ADHD, Food, Context and the process of understanding their limitless connections!
Here marks a checkpoint as I summarize some of my qualitative explorations thus far- the focal point being a follow up discussion with two of my participants. Supervised by the lovely Rebecca Todd!
Before listening: some preamble
Since September of 2023, I have been exploring and researching the endless relationships between ADHD and eating habits and other contextual factors with Rebecca Todd at the Motivated Cognition Lab at UBC. From Sept-Dec, I interviewed 4 first and second-generation immigrant women (aged 22-24) with ADHD on how their ADHD experiences link with their eating habits, symptom management regarding food intake, as well as contributing social, physical, and mental factors. Due to time constraints, I started with a more focused analysis of how these topics relate to cultural tensions between one’s ‘home culture’ and the Western culture we’ve been implanted into.
As of Jan 2024, I’ve been embarking on my full thematic analysis of that initial interview to draw a summarized picture of my participants’ lived experiences with these interwoven topics. In April, I conducted a follow-up discussion with 2 of the 4 initial participants, recapping what I had come up with and collecting their feedback and additional insights. You’ll get to hear more details on all of the above as I introduce the discussion in the recording!
While I could have finished things off with a typical paper, I really wanted to showcase my participants’ role as collaborators in this process! Over the course of my degree, I’ve come to highly value research processes which can immediately give back to the communities they study and engage with, and one of those ways is making them feel authentically seen and supported. Hence, one of my personal goals with this line of research was to provide content in which people like me and my participants could see themselves and hence find validation and solace, especially since this tends to be such an underrepresented demographic. I feel that this sort of open and casual approach to communicating my findings is far more conducive to that goal than an academic paper.
As per the participants’ request, I have edited their voices in the recording of this follow-up discussion below. “N” is the participant with the higher voice, and “K” is the participant with the lower I’ve also jotted down time-stamped notes and additional files, so you can follow along with the materials we viewed during the discussion and listen along while reading my little written annotation!
While listening: follow-along-able annotations (as promised^)
Here is the recording to follow along with:
2:51: K’s map! Here K starts to present and describe the map they drew, and here it is for your viewing pleasure!
5:57: Chatting about N’s map. This is what N came up with:
8:44: Here I debrief my participants on what I got up to in that first term of work, aka my COGS402 project, which (as I explain) discussed all of this within the more focused frame of ‘culture'. If you want more nitty-gritty or are just curious, here’s the full paper (extra credit: the citations provide some good further readings)!
And for those who want the visual aid without the paragraphs:
12:54-Bonus content (especially for those interested in qualitative methods and thematic analysis)! An exclusive behind-the-scenes peek at how I worked to group my first round of ‘codes’ (aka these lists of ‘descriptive tags’) into the themes I came up with:
13:39- Initial mind map of my findings which I walked through with the participants, and through the process which I described for a bit before this time-stamp. For the remainder of the discussion, I walked through each theme and we zoomed into that general area of the map from Emergent Barriers (pink) to Tradeoffs (yellow) to Motivation vs Shame (blue) and ending in the middle of the map with a discussion on the idea of how we embody aspects of our context and surroundings, thus influencing our physical and mental health.
After listening:
As you can likely tell, the session ended up being more involved in the discussion than the map workshopping, so following the conversation I listened back and made notes to make this updated map:
To free you from a complicated game of ‘spot the difference’, here are some of those notes on the key changes made as I relistened to the discussion. I’ve chunked things up for the sake of readability, but of course, there are points throughout the discussion which help motivate each modification (note that I’ve indicated the new links I added to the map with “→”):
Emergent Barriers [Largely discussed from 14:50-31:00]
To represent N’s discussion of her OCD diagnosis, I added sub-nodes “body image” and “identity” to “self-perception” as well as another code-to-code link: “Body image” → (health) “Anxiety”
I linked “Med System” → “Culture” (specifically home culture/family) as well as → “Friends/family”, as these shape your perceptions of and relationship to medication. For example …
‘Productivity and hustle culture’ (also linked to professional life) might influence your need for medication. Indicating how in many ways ADHD is only a disability relative to the context
Tensions between the biomedical focus of Western culture versus your home culture may influence your willingness to medicate. For example, some families may show reluctance towards the idea of medicating ADHD, while K’s mom actually encouraged and motivated K towards trying ADHD medication.
Tradeoffs [Largely discussed from 31:00-55:39]
I added some additional links from “live to eat vs eat to live” to…
→ “Culture”, since it’s been mentioned how our Middle Eastern home cultures often emphasize enjoying and sharing food.
→ ADHD meds. N mentions how their self-contradictions in response to this question relate to whether they’re on their meds or not.
→ Social features. For example, eating with others motivated N to eat, giving her a more “live to eat” attitude. Meanwhile, eating by yourself tends to prioritize ease and convenience and feels more “eat to live”. Also, K mentions how the reality is “eat to live”, but wants to be “live to eat”, showing how there’s some inner conflict happening.
I also strengthened (thickened) the link between social features and motivation/shame, as it became evident that these domains were even more linked than I initially realized. For example, what I pointed out above regarding N being more motivated to eat when eating with others
“Economic class” → “Eating out, eating schedules, groceries, snacking”
“Transitioning and independence” → “Social features” and → “Difficulties & barriers in food management”. Although the changing and erecting of barriers when moving away from family was something I noticed in my earlier analyses (hence why it was already linked to “Emergent Barriers”), I realized these details needed to be better represented better here as it’s a key feature of the lived experiences of many in our age range.
Somewhat relatedly, I also connected “Strategies and accommodations” → “Support systems; friends and family”. Here, roommates often played a key role in supporting participants who had moved away from family
“Understanding nutrition and health” → “Culture”, of course, think I just missed this initially!
“Eating out” → “Nutrition and health perception”, since it’s interesting how we often perceive eating out as an inherently unhealthy thing!
Within this discussion also arose this idea of there being no good tradeoff, where N does not feel satisfied so I also linked “Sense of hopelessness, dissatisfaction” → “Tradeoffs”
For example, eating out can result in guilt and shame, but can also feel good because of the ease and convenience. Meanwhile eating at home can leave you feeling dissatisfied, yet less guilty.
Shame and motivation [Largely discussed from 55:39-1:13]
“Self-motivation and acceptance” → the theme of Tradeoffs. This link relates to the frustrations regarding having to manage everything versus just wanting to be a person and needing to accept that you’re never going to be able to nail things down perfectly or permanently. Accepting this reality and the little wins could help alleviate shame and increase motivation.
I also added the node “validation & legitimacy” under social features, which aims to capture a few of the ideas that came up:
This idea of ‘stigma’, and relates to both the perception of others and your self-perception (hence the code-to-code links).
Via its parent of “Social Features”, its also strongly connected to the theme of Motivation and Shame. Both N and K agreed that spending time with people with ADHD and partaking in these discussions is motivating.
Embodiment [Largely discussed from 1:13 on]
Changed the node “It’s a journey” to “It’s a (nonlinear) journey” - subtle but I couldn’t help myself :P
Added a bubble in the centre, “listening and caring for oneself”. This calls to the idea of frequently needing to ignore one’s body, prioritizing other goals of ‘higher importance over your personal needs. This can result in a heightened tolerance for physical discomfort, putting you out of touch with your body. I’ve placed this in the middle not only because it feels tightly linked to this idea of embodiment, but also because it feels so linked to every other item on the map that it fits naturally here.
Overall, it was really encouraging to hear how much of my interpretation was reinforced and echoed! This discussion also brought attention back to features I had noticed in the original discussion but had pruned for conciseness, hence justifying their reincorporation into the map (for example, the “validation and legitimacy” node). It also provided slightly more astute ways to phrase existing ideas. Lastly, although there was plenty of reinforcement, I was also pleased to have drawn out some new connections between nodes as well as some initial ideas for new nodes which have prompted me to look back on my coding. I would be more than happy to hear any further observations and comparisons from any readers in the comments! Lastly, as was the case in the original interview, I was most satisfied and encouraged by the participants’s continually positive personal takeaways and overall sense of validation!
What now?
Since then, I’ve been engaging in the iterative process of combing back through my initial interview data to see if these additional considerations would provide new insights. I’m also hoping to dive back and forth between that and looking through more literature to gather further tools for painting the picture of what it means to have this sort of lived experience. Last, I’ve got some physiological measures from the initial interview to interpret! The complete mixed methods analysis will aim to generate hypotheses that can be tested using quantitative methods in future studies, as is one of the main goals of most qualitative research (in addition to representing the lived experiences of the participants). I’ll leave the rest of these details to the imagination — so stay tuned for updates towards the end of this summer!
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