Talk:Attention deficit hyperactivity disorder

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ADD

I'm sorry but what happened to ADD?? Have i been liveing under a rock since i was diagnosed or did it just dissapear?? Theres no such mention of ADD that i can find on wiki (although i just skimmed around\0 There is only one metion of ADD at all on wiki and that is one sentence. Shouldnt there be an ADD section of this page at least or a page of its on? can anyone enlighten me on this subject? 130.123.128.114 (talk) 02:58, 10 March 2009 (UTC)

You may have been living under a rock! The diagnosis of ADD was actually removed from the DSM in 1987; it became the "predominantly inattentive" subtype of ADHD. People still use the terminology because it makes sense, but it's technically not correct. Tim D (talk) 05:16, 10 March 2009 (UTC)

Well thats lame. Is there an article around explaining why ADHD is prevalent over ADD? And maybe it should be in here in a section of history of terminology or something like that. 130.123.128.114 (talk) 20:45, 10 March 2009 (UTC)

I think that would be good. Feel free to add a section under history about the changing terminology used to describe hyperactivity in children. This condition has been refered to be many different name over time and is refered to by different names in different areas of the world.--Doc James (talk · contribs · email) 22:01, 10 March 2009 (UTC)

FYI, there already is a section that addresses the history of terminology and such. But anyway, there are some researchers who argue that the predominantly inattentive subtype of ADHD is a completely different disorder from the combined subtype; it essentially comes down to how they're defined neurologically. I personally wouldn't be too upset if the DSM-V ended up redefining them separately... Tim D (talk) 23:58, 10 March 2009 (UTC)

Yes the classification is debated. The ICD10 uses different terminology and criteria all together. All I was saying is that if the above user find the discussion inadequate then he should feel free to clarify issues.--Doc James (talk · contribs · email) 01:16, 11 March 2009 (UTC)

ADD and ADHD are the same thing. It's just the difference between there being a "Hyperactivity" part there or not. The symptoms (possibly excepting hyperactivity), treatment, and diagnosis are the same. If you want to be technical, ADD is "ADHD predominantly inattentive"--Unionhawk ^Talk 18:19, 30 April 2009 (UTC)

Really ADD is the same thing as ADHD withouth the Hyperactivity. I think alot more people have ADD then ADHD. So really ADD is just not being able to pay attention and not remembering things. So it actualy covers alot of people. lol--Blake (talk) 21:57, 5 May 2009 (UTC)

I think there should be a separate page for ADD. I personally have ADD and dont like it when people assume ADD and ADHD are the exact same thing. And theres more to it than not being able to pay attention and not remembering things. Please do some research before making a claim like that. There's a distinction between ADD and ADHD. Please do your research. Sas 03:11, 29 May 2009 (UTC)Sas

Please if you disagree find a reference to back up what you say. ADD is the old term ADHD is the new term. Both terms are from the APA.--Doc James (talk · contribs · email) 03:42, 29 May 2009 (UTC)

To be technical, the DSM-IV TR refers to it as "Attention-deficit/hyperactivity disorder" which seems to refer to the optional subtypes. - cyclosarin (talk) 12:16, 11 June 2009 (UTC)

Stimulants and sudden death

Wondering were people think this paper should noted? "This case-control study provides support for an association between the use of stimulants and sudden unexplained death among children and adolescents."[[1]] The FDA recommends caution WRT the result which should be commented on as well.--Doc James (talk · contribs · email) 14:38, 16 June 2009 (UTC)

If I recall correctly the FDA has mandated stimulants have a black box warning for sudden death so I don't see why not.--Literaturegeek | T@1k? 01:08, 17 June 2009 (UTC)

surely this level of detail should go in the article of stimulants, not the article on ADHD. --Vannin (talk) 01:55, 17 June 2009 (UTC)

How about the article about the treatment of ADHD? Stimulants are not used for much else. And the FDA does comment specifically that this study should not lead to masses of parents removing their children from treatment.--Doc James (talk · contribs · email) 01:58, 17 June 2009 (UTC)

Vannin has a point, article is on ADHD. I think Attention-deficit hyperactivity disorder management and perhaps also stimulants article are more relevant.--Literaturegeek | T@1k? 02:02, 17 June 2009 (UTC)

The consensus is,...or was, that there was no increased risk of sudden death from the therapeutic use of stimulants. At face value this primary source challenges that notion. It is important to note that this is a single study and it is a correlation study. Correlation does not equal causation.

The FDA did comment on the study, "It's hard to characterize the results as reassuring," the FDA's Robert Temple said at a news conference. Still, Temple said, it's possible that the study missed stimulant use by the car-accident victims, because the parents of children whose deaths were unexplained might have better recall years later of what drugs they took. It's not a robust finding," he said, noting that if only one more automobile victim had been found to have taken an ADHD stimulant, the difference between that group and the sudden unexplained death group would no longer have been statistically significant. But, Temple said, "that doesn't mean that this is off the table and we're not concerned about it anymore." [2]--scuro (talk) 03:57, 12 July 2009 (UTC)

Low arousal theory

A question is asked at this article's talk page which I cannot answer. Just a heads up. - Hordaland (talk) 18:20, 20 June 2009 (UTC)

I've shorten that article by half and removed 1 of the 3 references. See its Talk. The article could just as well be deleted, but I'm leaving it there. - Hordaland (talk) 00:09, 7 July 2009 (UTC)

Section tagging the controversies section

I'm posting a cleanup tag on the controversies subsection for the following reasons:
1. This section needs copyediting for tone and flow. It reads choppily and awkwardly.
2. Some statments needs to be clarified. As an example, "One source of controversy is that the pathophysiology of ADHD is currently unclear." Who is it a controversy for? For anti-psychiatrists and the like, they argue that because there currently no definitive pathophysiology, ADHD doesn't exist. For the researchers in the field there is no question that there is a pathophysiology, but there are probably competing ideas on the precise identity of it.
3. Currently the section contradicts some of information in the main article ADHD controversies

"the promotion of ADHD to the public as well as policies aimed at schools which force schools to identify children with ADHD being blamed for over diagnosis." There is no mention of or only faint passing references in ADHD controversies about and "promotion of ADHD to the public" and "policies which force schools identify children with ADHD being blamed for over diagnosis".

"the high rates of ADHD diagnosis" - There are mainstream sources that say ADHD is under-diagnosed or may be under-diagnosed in certain populations like girls [3] or adults (NICE). Also this controversial view is currently presented without any counterbalancing information. This statement presents as fact that over-diagnosis is due to alleged policies which force schools due identify children with ADHD, when there is are also arguments that overdiagnosis might be due to vague diagnostic criteria. And again there are mainstream sources which state that some populations have ADHD under-diagnosed. This should probably be reworded somehow to better express the over-diagnosis debate.

4. Some aspects of ADHD controversy which have substantial page-time on the main controversies page are totally ignored here. These include impact of labeling and politics and the media. A mention for both could be worked in. Sifaka ^talk 00:56, 27 June 2009 (UTC)

You must have (at least) 2 monitors; how do you keep track to compare? The controversy section here is supposed to be a summary of the contoversy article. Should one rather begin there? - Hordaland (talk) 19:25, 6 July 2009 (UTC)

With regards to controversies, I don't believe the points below have been addressed yet. I've posted them again so that we can move forward on this issue.

1. What is the controversy?
2. What is the majority and minority viewpoint about the controversy?
3. Have both viewpoints been stated clearly with due weight according to wiki standards?

As wiki states WP:UNDUE "Undue weight applies to more than just viewpoints. Just as giving undue weight to a viewpoint is not neutral, so is giving undue weight to other verifiable and sourced statements. An article should not give undue weight to any aspects of the subject, but should strive to treat each aspect with a weight appropriate to its significance to the subject. Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, prominence of placement, and juxtaposition of statements."

Input would be most welcome.--scuro (talk) 04:07, 12 July 2009 (UTC)

I hadn't heard from anyone and wondered if some of you are considering what was stated but need more time to comment. Does anyone need clarification on the points made? If I can be of service to anyone please let me know. I'm eager to clean up what I perceive to be this long standing undue weight mess with regards to controversy.--scuro (talk) 16:44, 15 July 2009 (UTC)

Why do you not write something with references to the literature that you think is better / more balanced than what we have. Post it here and we can then discuss these proposed changes?--Doc James (talk · contribs · email) 17:01, 15 July 2009 (UTC)

It is entirely possible, as Sifaka suggests at the top of this thread, that we do need a more general discussion before attempting concrete re-writes? We don't have one controversy (as suggested by scuro "What is the controversy?"), but several. Sifaka explains/defines some of them; why not start there? - Hordaland (talk) 08:44, 16 July 2009 (UTC)

I've no problem with the viewpoint that there are several controversies. I also agree with you that a general discussion would be the best approach. Can't seem to find Sifaka's classification of controversies. Can anyone find a link?--scuro (talk) 10:57, 16 July 2009 (UTC)

An editor posted this link [4] on my talk page. Dr Silver is, "...a Child and Adolescent Psychiatrist, is in private practice in the Washington, D. C. area. He is Clinical Professor of Psychiatry at Georgetown University Medical Center. Prior to his current activities, he was Acting Director and Deputy Director of the National Institute of Mental Health of the National Institutes of Health. Prior to his positions at the National Institute of Mental Health he was Professor of Psychiatry, Professor of Pediatrics, and Chief of the Division of Child and Adolescent Psychiatry at the Robert Wood Johnson School of Medicine. For more than thirty years his primary areas of research, clinical, and teaching interest have focused on the psychological, social, and family impact of a group of related, neurologically-based disorders—Learning Disabilities, Language Disabilities,Sensory Integration Dysfunction, and Attention Deficit Hyperactivity Disorder". I think he would meet the criteria of an expert in the field, and the book is considered a clinical book. He clearly delineates between between current research and medical perceptions of little current controversy. Specifically, "current debate over ADHD within the research and medical communities has been minimal and mostly concerned with subtle details within the diagnosis process and treatment program". That would seem to be at odds with what the article states about current perceptions, based on citations that are 10 or more years old.--scuro (talk) 03:36, 19 July 2009 (UTC)

I don't see why that ref cannot be used scuro. You can use the book citation template Template:Cite book to cite it.--Literaturegeek | T@1k? 21:48, 19 July 2009 (UTC)

Ambiguity in the culture section.

The first paragraph of Attention-deficit hyperactivity disorder#Culture is difficult to follow. What do "The core impairments are expressed in different cultural contexts" and "ADHD is considered differently based" mean. Who are "they?" I am adding some inline tags requesting clarification. Sifaka ^talk 01:01, 27 June 2009 (UTC)

I still don't think part of the culture section has been made more readable, so I will explain in more depth.

ADHD is considered differently based on how those who have an interest in the topic approach the subject. --> This statement is awkwardly worded making its meaning unclear. "Considered differently based" is especially unclear in the "these words don't make sense together" kind of way. Based on what?

Depending on one's paradigm, the meanings of ADHD related subjects and terms vary within the everyday language of lay persons. --> "One's paradigm" is unclear. Does it refer to one's beliefs about existence of ADHD or how it is treated?

Part of this section was also directly copied from the abstract of the paper. It is now paraphrased. Although the source was cited, I want to point out that it is probably a violation of WP policy to copy-paste text without paraphrasing it unless it is quoted. (There wasn't a strong statement that I saw on the policy page to this effect but it seemed to be implied).

Also I am wondering if the title of the section should be changed to something like Perception of ADHD instead? Thoughts? Sifaka ^talk 23:29, 4 July 2009 (UTC)

The whole first paragraph in "Culture" belongs far above, in "Causes". Can probably be combined into a section up there. The explanation in quotes applies to ADHD, not just to the high frequency, I think.

The "differently based" sentence is not good, but not as bad as you'd have it. Read it with a comma after "differently". I think it says that people have different approaches to the topic, and, based on this, they "consider" it differently. I'd say: Obviously they do... But "consider" isn't a good word here. That paragraph makes an interesting point, but is so unclear that no one is going to get it.

"Culture" is a strange name for the section, but not sure "Perceptions" is any better? Maybe "In society"? Or does the content needs its own section, at all? There are parts which quite specifically echo "Controversies" (high frequency, etc.); could/should they rather be there? What is the point of including this section? I suppose it's sorting out various types of experts, lay people & media? - Hordaland (talk) 22:21, 6 July 2009 (UTC)

Thanks for clarifying the "differently based" line. It makes a lot more sense when you mentally insert a comma, but the whole sentence is kind of vague. I agree that the first paragraph belongs somewhere else. (epidemiology? I'm not sure.) The last paragraph (baseball) probably belong in the epidemiology section. As a name "ADHD in society" is ok too but maybe "ADHD in popular discourse" or "popular culture"? Ignoring the two paragraphs that belong in other sections, I think the culture section has two main focuses: How lay people perceive and discuss ADHD and instances of when ADHD became a popular topic and attracted a lot of attention - enough attention to affect general perceptions. I think the material is different enough in scope from that in the the controversies section to warrant its own section, but there are probably some details that need to be resolved. Sifaka ^talk 03:12, 7 July 2009 (UTC)

"Culture," "Perception of ADHD," "ADHD in society," "ADHD in popular discourse," "ADHD in society," and "Popular culture" were suggested above. I just happened to be over at NPOVnoticeboard and saw this suggestion in another context: "Societal views." I like it. Perhaps it could be its own section, instead of looking to be a part of "History." Alternatively the content could be considered history. Leaning toward "Societal views." - Hordaland (talk) 18:10, 10 July 2009 (UTC)

There is supposed to be a standard format for medical articles. I believe "Culture" can be one of the major subheadings and I have no problem with "societal views" being a minor subheading within that area. On the other hand, is this section just a rehashing of "alternative theories", which already has it's own section?

With regards to ambuguity, the lede sentence is just as confusing within the context of society, "Adaptive explanations of the high frequency of ADHD in contemporary settings propose that "the disorder represents otherwise normal behavioral strategies that become maladaptive in such evolutionarily novel environments as the formal school classroom." However, one study showed that inattention and hyperactivity appear to be at least as problematic at home as at school". What, or who believes in "adaptive explanations"? Is this Hunter/gatherer terminology? The sentence contradicts itself. Either ADHD is really only a problem in the classroom or it isn't. That is unless you want to divide this into majority opinion and minority opinion. The bigger problem is that the opening line should summarize the whole section.

The second sentence/paragraph(?) again contradicts itself, and yes...is not clear. The sentence seems to be written from the "social construct" theory. ie ADHD exists because the medical community has created terms etc, and people use these terms, so the disorder exists. Thoughts on all of this?--scuro (talk) 11:17, 16 July 2009 (UTC)

I think that you may be right about what that paragraph is about, but, I can't tell at all... I'm not sure that that paragraph even belongs in a culture section, but, it's too confusing for me to be able to tell one way or the other. And, of course, the source for that paragraph is blocked by parental controls... I'm going to take a guess and say that it's redundant. Revert if you disagree.--Unionhawk ^{Talk E-mail} 20:22, 16 July 2009 (UTC)

The line that I quoted in my previous post is now the lede sentence. Problems noted in that last post still exist. This sentence could also be removed, and a new lede sentence could be added. Or, does someone else have a solution?--scuro (talk) 02:37, 18 July 2009 (UTC)

Comorbid conditions

OK so can someone tell me after checking out citation 102 and 103 (which are identical) which states in the conclusion "There is no published evidence to suggest that either the short or long term treatment with methylphenidate increases the risk of developing seizures in children with ADHD."

can be reconciled with...

"Some forms of epilepsy can also cause ADHD like behaviour which can be misdiagnosed as ADHD"

The citation is regarding the drugs to treat ADHD and the correlation b/w the 2, not a diagnosis.

josst10 (talk) 01:46, 8 July 2009 (UTC)

Did you read the full citation? I don't see what you are trying to say. I recall reading that citation and it did mention that epilepsy can causes ADHD like symptoms which can be misdiagnosed.--Literaturegeek | T@1k? 02:10, 8 July 2009 (UTC)

Reconciled? Cutting out weasel words your two quotes say:

1. Person with ADHD will not get seizures from taking methylphenidate
2. Person with epilepsy may show ADHD-like behaviour

What's to reconcile? - Hordaland (talk) 14:33, 8 July 2009 (UTC)

I don't see a conflict either. Both are telling clinicians to be careful to determine whether the child has ADHD, epilepsy, both, or [shrugs]. htom (talk) 17:23, 8 July 2009 (UTC)

questionable sentence in the lede?

"In the first decade of the 2000s, ADHD diagnoses have increased dramatically in the United States, prompting some scholars from various fields to question the scientific validity of this relatively recent childhood disorder".[14]

Didn't the dramatic increase of the diagnosis of ADHD occur in the 90's? The use of "some" creates an undue weight issue in this sentence. Who are these scholars? Are they majority, minority, or fringe? That's kinda of important for the lede paragraph, don't ya think? The Journal of Ethical Human Psychology and Psychiatry is also of questionable standards. It has no wiki entry and was founded by Peter Breggin. I could be wrong but I don't believe it is viewed as a scholarly journal. An article from this journal is used as the citation for the sentence. Anyone have input here on who put that sentence in and if it should be removed from the page?--scuro (talk) 04:33, 12 July 2009 (UTC)

I am not at this time offering any opinion on whether that sentence should stay or go or be revised or be differently sourced.

I looked around a bit and see that Jeanne M. Stolzer, Ph.D., is (or fairly recently was) an Assistant Professor of Child Development at the University of Nebraska @ Kearney. Her "research interests include the biocultural implications of attachment parenting, the multivariational effects of labeling children, and challenging the existing medical model which seeks to pathologize normal range child behaviors." ...from this PDF, 2006. So we see which camp she's in: probably minority but not fringe IMO.

She's been using the phrase "the last decade" for some time. That phrase cannot be used in an encyclopedia article which is meant to be read 5 and 10 and 20 years from now. - Hordaland (talk) 13:20, 12 July 2009 (UTC)

Utter geniuses who are Nobel Prize winners, and dominate their fields,...have been known to take on extremely controversial positions outside of their field of expertise. One scientist that comes to mind was an utter racist to the core. Their reputation in one field has little credence within another field. Likewise, the position that one holds means little. The question should be, is this person a recognized expert in the field of ADHD, and if she is, why isn't she publishing in mainstream journals instead of "alternative" and exclusive journals? Is there a better source?--scuro (talk) 14:16, 12 July 2009 (UTC)

I have moved the source down to the controversies section scuro. There has been an increase both in the 90's and 2000's. It is not a review article. I have no idea who added that citation or sentence to the lede.--Literaturegeek | T@1k? 21:48, 12 July 2009 (UTC)

The controversy section should be a brief summary of the controversy page, not a catch all. What is the value of this sentence? The facts appear to be wrong, the source questionable at best, and the conclusion OR. I'd suggest removing it all together or finding a better source that states the same thing. It detracts from the quality of the article.--scuro (talk) 01:38, 13 July 2009 (UTC)

I would need to read the full text first, so dunno how they based their findings. As I did not add the ref, I want to wait and hear from other users first. I don't mind one way or the other if that ref gets deleted or not.--Literaturegeek | T@1k? 11:19, 14 July 2009 (UTC)

You are welcome to read the text, the issue though, is the source. Content within the source, in that regard, really doesn't matter. A possible solution here would be to put the "dubious" tag on the citation until you have had the time to consult other editors. The tag may pull in other editors with insights. Is this a workable solution..or do you still need more time?--scuro (talk) 15:27, 14 July 2009 (UTC)

Please remind me in January

ArbCom follow-up: diff, FYI.—Preceding unsigned comment added by Hordaland (talk • contribs) 09:28, July 14, 2009

Terrible Writing

This article's introduction is simply terribly written. What is up with all the quotes? I think the introduction to this article shows some of the weaknesses of group writing. —Preceding unsigned comment added by 63.209.224.182 (talk) 22:34, 20 July 2009 (UTC)

causes section

It would be my opinion that none of the alternative theories would have real acceptance in the Scientific and Medical communities as causes of ADHD. The low arousal theory speaks to a symptom. Diet as a direct cause of ADHD would also not have acceptance in those communities. This creates undue weight issues. As a solution, may I suggest that his material be moved from the causes section. It could be moved to the culture section because it is society which believes many of these things. I'm open to other ideas.--scuro (talk) 23:02, 20 July 2009 (UTC)

how to properly reference?

How would one properly wiki reference this citation? http://books.google.com/books?id=gjojY1WoIOIC&pg=PA4&lpg=PP6&output=html --scuro (talk) 23:08, 20 July 2009 (UTC)