Talk:Attention deficit hyperactivity disorder

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Information on genetic causes

was added (by whom?). Also, a short article on non-genetic causes. User:MichaelG

source: NIH

Much of the material in this article is taken from public domain NIH text from http://www.nimh.nih.gov/publicat/adhd.cfm and was written in cooperation with the editors of ADHS.info, the info base for ADD/ADHD.

Thankx

Thanx for the good co-operation. It would be cool to get in contact with each other. I suggest my black board at ADHS.info (it is called "mADDelirium", the board).

merge articles

There appears to be an article at Attention Deficit/Hyperactivity Disorder; these two should be merged. Jeronimo

done. Vaoverland 11:51, Apr 3, 2005 (UTC)

ADHD

http://www.ninds.nih.gov/

http://groups.yahoo.com/group/ADHD_Bulletin_Board/

http://www.nimh.nih.gov/publicat/adhd.cfm

The symptom of inattention can also be associated with some types of epilepsy (petit mal, absence, and so on). The meds used to treat ADHD and the meds used to treat epilepsy are different than one another.

Feingod Diet

Anyone object to a mention of the Feingold diet[1], which seems to be supported by a good number of careful medical studies? Graft 22:06, 29 Aug 2003 (UTC)

RESPONSE: References to medical studies about diets may be in order, but IMHO references to any one diet would be out of place here.

pharmacological treatment

Are some of the passages about pharmacological treatment (e.g. "this is often bypassed so the child can be medicated more quickly") POV, or am I just in a bad mood and reading sardonicness where none is intended? --Calieber 22:21, Oct 27, 2003 (UTC)

RESPONSE: Glad you asked. On Oct 28, some sentences that were both questionable and unsourced have been revised.

differentiation between ADD and ADHD

Personally, I think that there should be a differentiation between ADD and ADHD. I have ADD, but I'm certainly not hyperactive. Maybe a small comment would be appropriate in the first part of the article? - Pingveno 04:02, 18 Dec 2003 (UTC)

can you make differentiation between two fictional ideas? — Anonymous

Can you make a point without begging the question? By doing so, you make it plainly obvious that logic and reason are not something you are interested in. You want to be witty so you can feel better about your pathetic world view. The fact that some of us actually have to deal with the symptoms of this disease on a daily basis is enough of a burden; having to deal with the crass insolence of those like yourself only adds to our daily frustrations. If you have a valid concern regarding the over-diagnosis of ADHD in children today, then speak up. If all you can do to defend your opinions is invoke logical fallacies, then shut the hell up. — Darco 17:48, 13 May 2005 (UTC)[reply]

So, why does Attention Deficit Disorder redirect here? It's not the same as ADHD.

I was told the DSM merged the description of ADD with ADHD, as there was some sort of consensus among psychiatric practitioners that ADD should properly be considered a subset of the broader malady of ADHD. That is likely the reason why searching for ADD redirects to this article. —Ryanaxp 14:23, August 2, 2005 (UTC)

are my writings autobiographical

Re: The guidelines for writing articles which could be construed as being "autobiographical...In 1981, very little was known about Hyperkenesis. The subject was, and remains of utmost interest to me as my first son (born 1965) was diagnosed as being hyperkenetic. As a result, I chose this subject for a thesis paper in college (1981). I researched extensively, finding little I could use authoritatively, along with my own personal experience. My professor found it highly informative as did my classmates. My question is: would my findings and experience be appropriate for an essay on this subject? (user: Glenboy)

Q: percent link

Why is "percent" a link in the beginning of the article? That seems distracting (haha). -Steve

Moved paragraphs

These paragraphs have been moved from the Psychological testing section. All three deal with treatment rather than testing and so do not belong in the section to which they were added. I would have moved them elsewhere if they were not so vague. The general point that there is disagreement about ADHD is made elsewhere in the article.Peak 07:13, 23 Mar 2004 (UTC)

As attention deficit disorder, and ADHD are being researched there are many new developments on the horizon for the treatment of ADHD.

Treatments for ADHD/ADD are many and varied but tend to be working in two major arenas of medicince, chemical western medicine, and natural eastern medicine.

People with ADD/HD have certain symptoms that are noted by the DSM in our western medicine arena, and they are a discription of what ADD/HD is. Some disagree with the DSM and therefore the diagnosis is based on interpetation by many doctors, so one may derive that the DSM is not an authority on the many ways of treating ADD/HD.

Removed coping/curing via spirituality paragraph

The following edits were removed. See below for why.

Practice of Buddhism is a behavioral change that can cure ADHD.

Some people have noticed that certain spiritual practices can help reduce ADHD symptoms, for example, meditation. One commentator observed that the practice of Buddhism was a "cure" for ADHD symptoms. While that is undoubtedly overstated, it spirituality may hold keys to positive coping and adaptation to ADHD. Another person with ADHD found that a positive view of self, life's purpose, and relationships learned through the practice of Christianity was helpful for coping with ADHD together with appropriate use of medication.

"Practice of Buddhism" seems too general - which practice? which Buddhism? Is there a reference? The NPOV additions promoted a wikipedia editor to a "commentator", and added another presumably individual spiritual endorsement. Coping via Christianity seems too general for this article alone. Perhaps these comments could be merged into the Christianity topic. --Zigger 18:12, 2004 May 7 (UTC)

Skepticism

One of the most common skeptical points of view is that ADHD behavior is a result of bad parenting and not enough discipline, and many doctors have supported this theory. Some also say that increased ADHD behavior is caused by societal practices which encourage short-attention-span behavior, with television and video games often used as examples.

This text was under the heading "skepticism about ADHD as a diagnosis." However, this is not skepticism about the diagnosis, but a theory about the CAUSE of ADHD. Also, it's not backed up by any citations whatsoever. For now, I have removed it, until the evidence in support of it is better cited. (After all, "some" also think that ADHD is the result of sun spots and alien abduction -- we need research in order to support these claims.) — Adam Conover † 21:46, May 10, 2004 (UTC)

Section changes

As well as adding sections for history and "other controversies", I've changed the sequence of the sections "Treatment", "Skepticism towards ADHD as a diagnosis", "Psychological Testing for ADHD" to be Testing, then Skepticism, then Treatment -- which seems to be a more natural progression. --Zigger 18:56, 2004 Jun 10 (UTC)

Caps?

Why are all of the words in "Attention-Deficit Hyperactivity Disorder" capitalized in the title of this article? That is not done with, for example, hyperkinetic syndrome, where that is mentioned in this article. Normally on Wikipedia we do not capitalize initial letters merely because they're in an article title. Michael Hardy 20:46, 15 Jun 2004 (UTC)

Because the name of the disorder is generally given as "Attention-Deficit Hyperactivity Disorder", not "attention-deficit hyperactivity disorder". You might want to check here, or here. Since the capitals are considered part of the correct name of the disorder, they are used in the article's title. -- Antaeus Feldspar 08:00, 1 Dec 2004 (UTC)

Country specific view of drugs

The list of the drugs available for ADHD in this article is American specific. What drugs are available and what type of restrictions there are on them vary from country to country. In Canada Ritalin is the equivalent of non restricted, Dexedrine (dextroamphetamine...Australians often call it Dexamphetamine) is controlled but nowhere near as strictly as in the US. On the other hand until recently those were the only two stimulants that could legally be prescribed. A slow release of Adderall was recently approved in Canada. Desoxyn and such are not available for prescription here.

The result can be kinda perverse at times. It is not that hard to get a Rtialin prescription if there seems to be a problem (I have adult add that was covered by an anti-depressant and child add before that ---but when i had to change the anti-depressant because it wasn't working it became apparent that it was a problem again[actually the anti-depressant worked better for add than depression]...my doctor was willing to give me some Ritalin until i found a specialist but would not prescribe dexedrine because it was controlled---and i had a history of a bad reaction to Ritalin). However if Ritalin doesn't work it can be difficult to get the alternatives. Part of that is because by our law Dexedrine (for example) can only legally be prescribed for someone with ADHD, ADD or narcolepsy. In summary from what i see discussed it is initially somewhat harder and definetely more inconvienient to get Ritalin or other stimulants in the US, but there seems to be less focus on drugs other than Ritalin being inherantly more difficult or dangerous (they haven't generally shown to be in any studies i see up here)--Marcie 19:52, 3 Oct 2004 (UTC)

To expand on the drug situation in Australia, Adderall is not available in Australia because of reports of it inducing SID.--cheese-cube 07:21, 9 Jun 2005 (UTC)

Concerta as a treatment option

I have ADHD and i am currently using the drug Concerta to treat it. Concerta is an extended realse drug which means that the pill disovles slowy through out the day to elimient the peaks and vales in coverage that happen when taking ratlin. I also take ratlin in the moring so that the Concerta has time to take effect. I would like to add Concerta to this page but i am not quite sure how to do that. would someone please help me or just go ahead and add Concerta. Thanks -578 a new user

Also using Concerta and the same diagnosis and to answer your question about how to add sometime here is the link to it How to edit a page. Goanookie 20:27, 25 Dec 2004 (UTC)

causes

Could we put in something regarding treatment opinions being somewhat different from country to country...in Canada norephefine is often viewed as importantly as Dopamine...i know in my case Dopamine doesn't make a hell of a lot of difference, but the norephenefrine DOES. Generally the dopamine is what causes my tics....how do i know...experimentation with different anti-depressants to see if they helped...the one's with Norphenefrine (mispelled) seemed to make a bigger difference...although the dopamine might help.

I've seen very contradictory stuff on the Omega fatty acids...ranging from works doesn't do a thing. Could be an individual thing again. I take them for other reasons i haven't noticed a bit of difference in my adhd, although my body feels like it has a better balanced diet now and i think i can see a bit of a difference in my hair...and i've been taking them since May!...--Marcie 19:51, 27 Oct 2004 (UTC)

not always a bad thing

A book that has impacted my whole life When I was a teenager, I first read The Virginian Railway, written by rail historian and photographer H. Reid, a Norfolk native. He combined the usual information about locomotives and rolling stock customarily found in railroad books with the business strategy of the two founders of the VGN, who were each fascinating men with seemingly endless ideas and energy. These days they may have been diagnosed with Attention Deficit Hyperactivity Disorder!

Reid's storytelling writing style included many stories told by former railroaders, who came to be very loyal to the VGN, which paid its employees and vendors a little better than absolutely necessary. The building of the railroad was a story of little business winning over big business. It was built to the highest possible engineering standards, was enormously profitable, and operated an amazingly wide range of innovative equipment.

The Virginian Railway enthralled me and has impacted my life, career, and hobby interests greatly in the 40 years since I first read it. I have 3 copies of H. Reid's epoch book, including a rare first edition, which has the best quality photographs. I still enjoy re-reading it (as do many other Virginian Railway enthusiasts I have been told).

I also want to say that anyone who thinks they have ADD or ADHD or whatever should read Driven To Distraction. I would compare reading this book at age 44 to having a car and finding the owners manual in the glove box after you turn the first 100,000 miles!!! Vaoverland 12:25, 16 Nov 2004 (UTC)

Minimal brain d-----

Contrary to someone's edit summary, the terms "minimal brain damage" and "minimal brain dysfunction" were both in use at that time. See these papers: [2], [3]. -- Antaeus Feldspar 18:35, 10 Dec 2004 (UTC)

Other Causes

I admit, Having ADHD makes it is very, very difficult for me to maintain a npov when it comes to ADHD. It is even harder when I read something like the above. I have several gripes with these two paragraphs, but I'm not sure how to incorporate them into the article, or if I should even try.

The nutritional data has been well summarized in a review article (Burgess et al., 2000, Am J Clin Nutr 71:327-330). Children with ADHD have lower levels of key fatty acids. In fact, one study found that the lower the levels, the worse the symptoms. The possibility that fatty acid deficiency is a trigger for ADHD is especially plausible as nutrition scientists have recently demonstrated that the American diet is extremely deficient in omega-3 fatty acids. At the same time, the incidence of ADHD is rapidly increasing. More support for this idea comes from the findings that breast-fed children have much lower levels of ADHD, and that until quite recently, infant formula contained NO omega-3 fatty acids. These findings are only correlational, and do not prove a causal connection.
Initial studies with supplementation with various fatty acids found improved cognitive function, visual acuity, and reduction of at least some of the symptoms of ADHD. These findings are similar to those in which improved cognitive function and increased IQ are seen in breastfed children—who get more fatty acids from their mother’s milk than do formula-fed infants. The data from these studies are promising, but inconsistent. Why did only some of the studies see an effect, and why were only some symptoms improved? These questions cannot be answered unless one knows about the effects of these fatty acids on the dopamine system.

Gripe #1:

The possibility that fatty acid deficiency is a trigger for ADHD is especially plausible as nutrition scientists have recently demonstrated that the American diet is extremely deficient in omega-3 fatty acids.

ADHD has been diagnosed in children and adults all over the world and cases of it are easy to find in history. (George Villiers, 2nd Duke of Buckingham comes to mind). Ergo the fact that the American diet is low in omega-3 fatty acids is irrelevant.

Gripe #2:

At the same time, the incidence of ADHD is rapidly increasing.

Again this has nothing to do with diet and everything to do with awareness and the fact that CCHR's damage finally starting to be undone by real science.

Gripe #3:

Initial studies with supplementation with various fatty acids found improved cognitive function, visual acuity, and reduction of at least some of the symptoms of ADHD. These findings are similar to those in which improved cognitive function and increased IQ are seen in breastfed children—who get more fatty acids from their mother’s milk than do formula-fed infants.

Here, I see point 'A' and I see point 'B', but I don't see the line connecting them. Am I the only one? *Kat* 03:46, Dec 11, 2004 (UTC)

Modified for readiability *Kat* 07:18, Mar 28, 2005 (UTC)

New Section

Not sure if this should be up top or on bottom (i.e. if this is the start or end of the page), so, feel free to toss this to the bottom if it's out of place, but: Any thoughts on creating a section 'high-functioning and AD(H)D'? There is the fainest hint of such a section in the 'celebrities' / world figures references in this article, however, I was thinking of approaching it more seriously / technically. I think it could tie in well with the fact that the comorbidity between ADD and a variety of LDs is somewhat high (this could be contrastingly linked in the article subsection I'm speaking of) but, in contrast, there is also a wonderfully fat tail on the right hand side of the distribution for high-achieving individuals with ADD -- high kertosis values in more and more of the studies, although still left skewed. Anyway, please share thoughts on this ... if feedback seems receptive, I'll work on developing a section.

Trajan

Sounds like a great idea to me. There have been many times when having ADHD has helped me out. Let me know if you need anyhelp. bakuzjw (aka 578) 23:11, 14 Mar 2005 (UTC)

Hmmm...to a point that sounds like a good idea. So long as the article doesn't include historical figures who might of had or even probably had ADHD, I'm all for it.*Kat* 09:49, Mar 16, 2005 (UTC)

Out of curiosity, why do you oppose that? It seems like a natural tack to take... -- Antaeus Feldspar 15:09, 16 Mar 2005 (UTC)

Because it is speculation at best. There is no way to definitively prove that some historical figure had ADHD. Besides there is no shortage of confirmed modern day ADHDers. Ty (The Carpenter on Trading Spaces), the guy who played the middle son on the Brady Bunch are two that come to mind. Both have said in interviews that they have ADHD.

Speculation cheapens the diagnosis. Its easy to say that people such as Ben Franklin had it, but its impossible to prove, and more over it minimalizes the difficulties that we have. After all, Ben Franklin was a great statesmen and inventor, so why can't we get our homework done on time?*Kat*

Scare quotes

Ombudsman, putting scare quotes around specific words that aren't in the view you support hardly qualifies as eliminating bias. Putting bold around entire sentences because they support your own view is similarly not-cool and it is why I reverted your changes. -- Antaeus Feldspar 23:37, 27 Mar 2005 (UTC)

Thanks for the pointer, Antaeu. Your point is well taken, but reverting all the edits to a thoroughly biased version hardly amounts to enhancing NPOV. Simply correcting the unintentional but obvious error and any other specific edits you found unworthy would have sufficed. Ombudsman 02:36, 28 Mar 2005 (UTC)

Major clean up, and overhaul

I have just completed a major overhaul of this article. The job I have done may not be perfect, but its a start, and IMHO a good one. Below is the information that had been included but is no longer found in the article.

Note: Some of it may have been reincorporated and I forgot to remove it from this listing.

Second note: I'm not saying I've done the definitive overhaul, just made a good start on one.

*Kat* 13:09, Mar 28, 2005 (UTC)

Just realized that a computer glitch (on my end of things) caused some information not to post.

What I also intended to say was that the point of the overhaul was to give the article a more npov. The above poster was correct, the article was very much biased. Not necessarily in one direction or another, but hardly a line in the article could be considered nuetral. Instead the article was comprised of competeing viewpoints. What I was attempting to to was to turn the article into a generalized introduction of what ADHD is as well as what it is believed to be. If that makes anysense.*Kat* 17:20, Mar 28, 2005 (UTC)

According to most sources, including the CDC, the exact causes are currently unknown. Scientific speculation has largely centered upon apparent upregulation of dopamine function. It is thought that the term covers a variety of related disorders also related to dopamine upregulation. There are no objective medical tests that can accurately diagnose ADHD, though there are many subjective assessment tools, primarily promoted by the pharmaceutical industry. The diagnostic label is controversial because of its subjectivity, and this often leads to inappropriate medical intervention, according to critics of biological psychiatry.

According to some recent studies, ADHD is an inheritable 'dysfunction' of dopamine metabolism mainly in the frontostriatal region of the human brain. New studies consider the possibility that norepinephrine metabolism also affects this disorder (see Krause, Dresel, Krause in Psycho 26/2000 p.199ff). Incorporated in one form or another.

One should note that almost all of the latest studies have been sponsored by drug companies. Baseless and biased.

According to most sources, including the CDC, the exact causes are currently unknown. Scientific speculation has largely centered upon apparent upregulation of dopamine function. It is thought that the term covers a variety of related disorders also related to dopamine upregulation. There are no objective medical tests that can accurately diagnose ADHD, though there are many subjective assessment tools, primarily promoted by the pharmaceutical industry. The diagnostic label is controversial because of its subjectivity, and this often leads to inappropriate medical intervention, according to critics of biological psychiatry.

already reincorporated (speread out)

20th Century History

In the early 1970s an erroneous newspaper article, which is still often cited, inflated the prescribing rate of medication by a factor of 10, influencing some to avoid treatment with stimulants.

Without the title, I didn't think this was important enough to include in the timeline

In the mid-1980s, Helen Irlen from California took out a patent on certain tints for lenses to help those with reading problems associated with Scotopic Sensitivity Syndrome.

If I had a dollar for every patent on every alternative treatment used for ADHD, I would never work another day in my life

They [CCHR] were very effective at the time in scaring people away from treatment with stimulants.

npov

INDICENCE

However, rates of diagnosis vary widely even within the U.S. In some school districts as many as 60% of all children have been diagnosed with ADHD.

without citation, it is at best a rumour, and even with citation, its such an extreme example, that I don't know that it really belongs in the article.

~~Some experts theorize that ADHD is underdiagnosed in girls, since their symptoms tend to be less dramatic than those in boys and thus draw less attention from parents and teachers.~~

incorporated

The variation in the rates of diagnosis and in estimates of the rate of prevalence raises numerous issues. In fact, almost everything about ADHD has been the subject of intense debate, as discussed later in this article.

This line strikes me as being irrelevant

Critics contend this is primarily a result of pharmaceutical industry marketing, essentially designed to increase sales globally.

I'll refute this as soon as I look up the old Bregin v CHADD, NIMH lawsuit (not its actual name).

Diagnosis External social and environmental influences are given scant attention, as internal disorders are an assumption of the standard diagnostic protocols for ADHD.

ADHD often continues into adolescence and adulthood, according to proponents of the diagnostic label, and can cause a lifetime of frustrated dreams and emotional pain. However, children diagnosed with ADHD often go on to live normal lives, and wonder why their parents and schools felt the need to medicate them. Many complain of having needlessly suffered from the psychological trauma of the diagnosis, social stigmatization, and adverse effects of the drugs.

Now HERE's a nice load of uncited and unprovable (yet undisprovable) bologna.

~~A grave concern often cited by critics is their concern that prescribed medications may cause persistent substance abuse problems.~~

Inserted and refuted.

Others have written of how diagnosis and treatment improved their lives.

No where to put this

Other Causes

A number of different lines of research may be converging on an answer, or at least part of the answer. First, neuroscientists have determined that the dopamine system does appear to be central to the symptoms of the diagnosis, and certain changes in this system are consistently seen in those labeled as having ADHD. Second, certain essential fatty acids, omega-3 fatty acids, have received increasing attention from nutrition researchers as being essential for healthy brain development. This family of compounds has been directly tied into function of the dopamine system, and appears to be of critical importance in formation and maintenance of these systems. Third, clinical nutritionists have noted that ADHD labeled children are often deficient in omega-3 fatty acids, and that supplementation with various fatty acids may reduce some of the symptoms.

Is there really a connection between omega-3 fatty acids and ADHD? The research supporting such a connection was conducted by scientists in three very different areas who do not ordinarily communicate with each other. This means no one has specifically studied the possibility. However, the findings in each area are very suggestive. If the connection between omega-3 fatty acids is true, then dietary supplementation could be an effective prevention for the disorder, and could be a less costly alternative treatment, with fewer adverse effects, and would ultimately address the root problem, unlike current psychotropic drug treatments.

Initial studies with supplementation with various fatty acids found improved cognitive function, visual acuity, and reduction of at least some of the symptoms of ADHD. These findings are similar to those in which improved cognitive function and increased IQ are seen in breastfed children, who get more fatty acids from their mother’s milk than do formula-fed infants. The data from these studies are promising, but as yet inconsistent. Why did only some of the studies see an effect, and why were only some symptoms improved? These questions cannot be answered unless one knows about the effects of these fatty acids on the dopamine system, and the economic realities regarding who is funding studies attempting to debunk the correlation.

Making an adult lab rat deficient in omega-3 fatty acids results in significant metabolic changes, in the number of dopamine receptors and the amounts of dopamine in different parts of the brain responsible for learning, memory, and attention. Not surprisingly, adding n-3 fatty acids reversed these effects. More interesting studies have looked at developmental effects. If female rats are fed a diet deficient in n-3 fatty acids and then become pregnant, their offspring show marked changes in the dopamine areas of the brain, which look like those seen in ADHD-labeled children, and in the spontaneously hyperactive rat (Acar et al., 2003, Neurosci Res 45:375-382). The pups were also hyperactive. Supplementation of the female rats’ diet either during pregnancy or while nursing prevented this from happening. However, supplementing the pups’ diet after weaning only partially reversed the effects. This means that supplementation will only be partially effective as a treatment. Changing the diet of pregnant women and their infants and toddlers will be necessary to maximize the effectiveness of n-3 fatty acids in preventing ADHD symptoms.

Too much info for a general article on ADHD. Could be turned into its own article though.

Criticism of ADHD as a diagnosis

Diagnostic questionnaires are often subject to copyright restrictions, preventing a wider awareness of their specificity.

no way to work it in

It should be noted that many, if not most, creative individuals exhibit the characteristics of ADD, or ADHD, by virtue merely of their naturally divergent paths of thinking. As in the case of many, if not all, others who exhibit such characteristics, there is no cause to suppose that it is their constitution, rather than that of society generally, that is the condition needing to be rectified.

There is quite a bit of difference between a creative person and a person with ADHD, the two are often found together, but they aren't the same thing. ADHD is (in ten words or less) an

inability exercise self control - What does it mean?

Creativity is, (again, in 10 words or less) an ability to create something unique.

Creative people with ADHD aren't able to really control their creative spurts.

-What does it mean?

 Sometimes they can be creative, sometimes they can't .  However since none of this can be cited, I'm leaving out.

commentss: "Sometimes they can be creative, sometimes they can't" doesn't it describe all people on planet?

Some schools have required 'problem' pupils to undergo ADHD diagnosis (and treatment if diagnosed), which has caused protests. Some parents are alleged to have been threated with, or subjected to, child abuse charges for not allowing their children to be treated with psychotropic drugs. Some critics have suggested that the ADHD label should be abolished altogether.

no citation

Some schools have required 'problem' pupils to undergo ADHD diagnosis (and treatment if diagnosed), which has caused protests. Some parents are alleged to have been threated with, or subjected to, child abuse charges for not allowing their children to be treated with psychotropic drugs. Some critics have suggested that the ADHD label should be abolished altogether.

no citation

In the Thom Hartman paragraph

It has not yet been proven wrong that ADHD symptoms indeed could be a product of advantageous human evolutionary adaptations, and therefore not necessarily a disability, disorder, condition or mental illness.

already incorporated

Treatment

Because most of the medications used to treat ADHD are Schedule II under the U.S. DEA schedule system, and are considered powerful stimulants with a potential for diversion and abuse, there is controversy surrounding prescribing these drugs for children and adolescents. However, research studying ADHD sufferers who either receive treatment with stimulants or go untreated has indicated that those treated with stimulants are in fact much less likely to abuse any substance than ADHD sufferers who are not treated with stimulants.

Incorporated.

Data from 1995 show that physicians treating children and adolescents wrote six million prescriptions for stimulants. Of all the drugs used to treat psychiatric disorders in children, stimulant medications are the most well-studied in the field. However, to date there are no good long-term studies dealing with stimulants in children, and concerns exist pertaining to the ethics of conducting experiments involving children.

redundant

A 1998 Consensus Development Conference on ADHD sponsored by the National Institutes of Health and a recent, comprehensive, scientific report confirmed many earlier studies showing that short-term use of stimulants is safe and effective for children with ADHD.

reincorporated

This says nothing for the growing number of children who are on stimulants for years at a time. Some non-stimulant medications are now becoming available to treat ADHD such as Strattera (atomoxetine HCl), a selective norepinephrine reuptake inhibitor.

reincorporated

In December 1999, NIMH released the results of a study of nearly 600 elementary school children, ages seven-to-nine, which evaluated the safety and relative effectiveness of the leading treatments for ADHD for a period up to fourteen months. The results indicate that the use of stimulants alone is more effective than behavioral therapies in controlling the core symptoms of ADHD - inattention, hyperactivity/impulsiveness, and aggression. In other areas of functioning, such as anxiety symptoms, academic performance, and social skills, the combination of stimulant use with intensive behavioral therapies was consistently more effective. (Of note, families and teachers reported somewhat higher levels of satisfaction for those treatments that included the behavioral therapy components.) NIMH researchers will continue to track these children into adolescence to evaluate the long-term outcomes of these treatments, and ongoing reports will be published. This study has been severely criticized, as it was not double-blind and the sponsors failed to provide a control group.

There has been a lot of interesting work done with neurofeedback and ADHD. Children are taught, using video game-like technology, how to control their brain waves. This has a very high success rate, but is not widely used, or covered by insurance. Many professionals consider the treatment promising, but state that there is not yet sufficient evidence that it works after the immediate treatment is complete.

reincorporated.

Retrieved from "http://en.wikipedia.org/wiki/Talk:Attention-deficit_hyperactivity_disorder"

Other ADHD-related controversies

There are other controversies intersecting with ADHD, to do with:

prescribing psychotropic medication to children in general
prescibing Adderall XR®, the market authorization for which was suspended by Health Canada in 2005
prescribing medication for mental illness at all
psychiatry itself (see Anti-psychiatry), and
the involvement of the Church of Scientology in opposing specific treatments.

The controversies attract popular attention including the mass media. Media critics in the scientific community say that, despite often employing science reporters, such reporters have inherent inabilities to accurately report on scientific papers without sensationalising them, using exaggeration, undue emphasis of aspects, taking aspects out of context, and publishing point-of-view features within news contexts. They also say the mass media fails to identify procedural lapses in studies allowing dubious conclusions to be publicized. Such lapses include: lack of peer review, small sample sizes, lack of published error ranges, filtering of results, lack of control groups and lack of use of double-blind techniques or placebos. Examples of cited of such media misrepresentation include the University of Washington study (see below), which was widely reported as proving that television causes ADHD, despite disclaimers within the published study apparently seeking to avoid this very headline.

The Norwegian scientist Dr. Karl Ludwig Reichelt claims that peptides from casein (milk-protein) and gluten (grain-protein) worsen the symptoms in many ADHD-patients. Extensive testing of ADHD-patients is taking place in Norway, and diet has astonishing effects for many of them. Although good result are achieved in Norway, the peptide-theory is discarded by the scientific community.

Miscellaneous Fictious characters with ADHD include Animal.

Positive Aspects Some contemporary ADHD candidates have also been proposed, including George W. Bush, Whoopi Goldberg and Dustin Hoffman. (Libel)

Douglas Rushkoff suggest that the disorder may be primarily the result of cultural conditions to which children and adults alike are subjected. Primary among these is the omnipresence and exploitive qualities of advertising. In the time that ADHD has arisen as the epidemic it is often portrayed as, advertisement has become virtually unavoidable, and advertisements utilize much more sophisticated methods of deception. Some suggest that people (children, especially) are aware of this attempt at pervasive trickery, whether consciously or subconsciously, and react by avoiding extended attention in order to avoid being deceived. Naturally, this self-defense reaction, when carried over to school and home, presents obvious problems. From this point of view, prescribing drugs is effectively only to alleviate symptoms, but entirely avoids the cause.

Explanations are like alternative treatments, they are a dime to a dozen, and this is one of the more obscure ones.

Cleanup this page, New article on AADD

I did a little cleanup on this page, and added the talk box at top so new messages will go down here with a nice little header. We will need to create an archive soon for the older messages. In the meantime, please do not delete any.

I would appreciate any review and/or comments about the new Adult attention-deficit disorder (AADD) article. Please leave them on that talk page or on my personal talk page at User Talk:Vaoverland. I'd also love to see some discussion about hyperfocus, especially how to make it work to the good. Well, I've got three windows open and two articles in edit mode, so away I go. Thanks to all. Mark in Richmond. Vaoverland 11:51, Apr 3, 2005 (UTC)

Does it mean they don't know and buahaha

"Possible Causes"

Deas it mean that they don't know what couses "ADHD", they can't specificly describe it, and describe DRUGS to kids??

Only what they know is the name and wide range describe that fits 99% wikipedians. And they know wich drug to presicribe and probably its expensive one.

Have any one counted how many people did apnea during infacy and after that ware healthy? i Bet that numers are so big that all "NEW EVIDENCE CREATORS" would become a lot suprised or would lie in face.

Doest seems to you that some made an theory and some are trying to make this theory an fact and are finding more and more stupid explenations?

BTW. Do any one knows some doctor that was paid to describe some specifick drugs to kids?

Example of so called hyperactive person.

One child was send to psychoterapeut to be cured from being hyperactive. Kid was normal and healthy, so therapist invited family of that kid.

Since family come kid statred behave unnormaln. For many of you that means that kid was healthy, family was ill.

So describing and treating kids with drugs means harming them.

Another example is from "monroe institut" (guys that invented or use sound to for example put someone to sleep)

They treated one kid, after few weeks kid become as describe "self confident" and was as i remember optimistic. All in all he become independend and self confiden, when kid returened to the familly quickly he become same as before.

It means one kdi was healthy, his family was making him ill.

I hope you-the reader- are good. And if you are doctor, try retalin for yourself. and then find out what you are doing to kids for money.

I think i know how one can found who is making all ADHD theory and trying made other to belive it: Thoes who earn most from it. Thoes can be drug producers, teachers that insted of making interesting lessons are calling bored kids hyperactive.

And possibly others that make money from whatever is related to ADHD or others couse i think more people will lie about some syndromes will creat some names, will calling it some disorders, only to make what they are doing more easlier (like teachers) or to make money, (i wish them someone describe them some drug they ware making money of and make them take it for them self)

In the way of fictional couses and wide range description:

What works?

And please remember that after 6months of any thing can change person so writing that 6 months of prozac or retalin helped is an lie or harmful joke.

One angle

Any situation where the solution is just "prescribe the kid some pills" isn't properly handling in my opinion. There are a million ways to help an ADD person perform better and avoid the problems ADD does cause or deal with them. I think coping skills (or work-arounds) are more valuable than meds or at least as important. I need closed captioing to be able to watch TV without my mind wandering. Seeing the words makes the extra difference in having enough stimulation hold my attention. That beats popping a pill. However, some meds and the workarounds are the best balance for me. My doctor listens to me. However, I think it is tougher for the kids.

Also, some parents and teachers just focus on hyperactivity. If thats all thats wrong, then it ain't ADD/ADHD. Hyperactivity alone is not ADD/ADHD. But, because I ahve hyperactivity, I know it keeps me from making friends because people don't like it. So, I have to ask, is it enough of a problem that I care? Kids have other people making those decisions, so it's harder.

I think one point that is getting missed is that for an ADHD diagnosis, the items on the checklist have to be present in more than 1 setting and have to be causing functional problems for the individual within the past 6 months for a ADHD condition of any type to exist. If you had everything on the checklist and your life was going great, no diagnosis. The degree anyof it is a functional problem for the person (not the convenience of teachers or parents) is a critical piece. I know there is a condition regarding brain wiring because I have it. Its just the same as a talent. Someone can be a wonderfully coordinated athlete, someone else a musical genius, etc. I am not ashamed of it, I just need to tend to it like I would any other part of my bod. If someone gets a diagnosis and doesn't like the meds, it probably ain't ADD/ADHD. Doctors can be wrong, and a lot of folks think that too many kids are misdiagnosed currently. Also, Dr. Hallowell says the next time around, the DSM will be changing the labels again, so maybe they'll call, it genius syndrome next, I dunno. To me it is a difference, OK, people are different. The important thing is how does the person's life go? Because the meds can help with the extremes.

If everything in the person's life is OK, then it can't be ADHD by definition.

Vaoverland 21:19, Apr 6, 2005 (UTC)

Individual

One great thing about the Internet is that you can find out more for yourself. It is true that many teachers don't keep the kids challenged enough. Most of mine sure as hell didn't. But, when you are the main one bored (look around) and seem to suffer more than everyone, maybe that's a flag to understanding yourself better. I was relieved to start understanding about ADD because I always thought something was wrong with me, (too lazy, doesn't try hard enough, doesn't care enough, etc.). Now I understand me better. Thats totally different than being forced to deal with doctors by family or school when you don't think anything is in need of improvement with yourself (or could be). Keep in mind , the ADD symptoms are not in the voluntary area of a brain, so it ain't willpower or desire that control them. Also, people with ADD are often poor at self observation, so that's kind of a catch-22 for diagnosing ourselves. Vaoverland 21:33, Apr 6, 2005 (UTC)

Families

About the kid who is "normal and healthy" until family is present, it is a known fact that the ADD traits can run in families. Thus, a kid who can function well or has adapted in another environment could find chaos in a home managed by parent(s) with ADD behavior who are not successfully using coping skills, maybe even more chaotic with siblings. Vaoverland 13:50, Apr 7, 2005 (UTC)

The wikiPedia Search results

Doing a search on ADD/ADHD, which seems to be the most common reference used to the disorder, does not hit on any title. The results is a listing of pages which include the acronyms instead and offer many irrelevant pages.

Why the dash between Attention and deficit? Why a separate page for Attention Deficit/Hyperactivity Disorder?

This page mentions the three forms of the disorder. (two of which branched ADHD to the ADD/ADHD acronym didn't they?) As I follow it; ADHD is the inclusive term, with ADD being the form without the hyperactivity, and WHAT for the third?

Does all three forms have the (dis)ability to hyperfocus? I add the (dis) because I personally find hyper focusing to be less an ability as a requisite to any focus that kicks in on it's own accord. It's often in a direction other than the task at hand.

Apologies for mixing comments on the page with those on the condition. Which I obviously have...

Robt@McKenzie.ws --Robt 15:21, 15 Apr 2005 (UTC)

labels

as Robt has noted, there is an abundance of confusion over the various labels and subtypes. Dr. Ned Halloway has stated that additional changes are expected in the next round of the DSM. Maybe some of it will be easier to explain.

If I understand correctly, the three subtypes would be:

with hyperactivity (and not so much inattentiveness)

with inattentiveness (and not so much hyperactivity)

combined type (with both hyperactivity and inattentiveness)

Most adults are less likely to display the hyperactivity aspect, and perhaps that is why the ADD (without the "H") seems like a more comfortable term to use.

When we label ourselves, or let others do it, I feel that it is important to remember that part of the criteria for making an official diagnosis is functional impairment in our lives within the past 6 months. If you have the requisite number of "symptoms" on the checklist, and in multiple settings, but everything is going great in your life, you technically do not have the condition as a "disorder". However, for many of us, accepting the label of disorder opens the door for treatment, therapy, and medication which can relieve functional impairments.

Comments anyone? Vaoverland 16:53, Apr 15, 2005 (UTC)

About hyperfocus, it is only a good thing when the results are favorable. It is possible to be highly creative and productive when doing a project and in hyperfocus, but what if the house is on fire?

Immediate survival instincts are not an issue when in a state of hyperfocus. At the risk of reading too much into your example, there are very few tasks which one might hyperfocus on that would not immediately be interrupted due to things like smoke. If their house was burning down around someone who was in a state of hyperfocus, they would notice–if for no other reason than it would quickly become impossible to continue what they were doing. Hyperfocus is certainly a double edged sword, but for some of us it is only way to work efficiently. — Darco 18:16, 13 May 2005 (UTC)[reply]

Mainline treatment revision

Hello, All --

I've updated the section on mainline treatments. It's been modified to classify the amphetamines (deteroamphetamine, mixed amphetamine salts, and methamphetamine) together, and to standardize the format for readability. I've also added additional brand names where applicable. A legal warning was added to the bottom of the page for trademarks.

- Dave Suffling
Sunday, April 17th, 2005.

d s u f f l i n @ u o g u e l p h . c a

I'm really sorry...

Is it just me that sees the humour in that the article on an Attention-deficit disorder needs attetion? I'm really sorry for taking up your time, now please continue doing something not worthless. Gkhan 01:36, Apr 18, 2005 (UTC)

article needs attention?

I, for one, saw the irony in attention flag as well. The user placing it left no comments in the area he/she is suposed to, so I asked. The reply was that the article is too long. The oversize warning does pop-up when you edit it. Vaoverland 01:52, Apr 18, 2005 (UTC)

"among the mentally handicapped"

ADD/ADHD is often common among the mentally handicapped and physically disabled, which is quite ironic.

I am very leery of this contribution, perhaps a bit more so because it comes after a long series of clearly vandal edits. This is not overtly a vandal edit but:

it's unsourced;
it claims an "irony" that I can't see a reason for;
the claim it makes seems suspect; those of us who have been clinically diagnosed with ADD know how carefully the history of the patient must be compared to what would be normal for a "baseline" patient in order to be confident of a diagnosis. Therefore, I find the statement that ADD/ADHD are being diagnosed in great numbers in populations which are themselves far from "baseline" to be suspicious. Perhaps this will be possible when the organic basis of ADD/ADHD is better understood and it will be possible to look for the cause rather than for the effects, but that day is not yet here. -- Antaeus Feldspar 23:27, 20 Apr 2005 (UTC)

its a vandal, reverted. Vaoverland 01:47, Apr 21, 2005 (UTC)

attention flag removed

This article was flagged as needing improvement (Duh, what wikipedia article couldn't be better?). However, the user placing the flag said the only concern was the size of the article, which generates its own warning whenever someone edits it. We can keep working to condense some of the repetitive content, but a flag indicating there is a problem with the quality of the content is not justified based upon the commenst of the user placing it. Let's keep improving it folks. Mark in Richmond. Vaoverland 20:17, Apr 21, 2005 (UTC)

hyperfocus

RE: my comments about hyperfocus,I may have exagerated for effect "about the house being on fire" analogy. Losing track of time does happen to me when I am in hyperfocus, but I still consider hyperfocus to be a valuable attribute for me. I just wish to manage it better. Vaoverland 20:17, May 13, 2005 (UTC)

Internally Referenced Contextual Mind = ADHD

http://www.contextualmind.org

My model of AD/HD shows that it is a cognitive functional type in the Human species. It is what happens when iconic abstract storage is highly degraded or removed from cognition. All information is stored through sensory input. Abstract concepts like time, left/right distinctions, alphanumerical characters and culture are stored as sense tagged information.

See the wiki for more information on the models and please add your own thoughts :) Chain

Adding your experiences

I see 68.1.159.13 made personal expreiences to this article not long ago. If you want others to know about your history, pleas make a personal page, like I did. If you don't know how to make a personal page, then type in the address bar of your browser http://en.wikipedia.org/wiki/User:68.169.113.246 (or click this link) and make your page.

68.169.113.246 Talk to me, 68.169.113.246 My contributions 18:19, 2 Jun 2005 (UTC)

No bulk removal of changes occurred

<<Please note - I am the author of the previous version of this note and I was wrong -- sorry, I had problems with the ISP cache. Ombudsman's addition re the President's MH plan is much more useful than the previous version.>>

Ombudsman edit: Chemical imbalance repudiated?

I'd like to suggest a bit of clarifcation. Ombudsman recently edited

The exact cause(s) of ADHD are not conclusively known. Scientific evidence suggests most strongly that, in many cases, the disorder is genetically transmitted and is caused by an imbalance or deficiency in certain chemicals that regulate the efficiency with which the brain controls behavior.

to

The exact nature of ADHD is unknown. Medical research suggests, in many cases, the condition is genetically transmitted and is related to regulation of how the brain controls behavior.

First of all, I'll leave aside the question of whether chemical imbalance has been categorically repudiated because I'd have to get myself up to speed; so for the purposes of this discussion, let's assume that the motivation for Om's latest edit is valid. My problem, then, with the edit is that "regulation of how the brain controls behavior" is confusing, because the brain controls behavior but who regulates the brain? Well, in the old version it's clear that certain chemicals control the brain, but that's the part that we're trying to get rid of. So who's left to regulate the brain? It seems to me that if the chemicals aren't doing the regulating, no one else is, and "is related to regulation of how the brain controls behavior" should be changed to "is related to the brain's control over behavior" or some such. Thoughts? Thanks -- PhilipR 14:47, 9 Jun 2005 (UTC)

Thanks for the thoughtful response, Philip. The nature of interactions between relatively static brain architecture and biological processes is much better understood by some than the revised section intro would imply, but by and large the depiction is somewhat accurate. This prevailing assumption is in part fostered by the conflicted message that the brain is too mysterious to be understood, yet 'experts' clinging to the 'chemical imbalance theory' are imbued, unlike lay citizens, with the capacity to divine the truth of the matter. The saturation broadcasting of advertisements promoting the 'chemical imbalance theory' has apparently vanished, mysteriously, in recent months, perhaps as a result of efforts on behalf of psychiatric survivors. According to David Oaks, of MindFreedom.org, "Pfizer, Inc. does not explain the following important indisputable fact: There is no scientific evidence for such a chemical imbalance. For example, there is no reliable diagnostic lab test for any alleged chemical imbalance for any mental disorder. Pfizer, Inc. has broadcast this fraud many times on television, in print, on the web and in other material reaching millions of Americans The public believes that your agencies are protecting their interests, and you have approved these ads. FCC, FDA and FTC share responsibility, both legally and morally, for immediately halting this harmful deception.[4]

According to Karl Pribram, mental processes are mediated by wave interference patterns, which he implies are dependent largely upon the template of neural structure. Reading between the lines, his Holonomic brain theory infers neurochemical processes are secondary to brain architecture in terms of brain function regulation. The concepts entertained in Systems biology also tend to repudiate the simplistic notion that adding or subtracting chemicals in one column essentially offset 'imbalances' caused by chemicals in another column. What is known in terms of neurochemistry is that nutritional deficits or malnutrition generally cause vulnerabilities to psychiatric conditions. Typically, the remedies offered by Western medicine do not address brain structure, nutritional abnormalities, or sensory integration disturbances with anything substantive, aside from medications. The revised introduction has its shortcomings, but the previous intro was unacceptably biased toward the questionable and suspect POV. The brain is, apparently, regulated by its own wave interference patterns Ombudsman 16:10, 9 Jun 2005 (UTC)

I'm not an expert neurologist by any means, but the last tiem I checked, my ADHD is helped by a chemical. My brain is partially regulated by chemicals. Water is a chemical. Neutrotransmitters are chemicals. Synapses only work between neurons because of chemicals. What else exactly is in the brain to effect? I'm quite a bit confused, and I'd like something in a peer review journal before we commit to the idea that there is no such thing as chemical interference.--Tznkai 17:47, 9 Jun 2005 (UTC)

Either-or arguments are inappropriate in a highly polygenic (Bobb, Castellanos, Addington & Rapoport 2005) behavioural disorder. Pubmed shows literally thousands of articles on the chemical and electrical properties of the brain and of ADHD. Electromagnetic waves in axons both cause, & are caused by, chemical changes. An important recent article on dopamine in ADHD is Jucaite et al, Reduced midbrain dopamine transporter binding in male adolescents with attention-deficit/hyperactivity disorder: association between striatal dopamine markers and motor hyperactivity. Biol Psychiatry. 2005 Feb 1;57(3):229-38

"has been repudiated"

'chemical imbalance' theory has been repudiated, commercials (described POVishly by Antaeus as conspiratorial) making such claims have been withdrawn Ombudsman, this was your edit summary; would you like to go into details so that everyone realizes this represents mainstream research? Your edit summary does tend to create the impression that the "chemical imbalance" theory only ever existed in commercials, commercials that apparently have been withdrawn, instead of being one of the leading theories of medical researchers on the causes of ADHD. -- Antaeus Feldspar 22:55, 9 Jun 2005 (UTC)

My changes and See Also

As I noted in my objection to Chemical imbalance theory, that term is not widley used inthe mainstream, and is likley inherently POV. Furthermore, Ombudsman's edits are more confusing than neutral in using the word "symptoms". besides, when we say "treat a cold" or treat any medicine, we often "treat" it by neutralizing the symptoms.

Part two of edit was to remove all of the see also so we can come to a consensus on what should be there and what should not. See Alsos should be relevant to the reader, not POV forks. list of famous people I see. Auditory Processing Disorder, I do not. Learning disabilities should be on there. Chemical Imbalnce Theory is again, a neoglism. Holonomic brain theory gives me 230 hits on a google search as a term, just under 3000 for an all search, I may be flagging it as totally disputed as well, I will have to look. The rest seem to not be relevant, but again, links to a wider dispute. going on. ADHD is not a good place to soapbox, and niether is wikipedia.--Tznkai 18:41, 13 Jun 2005 (UTC)

Changes and reversions of great magnitude

Reversions "of this magnitude" need justification. If Antaeus Feldspar would care to change individual points, as ombudsman had the decency to do, this article would be better. I note that Antaeus Feldspar has done the same thing before, and it has been commented on.

(cur) (last) 23:49, 8 Jun 2005 Antaeus Feldspar (rv to last version by Brighterorange; 129.240.124.27, discuss edits of this magnitude) (cur) (last) 17:37, 8 Jun 2005 CesarB (→Legal - rm disclaimer; redundant with Wikipedia:General disclaimer) (cur) (last) 16:48, 8 Jun 2005 129.240.124.27 (Gave "superior self-direction" less prominence than low attention-- see discussion in hyperfocus article. "Positive aspects" altered to links.) (cur) (last) 16:40, 8 Jun 2005 Ombudsman (→Psychological testing for ADHD - restore censored material: removal of essential context unwarranted; there is no reason to hide growing global influence of US/UK drug industry practices) (cur) (last) 16:33, 8 Jun 2005 129.240.124.27 (Toned down overenthusiastic reference to effect on drug abuse. Similar on neurofeedback. Added link to "causes" article.) (cur) (last) 16:18, 8 Jun 2005 129.240.124.27 (Test altered to NPOV. President's commission removed as judgmental, hypothetical & only 1 country. Neurometrics stub removed -- minimal scientific support and misuse of general term) (cur) (last) 15:56, 8 Jun 2005 129.240.124.27 (Extended the list of conditions causing ADHD-like problems) (cur) (last) 15:40, 8 Jun 2005 129.240.124.27 (Clarified: checklists don't make the diagnosis; the medications are not "very dangerous"; reasons to avoid self-diagnosis) (cur) (last) 15:27, 8 Jun 2005 129.240.124.27 (Removed the hunter-farmer section as it is more fully covered in the linked article.) (cur) (last) 15:21, 8 Jun 2005 129.240.124.27 (Reference to milk removed as (a) not supported by evidence; (b) not in PubMed; (c) not suitable for encyclopedia; (d) addiction to milk is impossible by definition) (cur) (last) 00:29, 8 Jun 2005 Brighterorange m (→Psychological testing for ADHD - missing period (you can help!))

You can describe your own changes are "careful" all you like, but the fact is that you made not just one, but several large changes in a very short span of time, giving no one else a chance to get any input at all into the decision before you forced it on everyone. If you had proposed, for instance, "say, why don't we move all discussion of the hunter-farmer theory to its own article and replace it here with only a mention of 'go see that article'?" then you might have discovered that, while we may spin off sections, especially those getting large and unwieldy (which, at three paragraphs, discussion of the hunter-farmer theory was not), we try to retain a modest summary in the original article.

In short, the reason I made "mass reversions" is because you made mass changes. You can swear up and down that they were "careful" changes, but the fault is really your own for making them so quickly, in such profusion, that other editors had no choices but: a) spend hours that they may not have to carefully examining your changes to make sure they are fair, b) put blind trust in an unknown anonymous editor who doesn't show signs of knowing how Wikipedia works (hint: if you don't feel like getting a username, at least use ~~~~ to sign your talk page comments) or c) revert to return to a known status quo and ask you to discuss edits of such magnitude. -- Antaeus Feldspar 00:53, 18 Jun 2005 (UTC)

Antaeus, please review Assume good faith. At the Andrew Wakefield article, you have demonstrated your capacity for kindness in showing support for editors whose adherence to binary, deductive Aristotelian logic dovetails with your own; however you seem to lack an assuption of good faith in your approach to editors evidencing competence in using multi-variable, inductive null-A logic. Ombudsman 01:26, 18 Jun 2005 (UTC)

Perhaps you should review assume good faith yourself, Om. You seem to be quite confused, since "assume good faith" means assuming the best of another editor's motives (something which your own edit summaries make clear is hardly a matter on which you should throw stones) and says nothing about assuming the quality of another editor's changes. -- Antaeus Feldspar 12:18, 18 Jun 2005 (UTC)

Milk addiction

Objection to the statement about milk addiction was raised but was swamped by controversy over editing procedure. Let's remove the statement in 5 days along with its accompanying vauge allusions to unspecified researchers if no one can provide valid citations. The concept of addiction to milk is incompatible with mainstream definitions of addiction, but may be exploited by irresponsible popular news media. As an encyclopedia, Wikipedia should cleave to a higher intellectual standard and not allow its notion of addiction to become excessively diffuse. The article should be a guide to generally accepted and substantiated knowledge, not an alarmist polemic or a playground for speculation. Myron 30 June 2005 15:58 (UTC)

I would not call it completely incompatible, that is, I think it could be possible to be addicted to milk, but otherwise I fully agree. We'd need more citation for any claim of widespread "milk addiction". I believe the claims about a milk-ADD connection are more widely known, however; they should not necessarily go out just because they're next to the uncited "milk addiction" claim. -- Antaeus Feldspar 1 July 2005 11:55 (UTC)

Omega-3

" Omega-3 fatty acid supplements have been shown to dramatically improve concentration skills, and in particular reading, as well as decrease ADHD behaviors (Richardson, et.al, 2005, Oxford-Durham Study, Pediatrics" This was added in, and I have not checked the information myself, so I have no preference. the paragraph as a whole follows:

Nutritional data has been well summarized in a review article (Burgess et al., 2000, Am J Clin Nutr 71:327-330). Children with ADHD have lower levels of key fatty acids. In fact, one study found that the lower the levels, the worse the symptoms. The possibility that fatty acid deficiency is a trigger for ADHD is especially plausible as nutrition scientists have recently demonstrated that the American diet is extremely deficient in omega-3 fatty acids. At the same time, ADHD diagnoses are rapidly increasing. More support for this idea comes from findings that breast-fed children have much lower levels of ADHD, and that until quite recently, infant formula contained NO omega-3 fatty acids. These findings are only correlational, and do not prove a conclusive connection.

I have RV'd this claim because it would suggest self contradictory messages. Someone who knows more than I about O-3 acids should handle this

Treatments

Just to add to the fun debates around this article, I'm really shocked that there is no mention of behavioural treatments. That is, counselling, and suggested behavioural changes for parents to enact. Last I checked, most of the chemical treatments were far more effective (sometimes only effective), in the presence of behavioural intervention. Limegreen 8 July 2005 05:44 (UTC)

You got it backwards. Behavioral interventions are far more effective, and sometimes only effective when used in conjunction with medications.*Kat* July 8, 2005 23:13 (UTC)

As I understand it, it is very much dependent on the type of behavioural intervention. A good portion of the research comes from a single lab group (e.g., Transdermal methylphenidate, behavioral, and combined treatment for children with ADHD. Author(s): Pelham WE, Burrows-MacLean L, Gnagy EM, et al. EXPERIMENTAL AND CLINICAL PSYCHOPHARMACOLOGY 13 (2): 111-126 MAY 2005), but it seems a rather significant oversight. Regardless of which way round it is, I think it at least deserves greater mention than currently. Limegreen 9 July 2005 04:03 (UTC)

contributions by 24.182.35.167

I've removed the following sections inserted by 24.182.35.167 (talk · contribs), for reasons I'll explain separately. I don't doubt that they're good-faith contributions, but I don't think they're appropriate for the article, at least not in current form. -- Antaeus Feldspar 14:53, 17 July 2005 (UTC)[reply]

I agree. I saw them yesterday, and considered pulling them. At the very least they require some sort of referencing, but I would surprised to see if there is any actual science behind it. Limegreen 07:34, 18 July 2005 (UTC)[reply]

Improving the Impact of Stimulant Use for the ADD/ADHD Diagnosed

Some adults are finding better results from stimulant based medications when they are used for certain tasks, rather than taken regularly. While stimulants increase focus and productivity, they may also impede vocal communication and creativity. Therefore, it is suggested to try and experiment to find the most beneficial way of utilizing these drugs. Experimentation should include trying the various stimulant based drugs to see which have the best results for a given individual. Additionally, some individuals find more positive results from a lower dosage than one based solely on their weight. In worse case scenarios, some individuals are over medicated and fail to truly benefit from a well rounded therapy. Finally, encouraging the patient by giving them more control over their use of stimulants can sometimes be very effective in helping them cope with their symptoms. This approach demands much more time and patience from the psychiatrist or therapist and is more costly in the short term. However, when stimulants are used judiciously, in conjunction with diet, exercise and the cultivation of cognitive skills, the patient will ultimately experience a higher quality of life through maintaining both creativity and enjoying better focus control.

There may be the germ of an improvement to the article here, but some of the factual claims ("[stimulant ADHD medication]] may impede vocal communication and creativity") smell like original research, and the whole paragraph reads as if its purpose was to advise patients on the best way to find the correct medication strategy for them (so much so that I Googled to see if it originated on a site whose purpose that really was), rather than presenting information about how different patients may react to different medication strategies. -- Antaeus Feldspar 14:53, 17 July 2005 (UTC)[reply]

Industrialization and Mass Education

Perhaps ADD/ADHD is not a disorder at all. Perhaps it is a reflection on the failures of mass education, an evolutionary new kid on the block. Public education in the West has only been around at best since the 1800s. Prior to that time children of the elite had access to book learning and tutors. After all, it was Benjamin Franklin (supposedly another ADHD "sufferer") who introduced the concept of the public library. The mass majority of children either helped work in an agrarian setting and or served as indentured servants, where they enjoyed much more personalized developmental attention and guidance from either their families or their masters.

Just speculation, as far as I can see. I was about to say that the only part in it that seems to be other than pure speculation is the hunter/farmer theory, but it's not even about the agrarian lifestyle being especially well- or ill-suited for the ADHD person, it's the idea that mass education failed. -- Antaeus Feldspar 14:53, 17 July 2005 (UTC)[reply]

Image is misleading

The image on the ADHD page is of one person that is not on drugs and the other had been on stimulants.

“They concluded that the brains of ADHD subjects were 10% smaller than those of normals, and claimed this as proof that ADHD is a brain disease. What Swanson failed to acknowledge was the fact that virtually all of the ADHD subjects had been on long-term Ritalin treatment, and that this….was the likely cause of brain smallness. Swanson did acknowledge this fact, immediately thereafter, when I made the point from the audience. Castellanos acknowledged, in an interview published in the January 2000, Reader’s Digest that ‘Incontrovertible evidence (that ADHD is a disease) is still lacking,” and also that “these smaller areas of the brain could be the result of stimulant treatment.” Dr. Fred Baughman Pediatric Neurologist in response to the review of brain scans by a Dr. Swanson and Dr. Xavier Castellanos of the National Institute of Mental Health

ADD Psychosis

I don't think the ADD Psychosis page should be merged because it looks like a totally different disorder. There should be a distinction between them.

I'd have to agree with you. Unfortunately, someone has gone ahead and merged them, which is not irreversible, but would need consensus. Is there anyone else who also thinks the merge was incorrect? -- Antaeus Feldspar 00:10, 4 August 2005 (UTC)[reply]

ADD Psychosis?

I have never heard of ADD psychosis before reading this Wikipedia article (it appears to have been recently merged in from another article). However, even if it should have been merged in, placing information about this relatively unknown condition in the introduction seems inappropriate. Doing a Google search, it seems most of the results for "ADD psychosis" were Wikipedia and other online encyclopedias that have borrowed Wikipedia content, a few old research papers, and mostly pages where the word add (as in addition, not ADD) and psychosis happened to be contiguous.

Since I would have to pay to read these papers, what I gather from the abstracts is that:

ADD psychosis is the co-occurence of attention-deficit/hyperactivity disorder with psychotic features of various kinds.
ADD psychosis may be the result of personality detioration from severe symptoms of ADHD, possibly involving the prefrontal cortex.
ADD psychosis may resemble schizophrenia or an affective psychosis (i.e., bipolar disorder with psychotic features or clinical depression with psychotic features).
ADD psychosis may be treatable with psychostimulants instead of traditional antipsychotics.

I have no information about how common this ADD psychosis is in people diagnosed with ADHD, but it does not seem to be a highly researched topic.

My suggestion is that the reference to ADD psychosis be moved out of the introduction and a section of the Attention-deficit hyperactivity disorder article written to the effect of ADD psychosis being a severe manifestation of ADHD symptoms.

I had ADD at one time and never heard of a case where someone is psychotic AND had ADD before. I think we need to do some research on this. And since I see both my case manager, my psychiatrist, and my psycologist next week, I will ask all three of them about this and report back. Admiral Roo (Talk to me)(My Contributions)(See lyrics I created)18:27, August 11, 2005 (UTC)

About Certification in the field

My psychologist has an MA (Master of Arts), a MFT (Marriage and Family Therapist), and a CT (not sure what that is), and my case manager has a BALSW (whatever that is) and a CPSTP (whatever that is). What do those three innitials that I don't know mean? Admiral Roo (Talk to me)(My Contributions)(See lyrics I created)18:35, August 11, 2005 (UTC)

I'm not too familiar with overseas qualifications, but I'd suggest that your "psychologist" is possibly not. Or at least their MA may be in psychology, but you usually need a professional qualification ("clinical psychology") rather than being a "therapist". From what I understand, in the US, this tends to be a minimum PsyD or Phd [5]. That's not to say that I think people with that qualification are at all better, just that psychologist is a fairly ambiguous term.

I'd imagine that a BALSW is a Bachelor of A.L. S(ocial) W(elfare). No idea about the A.L. though. CPSTP is Community Psychiatric Supportive Treatment Professional.Limegreen 01:47, 13 August 2005 (UTC)[reply]

Self-medicating treatments: request for references

The "Mainstream Treatments" section previously started with information on caffeine, nicotine, and kratom. These sections admitted that these were used as self-medicating treatments; as such, I have moved them to the "Alternative Treatments" section. I am not familiar with these as treatments for ADHD, and I am concerned that they may represent Original Research. Could someone provide appropriate sources for this material? -- Creidieki 16:11, 12 August 2005 (UTC)[reply]

Removed Material: Caffeine, Nicotine, Kratom (Original Research)

There were no responses to my request for references on caffeine, nicotine, and kratom being used as common treatments for ADHD. I believe they may represent Original Research, as it sounds like individuals talking about their own experiences. I think that we would be better off removing this material until proper references can be found, so I have. The material is below: -- Creidieki 12:33, 20 August 2005 (UTC)[reply]

Caffeine

Though not an official mainstream treatment, the ubiquitous use of caffeine means that it is probably one of the most frequently used, unofficial treatments for ADHD. Caffeine is found in coffee, tea and cola soft drinks. Many students and adults will self-medicate with caffeine. Signs that one is self-medicating would be the observation that one's focus improves with the stimulant, and that one cannot function as well without it. Users often report that drinking caffeine in the evening does not impair their sleep, and that in fact, it may help soothe and relax them, thus helping them sleep better. Drinking only 1-2 cups daily is probably not self-medication, but someone who needs over 5 cups daily throughout the day in order to stay awake and focus may possibly be self-medicating.

Nicotine

Found in cigarettes, many students and adults will self-medicate by smoking several times daily.

Kratom

Kratom is a plant which produces a stimulant-type effect in lower doses. Little research has been done on the relation between ADHD and kratom, however it has been used for centuries in Thailand to help motivate laborers. In low doses, it increases awareness, and concentration, allowing someone to sustain work habits. As the dose increases, it can cause euphoria, which makes long tasks more enjoyable, which suggests that kratom may be an effective method to help treat ADHD.

Here's my take on it: The results that are purportedly achieved from the uses of these substances are unreferenced. However, I think the fact that individuals try to self-medicate with these substances (caffeine and nicotine, at least) is fairly undeniable and does not require references. -- Antaeus Feldspar 23:15, 20 August 2005 (UTC)[reply]

I don't have references at the moment, but it is pretty much common knowledge that many undiagnosed (and, for that matter, diagnosed) people with ADHD often self-medicate with nonprescription stimulants. This includes caffeine and also cocaine for more antisocial people with ADHD. People with ADHD are also more likely to have a dual diagnosis with a substance abuse disorder (and not just stimulants).

If they're self-medicating, then it could just be a placebo effect.Limegreen 08:56, 24 August 2005 (UTC)[reply]

Not likely, given the context. For people who are diagnosed with the disorder, sure, it's a plausible (if hard to falsify) theory that it's only a placebo effect. But the essence of the placebo effect requires that you expect a certain effect -- why would people who haven't even articulated that they have a medical problem generate a false medicalized belief that a certain substance would and does help them with this problem? Particularly substances that are similar in their effects to the prescription treatments? -- Antaeus Feldspar 00:03, 25 August 2005 (UTC)[reply]

I'm not too clear on the "context", but people self-medicate because they perceive a problem, in which case a placebo effect is clearly plausible. The definition of "medicate" is to attempt to treat or cure something. So if they haven't articulated that they have, or that they perceive they have, a medical problem, then by definition they can't be self-medicating. You are suggesting that people who are unaware they have a problem could be taking something that relieves their symptoms, however, that doesn't fit with a definition of self-medication. For example, eating steak is only "self-medication" if you believe that you have, or you actually have, an iron deficiency. Limegreen 00:19, 25 August 2005 (UTC)[reply]