Talk:Attention deficit hyperactivity disorder/Archive 3

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Video Talk:Attention deficit hyperactivity disorder/Archive 3

Treatment Section

The section which describes mainstream treatment only lists medications. However the section states "The combination of behavioral therapy and medication has a small benefit over medication alone." Why is behavioral therapy left almost entirely unmentioned as a treatment? If someone has any knowledge about behavioral therapy for ADHD please include it in the article. William conway bcc 01:44, 5 September 2006 (UTC)

Probably because the behavior therapy doesn't necessarily have to be specific to ADHD to be effective, while the medications are more specific (thus there's more ADHD-related information to find on them). Also, medications can change chemicals in the brain, but usually treatment occurs after behavior has developed and certain things are habits, etc. It's kind of like saying, glasses can make you see, but you'll still need to learn how to read; saying that medication alone might not seem to "solve" all the problems.

So while I don't feel like getting into a debate about medicating people, it simply seems that be that behavior therapy generally used isn't necessarily specific to ADHD, but simply that ADHD falls within the areas where some types of behavior therapy can help (which is why there might be a lack of info on this article). -- Ned Scott 03:58, 5 September 2006 (UTC)

Behaviour therapy has to be done at the point of performance, that is the exact enviornment in which you want to see a behaviour change. You can't do Psychosocial counseling in an office and expect the ADHD child to take anything of substance away from that to implement at school. That doesn't work. If you get into modtly immediate rewards and less consequences, right there at the point of performance...you can change behaviour, but only as long as the rewards are in place.

Psychosocial therapy is successful with the families of ADHD children and if there are comorbid conditions like anxiety. The therapy will help with the anxiety but it does little to change those with ADHD. Studies have shown that it is very important for getting parents on board and to be knowledgeable about the disorder. --Scuro 04:15, 22 December 2006 (UTC)

Maps Talk:Attention deficit hyperactivity disorder/Archive 3

Long term stimulant treatment outcomes

I noticed that there is no mention of long-term treatment outcomes. I think this information would be extremely valuable. The literature is almost universally supportive of the observation that there are few or no significant long-term benefits, academically or socially, to the long-term use of stimulants. Given the risks involved, it seems very important to include these facts in the discussion regarding treatment.

I would submit the following references:

Swanson, J.S., et al., "Stimulant medication and the treatment of children with attention deficit disorder: A Review of Reviews," Exceptional Children, 1993, Vol. 60, pp. 154-61.

G. Weiss, E. Kruger, V. Danielson, and M. Elmann, "Effect of Long-term Treatment of Hyperactive Children with Methylphenidate [Ritalin]," Canadian Medical Association Journal 112 (1975): 159-165. "They fully expected to see a beneficial drug effect. But they reported "no differences in adolescence between the drugged and the undrugged children in school marks, in number of grades failed, in amount of hyperactivity, or in antisocial behavior. The problems of organically hyperactive children seemed to linger on, whether or not they had been drugged."

Are ADHD drugs safe? Report finds little proof

M. ALEXANDER OTTO; The News Tribune Published: September 13th, 2005 12:01 AM

At a time when millions of children and adults are taking drugs for Attention Deficit Hyperactivity Disorder, the most comprehensive scientific analysis of the drugs to date has found little evidence that they are safe, that one drug is more effective than another or that they help school performance. The 27 drugs studied included Adderall, Concerta, Strattera, Ritalin, Focalin, Cylert, Provigil, and others that, in some households, are well-known for their sometimes calming affects.

The 731-page report was done by the Drug Effectiveness Review Project, based at Oregon State University. The group analyzed 2,287 studies - virtually every investigation ever done on ADHD drugs anywhere in the world - to reach its conclusions.

They found:

o "No evidence on long-term safety of drugs used to treat ADHD in young children" or adolescents.

o "Good quality evidence ... is lacking" that ADHD drugs improve "global academic performance, consequences of risky behaviors, social achievements" and other measures.

o Safety evidence is of "poor quality," including research into the possibility that some ADHD drugs could stunt growth, one of the greatest concerns of parents.

o Evidence that ADHD drugs help adults "is not compelling," nor is evidence that one drug "is more tolerable than another."

o The way the drugs work is, in most cases, not well understood.

http://www.thenewstribune.com/news/local/story/5174797p-4705010c.html

http://www.ohsu.edu/drugeffectiveness/reports/documents/ADHD%20Final%20Report%20Update%201.pdf

[Steve]

Dr. Russell Barkley had this to say about stimulant medication:

"Inhibition and Stimulant Medications

This theory suggests a more specific implication for the management of ADHD. Only a treatment that can result in improvement or normalization of the underlying neuropsychological deficit in behavioral inhibition is likely to result in an improvement or normalization of the executive functions dependent on such inhibition. To date, the only treatment that exists that has any hope of achieving this end is stimulant medication or other psychopharmacological agents that improve or normalize the neural substrates in the prefrontal regions that likely underlie this disorder. Evidence to date suggests that this improvement or normalization in inhibition and some of the executive functions may occur as a temporary consequence of active treatment with stimulant medication, yet only during the time course the medication remains within the brain. Research shows that clinical improvement in behavior occurs in as many as 75-92% of those with the hyperactive-impulsive form of ADHD and results in normalization of behavior in approximately 50-60% of these cases, on average. The model of ADHD developed here, then, implies that stimulant medication is not only a useful treatment approach for the management of ADHD but the predominant treatment approach among those treatments currently available because it is the only treatment known to date to produce such improvement/normalization rates.

Society may view medication treatment of ADHD children as anathema largely as a result of a misunderstanding of both the nature of ADHD specifically and the nature of self-control more generally. In both instances, many in society wrongly believe the causes of both ADHD and poor self-control to be chiefly social in nature, with poor upbringing and child management by the parents of the poorly self-controlled child seen as the most likely culprit. The present model states that not only is this view of ADHD incorrect but so is this view of self-regulation. And this model also implies that using stimulant medication to help to temporarily improve or alleviate the underlying neuropsychological dysfunction is a commendable, ethically and professionally responsible, and humane way of proceeding with treatment for those with ADHD". http://www.continuingedcourses.net/active/courses/course003.php

Passage from text ->"Those who believe that ADHD is a traditional disability or disorder often debate over how it should be treated, if at all." -> I don't think there is any debate at all within the medical community about how it should be treated. A large body of evidence has shown that stimulants significantly decrease symptoms. The debate really is more about if any other treatment, including all alternative treatments and psychosocial treatments, are effective at all. There are a number of antipsych groups and practitioners, including Scientology, that debate if mental disorders exist and why anyone would give medication to someone who doesn't have a disease. --Scuro 15:38, 9 December 2006 (UTC)

Yes, I know that's what Russell Barkley has to say about stimulant treatment. But notice that he is talking about symptom relief here, NOT about long-term outcomes. He states clearly in the text that behavior is "normalized" in a percentage of the population, but only as long as the drug is in the system. He makes no comments or implication that this normalization of behavior will improve any of the outcomes I mentioned. Please take note that I am referring you to a list of viable scientific publications that support this, most notably the OSU medication effectiveness study, which concludes without hesitation that there is almost no evidence (despite a reasonable number of studies) that stimulants have any LONG-TERM positive effects, such as reductions in delinquency and improvements in academic test scores. None of this contradicts or is addressed in the Barkley section you quote in any way. So I am not suggesting that stimulant medication is ineffective in treating symptoms short-term. I am trying to add the perspective that medication does NOT appear to be the determining factor in improving long-term outcomes like delinquency and school achievement.

I think it is VERY important for people to understand that giving a child stimulants IS likely to moderate their behavioral symptoms but is NOT likely, in and of itself, to result in improvements in long-term outcomes. Barkley himself has observed this. That's what the science says. I know it's not a popular or well-known set of facts, but that's what this process is supposed to be about - educating people as to the facts of the situation.

I think a section on long-term outcomes absolutely belongs in the article. To leave it out will leave people with the impression that stimulant treatment is a good way to make sure their ADHD child gets a good educational outcome or stays in school until graduation, which is not supported by the scientific facts as we know them.

[Steve] --The preceding unsigned comment was added by 159.121.4.162 (talk) 14:18, 15 December 2006

I'm not sure if I see your point, Steve. If one is taking a medication, and it works, then stops taking the medication, it would stand to reason that it would stop working. In this sense many medications are "short term". Also, your above comments about how there's little evidence to show these drugs are "safe" don't mention if there's evidence to show they're "not safe". This is important, because of Wikipedia's policy on neutral point of view. If you wish to say there is a lack of research or something, then ok, but you can't reasonably support one view or the other with such a statement alone. -- Ned Scott 22:20, 15 December 2006 (UTC)

Yes, I agree Ned. Stimulant medication is not meant to cure ADHD, just like glasses don't cure poor eyesight. Rather medication is used to decrease symptoms so that one is better able to function, that one is less impaired. Those who take theraputic levels of stimulants may reduce the long term risk of drug and alcohol abuse. [1] Within the mid-term range studies, there does seem to be academic and social gains found in children who used medication. I did read that there were no long-term results because this particular issue has not been studied over the long-term. Past long term studies have focused on negative outcomes that ADHD may cause. I believe in time, as they identifiy all specific long-term impairments of ADHD, new studies may look at this exact issue.--Scuro 21:35, 16 December 2006 (UTC)

• • • • I guess you don't see the point at all. I will try to explain again: One would expect that a successful treatment for ADHD would improve academic outcomes. Parents are often told that "untreated ADHD leads to delinquency and poor academic performance." One sees this kind of language in much of the anecdotal literature, as well as pamphlets, government publications, and websites such as CHADD. This seems to suggest that treatment will improve these outcomes. The evidence in the literature does not bear this out, at least as far as stimulant treatment is concerned. Whether or not the kids were medicated (wore their "eyeglasses" as it were), they still had the same kind of problems with delinquency and school failure - the stimulants did not seem to make a difference. So it would be unfortunate if a parent got the idea that they could give their child stimulants and that would be sufficient to address the kinds of difficulties that ADHD behaviors often are associated with in adolescence. If the reason ADHD children need treatment is because they will eventually fail academically and socially, doesn't it stand to reason that treatment should ameliorate these concerns in some way? But stimulant treatment has not been shown to do that. I am not saying that symptom management is not a legitimate goal. I am saying that we should let folks know that they will probably have to do something else if they want to see an impact on long-term outcomes, whether or not they choose medication to relieve symptoms. Don't you think people should know this?

• • • • As for Scuro's comment regarding a lack of long-term studies on outcomes, this does not appear to be the case. If you look at the OSU study, you will find that there are significant numbers of studies on long-term outcomes, especially regarding academic gains. The first REVIEW of these studies was done in 1978 by none other than Russell Barcley himself. (This would suggest that there were more than a handful of studies to review as of 28 years ago!) Barkley concludes unambiguously that the stimulants showed little or no sign of improving long-term academic outcomes in multiple studies, a result he called "disappointing". The 1993 "Review of Reviews" by Swanson listed above includes Barkley's review as well as a number of other reviews, so there were plenty of research articles on the subject already extant 14 years back. He also concluded that there was no indication that any long-term academic or social outcome was positively affected by stimulant treatment. Both Swanson and Barkley are very strong supporters of medication intervention, so bias is not an issue in these reviews. Scuro is correct in stating that there are a couple of pretty recent studies that suggest less chance of drug abuse while continuing to take stimulants in adolescence. This is pretty new information but has been replicated a couple of times, so seems likely to pan out in the end. But that also should be viewed in concert with the Nadine Lambert studies that suggest that early exposure to stimulants at therapeutic levels may be associated with increased stimulant use later in life, especially cigarettes. Of course, her study included many people who took stimulants for a couple of years and then stopped, so it's a different cohort we are looking at there.

• • • • As to the safety profile, I think the OSU article is pretty clear: the question has not been adequately studied. They do not conclude that they are safe or unsafe, only that their long-term safety has not been established. It's kind of a fundamental of science that something isn't true until it's proven true, so in this case, they are neither "safe" nor "unsafe" as far as science is concerned. They are untested. So if I am a parent, and I know there are not long-term safety studies available, it might increase my awareness that I have to be alert for unspecified effects in the long run. However, this point was not the major one I was trying to get included in the article. It was just a part of the article.

• • • • I am a bit puzzled as to why the question of long-term outcomes does not seem relevant to you. If you wanted to know all about ADHD treatments, wouldn't you want to know about long-term outcome studies? As an analogy, if I take a heart medication to reduce cholesterol levels, wouldn't I want to know if the medication would lead to less heart attacks or a longer life? If the Wiki policy is to be unbiased, it seems that presenting the conclusions of a review of essentially every piece of published scientific literature on long-term outcomes for people taking stimulants would be a pretty helpful piece of information. It is 100% scientific, unbiased, and relevant. What possible objection could you have to including it?

[Steve]

Steve, I hope you don't mind but I have corrected your spelling of Russell Barkley's name again. Am I supposed to do something like that? It's just if you mention his name, other readers may want to research him and you can'd do that if the name is spelt wrong, hope you are not offended. I have hyper-linked to Wiki's article on him which I am glad to say I have contributed too, the guy should win a national public service award for all that he has done with regard to ADHD. At that page on Wiki, I have added some links to extensive and good information that he has on the internet. --The preceding unsigned comment was added by Scuro (talk o contribs).

Steve, you are missing a major point, in that Wikipedia is not here to give advice to parents (see Wikipedia:Medical disclaimer). We are not here to give initial education on any kind of medical treatment. If a parent reads the Wikipedia article, but does not do additional research, then they're not being responsible. So as honorable as your "think of the children" argument sounds, it has no place here. As far as your claims themselves, ADHD medication does not cure, we've already told you this. It's not the same as heart medication.

Also, Wikipedia is not a soapbox. I find it hard to believe that you are actually here to contribute to the article, or any article, on Wikipedia. You got a beef with medicating children, go take it somewhere else. There are facts that back up the statements being made here about medication, not personal beliefs. -- Ned Scott 03:59, 20 December 2006 (UTC)

• • • • Scuro, Thanks for the name correction. I appreciate it. I actually caught another one!
      • Ned, I am not sure where you are coming from, here. I have provided you with published scientific information from a respected university research project with no conflicts of interest or axes to grind. How is that my personal opinion? The only disagreement I can possibly imagine is that you are saying it is not relevant information for people to read that there are no improvements in long-term outcomes for kids takings stimulants in the aggregate, according to scientific research. I suppose we can disagree about relevance, but the statements above are not my opinion at all. This is the summation of over 40 years of research, including dozens of studies. So your statement "there are facts that back up the statements being made here about medication" seems a bit odd to me. I don't mean to be critical, but is it possible that you are not open to this information? Do you have a fixed opinion on this? At no time in anything I wrote have I suggested that stimulants are harmful or that they should not be used to control symptoms. I have given you scientific references on every point. I am not using this as a soapbox - I just think the article is not going to be complete without this information. I am also not suggesting that Wiki should advise or make recommendations (where did I say that?) I am simply stating that this is scientific fact that is NOT generally available in the stock publications on the subject. If Wikipedia is aiming for full, non-biased coverage of the issue of medication use for ADHD, I think it should include what is known about long-term effects. Or to put it another way, how does it enhance people's knowledge base NOT to include this? Are you suggesting that it is better for people to be ignorant on the question of whether or not stimulants improve long-term outcomes?

• • • • And just as an aside, heart medication generally does not cure anything, either. It moderates symptoms. That's why I chose it as an example. Sometimes moderating symptoms leads to improved outcomes (i.e. reducing water retention via diuretics improves survival for congestive heart failure patients by reducing heart stress, though it does nothing to cure the condition). Sometimes moderating symptoms can cause worse outcomes, such as morphine for pain relief in terminal cancer patients. Sometimes moderating symptoms has no effect on outcomes at all - it just makes you feel better in the here and now (like cold medication). It is helpful to know which category whatever treatment you are taking fits into. Not that I am suggesting giving advice here, I just think it's useful information if you want a complete picture of what benefits can be expected from treatment.

• • • • Maybe you should run this by someone else at Wiki and see if they think this information would be of interest to readers, and whether they see any bias or lack of scientific backing. I am not sure you are being very objective on this point for some reason. I am happy to hear rational arguments regarding my suggestion, but so far, nothing you have said actually argues against including the information I provided above in the article. [Steve]

• • • • 12/21 - By the way, I just noticed that a comment regarding positive long-term outcomes for substance abuse is already included in the article, so obviously someone thought that long-term outcome data is relevant. Why not include the rest? [Steve]

Steve, it's pretty clear that you are biased, and that you are only trying to sound neutral by playing word games. The information you cite is backed by proof, but you are twisting the words to mean something it doesn't. Are you saying that stimulate medications do not improve an ADHD patients life in any way, whatsoever? That is what you are suggesting by saying things like "no evidence to show stimulants improve long term outcomes". If this is not your intention, then I apologies, but that is how it's coming off. -- Ned Scott 00:18, 22 December 2006 (UTC)

Notwithstanding the generally bogus stimulant safety issues Steve brought up, you must take some of those sources and the conclusions drawn, seriously. I'm going to be the diplomat here and say that Ned has a point too. Do stimulants improve the lives of those with ADHD? For those of us who work in the field and take medication ourselves, the answer seems obvious, of course it does. But could that be a little subjective bias there? Or...what else could be in play here? I'll attempt to come up with one plausible answer to show that this issue has many facets and may not be as black and white as it seems at first glance.

Certainly stimulants don't make you smarter. They relieve symptoms like hyperactivity, aggressiveness, and that great difficulty many ADHDers have of poor inhibition. Someone with ADHD will just go with whatever thought pops in their head and often they don't stop themselves from sticking to the task at hand. Short and medium term studies suggest that we see both academic and social gains. But then what..why no long term gains? Well, lets look at the kids studied. I'd hazard to guess that the kids in the short and medium term tests are elementary school kids. Getting work done and not poking people might be a significant improvement for a hyper adolescent kid.

With a long term study you are now dealing with high school students. That same kid on medication is still getting his work done. But the work has changed. All of a sudden this kid has to deal with abstract reasoning, inference, and word problems. Don't forget the complex multi-step math questions that require you to know a number of newly aquired math skills. They now also have to plan several major goals through time...say an essay due Friday, a peer assessment also due that day, a boy friend who wants your attention, and work outside of school. That summative research project is way bigger then anything they did in elementary school, and mom can't help because this is beyond her ability. How about that persuasive essay on Shakespeare? Do you think mom is going to help much more beyond editing with that? That essay is a highly complex multi-step task, which will expose the core deficits of someone with ADHD with or without meds. One of the first things that I informally studied in this field was the difference between abilities and skill sets of those who are taking meds and those who are not. Those long range planning skills and higher ordered thinking skills are still impaired to some degree, even with medication. You see, the impulsive traits diminish but you don't get as much of a corresponding uptick in higher ordered thinking.

There is a lot more to say on this topic but I'll leave it at that for the moment. --Scuro 05:38, 22 December 2006 (UTC)

src: behaviortherapyassociates.com

== Statement removed from Caption

There is some controversy over the meaning of the research by Dr. Alan Zametkin that produced these images; the statistical findings visually demonstrated here were found to be the result of sampling error. The adults in these studies were in most cases severely dysfunctional.Bitch Hoe.

I removed this statement because no reference is given and no reference could be found for it through Google. --*Kat* 17:35, 10 September 2006 (UTC) ==]

I have ADHD/Dyslexia. I have taken concerta for 3 years and haven´t found any "longtime" ill effects. Quite the opposite these drugs free dopamine. Dopamine is one of the neurotransmitors needed for making new connections in your brain. I read a studie from questionabel source, that sugested using methylphenidat whit omega-3 from the age of 15-30 actually will increase "IQ". These drugs have helped me very much. The diet thing with adhd is bullshit i was breastfed my brother wasn´t. I got adhd my brother dosen´t... Protein deficiency is a known cause to adhd like problems it dosen´t meen you have it. These drugs help IF used corectly.

src: asset.jmir.pub

Newbie requesting addition

I'm a newbie and do not know how to correctly add info; Could an expert help? I'd like mention of National AD/HD Awareness Day, Sept. 20, 2006 as named by Senate Resolution 544. This will be done annually, but the date changes. www.ADD.org (Attention Deficit Disorder Association) can be used as a "for more info" referral. Thank You,--BonzaiBev 15:59, 13 September 2006 (UTC)

src: adc.bmj.com

Reviewer comments

Hi all. I had a look at this GA candidate and had some comments. I'm putting the nomination on hold while you deal with these. Overall excellent, well referenced, NPOV and very comprehensive. Only one figure for a article of this size is unusual.

• No proper reference for source of brain images in figure 1, adding a ref in the caption would be best.

• The source can be found in the image itself.--*Kat* 17:28, 15 September 2006 (UTC)\

I saw that, but it requires the reader to go and hunt through the refs until they find those authors. A direct link would make it easier for them. TimVickers 18:34, 15 September 2006 (UTC)

Okay. Will find. --*Kat* 18:47, 15 September 2006 (UTC)

Done. TimVickers 00:56, 16 September 2006 (UTC)

update: Unable to determine where the scan was originally published, I have emailed Dr. Zametkin for more information about it. --*Kat* 00:50, 16 September 2006 (UTC)

• Good organisation of sections

Thanks!!! My apologies if I seem a little sensitive to criticism. I've put a lot of hours into editing this articles. --*Kat* 18:55, 15 September 2006 (UTC)

• Serious US bias throughout article, particularly in describing Terminology and Definitions. How does DSM compare to systems in Europe or Asia?

Added information about the ICD. --*Kat* 00:50, 16 September 2006 (UTC)

• Section on scans seems to imply MRI involves harmful radiation, unclear.

Fixed. TimVickers 00:56, 16 September 2006 (UTC)

• Incidence section only gives data for US. Sex-linked diagnosis rate may also reflect differing cultural expectations or initial differences in "basal" levels of hyperactivity and attention, genetic explanation should not be given undue weight.

• IIRC, there is exactly one short paragraph devoted to genetics. How is that giving the subject "undue weight". --*Kat* 18:21, 15 September 2006 (UTC)

Only mentioning one possible interpretation of the data gives an incomplete picture. I wonder if something like "indicating either that ADHD is a gender-specific disorder, or that males are more likely to be diagnosed." might be an option. TimVickers 18:34, 15 September 2006 (UTC)

• We don't offer any interpretation of the data, we only give the facts as they were reported in the sources cited. I'm not a doctor, I'm not qualified to make intepretations, and even if I was, that could be POV.--*Kat* 18:41, 15 September 2006 (UTC)

The phrase "indicating that" is followed by an interpretation of the data - that ADHD may be a gender-specific disorder. This is a reasonable hypothesis, but it is only one possible interpretation of these data. I have made an edit here, see what you think. TimVickers 19:22, 15 September 2006 (UTC)

• Suggest addition of image of Omega 3 fatty acid
• No need for list in first paragraph of Treatment section.

• How do you think the information should be conveyed?--*Kat* 17:28, 15 September 2006 (UTC)

I was bold and made an edit. TimVickers 18:34, 15 September 2006 (UTC)

Thanks. My apologies. I wasn't being deliberately obtuse, but I thought you were referring to the really long list under Mainstream Treatments. I've read this article so many times I tend to forget what it actually says.--*Kat* 18:47, 15 September 2006 (UTC)

• Image of the structure of one of the drugs could be added.

• done --*Kat* 18:26, 15 September 2006 (UTC)

• ADD coaching should be in its own sub-section.

• done.--*Kat* 17:28, 15 September 2006 (UTC)

• You could add an image of one of the people mentioned in the Positive Aspects section.
• The timeline is overly-detailed, concentrate on a smaller number of more significant points. Perhaps best to deny the Scientologists^TM the oxygen of publicity.

• done. --*Kat* 18:26, 15 September 2006 (UTC)
• but they are apart of ADHD history. A major part for that matter. Taking that point out would make the timeline less than NPOV.--*Kat* 17:28, 15 September 2006 (UTC) Nevermind, I see what you mean.

• The references need a standardised format, see Wikipedia:Citing sources

• Could you be more specific? --*Kat* 18:21, 15 September 2006 (UTC)

TimVickers 05:25, 15 September 2006 (UTC)

If you put the PMID in the ref itself it allows you to hide the link and makes the reference list both shorter and more readable. See Enzyme for more examples. TimVickers 18:34, 15 September 2006 (UTC)

These are very good suggestions. I'm willing to help out in whatever way I can. -- Ned Scott 07:00, 15 September 2006 (UTC)

Removed from Timeline

• 1867 - The term "hyperactive" is first used in reference to the "condition of the brain in acute mania." (Source: Oxford English Dictionary Online)
• 1961 - Ritalin first indicated for "various behaviour problems in children".
• 1970s - Canadian Virginia Douglas released various publications to promote the idea that attention deficit was of more significance than the hyperactivity, influencing the American Psychiatric Association.
• ~1971 - The Church of Scientology set up the Citizen's Commission on Human Rights (CCHR), which lobbied using the media against psychiatric medication in general, and Ritalin in particular.
• 1991 - The U.S. Department of Education rules that ADHD is an eligible condition for receipt of special educational services provided that it interferes with academic functioning. Most cases are dealt with under the "Other Health Impaired" category of special education while others qualify under the categories for learning and emotional disorders.
• 1998 - the NIH developed and issued a Consensus Statement attesting to the existence of ADHD. A link is provided in the External Links section below.

Any objections/additions? --*Kat* 18:07, 15 September 2006 (UTC)

I've changed ref 22 to:

Lou HC, Andresen J, Steinberg B, McLaughlin T, Friberg L. The striatum in a putative cerebral network activated by verbal awareness in normals and in ADHD children. Eur J Neurol. 1998 Jan;5(1):67-74. PMID 10210814

Since the original ref seemed to be wrong. TimVickers 01:14, 16 September 2006 (UTC)

Good edits Kat, certainly GA quality now. TimVickers 01:36, 16 September 2006 (UTC)

Yayayayayaya!!!!! --*Kat* 12:03, 16 September 2006 (UTC)

Passage from text ->"Those who believe that ADHD is a traditional disability or disorder often debate over how it should be treated, if at all." -> I don't think there is any debate at all within the medical community about how it should be treated. A large body of evidence has shown that stimulants significantly decrease symptoms. The debate really is more about if any other treatment, including all alternative treatments and psychosocial treatments, are effective at all. There are a number of antipsych groups and practitioners, including Scientology, that debate if mental disorders exist and why anyone would give medication to someone who doesn't have a disease. --Scuro 15:38, 9 December 2006 (UTC)

src: i1.wp.com

ADD and ADHD are not the same.

I could be completely wrong here, but I believe that ADD and ADHD are not the same diagnosis. Some sources: Web4Health.info add.about.com

Am I completely off base here, or do I have a point? Minidoxigirli 21:43, 19 September 2006 (UTC)

You're off base. You might want to check out CHADD.org, the nationally recognized advocacy group for ADHD.

Ah, got it. Should have checked there first!:)Minidoxigirli 02:37, 20 September 2006 (UTC)

ADHD and ADD are closely related, though not exactly the same. The hyperactive element of the disorder often tends to drop off in adulthood, although not always. This happened with me. I was diagnosed as hyperactive as a boy, placed on a stimulant med which did make a difference then, but i am no longer hyperactive.

But the other symptoms, such as distractibility and a tendency toward being impulsive remain. There are a few very good books on the subject, among them is one my doc pointed me to; "Driven to Distraction," by Edward M Hollowell MD and John J Ratey MD.

Dr. Ed writes in the first paragraph of his preface (paraphrased), "I have ADD. I first discovered I had this when I was a 31 year old grad student at the tail end of my course work in child psychiatry...." Use this book along side of the CHADD site, also an excellent resource.

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You might not be that far off. Check under SCT (sluggish cognitive tempo) on Wiki. There is a subgroup with the inattentive designation that appears to remarkably different from garden variety ADHD. --Scuro 21:12, 10 December 2006 (UTC)

---

---

An addition of mine was recently removed from the DSM section of ADHD on Wiki. I believe it is much more accurate then what is currently there.

-As it now stands, the information about SCT is inaccurate. Inattentive ADHD may be referred to as ADD or SCT, but those who do this, do this incorrectly. SCT does not equal ADHD PI. Hyperactive ADHDers in later life may qualify for a diagnosis of ADHD PI as their hyperactivity disappears. If they recieve their first diagnosis in later life it would be for inattentive ADHD because they would have enough inattentive symptoms for that diagnosis and may not have enough for the Hyperactive or Combined diagnosis. These former hyperactive ADHDers are completely different from SCT's in many ways.

-ADD is an older term and is no longer used by those in the field.

For further reading I would suggest Barkley's lecture notes on PDF. Go to section 2 entitled is Inattentive ADHD really a separate disorder"? SCT is a descriptive term only.

--Scuro 04:55, 12 December 2006 (UTC)

src: www.mentalhealth.com

Fred Baughman and other critics of ADHD

Shouldn't this page contain some mention of Dr Fred Baughman, the Paediatric Neurologist whose book 'The ADHD Fraud' argues against the claims of Zametkin and others to have found any kind of physical symptoms of ADHD? I cannot see any such reference and apologise if I have missed it. I should like to see the response of supporters of the ADHD diagnosis to this attack. The entry seems to me, despite its many seals of approval, to be subtly weighted towards the assumption that this disorder actually has an objective existence, rather than - which would seem to me more proper - accepting that there is still a major argument about its existence which remains unresolved. Given that an ADHD diagnosis is not a matter of pure theory, but often results in the prescription of actual drugs with powerful chemical effects on the brain, usually to children, isn't that rather important? Peter Hitchens signed in as Clockback 12:40, 20 September 2006 (UTC)

That is probably found in Controversy about ADHD--*Kat* 20:44, 20 September 2006 (UTC)

Well, it probably isn't. Try checking with a Ctrl 'F'. The whole article, absurdly classified as 'good'in my view, seems based on the premise that 'ADHD' is a proven complaint rather than a speculative one without any objective diagnosis. The controversy is surely more important than the description, when the controversy remains unresolved and the consequence is the widespread prescription of powerful psychotropic drugs (which do have objective physical/chemical/biological effects) to millions of small children. How can one describe and categorise a complaint whose very existence is still widely disputed by qualified medical practitioners and, in the eyes of many of them, unproven? Why, it's even illustrated with a scan that might be taken to suggest that such a diagnosis existed. Peter Hitchens logged in as Clockback 10:14, 21 September 2006 (UTC)

Peter Hitchens, AKA Clockback, believes ADHD is "made up" and has written articles on the topic [2] [3]. Mr Hitchens, Wikipedia is not a soapbox, nor is it a place to push your [[WP:NPOV|(Personal attack removed) point of view]]. These are policies on Wikipedia, and are not optional, I suggest you read up on them. -- Ned Scott 10:58, 21 September 2006 (UTC)

Mr Scott is perfectly right that Wikipedia is not a soapbox. That is why I have, under my own name ( and so only too happy that anyone should check my writings on the subject, should they be in the slightest doubt of my position), intervened on this discussion page (not in the entry) to argue that this entry appears to me to be lacking in the neutrality that Wikipedians are constantly telling me is their objective. I am not 'AKA Clockback' and I object to the suggestion that I am in some way concealing my identity. This user name is not a secret alias but one I always use in conjunction with my actual name. I made my intervention in the hope of correcting what appears to me to be an imbalance in the article, through the legitimate process of reasoned debate. I formed this view - that the article tends to accept implicitly the questionable presumption that ADHD exists - when I consulted the entry. As to whether my point of view is 'ignorant', I am happy to debate this with Mr Scott or anyone else. I think I have a reasonable layman's knowledge of the subject, and of the arguments which surround it, and have spent much time researching it. Mr Scott may disagree with me, but the fact that he disagrees with me does not automatically make me ignorant, so far as I know. Perhaps Mr Scott is omniscient on this matter, in which case he should make this clear. I think my intervention is perfectly legitimate. Does Mr Scott, for instance, maintain that proof exists of objective physical symptoms of ADHD? If so, can he direct me to the source of this assertion? Has the experimental work on which he bases this belief been repeated? Has it been confirmed in a peer-reviewed journal? Does Mr Scott deny that many qualified practitioners in the fields of psychiatry and neurology are sceptical of the existence of ADHD, and of the resultant dosing of children? Perhaps Mr Scott, or indeed anyone else, would tell me what these non-optional policies are, which prevent me from raising my concerns on this discussion page? I am not aware of any. I cannot think that Wikipedia could long endure if doubts are not to be tolerated on its pages. Mr Scott's attitude would appear to be one of irritation that anyone should challenge what he believes to be the truth. I suppose we can all sympathise with this emotion, since it is nicer when people agree with us, but I do not think it is a sound basis for the pursuit of knowledge. Peter Hitchens, signed in as Clockback 20:40, 21 September 2006 (UTC)

I'm not stopping you from doing anything, just making you aware of the policies that we all are required to follow. You can discuss this all you want, and I never meant to suggest that the subject was not open for debate.

I'm a 23 year old man who's been medicated for ADHD for about 16 years, so you ask me if I have proof for what I believe, I do. That is, if you are simply asking me to prove what I believe, since my own experience can't be cited to an actual article. However, I don't have to cite myself, Attention-deficit hyperactivity disorder#Footnotes has a hell of a lot of sources right there. Not only have I read all the things you've read, I've learned even more than that, AND experienced first hand what it is to have ADHD and to have treatment. Quite frankly, I have every right to call you (Personal attack removed), it's just not as obvious to some people.

As far as the majority of medical science goes, ADHD does exist. I do not doubt in any way that there are those, even very skilled and talented doctors, are skeptical of it's existence. Some people still believe the Moon landing was fake. Just because someone, somewhere doubts something (with insufficient evidence to back up their claims, to boot) doesn't mean they have equal say in the matter. But hey, this is Wikipedia, so we have Controversy about ADHD, because truth or not, the very controversy itself is now a notable part of our history.

Again, no one is stopping you from editing the articles, so be bold and do something, if you feel so strongly about it. I don't understand what you feel you will accomplish complaining about this on the talk page when it seems you are the only one taking issue with the article. -- Ned Scott 02:58, 22 September 2006 (UTC)

An interesting and, in a way, gratifying change of tone. One minute I'm being told I'm not even allowed to raise the subject on the talk page. The next, I'm being urged (by the same person) to edit the article to suit my position. Actually, I was hoping that those who had hitherto edited the article might show some interest in modifying its general tone. It seemed the polite and consensual thing to do. Your faith in the medical profession is touching but the fact that an individual has been diagnosed with this alleged disorder, and dosed for it, is not in fact proof of its existence or that the treatment prescribed is correct. I asked a specific question about proof of objective symptoms. Would you care to answer it? Or are you not able to do so? This is not a question of 'someone, somewhere doubting something'. You write as if that 'something' had been established by the usual means of research and experimentation, and as if the 'doubts' were therefore no more than irrational quibbles. Not so. Your comparison with those who doubt the moon landings is ridiculous. It is a question of millions of people, overwhelmingly children with little say in their treatment, being given physical treatment for a complaint whose physical existence remains - so far as I know - wholly unproven. By the way, I had not heard that the truth of a scientific proposition could be established by majority vote. Peter Hitchens, signed in as Clockback 09:19, 22 September 2006 (UTC)

As I already said, if you were simply asking me personally why I think ADHD exists then I could give myself as an example. And then I went to say, but for everyone else, Attention-deficit hyperactivity disorder#Footnotes contains a great deal of sources right there. I don't know what you consider "proof", but ADHD has been proven. Would you like to challenge a specific example from the footnotes, and have something to back up that view?

And please, this is NOT a message board where you get to share your thoughts for the hell of it. Unless you are directly challenging the references on this article, then there is no need for me to care what you think about this distorter. Discussion needs to be about the articles, and talk pages, just like articles, are not soapboxes here on Wikipedia. I suggest you use your blog to vent your (Personal attack removed) and unfounded views. -- Ned Scott 06:02, 23 September 2006 (UTC)

I must say that I am disappointed in Ned Scott's replies to Peter Hitchens. Mr. Hitchens is following the correct path of requesting the introduction of additional information, in this case Fred Baughman's dissent as to the validity of ADHD. It is Mr. Scott that is working the soapbox, tossing "ignorant" and other valueless comments.

Mr. Scott asks if Mr. Hitches would "like to challenge a specific example from the footnotes". It appears that he would, through the addition of references to serious ADHD dissenter Fred Baughman. There's nothing wrong with that, is there Mr. Scott? -- User jdavee 04 October 2006

I'd have to see what context he was referencing that additional source, as WP:NPOV would still apply, but I don't think there would be anything wrong with that. However, Peter seemed more interested in talking on the talk page than actually editing the article, so you'll have to ask him why he hasn't done this yet. -- Ned Scott 21:33, 4 October 2006 (UTC)

---

---

Fred Baughman is a noted anti-psych. Antipsychs don't believe any disorder exists unless there is a blood test for it. For instance, Fred would have you believe that Major Depression, Tourettes, Autism, and Alzheimers are not real disorders. He often states that there is no blood test for ADHD, nor is there a single gene for ADHD....true on both accounts. Yet complex traits often involve several genes. What makes ADHD so difficult to accept for many, is that ADHD behaviour often seems willful and at times, just seems plain disrespectful. The antipsychs take advantage of that intuitive belief. Thus we get the likes of Breggin (another antipsych) mockingly referring to ADHD as DDAD...or absent father syndrome. They would want us to believe that ADHD is really nothing more than the side effects of bad parenting.

The antipsych movement started with Scientology way back when. Some of the earlier antipsych critics like Baughman still have connections to Scientology. i.e. "An active opponent of the ADHD diagnosis, Baughman has been a child neurologist, in private practice, for 35 years. He is also a medical expert for the Citizens Commission on Human Rights (CCHR), an advocacy group founded by the Church of Scientology in 1969". [4] Others like Breggin try to deny any association to Scientology although typically they have been involved with the church at some point. Scientology and modern antipsychs share the same roots and have the same beliefs. It is hard to discern any real difference between the two groups beyond the fact that Scientologists openly admit that they belong to the church.

One could argue that there should be a separate section on antipsychs and the church of scientology in the main article. Anyone who has ever done an internet search on ADHD will encounter antipsych propoganda on the subject in a rather short period of time. Their misinformation has been widely disseminated and is often accepted to be true by the general public. One can often detect antipsych propaganda by: black and white terms and the use of capitals ie. FRAUD, anecdotal stories from average Americans that invoke fear, the cherry picking of facts, or the lack of citations to respected journals. Antipsychs Doctors also rarely do research that is published in respected medical journals. --Scuro 21:10, 10 December 2006 (UTC)

• • • Just a comment for Scuro: in light of your earlier objections to my suggestions about objective data being added, it seems a bit biased to be talking about "Antipsych doctors" as if this were some verifiable scientific catgory of physician that could be distinguished from "regular doctors". Certainly resistance to the current practices of psychiatry is a relevant issue, but using terms like "antipsych" suggest that you are just as biased in one direction as the target of your criticism is in the other direction. An unbiased article would report on the phenomenon without using loaded terms, either "fraud" on the one side or "antipsych" on the other. Throwing epithets around doesn't really forward the mission of Wikipedia, in my view.

[Steve]

I've objected to objective data!?? Say it isn't so.

The Anti-psychiatry label is well estabished. Some in that movement call themselves "antipsychs". Sorry if I didn't use the formal name. Dr. Baughman would probably be happy to be identified as an anti-psychiatry Dr, even if there wasn't a blood test for it! :) I allow myself a little more leaway in the discussion area, I'll tighten up my informality a bit for you...right after this post. lol --Scuro 03:52, 20 December 2006 (UTC)

Well, I guess if Fred Baughman doesn't object, who am I to complain? ;)

I appreciate your attidude! [Steve]

src: www.post-gazette.com

Help

Hello, Today friend of mine explaned to me what is ADHD as we were discusing my doghter pehaivier and gave me you'r web page and the most diffecult I think I will face is that we are from PNA(an outonomy in Israel)and we don't have any to help us or to give info in our language (arabic),can anyone help me ,please contact me at my e-mail:azalico@yahoo.com.thanks

src: www.hiline.cfschools.org

Brain scan image

The 'brain scan' photograph that leads off this page should not be there. Zametkin retracted his 1990 results as being the results of gender differences and flatly stated that Brain Scans cannot be used to diagnosis ADHD. It is very misleading (especially the colors, which do not appear in the original scan) and is basically a propaganda tool. As long as Wikipedia has stuff like this on it, it will be laughable. --The preceding unsigned comment was added by 146.201.100.221 (talk o contribs) .

I got an email from Zametkin the other day about that image. He didn't say anything about retracting its validity. And yes, I did ask. Cite your source.--*Kat* 11:04, 24 September 2006 (UTC)

Has this research been repeated? Peter Hitchens, logged in as Clockback 11:44, 30 September 2006 (UTC)

Zametkin had his research re-done on brains in 1996 and the outcome was: no difference in the brains. [5]If *Kat* had email contact with Zametkin and he didn't say anything about retracting its validity even though she asked, did he say it was valid? Immortale 21:59, 27 December 2006 (UTC)

src: asset.jmir.pub

need to talk.

we hae an adhd 7 yr old oldest of 4 girls. she has been on concerta for 6 months. helps but i wishi could do for ~ her and our family. need to share information with other peopls, Tammy --The preceding unsigned comment was added by 24.67.253.203 (talk o contribs) .

Would like to help you, but this is the talk page for a Wikipedia article, it's not a message board. Discussion should be about the article itself, not the topic of the article. Also, Wikipedia:Medical disclaimer. Try some of the links in the External links section. -- Ned Scott 08:36, 23 September 2006 (UTC)

Brain scan dosen´t show adhd i have been 2 times "no diffrence from normal person".

src: 3c1703fe8d.site.internapcdn.net

Problems with this statement

A recent Washington University in St. Louis study indicated that almost 50% of ADHD cases in America may not be detected and treated. This lies in stark contrast to the claim the condition is overmedicated.[16]

The study described seems to be about genetic influence rather than diagnosis in America, as all the test subjects were twins. How can the claim be made that is representative of all of America, if it only involves twins? The article cited states that "58 percent of boys and about 45 percent of girls who had a diagnosis of full-scale ADHD got any medication at all", so the cases are simply not treated, rather than not detected. The article states that 3.6% of Boys and 2.6% of girls in the study were taking stimulants, despite the fact they do not meet the requirements for diagnosis. Then the study does not contrast with the claim the condition is overmedicated, rather it proves it. Finally, a single, recent study by one university is not worthy of mention.

The statement should be removed. William conway bcc 22:18, 25 September 2006 (UTC)

support--*Kat* 02:35, 26 September 2006 (UTC)

done. -- Ned Scott 02:45, 26 September 2006 (UTC)

I've just had a look at the journal article that the press release references.

(1) Representativeness. That all their sample is from Missouri is probably more of an issue than that they're twins.

(2) The 3.6% of boys and 2.6% of girls that were treated for ADHD while not being diagnosed were, however, presenting with more than 8 DSM symptoms on average. Thus, that around half of all detected cases were not treated, and a small fraction of sub-syndromal cases were treated does argue for it being under-medicated (assuming, of course, that medication is appropriate).

(3)Finally, a single, recent study by one university is not worthy of mention. Recent studies are usually better than old studies; and if you object to "single" studies, then that would exclude the 80 odd percent of references that aren't meta-analyses and reviews then?

--Limegreen 03:27, 16 October 2006 (UTC)

• • • • Recent studies are not necessarily considered better than old studies. Much of the seminal work on ADHD is largely done in the 1970s. More recent studies are highly colored by both the controversy around what ADHD is and how to treat it, as well as the increasing financial investment that many professionals and businesses have in proving or disproving the ADHD hypothesis. Zametkin's work is a case in point. He studied adults and extrapolated this work to apply to teenagers and children. He also created his images from a composite of many subjects rather than looking at single subjects individually. His work was not replicated when attempted on teens. But this work was instantly acclaimed as proving the biological nature of ADHD, because folks wanted to believe that.

The most reliable reports are reviews of multiple studies over time, because that kind of work removes or reduces the effect of individual study bias. Publication bias is still an issue but tends to even out over time as well. There are important individual studies, some older and some more recent, but they really can't be given a lot of credence unless they are replicated by multiple researchers in multiple sites. Hence, Zametkin's work, while intriguing, contributes only marginally to the ADHD literature, despite the media hype that it generated.

New studies aren't always better! All studies should be judged by quality of design and by ability to be replicated under different study conditions.

---

Steve

src: www.fullertonspeech.com

Sins of Our Children

I have retrurned a link to ADHD and Other Sins of Our Children. Somehow it had disappeared (as well as most of the material I added to this page.) I will not repeat citations from all of the people who are behind the positions in this article, but it will be published as a chapter in Rethinking ADHD to be published by Palgrave Macmillan. You guys doing the cutting sure are relentless in making sure only one position gets represented on this page (with the exception of clearly nutty theories that somehow remain). Gee I wonder why this page is guarded with so much energy and persistence. My regards to Kat and William Conway and all the other rulers of this page --The preceding unsigned comment was added by Ss06470 (talk o contribs) .

I've re-removed that link as it violates WP:EL and WP:NPOV. Similarly, much of the information you are talking about was removed because of WP:NPOV, WP:NOR, WP:NOT#Wikipedia is not a soapbox, and other such policies. Most of that stuff would be better at home on Controversy about ADHD even if they didn't violate policy and guidelines. -- Ned Scott 03:31, 30 September 2006 (UTC)

Oh, and also, we don't tolerate personal attacks, such as calling Kat or William "rulers" of the article. Maybe if you learned a bit more about how Wikipedia works then you'd see why your edits were removed. -- Ned Scott 03:49, 30 September 2006 (UTC)

Thanks Ned. --*Kat* 18:45, 30 September 2006 (UTC)

Given your statement that you do not tolerate personal attacks, please explain three usages of "ignorant" when addressing a writer asking to add dissenting entries to the footnotes? -- User jdavee 04 October 2006

Thank you so very much for pointing that out to me. I had let the heat of the discussion get to me and, indeed, was guilty of also making personal attacks. I've removed those statements and I apologies to everyone, including Peter. -- Ned Scott 21:35, 4 October 2006 (UTC)

• • • How can we discuss whether a condition is over- or under-medicated when it is clearly stated and agreed by multiple professionals across every field that there is no objective criterion for diagnosis? As long as the diagnosis is subjective, there can be no conclusions regarding over- and under-diagnosis or over- and under-treatment. Nec pas? [Steve]

{

src: dralicetalks.com

Note about the Treatments section and a couple of proposals

Per the recommendations of the people at FAC, I have removed the list of medications used to treat ADHD and replaced it with a paragraph that summarized that list. (found here[6] ) Since the list contains so much useful information, I propose that a separate article be created for the contents of that list. I further propose that we do something similar with the Timeline section.--*Kat* 19:22, 30 September 2006 (UTC)

I'd rather see that information in this article directly, and possibly as a listed sidebar? The usefulness of a list (as I see it) is that one can quickly lookup material without reading through a paragraph to find it. Of course, the descriptions of how these are used that is currently in the paragraph is great in actually learning about them, but it's possible to just want to list them out (say for further study). AesopFable as --192.153.23.100 21:44, 24 October 2006 (UTC)

How about a discussion about specific behavior management approaches to ADHD? Many books have been written on this subject. I raised two moderate-to-severe "ADHD" children without any resort to medication, and they are doing well.

Also, alternative educational programming should be mentioned. I doubt we could have accomplished what we did without homeschooling and alternative schools. There was a Judith Rappoport study back in the late '70s that showed kids in open classrooms being virtually indistinguishable from "normal" children to a trained adult's eye. This is important data! [Steve]

src: vitalitymagazine.com

Drinking during pregnancy as likely cause of ADHD ?

Yesterday on UK TV there was a feature with a medical researcher claiming that there was probably a strong link between drinking during pregnancy and ADHD. Fetal scans where the mother has been drinking often show "startles" where the baby jerks about. It seems quite likely that this is related to ADHD. Why is this not mentioned here ? --Penbat 18:49, 3 October 2006 (UTC)

This is the first I've heard of it being a specific link. I mean, drinking while you're pregnant can cause a lot of different problems. Do you remember the time and channel it was on? Maybe we can hunt down some info on this to see if there's anything to it. -- Ned Scott 20:04, 3 October 2006 (UTC)

The TV program website isnt very useful, see http://www.itv.com/listings/ShowListings.aspx?itvregion=london&itvpackage=dt&itvgenre=0&channelid=LON&channeldate=02/10/2006

If you click on 20:00 Tonight with Trevor McDonald: Binge Drinking Babies you get:

"Report on new research into the dangers posed to unborn children by expectant mothers who drink excessively, including the possibility of causing them permanent brain damage. Linda Duberley investigates"

Apparently only very small amounts of alcohol can be harmful to babies (more than 4 units a week). In the UK there is a big trend towards young women (pregnant or non-pregnant) to drink. Try Google searching for more info on "startles" etc. They did mention a condition caused by alcohol. Cant remember what it was except it had the word "fetal" in it.--Penbat 20:27, 3 October 2006 (UTC)

Could you be thinking of Fetal Alcohol Syndrome? Kasreyn 01:32, 4 October 2006 (UTC)

Yes I am sure they referred to it as "Fetal alcohol spectrum disorder".--Penbat 08:17, 4 October 2006 (UTC)

Mild cases of FAS may look like ADHD. I'm sure there are subtle differences. I believe there is also a correlational link between smoking during pregnancy and a higher incidence of ADHD. It has been estimated that roughly 20% of ADHD is caused by environmental factors. The rest is attributed to genetics. ADHD is considered the most highly inheritable mental disorder out there. ADHD is more heritable then height, or even intelligence. --Scuro 22:13, 19 December 2006 (UTC)

src: asset.jmir.pub

Arbitrary Deletion of further reading link

My understanding of the reason a link to my articleADHD and Other Sins of our Children was removed was that it had originally been placed on this page by me. A fine clinician, with a doctorate in psychology, put it back last night (not me!) and it was promptly removed again by the thought police. (I am sure this description of the editing on this article is far less insulting than the act of removing material) How neutral are editors who remove links to PBS' Frontline discussion of ADHD, the Surgeon General's statement regarding the cause of ADHD as well as the NIMH's consensus statement about this. Also removed from the discussion page is high praise about my article from a professor who also happens to edit an important medical journal. Is there no higher authority where this kind of thought control can be contested? --The preceding unsigned comment was added by Ss06470 (talk o contribs) .

This has nothing to do with "thought control".

You've already disclosed that your article is unpublished. It doesn't matter how important you are, or the people who support your article, the very first step is getting your work published. This is a requirement of WP:NOR. (An alternative to having your work published in print, etc might be to meet the requirements of WP:WEB.. but that doesn't look like it will work for you ether.)

Secondly, your article doesn't cite proper sources, nor can it considering the whole thing is not an accurate study of the disorder but instead a series of large unproven assumptions.

Your additions violate core policies on Wikipedia. You continue to use this talk page to launch personal attacks and try to use it as a soapbox. Only your comments were removed (due to those two reasons) were removed. I see no edit to the discussion page that has removed this supposed "high praise" from your friend. (Again, his praise is not considered a reliable source).

If someone came around and wanted to add pro-ADHD stuff in the same manner you did, that information would be treated no differently. So please, be a little bit more mature about this. -- Ned Scott 11:24, 12 October 2006 (UTC)

A rather less Machievellian interpretation of its removal as a further reading link would be that the it is already referenced, and thus, isn't further reading. --Limegreen 15:12, 12 October 2006 (UTC)

As I noted elsewhere the article is to be published as a chapter in a book called "Rethinking ADHD" edited by SAMI TIMIMI and Jonathan Leo. Sami Timimi is a consultant child and adolescent psychiatrist who works full time in the National Health Service in Lincolnshire, UK. He writes from a critical psychiatry perspective on topics relating to child and adolescent mental health and has published many articles and chapters on many topics including eating disorders, psychotherapy, behavioural disorders and cross-cultural psychiatry. He has written two books, Pathological Child Psychiatry and the Medicalization of Childhood, published by Brunner-Routledge in 2002 and Naughty Boys: Anti-Social Behaviour, ADHD and the Role of Culture, published by Palgrave MacMillan in 2005, and co-edited with Dr Begum Maitra, Critical Voices in Child and Adolescent Mental Health due for publication by Free Association books in early 2006.

2. JONATHAN LEO is Associate Professor of Anatomy at Lake Erie College of Osteopathic Medicine in Bradenton Florida where he teaches gross anatomy and neuroscience to medical students, and co-editor-in-chief of the journal, Ethical Human Psychology and Psychiatry. He has written over 20 articles and book chapters about the oversimplification of the biological theories of mental illness. Influential articles include "The Biology of Mental Illness" recently published in Society, "Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature," co-authored with Jeffrey Lacasse, recently published in PloS Medicine, and "Broken Brains or Flawed Studies: A Critical Review of ADHD Neuroimaging Research", co-authored with David Cohen, which appeared in The Journal of Mind and Behavior.

As to Mr. Scott's reference to my "friend" that gave me high praise (see below)I have never met Bruce Charlton . He knows me from my written work. Here is what was removed from the talk page which includes this praise. The point of quoting all of this is that this article is not simply "opinions". Reputable people have found its content important

Here is what was removed: From Ned Scott: I'm really getting tired of playing games with you. Even if everyone agreed with how you feel on this topic that still would not qualify your edits for inclusion per WP:NPOV, WP:V, and WP:NOR. "Preaching" endlessly like you've done in the past on that same talk page does nothing. Wikipedia is not a soapbox: "Propaganda or advocacy of any kind. Of course, an article can report objectively about such things, as long as an attempt is made to approach a neutral point of view. You might wish to go to Usenet or start a blog if you want to convince people of the merits of your favorite views. You can also use Wikinfo which promotes a "sympathetic point of view" for every article." -- Ned Scott 11:35, 4 October 2006 (UTC)

My reply So you are getting tired "playing games" And don't like rudeness. Why don't you review some of your recent interactions with several others writing on this page besides myself. You might not like what you see in the mirror. You cannot be reached by anyone other than those who agree with your narrow point of view. Everyone else is a propagandist or not neutral. I will not bother to reason with you again. You are pathetic most of all because you see yourself as objective and fair minded which makes you closed to all argument. Once again. As I have repeatedly asked you to do, you might take a chance and take a look at my article rather than repeatedly dismiss it. Here, by the way, is a comment by the editor in chief of Medical Hypothesis, Bruce Charlton, Reader in Evolutionary Psychiatry School of Biology and Psychology Henry Wellcome Building Newcastle University regarding this very piece of propaganda that you see as my "favorite views "Thanks very much for the new links - I read your epic essay on ADHD over a few days - it really is an excellent piece. I feel as if my thinking has moved forward because of it...Your descriptions of the subjective effects of SSRIs and psychostimulants are superb - I havent seen anything as good anywhere else. Have you ever written about anti-psychotics in this way? or a different email from him "I hope you can get round to writing something for Medical Hypotheses sometime. Just drop me a line if you have something ready. If you preferred you might be able to publish an Editorial of more generalinterest, rather than a 'paper'.

My point in all of this is that this article should remain as further reading or a link. It does not violate neutrality. It simply presents a different point of view about a topic that is far from settled and proven from a scientific point of view. Removing this link violates neutrality. As to the neutrality of the point of view of the current article I still am waiting for an answer to why the link to the statement by the Surgeon General regarding the fact that the cause of ADHD is unknown was removed. Also this statement was removed from the NIMH which is the second to last sentence in this report. "Finally, after years of clinical research and experience with ADHD, our knowledge about the cause or causes of ADHD remains speculative" [7]

You have already removed the most important point I added about the role of parents and society in the development of ADHD. I know. The "experts" have rejected that possibility. They are convinced this condition is purely biological. I will no longer fight for that as it obviously will not be allowed as a possibility no matter how carefully worded. But not allowing this point of view to be added as a link, or as further reading, is beyond all fairness and is not neutral. And yes I do not believe the problem here is a bunch of scholarly pedants guarding against opinionated people like me. There is too much crackpot material on this site that remains.

The core issue is how much ADHD is or isn't biological and my article does a reasonable job of attacking a good many half baked assumptions passed off as science by "experts". I'm sure that Ned Scott and many of the editors here guarding this article are not employed by pharmaceutical companies. So, in that sense, their efforts are not Machiavellian. But I hold to my position that they are "true believers" convinced by priests who are indeed guilty of being paid to believe and spread a particular point of view. I once again refer you to my earlier "soapbox" statements (with references to Marcia Angell former editor of the New England Journal and the editor of the Lancet on this point as well as the link It was like a whitewash]to a very interesting site quoting Dr. Pelham, a disillusioned ADHD researcher --Ss06470 19:09, 12 October 2006 (UTC)

Until your article is published it fails WP:NOR and our discussion can easily end at that. However, once it does get published, as planned, it still violates WP:NPOV and WP:V because, as I said before: "your article doesn't cite proper sources, nor can it considering the whole thing is not an accurate study of the disorder but instead a series of large unproven assumptions."

Secondly, not that this matters at all, but if you do not know this "Bruce Charlton" in person, then how do you know that he added the link in? The link was added by an anonymous editor with the IP address 24.151.60.130 [8] [9].

I'm trying to resist the urge to show you how flawed your article is. I'm not interested in getting into a debate with you, as we're not here to debate the topics but to talk about the articles that cover the topics. I can easily pummel you with links, statements by doctors just as notable if not more than the ones you've cited, research, references, and so on that would tear your article's logic apart. But I don't need to, and I don't want to. You've come to unreasonable assumptions to spite your own misconception. There's a lot of kids who do just need to "shut up and sit down" and don't need pills at all. There are a lot of stupid parents out there who are lazy and would just rather stuff a pill in their kid than deal with them. Yes, it is true, but you've come to the flawed conclusion that this is the situation for ALL cases of ADHD, without reasonable evidence to support even a majority of cases.

There are a lot of misconceptions about things like ADHD. You are trying to enlighten people who have a misconception about it by ironically developing your own misconception as a polar opposite. You're both wrong and I will happily remove bias from both sides so that only facts remain. Wikipedia does have it's flaws, but those are flaws to be improved on and removed. You do not correct a flaw by adding another flaw, such as your article. This article is not perfect, but making it worse doesn't help or "balance it out". As the saying goes, two wrongs don't make a right. You do not know what I think, what I believe, other than what I have specifically told you. Do not take the article as it is now to be a representation in full or in part of what I believe in. (granted I'm not saying I agree or disagree with the article, or find it majority flawed or not, but only that one cannot judge the editor's own views based on the article he edits). -- Ned Scott 02:00, 13 October 2006 (UTC)

Two more things. One, you keep acting as if your view has no representation on Wikipedia at all, which is not true (Attention-deficit hyperactivity disorder#Parental role and Controversy about ADHD). Second, I was looking back at the edit that started our interaction, this one. Ironic that you ignored that I not only removed your link, but also link to concerta.net. -- Ned Scott 02:18, 13 October 2006 (UTC)

I didn't say Dr. Charlton added the link. I merely quoted some of his comments about the article you so comfortably removed because you were treating the article as just a bunch of my personal opinions. I know who added the link yesterday because we had discussed objections to the fact that I added reference to myself and she graciously thought that she might help. As for your absurd misreading of the contents of my article what can I say? You are not a very good reader and are even a worse editor. How you came to the conclusion that I think lazy parents are trying to stuff pills down their kids throat, or that the answer is to make kids "shut up and sit down." How interesting that you experience rational arguments as an attempt to pummell you with links. Do you do any thinking at all about the content of the links. If someone else reads these posts, can you direct me to how we can get an objective person to act as an arbiter. I have nothing further to say to you Mr. Scott. You are king of the mountain here through sheer persistence. Congratulations

Oh, and for the record this is the parental role portion that was deemed unacceptable. It dares to suggest not that biology is irrelevant but is being greatly exaggerated

"Another point of view is that the behavior of those with ADHD is the "natural" way for children to behave when they are stuck in a situation that doesn't engage them. It has never been a simple task to teach children how to behave in a "grown up" fashion. Understanding this, enormous amounts of time and energy have traditonally been spent by parents and educators trying to inspire, cajole, threaten, lecture, bribe (and every imaginable strategy) trying to teach a child how to gain self control, act with consideration for others, and do tasks that are not fun. In other words, a child who is not successfully taught how to behave, obey the rules and stay on task will display all of the symptoms of ADHD. While neurological impairments, or innate tendencies, can be a factor in the ability to stay focused on tasks being demanded, those who place emphasis on the parental role in ADHD claim that the nature (biological) aspects of the perennial nature vs.nurture controversy have been greatly exaggerated by biological proponents. They claim millions upon millions of children being diagnosed with this condition have nothing physically wrong with them. --Ss06470 04:00, 13 October 2006 (UTC)

So you basically want to just say that there are children who are misdiagnosed because their symptoms are not of ADHD but of behavioral problems due to their environment? Except your version tries to make it sound more extreme and further suggest that this is the case for ALL children with ADHD. Care to cite a source for "millions and millions of children"? Can you prove that millions and millions of children have been misdiagnosed with ADHD?

"You are not a very good reader and are even a worse editor." If you do not stop you will be blocked from editing and commenting on Wikipedia. Do you understand? I read your article, as you requested (I actually had read it before you requested that I read it). I disagreed with you, and you respond by saying I'm a bad reader. Real mature there.

Rest assure, I would only pummel you with links I have thoroughly read. The links would only be for convenience, as I could refer you to other media in print and such. But again, I'd like to avoid further debate on the topic.

As for the article on the topic, I believe I've made it clear that there are several policies on Wikipedia that exclude your additions, at least in their current form. Even if you somehow convinced me, right here and now, we still could not include your additions because of those policies. It is not I who stands in your way of including the information, but the Wikimedia Foundation who outlined those core policies. They are the kings of the mountain, as you have put it. -- Ned Scott 04:39, 13 October 2006 (UTC)

Where you came up with the idea that I am saying All children with ADHD do not have it is beyond me. ADHD is very real and millions upon millions of children are correctly diagnosed with it. The issue is what is ADHD. I am saying that the evidence for a biological basis, despite the thousands of articles that believe and seem to confirm its biological nature have not made their case from a scientific point of view. If you will take a look at the ADHD controversy page you will see the Zametkin PET scan is open to many interpretations. It is a very dramatic picture that seems to show a different brain but in fact shows nothing of the sort. If you will utilize the link for "It was like a whitewash" you will discover that some very funny things are going on in the ADHD literature. If you will utilize the link to Marcia Angell's editorial in the New England Journal of Medicine, "Is Academic Medicine for Sale" and her subsequent book on the subject, or the link to the editor of the Lancet you will discover that some very important people, the editors of the two most prestigious journals in medicine are very concerned about this. There are billions of dollars involved in convincing everyone that these illnesses are biological and medications are the answer.

That you somehow experience links as pummelling you its a very serious problem. Links are merely trying to get you to think. When I read what you have concluded from my article it absolutely amazes me. Where are you finding these conclusions? Let me say it as clearly as I can. I don't doubt that some children and adults probably have something physically wrong with their brains and this interferes with their ability to concentrate on chores that don't come easily to them. My contention is that most children and adults diagnosed with ADHD have not been taught well how to deal with work and challenges that frustrate them. Sitting still in a boring prison environment, or not daydreaming, is almost impossible for all children, but eventually most children learn how to do it. Why that happens or doesn't happen is a subject worth pursuing. I am claiming that a good many children (yes millions) are the result of a cultural or parental failure to accomplishing this. A whole assortment of reasons can lead to this failure.

I take the fact is that most children with ADHD concentrate very well when they are doing something that is fun as a key observation. Are you doubting this? The problem is how quickly tasks becoming drudgery with ADHD. My explanation for the usefulness of Ritaline and Adderall is that they turn drudgery into fun. Believe it or not I am not against using these drugs as a short term stop gap solution. I am against telling kids they are defective and must take this medicine to correct their chemical imbalance. There is no evidence that this is the case!!!! So there you have it. You think this radical position as added reading will distort your readers perspective. I think it is a fair presentation of information that your readers can evaluate for themselves. --Ss06470 22:18, 13 October 2006 (UTC)

"I take the fact is that most children with ADHD concentrate very well when they are doing something that is fun as a key observation. " Whoa, that is completely not true. I hate the assumption that children have only been medicated for school or chores, and that those are the only places of concentration difficulty. I understand those are the issues that most people seem to focus on in books and media reports, but they are not the only situations. ADHD is not selective like that. I take medication for the entire day, even if I'm not working and I'm just hanging out with friends. My close friends can tell when I have not taken medication. ADHD is indiscriminate, and it is not exclusive to work, chores, and school. We notice these things in those places because those are the things most children are required to do in a certain way. They're simply what other people notice most. When I play Halo 2, I play better when I'm on medication. When I'm with my friends I'm able to hold better conversations and follow what's going on better when I'm on medication.

"My explanation for the usefulness of Ritaline and Adderall is that they turn drudgery into fun" Not at all. Those tasks are no easier to accomplish while on medication than they are for any other person. It makes it "easier" for a person with ADHD because it allows them to become "on pair" with other people. Just the same way that someone wearing glasses can do something more easily than if they are not wearing glasses. You can't take a person who does not need glasses, put glasses on them, and then have that person do a task better. This is the same for ADHD medication.

I'm not sure I understand what you are talking about when you bring up that I said "pummel you with links". I simply meant that if we were in a debate that I'd gladly back up my claims with additional information, in bulk. Of course I do not come to a conclusion based on such things alone, but from a wide range of sources, my own personal experience, reflection on those things, and so on. I am also open to new ideas, but am highly skeptical of people who can't back up their claims. I asked if you could cite a source for millions of children, and you simply say that you are claiming that. You are claiming that based on assumption, without a scientific approach, without anything to show an accurate account for numbers. You even say that you think most cases of ADHD are misdiagnosed.

"I am against telling kids they are defective and must take this medicine to correct their chemical imbalance." Well, gee, thanks for putting it like that. I don't think anyone is calling children defective. If a child must wear glasses because their eyes are off, hey, that's just the way it is. The fact is, there is something wrong with their body, in this case their eyes, but we don't stop them from wearing glasses so we don't hurt their feelings. Some people need medication to live, and we don't look down on people for that. ADHD is a medical condition, not an insult to children or adults.

"Believe it or not I am not against using these drugs as a short term stop gap solution" ADHD is not short term. You cannot cure ADHD, you cannot teach someone to not have it. Although there are those with mild cases who can adapt to living with it without medication, the ADHD still hasn't gone away. I know that some ADHD medication can have undesired side effects, like stunted growth or lack of sleep. I took Ritialin for most of my life, and now take Adderall. I am 6 foot and 3 inches tall, and I sleep very well. All medications have side effects. When I was first taking medication they took regular blood tests, and medical checkups to monitor any bad side effects. This is no different from any other medical treatment. If one medication causes a bad effect, there's a good chance that an alternative can be used that does not have that bad side effect.

You are questioning if ADHD is biological or behavioral, I take it. There is reasonable evidence to show that it is biological. If you are looking for black and white, easy to understand, and true for every person, type evidence, you will not find it. It's not that simple, and showing that it's not simple or black and white doesn't prove anything. In my case, with multiple doctors, they ruled out a behavioral cause. I have three older siblings who do not have ADHD, and were raised very well and live successful lives. I grew up with them, in the same house, raised by the same parents.

That being said, I do not doubt there are those who have the same "symptoms", but do not have ADHD. I find that when most people try to explain the symptoms of ADHD, they dumb it down too much, and say very generic things like "can't concentrate well" or "has a hard time doing school work". This is a very flawed way to summarize ADHD, and I'm sorry so many people are not better with words to give better examples. In other words, simple and on-the-surface observations like this are not enough to correctly diagnose ADHD. It's a problem I would like to see improved upon, so that we can correctly identify who has ADHD and who simply has similar behavioral results but not a biological problem.

As far as medication companies trying to push research in a way that is favorable to them, yes, I am aware of that. However, I'd like to point out that is a problem that is not unique to ADHD and those types of medication. It is always good to be on alert when doing research where someone has a lot of money to be made based on the results. I think situations where results have been tainted or research was not properly carried out should no longer be considered reasonable research for ADHD, or for any medical condition. That being said, the remaining verifiable research is enough to show that some people do have a biological problem when it comes to how their brain handles attention, and in many cases medication can be used as an effective treatment. I pointed out to you before that when I removed your links I had also removed links to Concerta's website. -- Ned Scott 06:57, 14 October 2006 (UTC)

At last you are attemping to reason rather than venting your frustrations.

So let us address issues of content. (please excuse my use of bolds etc but I want you to particularly focus on certain things) I have no doubt that you perform better even when you are not doing "work." Almost everyone does better with performance enhancing drugs such as Ritaline or ampetamines. Here is a comment from the architect of the Statue of Liberty about his use of "Vin Mariani" ( a combination of cocaine and alcohol that in its day was used by two Popes, President Mckinley, Queen Victoria etc )

"Vin Mariani seems to brighten, to increase all our faculties; it is very probable that had I taken it 20 years ago, the Statue Of Liberty would have attained the height of several hundred meters."

Here is my speculations (from my banned article) about what I think is going on "Besides ADHD diagnosed adolescents, and their friends, who sometimes borrow their meds when they have to do chores that they dread, stimulants ("greenies"), according to David Wells , and more recently Mike Schmidt, have long been part of the professional athletes' equipment, helping them to step up to the plate with confidence. It changes their state of mind from a passive, reactive, position to a take charge proactive stance. Or as one basketball player put it, "Give me the ball. I can make the shot." This taking charge, "I can do it" feeling, when approaching tasks, is a key element in most people's perception of whether they are up to a challenge, and whether it is "work" or pleasurable" If you would like citations about these baseball players I can provide them.

There was also an article in the NY Times that non ADHD students were taking Ritaline to score better on their college boards. (It will take me some time but I can provide references to that as well)

And let me again quote from my article along similar lines (but here I am talking about "work")

"After he read this article, my son, who was then at Yale, told me that one afternoon he was complaining about the work he had before him, two finals and three papers that were due. His schoolmate piped in, "I got some Ritaline, want it?" The daughter of a friend said the same thing was going on at McGill. They are not alone. Here is a headline from the NY Times (different from the one I mentioned above)

"Latest Campus High: Illicit use of Prescription Medication, Experts and Students Say"

"Ritalin makes repetitive, boring tasks like cleaning your room seem fun" said Josh Koenig a 20 year old drama major from NYU.

"Katherinen Plyshevsky, 21, a junior from New Milford NJ majoring in marketing at NYU said she used Ritaline obtained from a friend with ADD to get through her midterms "It was actually fun to do the work," she said."

My article in a larger contextalso deals with the issue of the eyeglasses . Here it is (please have patience. I do get to this point, but I thouhgt this section of the article indirectly addresses the issue of some kids in a family having ADHD and others not having it by addressing the issue of how hard it is to raise any kid and all the things that go wrong)

"Many doctors feel they are being compassionate when they tell parents they have nothing to do with their child's ADHD. The kids were born that way. Undoubtedly it is great to get off the hook. It would be wonderful for my wife and I to believe that our children's problems growing up, and even now, have had absolutely nothing to do with our child rearing. But like it or not that isn't true. The joy and heartbreak of being a parent is, unfortunately, all too often related to what we are doing right and what we are doing wrong. Some of our children's qualities may also be a reflection, for better or worse, of who we are. Of course many problems have nothing to do with parental mistakes. There are high spirited kids who have greater difficulty than other kids when it comes to waiting their turn, sitting still, and completing tasks. Parents have to work considerably harder to keep them on task. Some of this may or may not be genetic. But children's willingness to go along with their parents' expectations, their effort to move ahead, or their refusal to cooperate has everything to do with the state of their alliance to their parents. That isn't to deny that even in the best homes there are going to be bumps in the road. Many bumps! Getting a child, any child, to go where he is expected to go is not easy. Some of it is luck, bad or good, and a lot of it is effort. The results of our strategies cannot always be predicted. And certainly, many parents may bring their children to doctors precisely because they have tried everything they can think of to improve the situation and nothing has worked. I don't want to be a big shot because my kids are basically okay at this moment, at least when I last checked on them. Being a good parent is one of life's impossible jobs. There are no easy to follow rules, no roadmaps that lay it all out perfectly. We will all fail at certain things, and succeed at others. But that is my point. It is not easy. Blaming ADHD on a gene is too easy an answer.

"Moreover it is not a blessing for a child to think of themselves as damaged goods, born with bad wiring in the brain, stuff like that. I can't think of a worse thing to do to a child. I remember how often I told my pals that I didn't study hard for this or that exam. It was my escape clause. My real fear was that a poor grade might reveal that I wasn't that smart, that I was born with inferior intelligence. It isn't just the self esteem of kids labeled with ADHD. It's expectations based on these labels. So often along the way, when things aren't going well people have doubts about whether they can or cannot do something. Children go through these crises of self-confidence all the time. Adults do too. They turn to their spouse or friends to pump them up, or they find resources within (including memories of the little engine that could). There are all kinds of studies that show expectation has a huge effect on outcome. And that includes teachers. Prophesies become self fulfilling. When teachers believe a child is limited, he will more often than not remain limited. If a teacher is told a child is gifted, performance on average will be at a superior level, even when the teacher has been lied to. Yes it would be cruel to ask a child with muscular dystrophy to toss away his wheel chair and play baseball like everyone else. But it is cruel to tell a child that he has been born defective with ADHD when he very well might not have been biologically cursed. More than one child has told me that he refused to take his Ritalin because it is for "retards"."

Back to you. Your experience of links as pummelling, your easy irritation at material that you disagree with, your complete misreading fo the written word. Let me again refer to my specualation above about how stimulants work: It changes their state of mind from a passive, reactive, position to a take charge proactive stance. Or as one basketball player put it, "Give me the ball. I can make the shot." This taking charge, "I can do it" feeling, when approaching tasks, is a key element in most people's perception of whether they are up to a challenge, and whether it is "work" or pleasurable

Would you even consider that you have a psychological problem concentrating when you are not in control. Mind you, most guys (including me) like to feel in charge, to win. As you probably have deduced, I enjoy a good debate and I like to win too. But it makes me pay more attention to what is being written so I can make my point. You on the other hand completely stop paying attention to the subject. I'm not talking about your irritation. I have lost my temper in this debate and vented my frustration with you plenty. I'm talking about your inability to think and absorb, caused by a psychological issue rather than a chemical problem.

Finally, one last point. You keep talking about my articles lack of scientific merit or my making claims about millions of kids without proof. What I am saying is that mainstream conclusions about these millions of kids diagnosed with ADHD are not supported by the evidence either. I keep coming back to the fact that, despite the impression many have that doctors understand what is going on with ADHD from a scientific point of view, they don't. Let me once again quote the introduction to my article.

"However, the article's main point of view is that bad science, science totally lacking science's clarity about what is known and not known, is worse than sensible, if imprecise, literary speculations and reasoning."

The question is whether a "think" piece should be suggested as "futher reading" for people interested in this topic--Ss06470 12:48, 14 October 2006 (UTC)

Again, the article is well supported by its footnotes section, although I have yet to read them all, and there are a few I don't completely agree with (that brain scan image, for one, is something I would think is too questionable to be used that way, true or not). Most of them, however, do a fine job at pointing people to relevant and verifiable research. I've even asked you to point out specific citations you disagree with, and all you can do is make a generic unfounded claim that "there is no evidence".

The people you quote seem to be experiencing a slight high, rather than actually being able to do something better. Did their shots become more accurate? These are stimulating medications, and people can abuse them, but you are taking things out of context. When people with ADHD take medication their ability to control their attention, both actively and passively, improves, and not because of "mood stimulation". Another problem is that only interviews were done in that situation, instead of any kind of medical evaluation of the situations where those kids took pills. This kind of "research", while interesting, is hardly conclusive and hardly something to prove a point on.

ADHD is about one's ability to focus; to have balance between active and passive attention, not about what they think is fun or "pumps them up". Superficial feelings such as those do not provide real results.

The parents are always involved, and always have to work hard with their children, ADHD or not. Medication is not something that you just give them and then expect all the problems to be solved. I find it absurd that people think that ADHD and medication is an easy way out.

"Let me again refer to my speculation above about how stimulants work" If I understand you, you are trying to counter (what you think is) bad science by being no better than it? Bad science over-turned by more bad science? You keep saying all this stuff but it doesn't have any weight behind it.

Again, I'm going to bring up a policy here on Wikipedia, WP:NOT#Wikipedia is not a soapbox. Whether I agree with you or not, your links and writings are inappropriate for inclusion on Wikipedia. This "debate" of yours will do nothing to change that. These are not my rules, these are Wikipedia's rules. -- Ned Scott 21:21, 14 October 2006 (UTC)

Your statement:  

"Let me again refer to my speculation above about how stimulants work" If I understand you, you are trying to counter (what you think is) bad science by being no better than it? Bad science over-turned by more bad science? You keep saying all this stuff but it doesn't have any weight behind it.

Please try to concentrate on the words that are on the page. I say that we do not have the science to back up the claim that we know ADHD is a purely biological disorder. The reason I put in the Surgeon General's statement regarding fact that we do not know what causes ADHD(since removed) by the thought police here, the reason I included the NIMH consensus statement regarding what is known about ADHD's cause (also removed) the reason I included the Frontline interview with DR. Castellanos (the then top ADHD researcher at the NIMH) that we know very little scientifically about ADHD (also removed) is that we don't know as much as people think we know about ADHD from a scientific point of view. The reason there is this wrong impression is, yes a Machiavellian effort by drug companies to fool people into believning that we know more than we do. (There are other issues about ideology in psychiatry which I discuss in the article but I'll keep it simple here) The incredible influence of drug companies is the reason Marcia Angell, editor or the NEJM wrote her book. Speaking about pummelling, if you could see the number of mailings I receive, the journals I receive, week after week after week, year after year. The net result is, that in the end,things get repeated so often that everyone falls into line. You say I provide no specifics about this, but if you would bother to read my article you will find plenty of them.

So point one is that we don't know very much about the science of ADHD. That is fine. We can only know something if we do know it. No one is at fault here. My argument is with those who falsely give the impression that we know things that we don't (for Machiavellian reasons) and there (now please Mr. Scott read the words) I suggest that we not replace bad science with my "bad science" but rather ""... that bad science, science totally lacking science's clarity about what is known and not known, is worse than sensible, if imprecise, literary speculations and reasoning."

Get it? I am not claiming to know something I don't know. I am freely admitting that I am speculating Yes, I am giving my thoughts as a better way to put together the evidence. But my article has the virtue of openly admitting what it is. It is intellectually honest. The bad science I am referring to is an attempt to intentionally deceive those not paying careful attention. The reason Zametkin's picture, which begins this article, is used over and over in promotional literature is that, at first glance, it appears to completely end the argument over the biological basis of ADHD. Look at thise. The brains are different!! I don't blame Zametkin. I blame the use of this picture. I attempted to put the meaning of this work in proper context, but my comments were eliminated. However, at least they left the fact that these are pictures of the brain when doing an assigned task. "ADHD controversy" page's comment about the picture is much more to the point. (I don't doubt that it will now disappear having mentioned it here) Since I got into this debate, many things I added have disappeared from that page as well.

Anyway, to repeat, for the last time. My article is a "think" piece. It is not new science. I think it belongs on this page as further reading, or as a link. Not allowing those interested in this subject to consider a different perspective is a not neutral position which is completely at odds with what I hope is the spirit of this page. It goes along with a very deceptive perspective being actively promoted by people with very subjective motives. As I have tried to demonstrate, my article is not a quack piece, and has the backing of significant number of people in the field. I am not trying to say, drop your resistance "important" people agree with me. Yes you are right, as you pointed out earlier, "important" people also disagree with me. Many of them. But the issue isn't the authority or prestige of people who think one way or another. I have only included supporting comments as justification that it not be passed off as just one person's(as you put it) "favorite opinions. " I will formally ask someone besides you to rule on this when I figure out how this is done. If other people are reading this debate I would appreciate their help. --Ss06470 11:24, 19 October 2006 (UTC)

Policy says that we cannot include your information, or even your links. I do not have the power to rule over anything, but those policies do. I could respond to what you've said, but it would be besides the point. It would also only fuel you to talk more, so I will no longer discuss or debate ADHD with you anymore. -- Ned Scott 14:33, 19 October 2006 (UTC)

A number of aspects of the debate above disturb me:

(1) A very active editor of the page clearly reveals strong (and strongly emotional) involvement with the subject of the article. While ADD is allegedly common and it is normal for people somewhat involved with a subject will be motivated to maintain an article on the subject, nevertheless it is clear that the personal involvement of this editor has led him to exceed the bounds of courtesy here on the talk page, for example, and may also have influenced his edits of the article -- I did not research this closely. For example, it is alleged below that a link to the Surgeon General's statement regarding the cause of ADD was removed. It is not clear why it was removed, perhaps it is in the archive, but it is hard to imagine any legitimate reason but, perhaps, redundancy. That does not seem to be the case.The Surgeon General could be completely wrong or misguided or may have later retracted the statement, but the statement itself, because of its source, is material for Wikipedia, and certainly a link to it should ordinarily be allowed to stand.

(2) A writer who added a link to his own writing here was properly informed that he was violating Wikipedia policy guidelines, which guidelines justified the removal of that link. However, if this writer was advised as to how he could edit the article to make it more balanced, I missed it. If his article contains or refers to material which does meet Wikipedia standards, he may add that material directly to the article. By his own acknowledgement, his article "presents a different point of view about a topic." Thus his article is, by definition, POV. But it may certainly contain information that is NPOV, and, if this information is relevant and verifiable (such as a statement from the Surgeon General) it should be allowed to insert this directly or, at least, in the links. Being a writer myself, involved in original analysis, I can understand the frustration of this writer. But Wikipedia itself is not the place for unpublished analysis, and a link to otherwise unpublished analysis easily falls into the same prohibition. Requiring publication adds a layer of restraint, otherwise every crackpot theory, maybe even my own, could find its way into Wikipedia, simply because the writer picks up some free web space.

(3) The discussion above is about 5% argument over article policy, 60% argument over whether or not ADD is an organic/genetic condition or not, and 40% personal dispute and allegation. (Note the common usage of "you" in the debate.) Only the first of these is appropriate on the talk page for a major article. (I have ADD and therefore I am, by the Americans with Disabilities Act, exempt from the requirement that percentages add up to 100.) I think this whole section, in fact, should be archived. But I can't resist adding a comment on the organic debate: writers on ADD such as Hallowell do not allege that ADD is a pure "genetic" disease, rather that there is strong evidence, from twin studies, for example, that a susceptibility to it is heritable. Triggering this susceptibility such that the syndrome actually develops is an environmental influence, and how parents raise children can certainly be a factor. Some of the writer's criticism of the position that ADD is genetic appears to assume that the claim is that it is like, say, haemophilia, which will develop regardless of environment. I don't think anyone is taking that strong a position. Hallowell notes that modern conditions may be causing the incidence of ADD to rise. If he thought it was purely genetic, he would not make that comment. Nor would he note, as he does, that the incidence of ADD is relatively high among adopted children. We may speculate that the same trauma and loss that accentuate attachment disorder among adopted children may also trigger ADD. Abd 20:34, 14 December 2006 (UTC)

You say that the statement by the surgeon general should be included, even if it is completely wrong or misguided. That doesnt seem to quite make sense to me. Are you saying we should delibratly put misleading information on the site? However, I agree with you on some other points. The arguments here are definatley getting very heated, and very personal, and im not too sure thats what wikipedia is about. Why don't we create another article, with the viewpoints of those who feel that there information is being edited by the "thought police." (who I actually happen to agree with on many points, I have ADD and so yes i do think it is a disorder, no im not a misguided child who has been underdisciplend as suggested in "ADHD and other sins of our children", and yes i do belive the medication helps, and if theres ever anyone who should have his heart absolutley set against stimulants and medications in general, its me. I know that sounds arrogant and all, but you're going to have to take my word for it because I dont want to talk about it.) If you all have a huge problem with the people who are "rulers" of this site now, we'll just have to find you a indiffrent third-party moderator or something who will check all your submissions. However, I will admit that there will probably be much debate over the title page of this, for it must be shown that it is not the main article on wikipedia on ADHD (sorry guys). just put it under like "further reading" or whatever cateogory there is that gives you links to other wikipedia articles. Im kinda a noob to wikipedia, so I'm not too sure if we could do that, just let me know.Da trout 20:06, 4 February 2007 (UTC)

src: www.psychiatry-uk.com

Conflicting Numbers

Another source of controversy, especially in the United States, is the use of psychotropic medications to treat the disorder. In the United States outpatient treatment for ADHD has grown from 0.9 children per 100 (1987) to 3.4 per 100 (1997).[49]. However it has held steady since then.[50]

The two sources give different numbers. According to http://www.nimh.nih.gov/press/adhdmedsuse.cfm (source 50)

U.S. children ages 18 and younger had increased sharply from 0.6 percent in 1987 to 2.7 percent in 1997

The problem here may be two different definitions of 'children' in the 49th and 50th source, it may be more complex. Someone should look into the conflicting numbers. William conway bcc 19:45, 14 October 2006 (UTC)

Merger discussion (re: article on adults)

This section is for discussion of the suggestion to merge the article Adult attention-deficit disorder into this main article.

Oppose. It might be appropriate to rename the other article, such as "Attention-deficit [etc]... in adults," to clarify the connection to this one, but the two topics have substantially different references from which to draw and the adult subfield is a large one all its own. I think merging the two would be inappropriate and would make the resulting article far too long. Lawikitejana 19:48, 19 October 2006 (UTC)

Wait now, lets hold off on the vote format and just discuss this.

Personally, I didn't even realize there was a second Adult attention-deficit disorder article, because Attention-deficit hyperactivity disorder already included information about the disorder that wasn't depended on age. The second article has only a handful of references, links back to this article twice, and then links to the same controversy article that this one does. They are not two different topics, they are two different groups of patients. The second article is in desperate need of cleanup, and what would be merged from it would not be as long as the full article itself. -- Ned Scott 20:29, 19 October 2006 (UTC)

Oh, and another section starts out with "The diagnostic criteria for ADHD in adults are identical to those for children. ". A very large portion of the article is nothing more than "is the same for children" or something to that extent and having an adult example. -- Ned Scott 20:33, 19 October 2006 (UTC)

In response to the section about "Is the same for Children" please see the comment below, regarding differences in practice between UK and US. Also, whilst the US does diagnose adults and childrenequally (very similarly at least), the UK does not. This would suggest that medical proffessionals believe that a) the one condition has very different diagnosises, or b) there are two seperate conditions which the US medical profession diagnoses as one and that the UK only diagnoses one of two.

• Oppose I agree teh adult article needs to avoid redundancy and needs some cleanup, but I think having a smaller, separate article is still a good thing. Vaoverland 02:59, 20 October 2006 (UTC)
  • Again, avoid the whole vote format, m:Voting is evil. I'm not sure I understand your rational here. Why is it a good thing? -- Ned Scott 03:15, 20 October 2006 (UTC)
    • Oppose merge because in adults it is a subtantially separate issue, with very different functional implications, and often a late diagnosis (not as a child). Vaoverland 05:58, 20 October 2006 (UTC)
      • So the symptoms are slightly different, because adults have different responsibilities. Within children we have a large range of different symptoms. They are not two different disorders. And the diagnosis section in the adult article just links back to this article. -- Ned Scott 18:43, 20 October 2006 (UTC)

I am confused to what is actually going to be merged. Only two of the sections in the Adult ADHD article are unique; the introduction and the Symptoms and hallmarks sections. However the value of these two sections is extremely limited. The introduction has zero sources, and is mostly just a repetition of introduction of this article. The symptoms and hallmarks section is very questionable. This section deals with pretty much only the ideas of Edward M. Hallowell. Before we can decide whether or not to merge the articles, we must know what information will be retained. William conway bcc 23:41, 20 October 2006 (UTC)

I figure that this is an opinion on whether we want to merger two articles, so APA guidelines are not required - if they are inform me and I will get them. But in my opinion, the two articles should NOT be mergered. Sytantax and Grammar aside, there are two reasons:

There is a lot of controversy on the subject (I'm not taking sides) and however much controversy there is on diagnosing children, there is even more in diagnosing adults.

Secondly, the book that GPs here in the United Kingdom use to reference conditions and their threatments states clearly that ADD (the new term to replace ADHD - now ADD is diagnosed without or without hyperactivity) is a childhood illness. And unless extreme circumstances exist it should not be diagnosed for the first time after the age of 18, and that at the age of 18 GPs (General Physiscians) should begin to lower medication with the intent of stopping further long-term treatment. This is not to say that there are not people over the age of 18 in the UK with (un)diagnosed ADD, who are going with(out)treatment, but since medical guidelines state that it is a childhood illness they would be in the eyes of the UK medical profession two seperate "ideas" per se. UK guidelines would support one artical and not the other; I realise that this is not the case with United States diagnosis and prescription guidelines however.

As such I propose both of the following courses of action for review:

Firstly, the two articles remain separate and get reviewed independantly, with hopes that in the future the syntax will change on each article to properly reflect that article's subject matter. I am not suggesting content for either article, but if they are not recognised as the same condition in at least a semi-global context then it would be innaccurate to combine them.

Secondly, should the two articles be merged, there should be a clear statement (as a paragraph with explainations, or as a single line) to the effect of, 'US guidelines say, "...", however, in the UK and "(other countries)", ADD (with or without Hyperactivity) is recognised only as a childhood condition. As such ADD is not usually diagnosed in the UK post 18, treatment is not commenced after this age, unless in extreme circumstances, and existing medication is slowly lowered in favour of behavioural controls'.

UK_PhiKap

The current ADHD article is 50 kB long. So having a shorter separate article that treats the issue specifically for adults would likely benefit those who are seeking information pertaining to adults only. I might be helpful if the intro to this article cited the adult article.   TheSeven 08:55, 24 October 2006 (UTC)

I see what you're saying, but the adult article isn't a standalone article. It pretty much requires that the reader have read Attention-deficit hyperactivity disorder as well. -- Ned Scott 02:06, 26 October 2006 (UTC)

New children's book about ADHD.

There are many books about ADHD but not too many for kids from the kids' perspective. I came across this book recently. It's quite nice. It's called "Stop the Traffic" and it's by a physician whose son has ADHD. (Nicole Switzer, M.D.) I got it from Amazon. Thanks. AR

Say what???

The neuropsychology literature looking at brain function in ADHD is "large and complex". Dysfunction of various fronto-striatal structures (lateral prefrontal cortex, dorsal anterior cingulate cortex, caudate, and putamen) have been implicated . Additionally, the cerebellum has been shown to be smaller in the brains of those with this disorder. Changes in dopamine transporters have also been observed .

I've clipped this paragraph out of the now removed Psychopathology section. It doesn't appear to be saying anything that the Hereditary Dopamine Deficiency section omits, but I could be wrong. If it goes back in, it should probably be dumbed down just a bit.--*Kat* 02:16, 26 October 2006 (UTC)

The dopamine stuff is only really related to the fronto-striatal structures, and not the cerebellum. It also leaves the Zametkin scan image hanging in the wind a bit, without referencing the other 30+ such studies conducted since then (many with improved technology over that available 15 years ago). I also think it would be preferable to have a section on known neural level changes, distinct from a causal discussion. --Limegreen 10:36, 26 October 2006 (UTC)

Analytical diagnosis

The Analytical diagnosis is redundant, perhaps we can remove it. The mention of the brain scans is simply a summary of the section that follows two paragraphs later. The idea of diagnosing through psychological analysis is mentioned earlier. Rares 03:59, 29 October 2006 (UTC)

Sources for Protein Deficiency as cause for ADHD-like symptoms

The Diet section contains information about how a protein deficiency can cause symptoms that are consistent with ADHD. While we have a source to back up that an early-life protein deficiency can cause this permanently, I have only barely managed to find something to back up that ADHD-like symptoms can be caused by an immediate protein deficiency. The source is, how shall we say, less than ideal. I would really like to find something in some form of respected medical journal, diagnostic reference, etc. Unfortunately, having little familiarity with medical "whatnots" I wouldn't really know where to look. I am hoping someone else will.

Just to be clear, there should be no concern over whether or not a protein deficiency can cause ADHD-like symptoms, only over finding a source to make it verifiable for Wikipedia purposes. I have confirmed the information numerous times with nutrionists (and an endocrinologist, of all things), but unfortunately none of them could offer me a handy reference I could cite for the information. -- Y|yukichigai 07:04, 29 October 2006 (UTC)

Misleading description of Neurofeedback

This is the given description of Neurofeedback: "Neurofeedback is a proposed ADHD remedy which involves teaching children to control their brain waves by the use of video-game technology." This almost seems like a mockery, to me. First, it's not just for children. More importantly, neurofeedback is based much moreso on neurophysiology & electroencephalography than video-games. Only in some instances is an interface resembling a video-game utilized. I would strongly recommend changing this. Perhaps some adaptation of the opening sentence from the Neurofeedback Wikipedia article could be used: "Neurofeedback (NFB), also called neurotherapy, neurobiofeedback or EEG biofeedback is a controversial therapy technique that presents the user with realtime feedback on brainwave activity, as measured by electrodes on the scalp, typically in the form of a video display, sound or vibration." --The preceding unsigned comment was added by 72.128.91.62 (talk o contribs) .

Attention Deficit Disorder

As ADD is now being classified separately from ADHD, the article shd not be merged -- _{The preceeding unsigned comment was left by Triund (talk · contribs)}

If you have a linkable source that can back that up it would be most welcome. -- Y|yukichigai 17:34, 31 October 2006 (UTC)

Not according to the DSM-IV-TR...unless there is a major update that has somehow slipped under my radar. -- Tim D 07:12, 1 November 2006 (UTC)

Having ADD, but not ADHD, and also working in the field - trust me, there is a huge difference - I find it somewhat inconsiderate that while looking up ADD I was redirected to ADHD. This is NOT the same thing. Can someone fix that???--Sparviere 01:05, 10 November 2006 (UTC)

"ADD" isn't officially a disorder in itself...at least not right now. It's a subtype of ADHD (primarily inattentive), hence the redirect to this article. -- Tim D 01:11, 10 November 2006 (UTC)

Perhaps a section could be dedicated to the differences? --*Kat* 02:26, 10 November 2006 (UTC)

Holy cow, I can't believe there isn't a section describing or comparing the subtypes! I don't know how I didn't notice. So yeah, we need to get on that. -- Tim D 04:26, 10 November 2006 (UTC)

Why is adult ADD it's own article? cyclosarin (previously raptor) 10:41, 14 November 2006 (UTC)

Yeah, I was confused about that too. The main article (this one) contains all the useful information anyways and it pretty much applies to both children and adults. I had proposed a merge not too long ago, but no one seemed to want to go along with it. -- Ned Scott 11:02, 14 November 2006 (UTC)

Anxiety

It would seem that anxiety could be quite easily mistaken for ADHD, especially in children. http://www.healthology.com/mental-health/stress/article261.htm In any case, I have Generalized Anxiety Disorder, and when I'm at my worst, it certainly seems to emulate the symptoms of severe inattentive ADHD (among others).

A number of things could be mistaken for a lack of focus and that is why you want an excellent practioner doing the diagnosis. Even so, an anxiety disorder has traits that are specific to it, that one would not find in straight ADD. --Scuro 22:19, 19 December 2006 (UTC)

Controversy

The Controversy section is getting pretty long. I think we ought to consider moving some of the information over to the other article. What do y'all think?--*Kat* 04:47, 6 November 2006 (UTC)

Sounds like a good idea to me. I understand that ADD-critics want to have their say, but if the section gets too big in the main article then the neutral-point-of-view on the over-all article goes off balance. -- Ned Scott 19:13, 13 November 2006 (UTC)

The question is: What should go, and what should stay?--*Kat* 08:25, 14 November 2006 (UTC)

The Controversy section doesn't seem very long to me. I think it is a great strenth of the article that time is spent talking about the fact that both the diagnosis and treatment ARE controversial. It would not be a factual article if it didn't include that information. I say leave it alone! - [Steve]

This would be true if we didn't have a second article reserved specifically for the controversy, Controversy about ADHD. This isn't about not including the information at all, but rather about how we want to organize the information. -- Ned Scott 22:25, 1 December 2006 (UTC)

WikiProject Psychology: Ummm...No.

ADHD is a Neuropsychiatric disorder. Not a psychological thing. The Psychology Wikiproject "aims to improve articles on psychology; psychological theories, psychological research, and psychotherapy." Making ADHD apart of this wikiproject gives the wrong idea of what ADHD is.--*Kat* 23:48, 18 November 2006 (UTC)

I agree. -- Ned Scott 07:43, 19 November 2006 (UTC)

It's both, actually. The sources of ADHD may be biological, but psychology is involved in assessment and intervention. -- Tim D 20:31, 19 November 2006 (UTC)

There is no hard boundary between psychology and psychiatry. As a result many medical schools have departments of "psychological medicine", containing both psychologists and psychiatrists. With respect to the research, many neuroscientists looking at ADHD will be in anatomy or psychology departments (and very rarely in psychiatry). Behavioural research will be the purview of psychology and psychiatry/psych med departments. I'm not aware of any neurologists actively studying ADHD, although their will be some.--Limegreen 22:07, 19 November 2006 (UTC)

I'm the one who added the banner. There was a discussion on WikiProject Medicine about whether psychiatry-related topics could be included under WikiProject Psychology or if they should fall only under WikiProject Medicine. The discussion was brief, but everyone seemed okay with psychiatry articles being listed under both WikiProjects. The discussion can be found at Wikipedia talk:WikiProject Medicine/Archive 2#Overlap with Psychology WikiProject. ADHD (as well as OCD, which was also removed from the project) are topics covered in psychology programs and are of interest to psychologists as well as psychiatrists, so I think that the Psychology WikiProject would be relevant to the article. --Cswrye 05:59, 20 November 2006 (UTC)

The discussion at the Medicine project was very brief, and it's not clear there was a consensus that medical conditions should be listed under the Psychology project: I don't necessarily agree that neuropsychiatric conditions should be part of the Psychology project, and believe that Project needs to get more involved with writing and improving psychology articles, which are woefully inadequate on Wiki, with several of them recently losing FA status, as no one from the Psychology project worked to improve them. Sandy (Talk) 15:23, 21 November 2006 (UTC)

Okay, I'll leave this out of the project for now. Thanks for the input. --Cswrye 16:38, 21 November 2006 (UTC)

There's a very blurry line between neurological/psychiatric and psychological issues. By the arguments here, almost nothing listed in the DSM should be included in the project! Personally, I do not think that there should be a necessary distinct separation between the fields of study -- Tim D 17:04, 21 November 2006 (UTC)

I agree with you, Tim D, but if the consensus of the editors of this article don't want this included in WikiProject Psychology, I'm willing to concede. Sandy makes a point in that we have many other articles we could be working on. --Cswrye 17:14, 21 November 2006 (UTC)

I think this argument is predicated on weak reasoning. Neuropsychiatry is a fairly recent buzz word, and despite the initial ADHD is a Neuropsychiatric disorder. Not a psychological thing., Neuropsychiatry is, by their own definition[10], interdisciplinary. There are no hard boundaries between any of these things as I, and others, have noted above. This statement also concerns me Making ADHD apart of this wikiproject gives the wrong idea of what ADHD is., because it could be interpreted as subtle POV (psychology=mental illness; neuropsychiatry=biological illness; mental illness is stigmatized; therefore let's make sure this is on the other side of the divide). --Limegreen 21:32, 21 November 2006 (UTC)

I was born with ADHD. I will die with ADHD. And no amount of psychological intervention can change that. On the other hand, the depression and anxiety that I have developed as a result of the ADHD, those are psychological issues. I was not born with them, I will not necessarily die with them. For me, that is the difference between a psychiatric and psychological disorder. Just my POV. --*Kat* 01:06, 23 November 2006 (UTC)

And anxiety, depression, etc. can (and in many cases, must) be treated as psychiatric issues with medications (although usually not if they're sourced in a situation). Techniques taken from psychology can teach someone with ADHD how to best cope with and fight against the problems that come with it, and co-morbid problems can be prevented or treated through secondary effects. Research has shown that the best treatment for ADHD is a combination of psychopharmacological and psychosocial interventions. There is absolutely no doubt that ADHD is neurologically based, but like it's been mentioned before, the classifications are not mutually exclusive! -- Tim D 04:06, 23 November 2006 (UTC)

Also, psychology doesn't equal psychological intervention. Psychology is the study of behaviour and cognition. It is not exclusively about humans, and really very little to do with mental illness. It is a *very* broad discipline, which overlaps with a great many things. Perhaps 10% of psychology overlaps with medicine, and probably 3/4 of that overlap is what might be considered psychiatry. However, very little of psychiatry does not overlap psychology. --Limegreen 11:17, 23 November 2006 (UTC)

Well, "consensus" is another tough thing to define on Wikipedia :) I wouldn't take a definitive judgment based on the opinion of a few, especially when the logic isn't completely clear. -- Tim D 00:58, 22 November 2006 (UTC)

Cultural References

Looking at Wikipedia:Manual of Style (medicine-related articles), I noticed that it recommened that articles such as this one include a section on cultural references. Which shouldn't be hard.

It also recommended that (if possible) we include some notable cases.

--*Kat* 00:01, 20 November 2006 (UTC)

smarter ADD/ADHDers

I wonder why no one stated that people with ADD/ADHD have a higher IQ than average --The preceding unsigned comment was added by 67.180.240.246 (talk) 00:03, 29 November 2006

Well, because that's actually not true. There are lots of smart people with ADHD, but no more than people without it. The only real difference is that learning disorders are more common with those who have the disorder. But if you have any reference about the intelligence thing, feel free to post it over here. -- Tim D 06:09, 29 November 2006 (UTC)

but people with ADHD are because of having a hard time paying attentin in clas getting lower grades. but some people lern to live with it and are able to pay atention (wich geves them high grades) and even to use some of the positiv efects of ADHD such as hyperfocusing witch can caus some people to think that their IQ is higher but IQ isn't only knowlige it isn't seposed to change over the years becaus you've learnt something.

StephanAB 12:31, 5 January 2007 (UTC)

Isn't creativity common with people with ADHD? How do you measure creativity? -- user:guitarpicks

It is very common, and often People with ADHD have a wide imagination, it is stated, in the positives of ADHD section. I have ADHD my self, and when younger had a pretty wide imaginiation. Hope that helps. --The preceding unsigned comment was added by Dennis Kussinich 08 (talk o contribs) 01:15, 5 December 2006 (UTC).

Clinical studies have not shown that those with ADHD are more "smart". The jury is out on creativity also. Those with ADHD may be slightly more creative in certain ways and less creative in other ways. --Scuro 22:29, 19 December 2006 (UTC)

people with ADD/ADHD have a high "theoretical" intelligence, they have alot of things negating that intelligence tho so they might need that smarts just to function properly. --RaDeus 07:04, 21 December 2006 (UTC)

And by "theoretical," do you mean your theory, or is there some published evidence of this somewhere? -- Tim D 17:19, 21 December 2006 (UTC)

speaking from personal experience, anyway, i should have added that it varies from case to case --RaDeus 01:06, 22 December 2006 (UTC)

people with adhd are creativ and tend to think about stuf others forget about

StephanAB 12:31, 5 January 2007 (UTC)

Television as a possible factor in developing ADHD

Hello- new here (this being my first addition), so please be gentle ;)

While doing research for a Psych final, I found an interesting bit of research stating early childhood exposure to television can be very harmful to the formation of an adaptive attention schema, as well as to the physiology of the brain itself. a report issued by the AAP (American Academy of Pediatrics) warned parents not to let their youngsters watch TV between the ages of 1-3, as it can "negativly affect early brain development"

ADHD is a genetic disorder that as far as I know (and I have been digging alot) is only Genetic or developed by a occigen shortage in the brein so I think it's unlikely that the tv can caus ADHD.

StephanAB 12:36, 5 January 2007 (UTC)

Quick Question, Sentence in Beginning of Article Does Not Make Sense

In the beginning of second paragraph of this article, we find this sentence:

"Controversy surrounds the designation of ADHD as a true medical disorder, such as whether or not the diagnosis denotes a disability in its traditional sense, an impairment, or simply describes the neurological property of an individual."

The DSM-IV quite clearly states that a diagnosis of ADHD requires that the symptoms create a significant impairment in normal life activities in at least two different settings. Under the Americans with Disabilities Act, such an individual would be legally considered to have a disability. I would also think that if one has a condition that causes impairment in normal life activities, especially if it does so in multiple settings, then one would generally consider such a condition to be a disability even without a legal definition. I do understand that this is a bit US-centric, but I cannot imagine that there exist many places in the world where such a condition would not be classified as a disability.

I'm not sure exactly how one might go about editing that sentence, though. Clearly the person who wrote it did not consider how the disorder is defined within the medical community, and the sentence as written simply makes no sense.

Oh, and one last thing. Can we please remember, in discussing this article, that we are discussing a medical condition. There are people reading this who may have this medical condition. Many of these people may have endured great difficulty as a result of this medical condition. Please do bear in mind that it is generally considered uncouth to trivialize another individual's medical problems.

Hyperion35 07:46, 20 December 2006 (UTC)Hyperion35

You could take a stab at it if you want. If your changes don't work out, they can always be reverted back or adjusted... -- Tim D 17:22, 21 December 2006 (UTC)

I looked at that sentence and didn't like it either but was new and didn't want to make waves. Without the word impairment in that sentence, it was even more stark. I took a stab at editing and simply added the word "impairment". That's how the disorder is viewed by those in the field, and by the way, there is generally little controversy about what the disorder is in their minds.

The sentence should simply read something like, "ADHD is an impairment in several aspects of life functioning. Several groups have challenged this basic assumption and believe that the behaviours can be better explained by ideas like human evolution, non-medical models, or conspiracies". Feel free to use any part of that and post it. --Scuro 06:21, 22 December 2006 (UTC)

back in June when I did an overhaul on the article, I had this paragraph in where that sentence is:

Much controversy surrounds the diagnosis. There is disagreement over whether or not the diagnosis denotes a genuine disability or simply serves as a label for something else. Of those who believe that ADHD is a true disorder, there is debate over how it should be treated, if it should be treated at all. Medical science generally regards ADHD to be a valid disorder, that, although not curable, can be treated with a wide range of medication.

Its since been edited half to death, but we can restore it.

--*Kat* 21:54, 22 December 2006 (UTC)

Let me make some minor alterations to that sentence.

There is disagreement over whether or not the diagnosis denotes a genuine impairment/disability or simply serves as a label for different but normal behaviour. Of those who believe that ADHD is a true disorder, there is little debate about how the disorder should be treated. Others believe that the disorder does not exist or that it shouldn't be treated at all. Medical science generally regards ADHD to be a valid disorder, that, although not curable, can be treated mainly with theraputic stimulant medication.

Wow...it needed a little more editing then I thought.

--Scuro 05:56, 23 December 2006 (UTC)

Trimmed it some more and integrated it into the paragraph of the article, hope that reads better. --Scuro 19:48, 27 December 2006 (UTC)

That was well done. --*Kat* 09:35, 28 December 2006 (UTC)

Reply to Scuro

1) Scuro wrote above: "Fred [Baughman] would have you believe that Major Depression, Tourettes, Autism, and Alzheimers are not real disorders".

This is not accurate. Baughman doesn't deny the existence of mental disorders, only that they are biomedical entities.

2) Scuro wrote: "Yet complex traits often involve several genes."

If you imply that ADHD is genetic, this is not the language of science (cf. falsifiability). Take a look at the Wikipedia article The Gene Illusion.

3) Scuro wrote: "They would want us to believe that ADHD is really nothing more than the side effects of bad parenting."

That may be the cause. Take a look at what psychohistorians have been saying for decades.

4) Scuro wrote: "The antipsych movement started with Scientology way back when..."

If I remember correctly the Scientology "connection" has already been addressed in your talk page.

5) Scuro wrote: "The Anti-psychiatry label is well estabished. Some in that movement call themselves 'antipsychs'."

Very few actually. MindFreedom International released a statement this year repudiating the label antipsychiatry for their human rights activities.

6) Scuro wrote: "Dr. Baughman would probably be happy to be identified as an anti-psychiatry..."

He'd hate the label.

7) Scuro wrote: "Those who believe that ADHD is a traditional disability or disorder often debate over how it should be treated, if at all." -> I don't think there is any debate at all within the medical community about how it should be treated.

The debate is so real and intense that Ritalin is used mainly in North America and Australia. Nordic people have not fallen (yet) in the folie a deux with Big Pharma.

8) Scuro wrote: "Several groups have challenged this basic assumption and believe that the behaviours can be better explained by ideas like human evolution, non-medical models, or conspiracies".

But certainly not conspiracy theories. The mental health professionals at ICSPP, who are very critical of the ADHD label, are no conspiracy theorists: they merely say that organizations such as the APA are partners of Big Pharma. -Cesar Tort 07:08, 22 December 2006 (UTC)

---

No, I believe that Baughman thinks it's all a FRAUD. He loves to do that. He loves to put FRAUD in capitals. If I see ADHD and FRAUD together, I don't even have to look for the author's name, it's Baughman. That's the name of his website. Not Baughman.com but ADHDFRAUD.com.

It took me 10 seconds of searching to find this Baughman quote, "All physicians (psychiatrists included) study the normal (no disease) and abnormal (disease) and are responsible for telling one from the other. When no abnormality/disease is present, there is nothing to make normal; no need for medical treatment. A third to a half of patients seek help for psychological/psychiatric symptoms, and have no abnormality/disease". If there is any doubt that he is talking about ADHD then the title spells it out for you ->ADHD: TOTAL, 100% FRAUD. He doesn't believe ADHD to be an abnormality plain and simple. His definition sucks too. So Baughman is a freemason. Someone should start a wiki page on him. Then we might all learn a bit more.

When you talk of the ICSPP, Szasz, Scientology, Breggin, Baughman, Mindfreedom et al,...really you can say they are all different, and they are. Szasz denies he ever was a scientologist while Baughman works for them. Breggin may have been but not since the 70's. ICSPP is not linked with Scientology yet the CCHR is. One thing for certain, the message is basically the same when it comes to Psychology or Psychiatry. One may be more extreme but they all speak with the same voice. More interestingly, one creates content for the other, and the other broadcasts it. It doesn't matter if the broadcaster or the content creator are affiliated to scientology or not. They share. They work together. They go to protests together. They show up at the same awards nights and fight the same battles. DO SSRI's make people commit suicide? You know which side the antipsychs and scientology are always going to be on...and that is the same side.

Some complain, as you do, that no one has a theory about ADHD. That really it is just a shopping list of symptoms. This isn't science they say, it's FAKE science. Yet, Barkley was already saying this about ADHD back in 2000, perhaps earlier.

"AD/HD delays the development of inhibition, which means that it delays the onset of the four executive functions, which means that it delays what those executive functions are doing for the individual, which leaves the person with AD/HD more under the control of external events and other people around them and the temporal now and immediate gratification".

From that he has made several predictions which he has tested, and the theory has not been shown to be wrong. But go ahead, do an experiment or look for facts that negate his theory. Are there other researchers with theories about ADHD?, yes there are. This is no shopping list of symptoms but what looks to be an active persuit of science to me. And, by the way, Breggin, Baughman, and Szasz are not researchers. Barkley has also pointed out that ADHD is one of the most highly inheritable disorders out there. ADHD is more heritable then height or intelligence. If ADHD is all about DADD and bad parenting, then why do separated twins have a very high correlation of the same set of ADHD behaviours?

"Nordic" people don't buy into ADHD!?!??!???...funny choice of a word. Why Nordic? No... Europeans have a lengthy history of believing in natural methods and natural living. But the use of Adderall and Ritalin is increasing in that region also. And why not, it's a no brainer. Take a look at the wealth of evidence with regards to therapeutic stimulants and a decrease in the symptoms of ADHD. What harm is done with a trial run of stimulants for Combined and HI type ADHD? Especially if there is major impairment in social or academic functioning?

--Scuro 06:31, 23 December 2006 (UTC)

Scuro wrote:

"Breggin may have been [a Scientologist] but not since the 70's"

Incorrect. Breggin never was a Scientologist, only his wife.

Scuro wrote:

"One thing for certain, the message is basically the same when it comes to Psychology or Psychiatry"

Incorrect. Neither psychiatric survivor activists nor the scholars who criticize the profession reject psychology. In fact, in ICSPP there are many professional psychologists.

Re psychiatry, the differences between Scientology and secular critics have been discussed by several editors in Talk:Thomas_Szasz#Scientology

Scuro wrote:

"More interestingly, one creates content for the other, and the other broadcasts it [...].They work together. "

Partially incorrect. While it's true that CCHR's material quotes many sources from the secular scholars, neither the activist organizations such as MindFreedom International nor the professionals at ICSPP have ties whatsoever with CCHR or with the Church of Scientology.

Scuro wrote:

"They go to protests together. "

Incorrect. MindFreedom International activists wait until CCHR's protesters finish their activities during, say, an APA convention before they show up picketing outside the convention.

Scuro wrote:

"They show up at the same awards nights"

While sometimes they come across each other they don't talk to each other. Breggin wrote during the aftermath of the Tom Cruise/Brook Shields TV show that he does not engage personally with church members.

Scuro wrote:

"And, by the way, Breggin, Baughman, and Szasz are not researchers. Barkley has also pointed out that ADHD is one of the most highly inheritable disorders out there. ADHD is more heritable then height or intelligence. "

A book of Jay Joseph released in 2006 debunks the current genetic theory of ADHD [11]. Also, you don't have to be a researcher to expose a pseudoscience. Occam's razor and Karl Popper's falsifiability criterion are enough.

Scuro wrote:

""Nordic" people don't buy into ADHD!?!??!???...funny choice of a word. Why Nordic? No... Europeans have a lengthy history of believing in natural methods and natural living."

That's not the reason. Generally speaking Scandinavian modes of childrearing are less abusive than North American modes. That's why they do not psychiatrically drug their children as much as Americans do. (Also, they don't allow their children to watch violent TV as much as Americans do.)

Scuro wrote:

"What harm is done with a trial run of stimulants for Combined and HI type ADHD? Especially if there is major impairment in social or academic functioning? "

The harm is obvious. Baughman wrote:

The Hippocratic Oath does not permit such "practice." It does not permit the "treatment" of children [...] for "diseases" that are not real diseases. The Nuremberg Code does not permit the "treatment" of normal, disease-free children with addictive, dangerous, Schedule II drugs for profit. It does not permit deception and the abrogation of informed consent rights that is occurring today in virtually every case across the United States. This is criminal. It is child abuse. Nothing about it is the legitimate practice of medicine. It must be exposed. Those responsible for the fraud and deception must be exposed and held accountable.

-Cesar Tort 10:29, 23 December 2006 (UTC)

was Breggin involved with Scientology?

He was certainly involved with scientologist organizations and his wife was a scientologist. Why is that important? Because you can see where some of the influence of his formative ideas may have came from. That is important because when you compare his views and that of Scientology on ADHD, really, there is very little difference in content.

He denounces scientology now.

but...

Back a few years ago when Breggin was leading the class action lawsuit against the makers of Ritalin, he was getting a lot of press. PBS decided to do a major series on ADHD and brought in the big names in for the debate about ADHD. Here was a national platform for Breggin to categorically deny that he was EVER a scientologist or EVER had anything to do with Scientology....and here is what he said; "... I have nothing to do with Scientology. For approximately 25 years, I have conducted reform work with nothing to do with Scientology. There is no issue whatsoever about me and Scientology". --Scuro 04:25, 26 December 2006 (UTC)

Since the editors of the ADHD article have asked to end this discussion on this talk page, I took the liberty to copy and paste your latest post to the antipsych talk page since, apparently, you want to use these arguments to modify the Anti-psychiatry article. -Cesar Tort 22:45, 26 December 2006 (UTC)

more on Breggin, Baughman, Szasz, and other antipsych viewpoints on ADHD

"A book of Jay Joseph released in 2006 debunks the current genetic theory of ADHD".

Even if John the Baptist himself wrote that book, this would not be enough to "debunk" or "refute" the wide body of evidence that supports this theory. Someone didn't come up with the theory over dinner, on the back of a paper napkin. Researchers have been examining the genetics of ADHD since the 1970's. And that in a nutshell is where the Anti-psych's house of cards falls apart. When antipsychs believe a theory to be wrong, they don't do research. Sure they may quote one particular study, and they often do that out of context....but they don't do research. Why is that? Well, first of all what would they do if their own research went against their biased belief system? Could you picture Baughman stating, "my own research supports the conclusion that therapeutic stimulants, have once again been shown to clinically decrease the symptoms of ADHD". Would Antipsychs change their mind on the subject like a true scientist would?

Honest research is also peer reviewed. The Scientific community would have the right to examine their research and be allowed to comment on it. They would never put themselves in such a position because their biased and bogus conclusions would be taken up the flagpole for all to see in a respectable journal.

More later. --Scuro 15:08, 24 December 2006 (UTC)

Scuro wrote:

"the wide body of evidence that supports this theory."

As I told you above, this is not the language of science. Real scientific hypotheses must be falsifiable. All that we have in "genetic" biopsychiatric research are claims that ADHD is inheritable without lab proof confirming the hypothesis. In other words, it's a bio-reductionistic postulate that that ignores the psychogenic theory, not a proven fact. [12]

Scuro wrote:

"Researchers have been examining the genetics of ADHD since the 1970's."

You failed to add that psychiatric "research" is published in journals paid by the pharmaceutical industry. The research is biased.

Scuro wrote:

"When antipsychs believe a theory to be wrong, they don't do research."

You got it backwards here. It's a basic tenet in science that the burden of proof rests upon the shoulders of the claimant alone. It doesn't rest upon the skeptics' shoulders to disprove the claims.

Scuro wrote:

"Could you picture Baughman stating, 'my own research supports the conclusion that therapeutic stimulants, have once again been shown to clinically decrease the symptoms of ADHD'."

This is nonsense. You can control whoever's conduct you want with a cocktail of psychiatric drugs of stimulants, neuroleptics, minor tranquilizers or mood stabilizers. Former Soviet Union championed the use of psychiatric drugs to control the political dissidents. They still do it in Cuba. Paraphrasing you, they could say that the drugs "decrease the symptoms" of those who don't pay attention ("ADHD") to the party's slogans. I could even control the behavior of the Wikipedia editors of this page if I could involuntary drug them!

Scuro wrote:

"Honest research is also peer reviewed [...] for all to see in a respectable journal"

But biopsychiatry research is dishonest. Breggin wrote:

That the twin study appeared in its distorted form in the New England Journal of Medicine, perhaps the world's most respected medical publication, is unsettling. It indicates how thoroughly medicine has closed ranks with psychiatry against openmindness and fairness in psychiatric research. The peer review system in medical journals is supposed to guarantee a high standard by requiring each manuscript to pass through a panel of experts in the field before acceptance and publication. In the field of psychiatry [...], peer review has become more old-buddy network guaranteeing that critical viewpoints never see the light of the day while badly flawed studies supporting the establishment are rushed into print. (I have not found that medical research or practice in general suffers as much as bias and outright corruption as in psychiatry.) Recently I was interviewed by a newspaper reporter who was writing an article obviously slanted in favor of neuroleptics. In the course of our interview she challenged, "If you've seen so many cases of brain damage from drugs, why don't you publish your data in the New England Journal of Medicine?" To those unsophisticated about how the old-buddy system works, it's not an outrageous question. But any such submission to that journal on brain damage from any psychiatric treatment will be sent for "peer review" to the same "experts" who have been denying the damage for years, the very experts who make their living promoting the drugs, shock treatment and lobotomy. And as we'll see in the chapter on the psycho-pharmaceutical complex, the drug experts often benefit directly from the largess of the drug companies.

-Cesar Tort 18:14, 24 December 2006 (UTC)

Cesar, so there's basically nothing we can say that you will accept. If we cite evidence you'll just tell us it was paid off by medical companies. This argument is about as retarded as an argument about the world being flat or round. Yes, we should have a neutral point of view and an open mind, but the twist you are trying to put on things is far more biased and without evidence than the claims themselves. You are suggesting we counter what you think is bad science with... more bad science. That won't help anything. This is the talk page for this article, not a place to debate whether or not ADHD exists or is biological. For the time being we are defaulting to what is generally accepted by the medical community for our NPOV. If you don't like it, do some research, publish a paper, come back, and maybe we'll be able to change something in the article. Until then, cut the dramatics and the trolling debates. -- Ned Scott 18:36, 24 December 2006 (UTC)

I agree with you that this talk page is not for soapboxing and I will not use it anymore to discuss topics unrelated to the improvement of the article. This said, I must add something as my parting word.

You say that I counter bad science with bad science. This is incorrect. Please take a look at your DSM manual, the psychiatrists' "Bible". You will read there that there are no lab proofs for the clinical evaluation of ADHD.

Good bye. -Cesar Tort 19:02, 24 December 2006 (UTC)

The issue here is not that your viewpoint is necessarily wrong. The issue is that in terms of verifiability the corroborating(sp?) evidence for ADHD being real far outweighs the evidence against it. However, there is a Controversy about ADHD section and separate article due to the fact that there is evidence, however controversial or disputed it may be, to support your claim. As it is both WP:V and Occam's razor leave the existence of ADHD as the favored interpretation.

Last but not least, I do have to respond to your "parting comment": lack of "lab proof" does not mean something is not real. For an example of what I mean, look at the disease Lupus erythematosus. -- Y|yukichigai 19:26, 24 December 2006 (UTC)

I am not claiming that the behaviors that get labeled as ADHD don't exist. Only that they're not biomedical entities. What biopsychiatrists ignore altogether is the Trauma model of mental disorders.

"lack of 'lab proof' does not mean something is not real." But it means that biopsychiatrists are violating Occam's razor for not considering the trauma model, since it's clear that the diagnosed kids are being abused at home.

BTW, I said parting word and "good bye" since I thought I was not supposed to discuss here general topics but specific improvements to the article. However, if my input may be of some help to you I'm willing to engage in a non-trolling discussion of the issues. -Cesar Tort 19:53, 24 December 2006 (UTC)

  Postscript.  

"For an example of what I mean, look at the disease Lupus erythematosus."

Curiously, you chose an example that perfectly illustrates my point.

Lupus erythematosus is an authentic biomedical disease of unknown etiology. But its existence as a biomedical entity is not controversial. It is enough to click on the WP article Lupus erythematosus -and see the skin of a poor woman afflicted by the classic malar rash of the disease- to know that her problem is clearly somatic. (BTW, two of my first cousins died of Lupus.) On the other hand, diagnoses of the alleged psychiatric disorders "of unknown etiology" are so subjective that their inclusion in the DSM has to be decided by votes in congresses of influential psychiatrists. Your point would not have strained my credulity to the breaking point if most of the 374 DSM-IV diagnoses were already proven biomedical illnesses with only a few of them remaining as mysterious diseases. But we are asked to believe that dozens upon dozens of DSM behaviors are mysterious diseases "of unknown etiology".

The MindFreedom International 2003 hunger strike of psychiatric survivors in Pasadena, California, who demanded scientific proof of mental illness as a genuine biomedical disease, will illustrate my point further.

The hunger strikers' demand was addressed to the American Psychiatric Association and the offices of the Surgeon General. Psychiatrist Ron Sterling dismissed the strikers' demand for positive scientific proof describing the mental health field in the following way:

"The field is like cardiology before cardiologists could do procedures like electrocardiograms, open-heart surgery, angiograms and ultrasound [...]. Since brain structure and physiology are so complex, the understanding of its circuitry and biology are in its infancy."

The Surgeon General Office did not even bother to respond. However, in a statement released in September 2003 as a response to the strikers the American Psychiatric Association conceded that:

"Brain science has not advanced to the point where scientists or clinicians can point to readily discernible pathologic lesions or genetic abnormalities that in and of themselves serve as reliable or predictive biomarkers of a given mental disorder or mental disorders as a group [...]. Mental disorders will likely be proven [my emphasis] to represent disorders of intracellular communication; or of disrupted neural circuitry."

The trick to be noticed in the above public statements is that psychiatrists, physicians all things considered, are stating that even though the etiology of mental disorders is unknown (such as ADHD, again see the ADHD DSM pages please), such etiology is, by definition, biological; and that it is only a matter of time that it will likely be proven. This is the hidden meaning of the code word "of unknown etiology." By doing this psychiatrists dismiss in toto the work of the many researchers who have postulated a psychogenic origin of mental distress and disorders. Although it is more parsimonious (Occam's razor) to consider a psychological cause for a mental disturbance that has no known biological markers, with its somatogenic dogma orthodox psychiatry ignores the more simple hypothesis, the model of trauma. In other words, by talking of unknown etiologies that will be discovered in the future by medical science --never by psychologists--, these physicians have presented us a biological hypothesis of mental disorders in such a way that, even if wrong, it cannot be refuted.

This -an irrefutable hypothesis- is the sure-fire sign of a pseudoscience. -Cesar Tort 00:42, 25 December 2006 (UTC)

---

Hmmm...a "body of evidence" is not scientific language...but if you write a book and "debunk" and "refute" a theory based on 6000 studies....this is science? Looking at your hyperlink, the theory of ADHD would qualify as a hard science. As I have already mentioned, the disorder is also falsifable. You make the contrary claims, prove this wrong with specific evidence related to the definitions.

When you speak of lab proof, what lab proof are your referring too? Are you harping again, like Baughman does, that there is no blood tests for ADHD? Well, there are no blood tests for Epilepsy, Alzheimers, Tourettes, or Schizophrenia. Are all of those disorders FAKE!!....and is the perpetuation of these disorders is a FRAUD!?!!! Those of us who have lived with someone who has any of those disorders will tell you that these disorders do not have a primary psychogenic cause or what Breggin refers to as DADD. i.e. I got Epilepsy because my dad never went to any of my baseball games.

The comments about biased research is ironic. Here are what court judges had to say about Breggin.

"This court finds that the evidence of Peter Breggin, as a purported expert, fails nearly all particulars under the standard set forth in Daubert and its progeny. Simply put, the Court believes that Dr. Breggin's opinions do not rise to the level of an opinion based on "good science." The motion to exclude his testimony as an expert witness should be granted. -- Magistrate Judge B. Waugh Crigler in Lam v. The Upjohn Company, No. 94-0033-H, W. Dist., of VA (Harrisonburg Division, U.S. District Court, 1995)

The court believes not only is this gentleman unqualified to render the opinions that he did, I believe that his bias in this case is blinding. I find that he was not only unprepared, he was mistaken in a lot of the factual basis for which he expressed his opinion. The court is going to strike the testimony of Dr. Breggin, finding that it has no rational basis. -- Judge Hilary J. Caplan in Lightner v. Alessi, No. 94013064/CL174959 (Baltimore City Circuit Court, 1995).

Dr. Breggin's observations are totally without credibility. I can almost declare him, I guess from statements that floor me, to say the he's a fraud or at least approaching that He has made some outrageous statements and written outrageous books and which he says he has now withdrawn and his thinking is different. He's untrained. He's a member of no hospital staff. He has not since medical school participated in any studies to support his conclusions except maybe one. I can't place any credence or credibility in what he has to recommend in this case. -- Judge James W. Rice in Schellinger v. Schellinger, No. 93-FA-939-763 (Milwaukee County Circuit Court, 1997)"

Breggin was also was involved in the five separate State failed class action lawsuits against the makers of Ritalin. I believe that case hinged on the idea that ADHD is a FRAUD(sound familiar?) He was an expert witness for the losing side during the trials.

The thing is, if you are going to make some outlandish claim that all mental disorders as we know them are FAKE!!!, I don't think the burden of proof rests with scientists in the field to show that you are wrong. These researchers are simply going to look at you and say, here we go again, we have a scientologist or a conspiracy nut here. They are simply going to ignore you, as they do Breggin, because claims in those class action lawsuits, like the actual claim that the makers of Ritalin created ADHD to create a market, is simply to stupid for words.

I have taken time to post about the Antipsychs because the other side of what antipsychs are about should see the light of day. Especially, because they try so darn hard to get their false message into the main article of ADHD on Wiki. --Scuro 03:49, 26 December 2006 (UTC)

Scuro wrote:

Hmmm...a "body of evidence" is not scientific language...but if you write a book and "debunk" and "refute" a theory based on 6000 studies....this is science?

6000 studies paid by Big Pharma are neither "body of evidence" nor scientific. They're just a biological pseudoscience like phrenology or Lysenkoism.

Scuro wrote:

When you speak of lab proof, what lab proof are your referring too?

I'm referring to the 2003 APA statement quoted above. The APA itself conceded they don't have biomarkers for the major psychiatric disorders. In other words, the hunger strikers defeated the APA!

Scuro wrote:

there are no blood tests for Epilepsy, Alzheimers, Tourettes, or Schizophrenia. Are all of those disorders FAKE!!....

This is unresponsive to the issue. The fact that political dissidents were against the government in the former Soviet Union never meant they suffered from "schizophrenia": a clearly political, not medical, label -just as is the ADHD label for children who cannot pay attention in traditional schooling (or even those genuinely-disturbed people that cannot concentrate because of a psychological condition). Unless there's a biomarker there, due to the parsimony law we may better assume that psychological disorders are not diseases in the original Virchowian sense of the term.

Scuro wrote:

Those of us who have lived with someone who has any of those disorders will tell you that these disorders do not have a primary psychogenic cause...

I don't buy this. Many people have no insight at all.

Scuro wrote:

Here are what court judges had to say about Breggin [...]. He's untrained. [...] He has not since medical school participated in any studies to support his conclusions except maybe one.

You missed the big picture here. Breggin has won other cases. Why do you call him (cf. his Harvard psychiatry training) "untrained"? In the year 2000 he was even called to testify before the U.S. Congress about the dangers of stimulants.

Scuro wrote:

here we go again, we have a scientologist or a conspiracy nut here.

Again, you're unresponsive to my comments and clarifications. Was it not enough to state above the big difference between religious (or conspiracy-theories) attacks of psychiatry and secular criticisms?

Scuro wrote:

I have taken time to post about the Antipsychs because the other side of what antipsychs are about should see the light of day. Especially, because they try so darn hard to get their false message into the main article of ADHD on Wiki.

I have not edited the ADHD article and, due to the "due weight" policy, I'd not be able to edit it as it should be. The best way to explain this is to call your attention to the letter I wrote to Jimbo. -Cesar Tort 05:05, 26 December 2006 (UTC)

This doesn't seem to be getting anyone anywhere. I think it's fair to say that neither side will be convinced with a simple message left by the other on this talk page. Everyone just needs to stop responding to each other and continue editing and follow important policy and guidelines. If someone has a problem with a policy, then take it to that policy's talk page, not this one. We cannot change policy on this talk page, and it's not a good use of time. I've made the mistake of being pulled into a similar conversation in the past (as seen on this very talk page). By now we clearly know Cesar's thoughts and view on the article and the topic at hand, as well as mine and Scuro's. There's no reason to keep this conversation going. We won't learn anything new, and it won't actually effect the article. -- Ned Scott 06:19, 26 December 2006 (UTC)

Agreed: discussion is over. There was something new though: nobody had presented on this page an attack to biopsych from Popper's criterion of falsifiability in conjunction with Occam's razor and the 2003 hunger strike that defeated the APA. -Cesar Tort 06:52, 26 December 2006 (UTC)

ADHD Imaging

After twenty-five years, and thirty-five studies, there is not a single straightforward experiment comparing typical unmedicated children with an ADHD diagnosis to typical controls. The overwhelming majority of studies that have compared "ADHD" children to controls have used ADHD children with a history of medication use. Why the researchers have not used medication-naive children is unknown. It is hard to know if any differences seen between the patients and controls in these studies is due to an organic brain defect, as proposed by the researchers, or to the effects of the medication. In a 2002 NIMH sponsored study by Castellanos three groups were constituted: 49 unmedicated patients, 103 medicated patients, and 139 controls. Thus the authors had the opportunity to make numerous comparisons: unmedicated versus medicated, unmedicated versus controls, medicated versus controls, and ADHD versus controls. The most important comparison being between unmedicated patients and controls. However, compared to the controls, the unmedicated patients were two years younger, shorter and lighter.Thus the researchers had to age match the patients with controls. Why the researchers could not find more appropriately matched aged controls is unclear. (Leo and Cohen, 2003. Available at: http://psychrights.org/Research/Digest/NLPs/criticalreviewofadhd.pdf

In a 2003 NIMH sponsored study by Sowell et al the researchers also had a group of non-medicated children but according to the authors, "We did not directly compare brain morphology across groups of patients on and off drugs because the sample size was considerably compromised when taking lifetime history of stimulant drugs into account" (p.1705). Although NIMH states that researchers who receive grants should be willing to share their data, even a Freedom of Information act request to see the Sowell data was denied. See Cohen and Leo 2003 for more discussion at: http://psychrights.org/Research/Digest/NLPs/neruoimagingupdate.pdf

---

Perhaps the answer is that there is no such thing as a "straighforward" experiment when children and brain imaging are involved. Any experiment involving children involves serious ethical constraints. Finding parents willing to allow their children to participate is difficult in and of itself. Then there's the issue of the brain scans: PET and SPECT brain scans involve not only ionizing radiation, but the injection of radioactive materials into the body. While the health risks are generally considered small, there is still some risk involved, especially when you're considering control subjects, who do not have the condition and thus receive absolutely no benefits from the study. Functional MRIs (fMRI) are at least safer in that they do not involve ionizing radiation, but most of the studies I've seen are either PET or SPECT.

And then you have the problem of finding medication-naive patients. Most persons diagnosed with ADHD will take medication at some point in their lives. For what you're asking, to completely rule out the effects of medication, you would have to find those who have been diagnosed but never medicated. Newly-diagnosed patients might be an easy source for such volunteers, but newly-diagnosed patients would also present a problem in that there might be less certainty of an accurate diagnosis. This also presents problems with age-matching, because diagnoses tend to occur at certain ages, since we are talking about a developmental disorder. Aside from those patients who are newly-diagnosed, and those who cannot take medications for other health reasons (which might complicate the experiment anyways), I'd imagine that many parents who refuse to medicate their children would tend to be the types who would be highly distrustful of mainstream medicine and highly unlikely to allow their children to volunteer for such experiments.

68.83.217.164 10:25, 4 February 2007 (UTC)Hyperion35

Executive Function and Working Memory are not the same thing (as stated in the article)

EricaAckerman 23:00, 18 January 2007 (UTC)

Grammatical Error

There is a grammatical error in the third paragraph of the "Hereditary Dopamine Deficiency" heading. In "the study was done by injected 20 ADHD subjects..." the "injected" should be "injecting" Sharksandwich 03:11, 20 January 2007 (UTC)

Done. -- Ned Scott 07:59, 20 January 2007 (UTC)

Disease database - highly offensive

I suggest people remove this link, and keep taking it out until it stays out! --Rdos 20:30, 23 January 2007 (UTC)

What specific link are you talking about? -- Y|yukichigai (_ramble argue ^check) 20:51, 23 January 2007 (UTC)

I assume the link in Template:Infobox Disease. However, I would have thought that if you object to the idea of ADHD as a disease/illness, you'd be after removing the entire infobox, not just that link. I don't know anything about the disease database, so I'm not sure if it is particulary more or less offensive. There is a little discussion at Template talk:Infobox Disease about the box not being appropriate for "symptom" articles. However, despite a (perhaps significant) minority perspective that ADHD is not a medical entity, I think that is already fairly well covered here and in other articles. --Limegreen 22:18, 23 January 2007 (UTC)

If it's in the ICD-9, ICD-10, OMIM, and other databases, then I'd think that implies that the infobox is appropriate and necessary. It's entirely NPOV, stating that those medical databases have specific medical information on this medical condition. These are well-respected sources of medical information, and the classification numbers themselves are an important reference that someone might want to be able to find easily at the beginning of the article. But most importantly, it's a standard reference template containing standard information identical to that which can be found on thousands of other pages without objection.

As an aside, though, perhaps it might make sense to add the DSM-IV stuff to it, or is that difficult for copyright reasons? I know that the DSM wording is proprietary (like the specific CPT terminology) and copyrighted by the APA, so maybe that's the reason why, or is it just because DSM-IV and ICD-9 codes are identical? If it's possible to add it, though, it might be useful as the actual DSM description is somewhat different from the ICD-9, separating out the inattentive, hyperactive-impulsive, and combined subtypes, rather than simply going with the inattentive/hyperactive-impulse dichotomy.

68.83.217.164Hyperion35

zametkin issue

First, the Zametkin findings in the article need to be clarified. The original study turned out to be sampling error. Above, in the discussion section, someone mentions this and then says that because they can't confirm it with Google, they deleted a previous comment to this effect. I would say that if you expect it to be found on Google, that's a bit silly. You will need to access PubMed or find some other way to actually read these articles.

The images are misleading also.

You're perpetuating a huge myth about ADHD because you are getting all your information from lay sources.

---

Do you have a source for your claim that Zametkin's original study (do you mean 1990? 1993? which study?) was due to a sampling error? Did he retract the study or its findings, and if so, could you please provide a citation for the retraction? Also, I think that the google remark may have been referring to http://scholar.google.com , a google engine that scours scholarly (and some not-so-scholarly) journals. That being said, a pubmed search for "Zametkin AND retraction" and "Zametkin AND retract" produces no results (and no, I did not use the quotation marks in the actual search, I merely use them here to separate the Boolean "AND" from the conjunctive "and"). A similar search of http://www.nimh.nih.gov also produced no findings. If the study or its findings were retracted, the retraction should have been published in the journal that originally published them, and should be available for citation. It is your responsibility to provide evidence for your claim that the study was in error or was retracted, just as it was originally the responsibility of those writing the article to cite the study itself. The study has been cited in the article, and will likely continue to be cited in the article until you provide evidence that it has been retracted.

Finally, the source for the PET scan image and its caption is cited as being the "New England Journal of Medicine", which was not a lay source the last time I checked. In fact, a large number of the citations, especially in the sections to which you seem to be objecting, appear to be from peer-reviewed scientific journals. Finally, what is this "huge myth" to which you refer?

68.83.217.164 10:48, 4 February 2007 (UTC)Hyperion35

New reading source

Rafalovich, Adam. 2004. Framing ADHD children : a critical examination of the history, discourse, and everyday experience of attention deficit/hyperactivity disorder. Lanham, Md: Lexington Books.

Buddyholly41 03:37, 1 February 2007 (UTC)buddyholly41  

External links spam

I've noticed there's been a lot of edit-warring over the External Links section, and yet most of the links there seem to be site promotion (WP:NOT#DIR). I think the entire section should go. Everything in there that doesn't better fit into the References section is going to be site promotion, "alternative" treatments, and general crap. --Boradis 23:28, 2 February 2007 (UTC)

Well, we should certainly keep the stuff from CDC, NIH, NIMH...with the rest, it's hard to tell. Some are clearly crap, and misleading as well (although that often seems par for the course when it comes to altie-woo), like that "ADHDAwareness" link, which claims to be "Help, support, and personal stories and experiences from an individual with ADHD[,]" but turns out to be a site giving out potentially harmful "medical" advice, along with what may be thinly veiled ads hawking supplements. The NESS articles are basically exercises in mental masturbation, although the "Defending ADHD" article isn't a bad explanation of many of the logical fallacies and myths that underly the so-called "anti-psychiatry" philosophy. The other one, "Why is someone called ADHD," is painful to read, starts off with an appeal to inappriopriate authority (his own, or lack thereof), and denegerates into several pages of quote-mining, false dichotomies, straw men, and sundry other logical fallacies. Mostly, however, I think that an essay that begins by stating "...I am not an acknowledged scholar of ADHD," is by its own admission inappropriate as a link.

Most disturbingly misleading is the "National Institute for Clinical Evidence" link, which does not link to their clinical guidelines, but rather to comments made on their clinical guidelines by a group calling itself the Critical Psychiatry Network. However, this is done in such a way as to miselead the reader into believing that this is actually the position of, or endorsed by NICE. Presuming that NICE operates under similar guidelines as its US counterparts, these comments are not peer reviewed and are certainly not presumed to be NPOV or even accurate. I have (in a professional capacity) submitted comments on clinical guidelines in the US, and know that such comments merely reflect the position of the relevant organization or medical subspecialty society, and are published as part of the public record. That NICE published their comments has no bearing on the accuracy or relevancy of those comments...furthermore, while I am not familiar with the "Clinical Psychiatry Network," the (tediously long[[Link title]) manifesto they have submitted includes links and references to the Scientology-supported "Death from Ritalin" website.

It should be removed, and if this "Critical Psychiatry Network" insists that we link to their comments, they can provide us with their own webpage or other source, rather than a link that misleadingly implies NICE endorsement of their views.

On the flip side, the "Information for anyone living with ADHD" link appears to go to the British pharmaceutical company that produces and sells Concerta in the UK (roughly analogous to the Adderall.com and Concerta.net sites here, I believe). I'm not sure if this also violates some rule somewhere. I'm generally skeptical of linking to the producers of any treatment, whether it's evidence-based medicine or altie-woo crap, on the grounds that if there's reliable independent evidence, it should be readily available from other sources (eg Pubmed, NIH) as well.

Hyperion35 14:44, 4 February 2007 (UTC)Hyperion35

I agree perfectly. ADHDawareness.com contains many not-so disguised advertisements, and doesnt belong on the page. And why does the bar at the top of the page say "Schizophrenia Guidelines" on the NICE:Comments on ADHDDa trout 20:31, 4 February 2007 (UTC)

If you check the peer-reviewed literature you will find that, indeed, he is correct.

zametkin

If you check the peer-reviewed literature you will find that, indeed, he is correct. You are constructing a page on a complex behavioral condition by reading *abstracts*....?

---

A: Please sign your posts, it makes things easier for everyone, especially those of us with short attention-spans.

B: To whom are you referring when you state that "he is correct"? Are you asserting that Zametkin (and/or his findings) were correct, or are you agreeing with someone on the talk page who asserted that Zametkin's findings were in error? Please be more specific.

C: "Peer-reviewed literature" is an extremely broad category, mind narrowing that one down for us? Are you referring to a specific study, a specific journal, a specific researcher?

Your statement is as abstract as any pubmed search (ba-dump-bump-ching!)

Hyperion35 22:47, 5 February 2007 (UTC)Hyperion35

Zametkin

The previous poster's point that the Zametkin study is mischarcterized is in fact correct.

You have posted these colorized pictures as if they show something real.

See Tyson (1991)

see Zametkin et al(1993)- in which he finds that cerebal glucose metabolism betwteen hyperactive teens and a control group are NOT significantly different.

And I don't have the followup for the original zametkin study but yes it is sampling error, oversampling of females I believe.

I don't mean any offense but writing a page like this without having access to a real library is going to result in many inaccuracies, biased towards lay understandinG.

````doofeydookie

zAMETKIN REFERENCE AND FIGURE

I edited the Zametkin picture from NEJM and put in the appropriate caveats. This picture belongs in this Wiki entry as an example of a well-distributed image that has been used to explain ADHD, but it seems reasonable to add enough information to give real context. If someone went through the stimulant treatment and other sections with a critical eye the would also have to reduce claims and be more realistic. Blingbling1000 19:17, 6 February 2007 (UTC)blingbling1000

---

I do not believe that you are very familiar with positron emission tomography (PET) scans. I have never seen a monochrome (black&white) PET scan. I do not believe that there is such a thing as a monochrome PET scan. PET scans are colored because they are measuring the strength of the photon emissions resulting from beta+ decay of the radioisotope tracer. There is a wiki page on Positron_Emission_Tomography that may be helpful. A monochrome PET scan would be completely useless, as the PET wiki page states: "The resulting map shows the tissues in which the molecular probe has become concentrated, and can be interpreted by nuclear medicine physician or radiologist in the context of the patient's diagnosis and treatment plan."

The entire point of the scan is to demonstrate the relative concentrations of the injected tracer, based upon strength of photon emissions. By definition, ALL PET SCANS ARE COLORIZED TO ACCENTUATE DIFFERENCES. That is the point of the PET scan. Do we mention in the caption of every photograph that it was converted from a photo-negative??? No, because it's redundant and pointless, and has no bearing on the content. It is not an appropriate caveat, it is an attempt to cast false aspersions on the veracity of the findings by making it appear as though the scans are exaggerated, when in fact they are not. I'll assume that this was an honest error, that you must have confused CT and MRI scans (monochrome) with PET scans (color).

Looking at Zametkin's findings, I have to wonder which one of us has ADHD here, because you guys are leaving out some fairly important points:

First off, the 1990 findings involved medication-naive patients, contrary to claims made earlier. With regards to gender sampling errors, the abstract quite clearly states "When the seven women with hyperactivity or the six patients with learning disabilities were omitted from the analysis, the results were similar." Now, maybe there was an error in the math deeper in the full text or something, but a cursory look seems to imply the exact opposite of your claim. Do you have a citation showing that there was, in fact, a sampling error in the 1990 study, and that there is a recalculation published in a respected peer-reviewed journal showing significantly different findings? If you do not, then please do not claim, without a source, that there is a sampling error involved, especially when the 1990 paper claims to have already accounted for gender and other statistical discrepancies.

Unfortunately, I cannot find Tyson's comments, are they the April 25, 1991 comments? I'll do some serious digging through my old university contacts to see if I can find it, but if I go to this trouble, it had better be good.

With regards to the 1993 study, I can only presume that your comments are intentionally misleading. Here are the results from that study: "RESULTS: Global or absolute measures of metabolism did not statistically differ between groups, although hyperactive girls had a 17.6% lower absolute brain metabolism than normal girls. As compared with the values for the controls, normalized glucose metabolism was significantly reduced in six of 60 specific regions of the brain, including an area of the left anterior frontal lobe (P < .05). Lower metabolism in that specific region of the left anterior frontal lobe was significantly inversely correlated with measures of symptom severity (P < .001-.009, r = -.56 to -.67)."

And yet the edits made claim that there were no significant differences found. This is not an accurate summation of these findings at all, but rather is intentionally misleading by conflating global values with local values. I also find it interesting that no mention is made of the fact that large differences were found in girls, although admittedly it is unclear whether 17.6% difference is statistically significant.

If you read those results, they are explicit in stating that although the differences were not statistically significant on the global scale, there were six specific regions, including at least one that has been implicated in many other studies, in which statistically significant metabolic differences were found. A P<.05 was statistically significant when I last took empirical stats. Further, that there is an inverse correlation between metabolism in that region and measures of symptom severity, and that this correlation has a phenominal P value, is very important information from this study.

I'm going to see what I can do to edit those edits to make them conform to the literature. I really want to assume good faith, but these changes reek of quote mining and factual inaccuracy.

Hyperion35 07:42, 7 February 2007 (UTC)

Revised Picture Caption

Almost forgot to write up the changes here, just for reference. The caption now reads:

"An early PET scan study found that global cerebral glucose metabolism was 8.1% lower in medication-naive adults who had been diagnosed as ADHD while children. The image on the left illustrates glucose metabolism in the brain of an 'normal' adult while doing an assigned auditory attention task; the image on the right illustrates the areas of activity of the brain of an adult who had been diagnosed with ADHD as a child when given that same task. Additionally, the regions with the greatest deficit of activity in the ADHD patients (relative to the controls) included the premotor cortex and the superior prefrontal cortex. [16] A second study in adolescents failed to find statistically significant differences in global glucose metabolism between ADHD patients and controls, but did find statistically significant deficits in 6 specific regions of the brains of the ADHD patients (relative to the controls). Most notably, lower metabolic activity in one specific region of the left anterior frontal lobe was significantly inversely correlated with symptom severity. [17] These findings strongly imply that lowered activity in specific regions of the brain, rather than a broad global deficit, is involved in ADHD symptoms."

I removed the part about color being added, since it's a PET scan and thus redundant. I added that the patients in the first study were medication-naive. I left in the part about failing to find statistically significant global differences in the second study but added that there were important differences in specific regions, including the part about correlation to symptom severity (which is really the most important part of the study). It might be a bit long, but at least it contains the main important information from Zametkin's 1990 study and the 1993 follow-up. Also, it should be remembered that Zametkin wasn't the only one to find imaging differences, such as the multiple studies showing excess DAT density (Dougherty et al and Dresel et al are listed, also several studies by Krause et al could be included in that). It's not just the one Zametkin study here, there's a long chain of evidence pointing to something odd going on involving dopamine and certain frontal lobe and associated striatal areas (and there are likely a few other regions involved as well).

By the way, a PubMed search for author Tyson between 1990-1992 returned 64 citations, but none of them were relevant to this discussion. As I mentioned earlier, there is an unsigned editorial in NEJM from April, 1991, but I can't imagine that this is the Tyson article to which you refer, as it is an editorial essay and not peer-reviewed research. I tracked down the link at NEJM, but there's no author listed.

Hyperion35 12:47, 7 February 2007 (UTC)

Any "caption" that's that long should just be another paragraph in the article. Then the caption can just be a few simple words, as captions are supposed to be. --Boradis 20:00, 7 February 2007 (UTC)

I agree with you wholeheartedly, but as I look at the history of the page, every time it gets shortened back to a few words to just describe what it is and where it's from, some jokers immediately start adding in weasel wording and complaining that the picture is misleading, which then necessitates even longer captions. Look, I'd be happy with just:

"This PET scan was taken from Zametkin's landmark 1990 study, which found lower glucose metabolism, in the brains of patients with ADHD who had never taken medication. Scans were taken while patients were engaging in tasks requiring focused attention. The greatest deficits were found in the motor cortex and superior prefrontal cortex."

The problem is that you get people who start objecting and adding things to it...although this is the first time that I've ever heard people complain because a PET scan was colored. Geez.

Hyperion35 06:06, 8 February 2007 (UTC)

As a former newspaper and magazine editor, let me just say that bloated captions offend me in a semi-religious way. :) Seriously though, how about a subsection of the article that's just about the photo that says what needs to be said, and the caption can just be the image credit: "Zametkin, et. al, 1993" or whatever. --Boradis 00:47, 10 February 2007 (UTC)

That sounds great. As a policy analyst, having to summarize complex findings into an extremely short caption offends me in a semi-religious way as well (shhh, we aren't technically supposed to have emotions or get offended)  :). I think that the section on brain scans could probably be greatly expanded. It could include basic discussions of the technology involved and how it is used, as well as in depth discussions of Zametkin's findings as well as some of the newer SPECT findings. Some of the SPECT studies comparing activity on and off medication are really interesting. I think it would also be nice for the section to clarify what these results mean, and the limitations involved.

Additionally, it would be kinda cool to tie these in with other fields, like discussing how these results are changing how researchers view the neurological issues involved in attention and executive functions in general or as presented with other conditions. ANPA (American Neuro-Psychiatric Association) published a great paper on the role of Executive Functions in clinical research:

Royall D, Lauterbach E, et al: Executive Function, a Review of Its Promise and Challenges for Clinical Research; J Neuropsychiatry Clin Neuroscience 14:4, Fall 2002

Should be available in full text on their website, unfortunately I've lost the link. I think it's important to underscore the point that these findings aren't just happening in a vacuum, and that they both involve and effect advances in many other areas. Reducing these results down to pointless debates over the role of medication ignore the far more interesting role that these findings play in unlocking some very interesting secrets of the mind.

Hyperion35 02:00, 10 February 2007 (UTC)

Hippocrates

HAHA that bust of Hippocrates is funny! You guys really take yourselves seriously don't you? {{subst:ungisned|60.229.242.69}}

ADHD Contoversy

I think that the controversy surrounding ADHD should comprise at least half of the article! This change should be made, to reflect the actual status of the matter ! --The preceding unsigned comment was added by 60.229.242.69 (talk o contribs).

We did one better than that, we gave it it's own article called Controversy about ADHD. -- Ned Scott 06:06, 8 February 2007 (UTC)

No, There should be as much of the article dedicated to wether this exists, and skepticism about it, as on an article about UFOs. A seperate article should not suffice. --The preceding unsigned comment was added by 60.229.129.192 (talk o contribs).

Sorry, that's not how things work here. Go troll somewhere else. -- Ned Scott 11:05, 9 February 2007 (UTC)

Well, we could always apportion it out based upon the percentage of published peer-reviewed research supporting both contentions. By my estimate, the "controversy" section might merit an entire sentence in this article, and even that would be rather generous.

Hyperion35 02:25, 10 February 2007 (UTC)

OK, we should change the phrenology article based on that.

Comorbility

I think that there should be a whole chapter about comorbility in ADHD since its known to be very commonly associated to many different syndromes such bipolar disorder (see articles of Biederman), learning disorders; drugs and alcohol abuse;antisocial behaviour... and quite some others (even more risk of having brain injuries or car accidents) This problems are crucial both in the diagnostic procedure and for the outcome of the patient. Does anybody agree? --Garrondo 19:17, 8 February 2007 (UTC)

zametkin and other stuff

wow i can see why some people get frustrated with this page.

-a PET scan being colored is not redundant, based on how it is colored, it can make the differences look more and less striking.

- the revised caption to the Zametkin illustration certainly demonstrates the bias of those who are commited to keeping this page shaped towards sloppy non-significant evidence

---

Ok, but the caption edit that was made before claimed that the original scans were monochrome, and that they were given color to magnify the differences. This is incredibly misleading, as all PET scans are colored, because the entire point of the PET scan is to highlight differences in signal intensity. It is not an MRI. Now, the study itself reported that it found statistically significant differences in the data. Given these findings, it should not be surprising if the scans themselves show differences. Do you have any evidence, aside from unsourced assertion, that the image used is falsely magnifying the differences as found in the study? Do you have any evidence that the image used is colored in a manner not consistent with generally-accepted PET protocol? Do you have any evidence that the differences highlighted in the image are well within generally accepted norms for PET imaging? If you have some evidence to show, then perhaps it might be worth including in the article, but do you really expect that people are going to remove or alter a widely accepted published peer-reviewed article based upon unsourced assertions by an anonymous poster? Even by wikipedia's admittedly lax standards, that's a bit of a stretch.

Also, how was my revised caption biased, and what "sloppy non-significant evidence" was involved? I cited Zametkin's 1990 study as published in NEJM, and his 1993 study as published in the Archives of General Psychiatry. Both are well-respected peer-reviewed scientific journals. I also only mentioned findings that were considered statistically significant. I do not know how you can call findings with P values of .05 and .001-.009 (from the 1993 study) "non-significant," as these are the statistical values that specifically measure the significance of a given finding. In fact, the P values of .001-.009 encountered in the findings of correlation between specific frontal-lobe deficits and symptom severity are phenominally solid.

Hyperion35 01:36, 10 February 2007 (UTC)

yes

yes the caption on the Zametkin photograph is misleading. They found statistical signifcance by lumping all the brains together and doing in aggregate statistical analyses. Individual comparisons found NO DIFFERENCES!!!!

---

Errrrm, no. Presumably they found some differences between individuals, as any brain imaging will find at least some differences between individuals. The entire point of performing aggregate statistical analysis is to figure out which differences are statistically significant and which ones are meaningless. The whole point of using multiple patients is to analyze the data of the group rather than comparing a few individuals, thus minimizing the effects of random variation and hopefully finding significant differences between the two groups if they exist. That's the whole point of the phrase "statistical significance." First you claim that the lack of statistically significant aggregate differences in global metabolic levels is an important finding (and I agree, albeit for different reasons), and now you claim that aggregate statistical analysis gives misleading findings. Well, which is it? Also, I have seen no mention in the literature of "individual comparisons," just about every study discusses statistically significant aggregate differences (for the reasons I just mentioned), so could you please provide a citation for your claim that there were individual comparisons made that found no differences?

This is an encyclopedia entry, it ought to be based upon published medical research. This research was published in NEJM, which is one of the oldest and most respected medical journals in the world. I understand that you disagree with these findings, and I understand that you believe that this is somehow misleading, but you have not actually cited anything to back up your claims. Zametkin's studies are not the only ones that have found significant differences between ADHD and non-ADHD patients on imaging scans. Krause and others have found significant differences in frontal-lobe dopamine uptake on SPECT scans:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16894328&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16861140&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16839567&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16616981&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16479247&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16139732&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16091862&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15486990&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=14624805&query_hl=1&itool=pubmed_DocSum

I could go on, but you're beginning to get the picture here. These are all studies that are going one step further than Zametkin's early pioneering works. They've gone from showing broad differences with PET scans into using far more sophisticated SPECT (single-photon emission computed tomography) scans to look at specific neurophysiological differences in dopaminergic activity, which is a logical place to look given that all known ADHD medication have an effect on uptake of either dopamine or it close chemical relative (and metabolite) norepinephrine. The reason why Zametkin's 1990 study is so widely discussed is because it was the landmark study that first showed statistically significant differences. It is also a broader study that is perhaps easier to comprehend for lay individuals than disussions of dopamine transporters and uptake activity. In a basic encyclopedia article, it makes sense to refer to the first major study to demonstrate differences, and then include links to more information, but perhaps including this in the main article would be helpful since some individuals seem to believe that there hasn't been any progress in this field in 17 years.

Xavier Castellanos has an interesting commentary piece in the Journal of Nuclear Medicine comparing several SPECT studies and discussing the limitations of the technology and of testing in general. He also has concerns over statistical validity and sample sizes, but notice that he actually cites data, and acknowledges that many of these difficulties are difficult to surmount (such as finding adequate control subjects). It is a very interesting look at how far brain imaging has advanced since Zametkin:

http://jnm.snmjournals.org/cgi/content/full/43/12/1630

Hyperion35 01:13, 10 February 2007 (UTC)

zametkin diagram

for this to be accurate it should be noted that although the picture shows the brains that look 'different', you cannot compare two brains and tell which one has ADHD through this imaging- there is significant overlap between ADHD and non-ADHD brains. It seems to give the misleading impression that this is like comparnig a brain with MS versus one without MS- and it is nothing like that. if you show individual brain scans to a neuroscientist, he can't tell you who has ADHD and who does not. when he does aggregate statistics, he finds some statistically signifcant differences may arise (along with significant overlap in many cases)- which leads to the question, does this picture accurately reflect the true situation?

That information is in the 'Brain Scan' section. Also, it seems quite likely that each of those "brains" is actually an average of all the brains in each group, rather than being an image of a single participant. --Limegreen 00:30, 12 February 2007 (UTC)

I think that it should only say that this image is an average of the different brains in the study; since its alredy said in the diagnosis part that no imaging method can right now say if a person has ADDH. I do think that this picture doesnt have less value because of this: it means that the brains of the people with ADDH as a group are different from those that doesn´t have ADDH and consequently their brain probably works in a different way; and this is an important fact for itself. Of course it would be much better if just by an image scan we could say if a person had ADDH, but this doesnt make the Zametkyn study less important --Garrondo 11:47, 12 February 2007 (UTC)

Before we change the caption, let's see if we can get a definitive citation on whether these are comparisons of two individual PET scans or a comparison of composites or averages of the two groups.

Hyperion35 14:47, 12 February 2007 (UTC)

CAN ANYBODY GET THE ORIGINAL ZAMETKYN ARTICLE SO WE CAN FINALLY CHANGE THE CAPTION?--Garrondo 10:18, 13 February 2007 (UTC)

Yes, a colleage will be sending me a copy within a few days. If my fax machine were working, I'd have it by now, but for now we'll just have to trust the good old USPS.

Hyperion35 16:49, 14 February 2007 (UTC)

DISEASE

the definition of a disease would be an entity that can be shown via some sort of objective imaging, dissection, or pathological examination to exist within an indvidual. NO other diseases are thought to be real through GROUPS of people being examined. it's ludicrus.

---

Ummmm, no. Almost every disease is discovered through groups of people being examined. And many diseases do not involve imaging, biopsies, or other pathological testing. Even when they do, labwork is not and cannot be the sole component of any diagnosis. This isn't CSI. The main diagnostic technique in many medical fields is still the Differential diagnosis, for which imaging or pathological testing can sometimes be an important component. Just to give you an example, MRIs and autopsies have shown that persons with Alzheimer's Disease have damage to the cholinergic neurons in the hippocampus, which is thought to be caused by a buildup of beta-amyloid plaques that are found upon autopsy. This has been discovered through testing GROUPS of persons with Alzheimer's, and finding that on average, they have more damage and more plaque buildup than persons without the disease. However, there is no clinical imaging or blood test that can test for Alzheimer's disease. There are tests that can be done to rule out other possible problems, such as a brain tumor, stroke, vascular problems, etc, which can aid in the diagnosis, but nothing that can test FOR Alzheimer's disease. According to the Wiki page on Alzheimer's disease:

"The diagnosis is made primarily on the basis of history, clinical observation and tests of memory and intellectual functioning over a series of weeks or months, with various physical tests (blood tests and neuroimaging) being performed to rule out alternative diagnoses. No medical tests are available to diagnose Alzheimer's disease conclusively pre-mortem. Expert clinicians who specialize in memory disorders can now diagnose AD with an accuracy of 85-90%, but a definitive diagnosis of Alzheimer's disease must await microscopic examination of brain tissue, generally at autopsy."

Aside from the autopsy part, every other part of that paragraph could just as easily diagnose ADHD. So, is Alzheimer's disease not real? Is Alzheimer's disease ludicrous?

If this post is a good example of the extent of your medical knowledge, perhaps you should do some more research before suggesting changes to this (or any other) medical page.

Hyperion35 15:02, 12 February 2007 (UTC)

---

if the definition of a disease had to be "an entity that can be shown via some sort of objective imaging, dissection, or pathological examination to exist within an indvidual" diseases would have only existed the past 100 years since no objective method had been invented yet. Your deffinition would make depend the acceptance of diseases of advances of technology; thankfully we are capable of describing a disease before havin objective methods (which doesn´t mean we won´t have them in the future) --Garrondo 17:45, 12 February 2007 (UTC)

ADHD a ludicrous disease?...no silly it's a disorder

How come the word disease keeps on getting interjected into the discussions about ADHD? It is not called Attention Deficit Hyperactive Disease. Some people must be reading Fred Baughman of "ADHDFRAUD.COM" fame. He uses the word disease often with regards to ADHD. He does this so that he can then state, if it's a disease where is the blood test for ADHD? Well Fred, it's not a disease, there is no pathogen, it's genetic. Fred works for the CCHR and it's his job to discredit ADHD as a concept.

Studies using DSM4 list of criteria it has been determined that the heritability of the disorder is 97%. Michael Goldman had this to say about Steadman's definitions of the words disease and disorder. His interpretation of these ideas seem logical and fits in with the genetic theory of ADHD.

Steadman defines a disorder as a disturbance of function, structure, or both resulting from a genetic or embryologic failure in development. This is an extremely important point because when we, as doctors, think about a disorder, we're saying something is wrong. We can't define it, we don't know what it is but something went wrong either before birth or in genetics and you have a fixed entity that's not a disease process.

Steadman's Dictionary defines disease as an interruption or cessation or disorder of bodily functions, system or organ illness, morbus, ill, sickness. A morbid entity characterized by at least two criteria: a recognizable agent, an identifiable group of signs or symptoms, or consistent anatomical alterations. Literally, disease means something is wrong with the body.

--scuro 04:49, 13 February 2007 (UTC)

Well said. -- Ned Scott 06:38, 13 February 2007 (UTC)

disease

the first paragraph of this entry refers to the 'neurological pathology' of ADHD. pathology is the study of human disease. for instance you can biopsy the brain of someone with MS or alzheimers and find pathological evidence of neurological disease. this isn't possible with ADHD and the brain will appear normal aside from perhaps morphological changes due to long-term psychostimulant use. hence no actual pathology. hence no disease. hence much of this article is overblown and biased with everything slanted. the caption for the zametkin pic is a good example.

alzheimers

the point above about alzheimers misses the point entirely. on post-mortem you can find pathology in an alzheimer's brain. an ADHD brain on autopsy looks COMPLETELY NORMAL!!!! everyone should know this. this should be in the main text of the article.

the DSM states this, there are no laboratory tests or findings that can identify ADHD. why isn't this in the main text of the article since the DSM defines what ADHD is? --Preceding unsigned comment added by 146.201.100.221 (talk o contribs)

Ok, one major reason why an autopsy is not a good way to look for ADHD is because there is usually a very long time between the onset of symptoms and the post-mortem autopsy. Alzheimer's is (almost always) a late-onset degenerative disorder that strikes late in life. Because the deficits increase over time and because the patient usually dies a few years after the symptoms become severe, it is easier to find on autopsy. With ADHD, you have a developmental disorder that presents first in childhood. As most patients have a normal lifespan, it is hard to tell on autopsy what differences might be due to ADHD and which are simply the sequellae of 70+ years of life.

That being said, the SPECT studies to which I have linked earlier found physiological differences in ADHD patients, and some of these studies were using medication-naive patients. This is in addition to Zametkin's studies showing different brain activity in medication-naive patients. The vast preponderance of the evidence strongly implies that the disorder is due to physical differences at the cellular level that affect how neurons in certain regions of the brain communicate with each other.

Also, I think you misunderstand the importance of what I mentioned regarding Alzheimer's: There is currently no laboratory test that can identify Alzheimer's disease while the patient is still alive. In general, physicians like to treat patients while they are still alive for obvious reasons. Thus patients are diagnosed with Alzheimer's disease, and given medication, based upon physical examination, patient history, observations of cognitive abilities, etc, JUST AS IS DONE WITH ADHD! The point that I am attempting to make here is that current diagnosis and treatment of ADHD is done in a manner no different from that of Alzheimer's disease. A differential diagnosis based upon patient symptoms, history, and observed behavior and abilities is a perfectly acceptable and common method for diagnosing and treating medical problems, so your objections on this point are irrelevant unless you are also criticizing the diagnosis and treatment of a number of other unrelated and relatively non-controversial diseases.

Hyperion35 17:08, 14 February 2007 (UTC)

there is no pathology, no disease...ADHD is a disorder

I have eliminated the term pathology in the text of the article. Researchers do not use that term when discussing ADHD. Russell Barkley said this about ADHD and pathology. "AD/HD is not a pathology, it's a trait. There is an AD/HD trait in the population. It's called self-control, and AD/HD represents the lower end of that trait". Lets look at the disease model. WIth a disease there is something which causes the disease and that thing is called a pathogen. There is so single cause of ADHD, there is no environmental cause which could lead us to the conclusion that it is a disease. Furthermore, the DSM4 defines ADHD as a disorder, hence the classification of the condition as a "disorder". That point seems like a no brainer to me. I haven't foggiest idea why anyone would call ADHD a disease unless they were confused or purposely wanted confuse people which we see with propaganda.

146.201.100.221, you are right, we can not look at a single brain, do a single lab test or brain scan and conclusively say that this person has ADHD. No one denies this. Does this mean that one can infer that the condition and the article is "overblown", "biased", "slanted"...and in Fred Baughman terms...a FAKE and a FRAUD? No, not at all. If we believe one disorder is not real because we can not measure it, then what about all the other disorders? Are they all not real also? Does this mean that Epilepsy, Schizophrenia, Bipolar, and Tourettes...are all FAKES and FRAUDS? Anti-psychiatry people and the CCHR would want you to believe this. They would blame ALL abnormal behaviour on some adolescent personal trauma. They would say he is twitching because his dad never loved him. They simply see the behaviour as a reaction to a negative environment. The scientific community doesn't see it this way nor do any any of the National medical associations of America like the Surgeon General. Nor do parents who live with anyone who has those conditions. But that neither here nor there...for the article we simply need to know that ADHD is seen as a disorder, end of discussion.

--scuro 21:24, 13 February 2007 (UTC)

Scuro, Wikipedia is not a soap box. This has continuously been told on this page to opponents of the ADHD hype. But you, Ned and a few other defenders of ADHD seem to use this article as a support group for those who have been diagnosed with ADHD. When it comes to objectivity, is it a good thing that the article is mainly written by the ones having this ADHD label? The anti-psychiatry people and the CCHR do not blame ALL abnormal behaviour on some adolescent personal trauma. I do not need to ask for a source because you know such statement is made to throw sand in the eyes of the readers. You keep referring to traumatic causes as 'a father who never loved his child'. This is oversimplifying in the extreme, if not untrue.

You also keep referring to the majority of the mainstream science backing up ADHD as a real disorder, with genetic causes, without giving a source. Where is the research done that someone read and investigated (meaning separating pharmaceutical propaganda from real science) all AHDH related science? I'm sure that 600 years ago, the majority of the establishment would dearly defend the Earth being flat. In other words, the majority of science is not an argument for the truth or validity of the outcome. After all, most scientists like to keep working as a scientist and are being paid mostly by the industry. Plenty of examples of scientists who ended up with negative outcome, got fired or whose funds were stopped. Science shouldn't become a religion in which you try to explain every single aspect of that great and wonderful mystery called human. (Immortale 11:15, 14 February 2007 (UTC))

Ok, a lot of this is rather irrelevant to the discussion of this page. The general issues related to modern scientific research and funding is better left for the editorial pages of JAMA. What is relevant here is Wikipedia policy regarding medical articles, which states that sources should be from respected peer-reviewed journals. Now, if you have a specific objection to the papers cited in this article, that's certainly relevant to the discussion, but complaining about the reliance on published papers or complaining about the general state of the scientific publishing community is a pointless attempt to confuse the issue.

As for persons with ADHD contributing to this page, I do not see why this is either objectionable or abnormal. Surely cancer survivors have contributed much to the various cancer pages. I seem to remember reading a number of additions to pages on deaf issues written by those with hearing impairment. I'd imagine that a number of medical wiki articles involve contributions from those afflicted, as they are often the lay persons with the most extensive knowledge (not by virtue of having the condition, but because some patients tend to do a lot of research), and medical professionals are hard to find and rarely have time to contribute to wiki (I myself am only able to contribute because I am currently unable to work due to serious health problems).

As for non-pharmaceutical funding for research, much ADHD research is funded through the National Institute of Mental Health (NIMH), which is a branch of the National Institutes of Health (NIH). For instance, Zametkin's 1990 study appears to have been funded through NIMH. The famous MTA Study that showed that medication was the most effective single treatment option was also funded through NIMH. The link on this article to the OMIM information of the genetics of ADHD references a number of studies showing possible genetic causes. I picked one of the studies cited at random:

[13]

This study looked at genetic differences between sibling pairs where one had ADHD and one did not. One really basic finding was that the differences found between affected and non-affected siblings were consistent across a decently large sample size. A far more interesting finding is that one particular genetic difference occurred in a region that is also implicated in autism. Some autistic persons are known to have symptoms of inattention and hyperactivity, and the comorbidity rates between the two disorders are orders of magnitude higher than would be expected by chance alone. Thus, this finding is especially interesting because it fits with prior findings and explains a number of unanswered questions about comorbidity rates and common symptoms.

Oh, and this study was also funded primarily through NIMH.

The funds for NIMH, as with all NIH grants, come directly from the federal government. NIH is part of the Department of Health and Human Services (HHS), a cabinet-level department that is generally considered to be one of the more non-partisan branches of the government. Pharmaceutical companies really don't care to fund much research beyond that required for the approval of their medications. Studies on aetiology generally don't attract their interest, and neither do studies looking at medications that are available generically...there's simply little profit motive there. Contrary to popular belief, most of the research on ADHD is publicly funded, generally through NIMH.

Hyperion35 17:56, 14 February 2007 (UTC)

Ahhh the irony, Immortale pushes me off the soapbox, and then stands up there to preach and judge!

As someone with ADHD I'd say I have added insight that those who have never had ADHD or taken ADHD medication will ever have. I also have the experience of having two daughters with the disorder and of working with ADHD children everyday. One could literally say that my whole day has focused on ADHD for over a decade. One could make the argument that this insight and experience is subjective and I would buy that. But I seek evidence first and then compare this evidence to my observations and my own personal experiences. In a nutshell I have read a great deal on the disorder. If all this information gels together then I personally see this as a truth or a falsehood. For example I have come to the conclusion that Breggin's contention that ADHD medication shrinks brains/causes mental dsyfunction is false. I have read the literature, and observed students, my own children and my own abilities and behaviour. Nothing would lead me to believe that Breggin is correct. Bias again? Wikipedia has said, "we all have bias", and that would include you. None of this matters though because I do what I consider to be a very good job of sourcing my edits on the main articles. I offer no original research. I may talk more freely on the discussion page but it's a different story on the articles where I take my edits very seriously and try to be fair and make the articles balanced.

If I get carried away a bit in discussion, it's because there are some really brash and sometimes faulted contentions made on this page. These contentions literally beg for correction when someone makes broad sided and misguided attacks on the whole article or sections of it. What is wrong if I illustrate why the article is correct and point out the failure in fact or faulted history of reasoning in the criticism?

--scuro 21:46, 14 February 2007 (UTC)

On a general basis, I would say that it isn't surprising that any one person with a huge amount of childhood repression and denial, has children who have been given the dignosis ADHD.

Momo2 17:13, 18 February 2007 (UTC)

Attend

Under the subheading of homeopathic alternatives, it reads

"Many alternative treatments have been proposed for ADHD. An example would be the homeopathic treatment "attend".

"Attend" appears to be a very specific 'alternative remedy' and unless it can substantiate itself in a reputable journal we shouldn't pass itself off as an example. If someone is searching for herbal alternatives to ADHD it would seem to be misleading to present "attend" - one might infer that it was more effective than other herbal supplements or that it was used more frequently. It may well be, but someone would have to support that idea with a credible citation. --Substantiate 10:29, 15 February 2007 (UTC)

I agree, there´s no place for this sentence in that part of the article unless it was one of the most used alternative remedies. I procceed to eliminate it. If anybody thinks it should appear he would have to bring some kind of proof of its use; and even then it shouldn´t appear in that place; since its the introduction to the alternative treatments and there´s no need for examples there. (there are plenty of them afterwards)... It sounds like advertising to me.

adhdmymm

My son who is ten has adhd but is also violent with it he is on ritalin.where does the violence come from we are at our wits end he runs away and smashes the house up and the windows refuses to do school work attacks other children at school attacks me his sister and step dad hardly sleeps please help susan forrest --Preceding unsigned comment added by 81.97.196.141 (talk o contribs)

I'd go to ADDforums if you want advice from other parents about Ritalin, it has a large community. If he is smashing up your windows and wrecking your house only on Ritalin it would be advisable to stop the medication but please get an appointment with your Dr. as soon as possible.

This talk page is more improving the ADHD article.

--scuro 04:26, 20 February 2007 (UTC)

Ive created a subpage <here> if you want to ask questions. - I may be of some help. thuglas<sup>talk|edits</sup> 03:18, 23 February 2007 (UTC)

Source of the article : Wikipedia