This week, Mad in America examines four studies related to the use of language around disabilities and mental health diagnoses. The first finds that strongly identifying with a disability predicts a preference for identity-first terms, such as “disabled person,” as opposed to person-first language, such as “person with a disability.” The second reports that identity-first terms for people diagnosed with schizophrenia have decreased in academic publications over time. The third finds that people that strongly identify with their ADHD label are more likely to take psychotropic drugs and prefer identity-first terms. The fourth finds that identity-first language is more common in social media posts about autism while medical framing is declining.
The APA has argued that person-first terms, such as “person diagnosed with depression,” are less stigmatizing than identity first-terms, such as “depressed person.” Other experts have expressed concerns that person-first terms may actually accentuate stigma. While people with some diagnoses, such as ADHD, are more likely to prefer person-first terms, others, like autistic people, often prefer identity-first language to describe themselves. The following studies show that language around mental health diagnoses is a complex issue, with preferences and practices often varying based on diagnosis and personal perspectives.
Disability Identity Predicts Language Preferences
A new study published in Rehabilitation Psychology examines the relationship between disability identity and the use of person-first (person with a disability) and identity-first (disabled person) language. This research, led by Connie Janiszewski from Deakin university in Australia, finds that stronger disability identity was linked to a preference for identity-first language. This study also found that younger age, nonbinary gender, and having a visible disability were linked to stronger disability identity and preference for identity-first language.
The goal of this study was to examine the link between disability identity and language preferences around self-identification and referring to others. In total, 776 participants completed a self-report survey providing information on demographics, health, disability identity, disability language use, and perceived appropriateness of disability language in different contexts. Most participants were from Australia (87.2%), the US (6.1%), or the UK (3.6%).
Younger age, nonbinary gender identity, congenital conditions, having a visible disability, and living in a country outside Australia were all linked to stronger disability identity. Neurodevelopmental, hearing, and pain disabilities were associated with stronger disability identity while those with digestive and mental health disabilities were less likely to have a strong disability identity. The authors also note a “weak but significant” link between longer disability duration and stronger disability identity.
Stronger disability identity was linked to preference for identity-first language. Participants with an undergraduate degree were also more likely to prefer identity-first language compared to participants with vocational and trade qualifications.
This research had four main limitations. The design of the study means this data can only speak to relationships, not causes. This means this research cannot definitively say that disability identity causes a preference for identity-first language. Some factors that may have influenced language preference, such as knowledge of neurodiversity movements and participation in online advocacy, were not measured. The self-report nature of the survey means the data was susceptible to bias by misreporting and participants providing answers that were socially acceptable rather than accurate. The overwhelming majority of participants were Australian, limiting generalizability to other populations.
Identity-First Language for People with a Schizophrenia Diagnosis Has Decreased Over Time in Academic Publications
A new study published in Schizophrenia examines the use of person-first (person with schizophrenia) and identity-first (schizophrenic person) language in academic papers about schizophrenia. This research, led by Maria Dino from the Universidade Federal de São Paulo in Brazil, finds that identity-first language used to refer to people with a schizophrenia diagnosis has significantly decreased over time.
The authors located past research about schizophrenia published in English. They randomly selected 500 articles and assessed their use of identity- and person-first language. Articles were divided into three time periods (1951 – 2005, 2006 – 2013, and 2014 – 2023) for the purposes of analysis and categorized based on the overall language use as identity-first, person-first, or neutral (schizophrenia patients).
Of the 500 articles examined by the authors, 475 used at least one term to refer to people with a schizophrenia diagnosis. Identity-first language was used in 50.1% (238) and person-first language in 48% (228). Both identity- and person-first language was used in 18.2% (91) of articles.
In studies published between 1951 to 2005, 50% of references to people with a schizophrenia diagnosis were identity-first, 39% were neutral (schizophrenia patient), and 11% were person-first. In studies published between 2014 to 2023, just 8% of references to people with a schizophrenia diagnosis were identity first compared to 66% that were neutral and 26% that were person-first.
This research had three main limitations. The majority of articles were from Europe and North America. Low- and middle-income countries were significantly underrepresented, limiting generalizability. The authors used the search term “schizophrenia” to locate articles, meaning any articles using alternative terminology would have been excluded. Only English language publications were included. This means the current work cannot speak to how non-English publications use person- and identity-first language around schizophrenia.
Higher ADHD Identification Linked to Preference for Identity-First Language and Psychotropic Drug Use
A new study published in the British Journal of Psychiatry finds that people with ADHD in the UK prefer person-first over identity-first language. This research, led by Kate Cooper from University College London, also reports that ADHD social identification was linked to a preference for identity-first language and higher rates of psychotropic drug use.
The authors recruited 319 adults from the UK to participate in the current study. Two-hundred fifteen participants had an ADHD diagnosis and 104 self-identified as having ADHD. Participants completed a self-report survey that measured ADHD identification, self-esteem, well-being, anxiety, depression, person- versus identity-first language preference, psychotropic drug use, and sources used to learn about ADHD.
The majority of participants (77%) preferred person-first language (I have ADHD). Higher rates of ADHD social identification was linked to a preference for identity-first language (ADHDer) around ADHD and higher rates of ADHD drug use. Learning about ADHD through social media was linked to higher rates of ADHD social identification. The authors also report that ADHD social identification was associated with higher self-reported anxiety and depression, but these findings were non-significant and may have occurred by chance.
This study had four main limitations. The study’s design means it cannot speak to causation. For example, this data cannot definitively say that ADHD social identification causes increased ADHD drug use. The self-report survey is prone to misremembering as well as giving answers that are socailly desirable rather than accurate. The sample was self-selected and may not accurately represent the UK ADHD population. As this research used participants exclusively from the UK, generalizability to other populations is limited.
Identity-First Language More Common in Social Media Posts About Autism While Medical Framing is Declining
A new study published in Frontiers in Psychology finds that identity-first language is more common than person-first language in social media posts about autism. This research, led by Patricia López-Resa from the University of Castilla-La Mancha in Spain, also reports a significant increase in neuroaffirmative language in social media posts about autism since 2023. This could indicate a move away from the medical model in popular narratives around autism.
The goal of this research was to examine how different cultures and languages talk about autism on social media. The authors chose to examine posts on the social media platform X (formerly Twitter). They collected 678 posts written in English (175), Spanish (175), French (173), Norwegian (80), and Georgian (75). The authors assessed the terms used in each post for the presence of medical (suffering from autism), neuroaffirmitive (proudly autistic), person-first (person with autism), and identity-first (autistic person) language.
Medical framing of autism ranged between 31.2% in Norwegian language posts to 45.1% in Spanish language posts. Neuroaffirmative framing ranged between 28% of Georgian posts to 43.4% of English posts. Medical framing was used more often than neuroaffirmitive framing in Spanish and Georgian posts while neuroaffirmative was more common in English, French, and Norwegian. Neuroaffirmative framing of autism on X/Twitter has increased significantly since 2023.
Identity-first terms were more common than person-first in every language, ranging between 32% in Georgian to 42.3% in English. A significant number of posts did not use person- or identity-first terms in each language, ranging between 31.8% in French to 66.7% in Georgian.
The authors note that these findings likely reflect the influence of the neurodiversity movement, which typically prefers identity-first terms and neuroaffoirmative framing around autism. These findings also reveal linguistic and cultural divides in understanding and framing of autism.
This research has three main limitations. The authors only looked at social media posts on X/Twitter. These results may look different when other social media platforms are included. The sample is not representative, and likely gives more weight to vocal online autism advocates. This means these views may not accurately represent the larger autistic population. Mapping concepts such as person- and identity-first terms across different languages is inherently imprecise.
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Cooper, K., Thomas, K., Burnley, A., & Smith, L. G. (2026). Understanding ADHD identity and preferred terminology for adults with ADHD in the UK: Associations with Medication Use, well-being and mental health. The British Journal of Psychiatry, 1–9. (Link)
Dino, M., Koga, G., Yokoji, A., Haguiara, B., Pacheco, I., Ziebold, C., Bressan, R., Crossley, N., Orsi, J., Thornicroft, G., Slade, M., Mari, J. de, Evans-Lacko, S., Andrade, M. C., & Gadelha, A. (2025). How researchers refer to individuals with schizophrenia: Person-first and identity-first language in academic papers. Schizophrenia, 11(1). (Link)
Janiszewski, C. M., Friedel, E., Skvarc, D., Koller, D., & Grech, L. B. (2025). The relationship between disability identity and use of person-first and identity-first language. Rehabilitation Psychology. (Link)
López-Resa, P., Skafle, I., Rebecchi, K., Kalandadze, T., Nordahl-Hansen, A., & Gabarrón, E. (2026). Discursive constructions of autism on social media: A multilingual analysis across five languages. Frontiers in Psychology, 17. (Link)