I still have not finished shopping by giving
up, or started my bio report in proper (typed the title and my name, weak) or read some of the
tabs I have open, after, like, 6 hours. At any one time, I have about 3-5 tabs open that I found
and go distracted from reading/dealing with. I periodically have to go around closing tabs to
clear up the clutter and tell myself to give up on the ever getting around to reading some website
I wanted to read in the its entirety. Even though I think I’m going to read it, it’s probably not
gonna happen and it’s ok. It’s like I’m a web browser tab hoarder. I’m constantly stuck in a
loop of curiosity, leading me through links and Google searches until I have 10 tabs and no idea
where I started or what I was going to do. I have often gone to the computer, specifically to look
up something I didn’t know for a test I was studying for at that second, and managed to be
197

attacked by a rogue curiosity. 20 minutes later I need to remind myself what I was originally
going to do because I’ve forgotten.
Writing assignments like bio lab reports are particularly horrible for me for this reason.
Everything is typed these days, and research is done electronically. Therefore, I can’t just stay
away from the computer/internet and it’s absolutely painful organizing my thoughts into neat
groups. While I write this journal, I find it slightly difficult to stay on track. I can stay on top of
continuing to write here because I enjoy introspection and no-pressure thinking, but I constantly
want to talk about all these things at once. I feel like these are things I want to get out before I
forget about them because I will think of something else soon, and when I think of something
else I will forget what I want to say now. I’m aware that I tend to be redundant and rambling and
slightly scattered in my writing as a result.
I’m going to have to go to bed soon because it’s 4am and I have not done any school
work today. Sigh. It’s not even hard schoolwork. Plus! I have been putting off forgetting about
making an appointment with my psychologist for 3-4 weeks, and another doctor for 4 months. I
swear I am not afraid of the appointment itself or avoiding doctors. I also need to tell my other
teachers I have exam time extension. But maybe it’s too late now and I don’t actually deserve it
and I don’t actually need it? I still have an underlying feeling that it’s not fair to all the other
people in my class who could use extra time… I don’t know I am so lazy, though.
November 30, 2011
I’ve had a test each day for the last three days. Even though the studying wasn’t very
heavy for the first two, I still ended up staying up late and not getting enough sleep. Then, I had
to take a nap during the day so that I wouldn’t be too tired to study for the next test. In turn, this
nap allowed me to stay up even later/procrastinate before getting down to studying for the next
test. Unfortunately, the 3
rd
test actually required about 8 hours of sold studying (or learning,
rather, since I never went to this particular class because it was at 8am). I have serious, serious
trouble getting up on time in the morning. My Grand Plan over Thanksgiving Break was to get
studying done for these tests, but really, there was too much TV and Angry Birds to resist. I was
also at my boyfriend’s family’s house, which doesn’t have a room with just a table and chair,
similar to the study rooms I usually go in when I actually need to get things done. I have zero
self-control so the only thing that works is to remove myself from all electronic devices and
people. I do have to use music to tune out passerby and silence sometimes.
Procrastination: “I’m tired and overwhelmed by thought of work OR
Terrible loop: “It’s break and I really want to get some work done because I know how
stressed I get when I’ve run out of time to study. But I’ll just worry about it tomorrow I
still kind of have time.”
I’ll just watch this one show… 5 hours later, stuck in TV stimulated mode
I’ll just check my email/download my notes/look up study related definition… 2 hours
later, what was I doing again? Oh God
198

Become sucked into curiosity and Google’s endless capacity to search for irrelevant
information. Mind swirling with all the tabs I have open. Must finish. Reading all these
tabs.
In fact, if I get fixated within interneting loops of thought, it becomes impossible to
properly focus on homework/studying until I manage to make my brain change gears.
Also difficult to go to bed in this state, until it is super late and I’ve tired myself out. If I
get really worked up and I’m not tired, I can’t even go to sleep properly. I have too many
thoughts.
I think I have internet addiction.
I managed about 7 hours of studying for that last test, out of anxiety and fear fueled self-control.
Put myself in empty study room and refused to start playing Angry Birds approximately 5 times.
Still was not entirely prepared but was prepared decently.
No matter how much time I have to study, how nice of a schedule I’ve set for myself, I
get distracted and waste huge swathes of time. Then I freak out, don’t sleep, and become run
over by all the things I’ve allowed to pile up. Tests are then sometimes a tossup-will I manage to
prepare in time?
I’m in ASBE this semester (mostly on paper, haven’t managed to get involved)-
Association Students of Biomedical Engineering. I got an email last week from the freshmen
mentoring coordinator with finals studying advice for freshmen, written by people in my class.
Made me laugh at juvenile my study habits are in comparison to these freshmen mentors. They
mentioned all these organized-scheduled-time manager-self disciplined tips for finals week, and
all I have to say is, “Hah”. I wish I could just wake up at 9am every day and stay productive
when I want.
I finally got around to making an appointment with graduate advisor yesterday. I had an
advisement appointment a month ago, but I forgot about it and over slept. Sigh. I also still need
to go make an appointment to see psychologist again. I don’t really know for what I need to see
him but I dropped the ball a month ago.
I get these episodes, usually at night when I’ve been interneting, where I get really
inspired and excited to do all these crazy things. I can’t even contain frustration from not being
able to try these things because I don’t have the supplies or background or what not. Then, I go
to bed and wake up normal, unmotivated, bogged down by all the work I have that I don’t want
to do and forget my “excitement”. The next time I’m excited again, I’m disappointed in myself
that I’ve wasted precious time that could have gone towards trying all these things or signing up
for things or applying… but this time instead was spent being apathetic and trying to get
schoolwork done. I’m definitely not someone who can passionately pursue something; I get
tired out and use up all my motivation doing mundane things sometimes.
Yesterday, I lost track of what day it was, and such, and forgot to go to chemistry lab
checkout. Was going to go make that up this morning bright and early, but stayed up until 4am
for no reason (even though I told myself to go to bed starting at 1 or 1:30am) and overslept.
Ended up doing it really quick right before my 2pm class (whose quiz I failed to prepare for, like
199

usual). Thank goodness the lab director was nice and let me checkout at a strange time.
Embarrassing to be a senior and forgetting I have things I need to go to.
Have been putting off writing theatre class journals for 3 weeks and I think they’re due
tomorrow. I was supposed to journal about things as they happened-now I have to go back and
remember what I did that I was going to journal about… I think I’m gonna have to do that
tomorrow. Pretty tired today from staying up last night and running some errands today…zzzz.
December 4, 2011
I figured I should write this down before I floated off or didn’t feel like doing it now and
procrastinated until I forgot the details. Tonight, I’ve been flitting around the apartment a little
bit. Right now I want to study for my chemistry final, play Angry Birds (because I have the
“time” because my tests are all a week away), talk to my friend all at the same time. I was
gathering my study materials together:
-I downloaded all the electronic tests.
-surfed the internet (a break) before I told myself I’d look for my paper printout type
notes.
-got up to find paper notes, couldn’t find all of them; they’re probably somewhere in the
disseminated paper piles.
-gave up on finding the rest, look for highlighter to make marks on this one review sheet,
see snack nearby highlighter, think of clipboard need.
-eat snack while looking for notebook and clipboard, can’t find clipboard.
-decide to do without clipboard, put snack down in one room.
-forgot highlighter in other room, go back and highlight marks on the study sheet.
-go back to bedroom and finish snack on bed. Start chatting with friend online.
Remember journaling, should do before forget.
-go to other room to retrieve journal, see ipod.
-retrieve ipod and journal back to bed where all the study materials are.
-now want to take an Angry Birds break but I know that would probably turn into 2 hours
of Angry Birds.
-I’ve been here 1.5 hours and haven’t actually done any studying, except for a cursory
glance over an old exam. I don’t really want to figure out where to start studying for a
comprehension test. I kind of just want to jump around until I get a better idea, which
will likely be somewhat more systematic.

200

-But I’d much rather play Angry Birds. I feel resolve fading but I’ll hat myself if I don’t
get a good amount done.
***Frustrated.

Abstract (if available)

Abstract A review of the extant research literature reveals limited data on college students with Attention-Deficit/Hyperactivity Disorder (ADHD). Even less information is known in regards to minority populations living with ADHD, specifically Asian American college student. This research project was focused on Chinese American college students with ADHD. A qualitative design using a life history approach allowed the individual case studies to provide a vivid detailed account into the experiences with ADHD. The project was centered on a systems theory approach to understanding the psycho-social and cultural factors that influence the experience of ADHD in Chinese American college students as well as the coping strategies used in order to be effective learners. This project allows the reader to understand how Chinese American college students make sense of their ADHD diagnosis, cope with their condition and what this may mean for these students as they embark on their ADHD journey. ❧ This project aimed to seek answers to these questions: 1) What are the different pathways to being a Chinese American college student with ADHD? 2) How do psycho-social, cultural and other factors shape the experiences that Chinese American college students have with ADHD? 3) How do Chinese American college students with ADHD navigate their academic environment in order to be successful learners? ❧ The project found that social supports in the form of family and friends help the Chinese American college student to cope with their ADHD diagnosis, symptoms and academic struggles. The use of professional services inclusive of psychotherapy, psychopharmacology and psychological testing helped students to cope and make sense of their condition. The Chinese American college students found their academic performance improved with the use of the disability services offered by the university.

Linked assets

University of Southern California Dissertations and Theses

Conceptually similar

PDF

Navigating and accessing higher education: the experiences of community college students with attention deficit hyperactivity disorder

PDF

ADHD identity: a conceptual developmental model

PDF

The role of self-regulation strategies on two- and four-year college students with ADHD

PDF

Factors influencing the academic persistence of college students with ADHD

PDF

Supporting learners with attention deficit hyperactivity disorder: a professional development curriculum for elementary teachers

PDF

Social skills and self-esteem of college students with ADHD

PDF

Perceptions of college students with ADHD and their learning strategies

PDF

The executive and academic functioning of stimulant-medicated and non-stimulant medicated adult college students with ADHD: a neuropsychological perspective

PDF

Transfer students from California community colleges: a narrative approach to understanding the social capital and institutional factors that lead to a timely transfer to a public, four-year univ...

PDF

An exploration of student experiences in a preparation program for online classes in the California community college system

PDF

Stories of persistence and courage: undocumented students' educational experience enrolled at a 4-year institution

PDF

Examining the relationship between students’ pre-college experiences and outcomes in diversity courses

PDF

Ethnic identity development, ethnic student organizations, campus racial climate, cultural integrity, and sense of belonging for Filipino American undergraduate students at a selective predominan...

PDF

Effective strategies used by general education teachers to address the learning needs of students with selective mutism

PDF

Food insecurity and the impact on community college students

PDF

Bridging the gap: a case study of an African American residential community at a predominantly White institution

PDF

African-American/Black students’ experience and achievement in asynchronous online learning environments at a community college

PDF

Identifying and defining environmental stressors influencing law student wellness and well-being: an exploratory study

PDF

Chinese-Vietnamese American college students: narratives of educational experiences and college success

PDF

The impact of college success program on first generation college students in their preparation for college

Asset Metadata

Creator Young, Edmund Wong Din-Mond (author)

Core Title Understanding the psycho-social and cultural factors that influence the experience of attention-deficit/hyperactivity disorder (ADHD) in Chinese American college students: a systems approach

School Rossier School of Education

Degree Doctor of Education

Degree Program Education

Publication Date 05/08/2012

Defense Date 05/07/2012

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag ADHD,attention-deficit/hyperactivity disorder,Chinese American,College students,coping strategies,cultural,life history,OAI-PMH Harvest,psycho-social,systems theory

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Tobey, Patricia Elaine (committee chair), García, Pedro Enrique (committee member), Lang, Karen A. (committee member)

Creator Email edmundwyoung@yahoo.com,edmundyo@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c3-36310

Unique identifier UC11290173

Identifier usctheses-c3-36310 (legacy record id)

Legacy Identifier etd-YoungEdmun-814.pdf

Dmrecord 36310

Document Type Dissertation

Rights Young, Edmund Wong Din-Mond

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA