Talk:Attention deficit hyperactivity disorder controversies

Article Improvement

If I can direct you two to the article, I've added two references covering the fringe theories involved in the causation of ADHD. Paranormal Skeptic (talk) 13:47, 25 September 2009 (UTC)

I searched the two books on google using keyword fringe, no results found.--Literaturegeek | T@1k? 15:20, 25 September 2009 (UTC)

The reference does not say theories are fringe, says social critics and fringe religious groups, (eg scientology). It is self published source to a personal website of Dr Russell Barkley. Please see WP:MEDRS and also Wikipedia:Verifiability#Self-published_sources_.28online_and_paper.29. The use of this ref is questionable and certainly should not be in the lead. Also it is being misrepresented.--Literaturegeek | T@1k? 15:35, 25 September 2009 (UTC)

I have removed information added to this talk page that was taken from my user talk page by another user, as this makes the discussion a bit confusing. However, if you are referring to Barkley's consensus statement, that was published in a peer reviewed journal, I merely linked to the version stored on his website for ease of reference. It was not self-published, as you should have noticed. ~ Hyperion35 (talk) 15:38, 25 September 2009 (UTC)

Additionally, as I mentioned in an above section on this talk page, the important question is whether a reliable, verifiable source describes a particular viewpoint in such a way that it qualifies as a fringe viewpoint under WP:FRINGE guidelines. Specifically, the WP:FRINGE guidelines describe a fringe viewpoint as one that departs significantly from mainstream view in a particular field. Even if a source does not specifically use the term "fringe," we may still apply that label if the source describes a viewpoint in that manner. ~ Hyperion35 (talk) 15:47, 25 September 2009 (UTC)

The theories of ADHD not even existing have been posited by fringe religious groups. They have no basis in scientific research. The remaining theories are not supported in mainstream science, and therefore, deserve mention (Meet notability), but they are fringe theories as well.

This is getting tiring to say the least. No journal is going to refer to a theory as fringe, just like no journal will say water is wet either. Paranormal Skeptic (talk) 15:52, 25 September 2009 (UTC)

It is unencylopedic to label things fringe as it is a POV judgement call especially if references don't say so. The idea that "if it wasn't for scientology" there would be no controversy is bogus. That is just a myth promoted by the likes of Barkley who works for the drug companies. Why not just use a non-POV word like "minority" and give it due weight or put controversies into context? Instead of all of this POV arguing and editing. You keep reverting anything I add, which is approaching ownership.--Literaturegeek | T@1k? 15:59, 25 September 2009 (UTC)

If we were going to give due weight and whatnot, the controversies wouldn't even be mentioned in the lede of the article. You are lending undue weight to the theories mentioned in the lede. The entire idea of the other theories hinge on one or two proponents in the medical field. Do you consider fringe being what the majority or minority of viewpoints are? Paranormal Skeptic (talk) 16:05, 25 September 2009 (UTC)

The reference by the way of Barkley is a self published source, which should only rarely be used and rarer more in a medical type article. The fact that it is now in the lead is really a misuse of refs.--Literaturegeek | T@1k? 16:00, 25 September 2009 (UTC)

LG, please for the love of god read the WP:FRINGE page. It will take you no more than 5 minutes at most. Please familiarize yourself with what the WP definition of "fringe" is, for the purposes of a WP page. It does not matter how you feel "fringe" should be defined, and furthermore you should know that slinging around the old "pharma shill" fallacy does nothing to bolster your argument. "Fringe" is not a POV term, it is part of Wikipedia policy. ~ Hyperion35 (talk) 16:02, 25 September 2009 (UTC)

Refs do not say fringe, it is you making that judgement. As I stated on my talk page but will say aggain for other readers. All that I ask is that the articles reflect the references. If a theory is rejected by an important review article say by NICE, WHO, NIH etc then state that, say "some people" or a "minority of doctors" believe xyz however, this view is rejected by NIH, NICE, WHO etc. It is like the Hitler article, majority opinion is he was evil, but yet the article does not say "hitler was an evil man", making judgement calls is unencylopedic, just report the facts is all that I ask, I am not trying to edit war facts out of an article. It is like a tabloid newspaper if you do that. Also you and paranormal discussing deletion of the article may have played a role in me trying to improve referencing. Just because wiki has an article on "fringe" does not mean that that gives you or anyone else the right to go "deciding" in article text what to label as fringe and what as not. Wiki has a neutrality policy to but that doesn't mean that I can go and say NIH, NICE were unneutral or such and such is unneutral as that would be an original research judgement call. If something is rejected by NICE, NIH then REPORT IT as the ref says, all I ask is no original research judgements, just REPORT THE FACTS. We are writing an encyclopedia not a newspaper article.--Literaturegeek | T@1k? 16:55, 25 September 2009 (UTC)

Also you both need to familarise yourselves with WP:MEDRS, we now have a self published source in the lead of a medical article, the barkley personal website. Furthermore it is a contested and I alledge misrepresented edit but yet I am the one getting accused of "pushing POVs", huh? Peer reviewed sources should only be in the lead in a medical article, preferable secondary sources.--Literaturegeek | T@1k? 17:03, 25 September 2009 (UTC)

Yep, familiar with it. You know where it says we are to present the prevailing medical opinion? Which is: a) ADHD exist b) Hunter theory, neurodiversity, and social construct theory and any other fringe theory shouldn't even be presented. In fact, according to WP:MEDRS, this article shoulnd't even exists, as it's merely a POV fork.

Screw it. Better things to do on WP than argue if water is wet. Paranormal Skeptic (talk) 17:27, 25 September 2009 (UTC)

Yes and I accept it exists and also the article references it as the prevailing theory. The extreme view that ADHD does not exist is just a very small part of this article, so I disagree that the article "shouldn't exist". Hunter theory, neurodiversity, and social construct theory etc probably shouldn't be in the lead a they are minority views.--Literaturegeek | T@1k? 17:34, 25 September 2009 (UTC)

(outdent) I reworded a misrepresentation of the NICE publication.--Literaturegeek | T@1k? 00:04, 10 June 2010 (UTC)

EDIT to Below: why isn't anything said about it being connected to how we learn to use our Reward System? The connection is so obvious by looking at brain scans comparing dopamine activity of ADHD brain to baseline. Thanks, OasisMikeI've learned a new way of thinking. (talk) 18:00, 31 October 2012 (UTC) Please, can something about this theory fit? differentiation of cause as developmental: infants bond with adults who remain emotionally calm and emotionally available, thus developing a dopamine pathway natural to humans. When deprived of this experience, or forced to defend themselves against harsh emotional environments they are not developmentally capable of handling, they defend themselves by shutting off their dopamine. This self-defense can be described as an "aversion to bonding" emotionally with others, and gets locked in place before the age of two. Because humans have a genetic "drive" to experience dopamine, however, they later form their own pathways. Lacking any road map they often borrow from cultural narratives available (which get it wrong at a basic level, and do not satisfy their needs except briefly). When the drive to access the Human Reward System is not met, it results in Reward Deficiency Syndrome, and a pattern of self-medication often begins by developing behaviors intended to compensate. Dopamine pathways most natural to the human species include emotionally bonded relationships, prayer or meditation, and joy experienced over other's accomplishments or good fortune (Zen "Mudita," not pride). Dopamine pathways popularly considered unnatural to humans include excessive watching of television, drug usage, excessive television viewing, hoarding, alcoholism, smoking cigarettes, sexual addiction and paraphilias, online gaming addiction & cannabis use. (It should be noted hoarding and paraphilias constitute both a result and an end in themselves, in that lacking the ability to concentrate for any period of time on tasks they are not somewhat obsessed with, items build-up and then the patient justifies the build-up in a variety of ways to protect their self-image, often building an addictive pursuit that may provide some brain-chemistry modification, and paraphilias or extreme fantasy helps them focus through their cycle of arousal to completion. I believe this closely follows the narratives of Dr Gabor Mate, which may be called fringe, but...well, from my POV, it fits. I am 50 and was diagnosed a year ago, and have done a lot of reading online (abstracts of brain studies). I know there are separate pages to specific models (RDS & the Conditioned Attentional Avoidance Loop response model) but it would be nice to get them added to either the main or controversies pages, at least as links. What do you folks think? (how do you handle it when the dominant view of the accademic literature has been so heavily clouded by cultural opinion about personal responsibility and punitive justice? - they aren't co-morbid conditions because they don't occur in the normal population at all). Please, tell me I'm crazy...if I am.

 - Crazy talk lookin' for a home below this point --------

[And, where would it fit to add something really fringe, like, um, how television filters out narratives necessary to understand ADHD because they leverage us for our shared learning disability that limits us to television, and that's who paid political advertising works on, a captive audience (Yes, I am saying every dollar spent on political campaigns is betting on swaying someone with a childhood condition, and the net effect is the ADHD population of America is the Corporate swing-vote)...someplace for something real, but that cannot be substantiated?] Thanks for your time! I've learned a new way of thinking. (talk) 10:25, 12 September 2012 (UTC)

A reference supporting the text you would like to add is needed. See this page, WP:MEDRS and WP:NOR. Do you have a good quality reference to support your viewpoint?--MrADHD | T@1k? 20:15, 31 October 2012 (UTC)

Section on Financial conflicts of interest

About CHADD it says "Children and Adults with Attention-Deficit/Hyperactivity Disorder, CHADD, an ADHD advocacy group based in Landover, MD received a total of $1,169,000 in 2007 from pharmaceutical companies. These donations made up 26 percent of their budget.". But the source says "Total pharmaceutical donation support of CHADD as of June 30, 2007 was 26.11% of CHADD’s budget ($1,169,000)".

To me(please note that English is not my "mothertounge")the claim on wikipedia is not back up by the source. The source seems to indicate that they recieve pharmaceutical support, not necesserly that the support is from pharmaceutical companies. The fraising in this articel is very suspisious. Therefor I remove this line until this meaning is clairified. —Preceding unsigned comment added by 192.71.219.1 (talk) 09:52, 11 July 2010 (UTC)

I do not see what is unclear about this? Doc James (talk · contribs · email) 10:37, 11 July 2010 (UTC)

Just like you I am a non-native English speaker, but the only way I can interpret "pharmaceutical support" is by "support from pharmaceutical companies". In which other way do you interpret this? Lova Falk talk 16:11, 11 July 2010 (UTC)

I read the .pdf from CHADD more carefully today. I thought that "pharmaceutical support" might mean pharmaceutical(medical) support and not necisserly as pharmaceutical(company) (monetary)support. —Preceding unsigned comment added by 85.224.168.108 (talk) 16:40, 12 July 2010 (UTC)

Relevance of links

Quote: "despite being a well validated clinical diagnosis.[7]" Well, [7] concerns "legal and ethical aspects", it says nothing about clinical validation /symptoms, testing and approval of their presence/, therefore it doesn't approve it. My conclusion - NO validation of this diagnosis. —Preceding unsigned comment added by Q2 (talk • contribs) 08:49, 22 July 2010 (UTC)

Revert of this: [1]

Saying that it's "relevant, properly sourced, not overstated, and certainly not deserving of the 'weasel' tag" doesn't make it so. Support your words.

Frequency of stimulant use

• Says nothing about the frequency of stimulant use.
• Is not self-evidently relevant. How does the fact that the United States uses the most stimulants have any bearing on controversies? The section should say. "Frequency of use" is not a controversy (at least, not as presented in the section), and should not have its own section anyway.
• The number is scary, but, again, there's nothing to say how it matters. It just IMPLIES something bad. That's subtle bias.

Concerns about side effects and long term effectiveness

• "Studies have shown that stimulants offer no benefits over behavioral management for periods over 3 years."

So yeah, those studies. Those studies "have shown" that there's no benefit? How do you "show" that something has no benefit? I changed it to "have suggested"; why was this reverted?

• Also, someone left a concern in the comments that a source does not support what cites it. Someone should check the rest of that.

--146.96.130.201 (talk) 15:18, 8 September 2010 (UTC)

• This is a statement that I restored: "In the 1990s the United States used 90% of the stimulants produced globally, in the 2000s this has decreased to 80% due to increased use in other areas of the world." The statement is backed up by a reliable source. What is your objection? Do you not consider it a reliable source? Do you doubt the percentages that are provided by the source? I fail to see any reason this should have been removed.
• "Some parents and professionals have raised questions about the side effects of drugs and their long term use": Again, backed up by a source. No weasel words. It's a statement of fact.
• "Studies have shown that stimulants offer no benefits over behavioral management for periods over 3 years.": Backed up by a source. No weasel words.
• "Other side effects of concern include addiction, growth retardation, suicidal thoughts and effects on the heart. This has led to interest in non-drug treatments such as omega-3 oils which can help symptoms of ADHD.": Backed up by a source. No weasel words.
• You say, "It just IMPLIES something bad. That's subtle bias." I have no idea what point you're trying to make here, so you're going to have to explain how providing reliably sourced statistics is intended to be "scary", "implies something bad", or is a "subtle bias". Your comments make no sense.
• How do you show that a drug has no benefit COMPARED TO behavioral treatment? That's fundamental science. You have a group that receives the drug, and a group that receives behavior management. After the treatments, if the drug group shows no significant improvement COMPARED TO the behavior management group on relevant behavioral measures, the conclusion is that the drug "offer no benefits over behavioral management". That's covered in Scientific Method 101. Read Scientific method and related links.
• You say, "someone left a concern in the comments that a source does not support what cites it. Someone should check the rest of that.": I'm not sure who the vague "someones" are here, but I have read the sources and there is no problem. If you think there is, read the sources and give up specifics on this talk page. Cresix (talk) 22:58, 8 September 2010 (UTC)

• My objection is that there's nothing saying that it has anything to do with "concerns". A relevant statement would be, "So-and-so organization have expressed concerns about the prevalence of stimulant usage in the United States versus other countries, citing that 90% blah blah blah." The whole section has a misleading section header, and keep in mind that its parent section is "Concerns about medication".

Your comment is quite unclear, but you mention the header. The header is "Frequency of stimulant use" and the text is about frequency of stimulant use. I don't see a problem. Cresix (talk) 17:23, 12 September 2010 (UTC)

My objection is that there's nothing saying that it has anything to do with "concerns". A relevant statement would be, "So-and-so organization have expressed concerns about the prevalence of stimulant usage in the United States versus other countries, citing that 90% blah blah blah." The whole section has a misleading section header, and keep in mind that its parent section is "Concerns about medication".

Feel free to find the sources and add. That's much more appropriate than wholesale removal of sourced and accurate information. Cresix (talk) 17:06, 13 September 2010 (UTC)

Also, "frequency" is "x per time". "90% of stimulants"... what does that have to do with frequency of usage? --68.161.172.2 (talk) 06:49, 13 September 2010 (UTC)

• I'll back off on the weasel words accusation.

Well done. Cresix (talk) 17:23, 12 September 2010 (UTC)

Patronization is hardly becoming of a Wikipedia editor. A little something called Wikiquette. --68.161.172.2 (talk) 06:49, 13 September 2010 (UTC)

Hypersensitivity and false inneuendo are not becoming of a Wikipedia editor either. A little something called Wikiquette. Cresix (talk) 17:06, 13 September 2010 (UTC)

• You really don't see how statistics placed in a certain context can make implications?

Of course I do. I've conducted dozens of studies using a vast range of statistics. But you have provided absolutely zero support for such an accusation here. Cresix (talk) 17:23, 12 September 2010 (UTC)

I'll state it outright then. It's implying:

• There is "too much" of it being used in the United States.

Find good sources and add that, but please conform to WP:WEIGHT. Cresix (talk) 17:06, 13 September 2010 (UTC)

As it stands, it's just a statistic. It's not SAYING anything about controversy, which is what the section is about. Find someone who actually says, "There is too much stimulant usage by children diagnosed with ADHD in the United States." Statistics in an article need to support some statement, or claim, within the article. What does this statistic support? --68.161.172.2 (talk) 06:49, 13 September 2010 (UTC)

The statistics support the facts that they describe. If you want something about "too much stimulant use", you find sources and add according to WP:WEIGHT. Again, that's much better than wholesale removal of accurate and sourced information. Cresix (talk) 17:06, 13 September 2010 (UTC)

• You misconstrue my objection. "Benefit" implies ANY benefit, rather than just the intended effect. If the studies show that there's an improvement in behavior in one group over the other, then the wording should be clarified. How do you prove that one treatment has NO benefits? They would have to measure general health, happiness, relationships, and an uncountable number of other possibilities. I highly doubt that they've made such a claim.

Have you actually read the research, or are you simply jumping to conclusions based on what you think the research is about? "Benefit" refers to reduction in measurable ADHD symptoms. What other other benefit do you suggest? The wording does not need to be clarified; this is an encyclopedia, not a journal article. An encyclopedia summarizes much more extensive information. Every detail of every study does not need to be described. If the information is from peer reviewed journals, the assumption is that the results are valid unless someone can provide evidence to the contrary. Cresix (talk) 17:23, 12 September 2010 (UTC)

I added a few words of clarification. Now, I hope that puts to rest this rather overblown objection. Cresix (talk) 17:59, 12 September 2010 (UTC)

"Benefits": You mean besides the possible benefits that I've already suggested? Well, less negative side effects, less extreme side effects, and less possibility of suicide are all things that I think are commonly considered medical benefits. I don't see how you can argue against this. Did the study go through each and every one of them, and much more? I don't need to read the article to know that it's impossible for them to have done so. Peer-reviewed articles tend to be more precise. (By the way, the second ref for it [2], and the second time the second ref was used, actually said that there was an improvement in behavior according to parent/teacher ratings. Totally not "no benefits", or even "no ADHD-related benefits".)

The studies, and the statements in Wikipedia, are concerned with reduction in ADHD symptoms. Side effect issues are discussed elsewhere. Every study does not need to go through every issue related to every controversy. That's absurd. Cresix (talk) 17:06, 13 September 2010 (UTC)

"Shown": A few studies is a "suggests" more than it is a "shows". The second article itself says that more research is needed. --68.161.172.2 (talk) 06:49, 13 September 2010 (UTC)

• As for the scientific method, don't patronize me about science while at the same time claiming that a few experiments can be proof of a very vast claim. One of the principles of science is that you can't prove anything. This is especially true once you involve people and statistics, and even more so when it's psychology. There, it's not easy to prove something even beyond a reasonable doubt.

No one has used the word "prove". Give me quote from the article or from the sources in which the authors argue that something has been "proven". You set up a straw man to attack with absolutely no foundation. The results are reasonably stated based on the study results. If you make a statement that shows a blatant disregard for the scientific method, I have no choice but to challenge it. This is a medical article based on scientific research. It's not a playground for you to make outlandish statements that are contrary to the sources for the article. Cresix (talk) 17:23, 12 September 2010 (UTC)

"Shown" is a synonym for "proven" in the context of the sciences. If you disagree, well, replace all instances of "prove" with "show" and stop nitpicking.

First, you are simply wrong. "Shown" is not a synonym for "proven", especially in scientific research. Read a few journal articles. A study can say that Group A was shown to score higher on the WISC-IV than Group B; that's not the same as saying that Group A is proven to be smarter than Group B. Again, you create a straw man to attack that is baseless. Cresix (talk) 17:06, 13 September 2010 (UTC)

This has nothing to do with the scientific method. The scientific method simply gives you the steps to either disprove a hypothesis or fail to disprove it. It has to do with the specific wording of the article making a broad claim that no peer-reviewed article would make (i.e. "shown to have no benefits").

It has everything to do with the scientific method. If a well controlled study shows that Group A and Group B are statistically identical on measures of benefits 1, 2, and 3, then the study has shown that the groups are not different on the measured outcomes. One more time: Every study is not required to investigate every disputed issue. A study focuses on specific issues and reports on those specific issues. Give me example in which the sources cited reach conclusions about issues that were not studied. Your argument is utterly confusing. Cresix (talk) 17:06, 13 September 2010 (UTC)

I've given you no reason to assume that I'm ignorant of the tenets of science, except that I'm disagreeing with you. Stop insulting me and make your points with your points. --68.161.172.2 (talk) 06:49, 13 September 2010 (UTC)

Then please stop making wild and false claims that suggest either lack of knowledge or completely ignoring the scientific research on ADHD for the past 20 years. And you please stop insulting my understanding of the scientific method, behavioral research, and an actual knowledge that comes from actually reading the studies rather than assuming things about them. Cresix (talk) 17:06, 13 September 2010 (UTC)

• The "someones" aren't a mystery person. There's an HTML comment: "Neither safety nor efficacy of stimulants has been determined beyond two years on following ref." I haven't checked on the ref myself, but it should be checked. --74.73.95.226 (talk) 16:10, 12 September 2010 (UTC)

Let me repeat myself. I have read the sources. There is no problem. If you haven't read the sources, by all means please read them and tell us what the problems are. Cresix (talk) 17:23, 12 September 2010 (UTC)

Let me clarify: it should be checked by someone who isn't currently involved in this discussion, free of a need to win an argument. --68.161.172.2 (talk) 06:49, 13 September 2010 (UTC)

I don't have a problem with that. That, of course, rules out you and me and anyone else who has been a major contributor to the article. If someone checks, I trust they'll let us know what they find. Until then, however, please don't make a mountain out of a molehill. Cresix (talk) 17:06, 13 September 2010 (UTC)

Ref-check

The second ref says that there was only ONE study, and that it wasn't a randomized controlled trial. And the study it cites is the other ref. What are the rest of the "studies"? This isn't giving me much confidence in the ref-checking for this article.

At 3 years post-randomization the percentage of children taking medication >50% of the time was: behavioural 45%; stimulant 72%; combined 70%; and usual care 62%. Five outcomes that were previously statistically different or particularly clinical relevant were measured at 3 years. There were no significant differences between therapy groups for any of these 5 outcomes. Furthermore, the proportion of children meeting the diagnostic criteria for ADHD had dropped to about 50% and was not different between the 4 therapy groups.

— http://www.ti.ubc.ca/letter69

I'm honestly not certain what it's saying, but it seems to me that there's no difference between ANY of the treatment options, including combined and usual care (i.e. random kids who mostly got stimulants as represented by the norm). And many of them started taking stimulants anyway (45% for the behavioral group, who I assume started out not taking drugs). The refs never state anything like "no benefit between behavioral and drug care", and in fact doesn't try to explain the discrepancy as such. And the WP page ignores that there's no difference between combined and behavioral, either, leaving out important information for the reader that could give them a different view of the results.

This is definitely a problem. --68.161.172.2 (talk) 07:10, 13 September 2010 (UTC)

Without getting into the details of any study, what happened to your idea that the ref checking must be done by "someone who isn't currently involved in this discussion, free of a need to win an argument." Did you suddenly develop total amnesia and forget that you are involved in the above arguments? Cresix (talk) 17:06, 13 September 2010 (UTC)

BTW, I'm not sure what you are reading into (or failing to read into) the Jensen study and the Therapeutics Letter, but here are the essential findings as reported by each:

Jensen study: "treatment groups did not differ significantly on any measure at 36 months"

Therapeutics Letter: "At 3 years post-randomization ... there were no significant differences between therapy groups for any of these 5 outcomes"

The two report the exact, same finding (which is to be expected because the TL source is reporting on the Jensen study). No difference in ADHD symptoms measured after three years. I don't see the problem. The words don't have to be word-for-word identical to state the same conclusion. But since you have declared me an unfit interpreter of the findings (and I have declared you equally unfit), we must see what someone else says. So until then, as I said above, stop making a mountain out of a molehill. Cresix (talk) 01:25, 14 September 2010 (UTC)

I was pointing out why there needs to be someone else checking, because I'm clearly reading something different from what you're reading. Just because I checked it myself doesn't mean I still think there's a need for someone else to check it. Thanks for being petty.

My point was that saying "There's no benefit of A over B" when listing reasons why drugs are bad gives very different connotations than (what was actually said) "There's no significant difference between A and B, nor C, D, and E." --68.161.150.98 (talk) 15:39, 15 October 2010 (UTC)

Listed on Wikipedia:Third opinion. --68.161.150.98 (talk) 15:43, 15 October 2010 (UTC)

Scientifically, statistically, and logically, stating that "There's no [demonstrated] benefit of A over B" (my clarification in italics) is equivalent to saying "There's no significant difference between A and B". To state that A or B has benefit over the other requires a statistically significant difference. That's a fact that virtually anyone with an undergraduate degree in a science knows. Cresix (talk) 16:20, 15 October 2010 (UTC)

Agreed. It also says nothing about A vs B vs untreated. htom (talk) 18:00, 15 October 2010 (UTC)

They're not the same thing. $A\leq B$ is obviously not the same thing as $A\sim B$. If the article had read, "Studies have shown that behavioral management offers no benefits over stimulants...", that would give the completely opposite connotation from the original statement, and puts behavioral management in a bad light. Especially since the section is basically about "Why do people think ADHD medication is bad?"

It's patronizing and disrespectful to once again imply that I don't understand science, when the main cause for you believing that is that I'm arguing with you. I'm not exactly flaunting my scientific certification to lend weight to my argument, so why do you feel the need to do differently? --67.243.1.227 (talk) 12:57, 21 October 2010 (UTC)

No one has said that $A\leq B$ is the same as $A\sim B$. And it's not patronizing for someone to say you are wrong when you are, in fact, wrong. I could claim that gremlins broke my car engine; it's not patronizing to tell me that, mechanically, that is wrong. You've made a weak attempt at creating a straw-man: "If I say anything you disagree with, I'm always right and you're always wrong. Don't patronize me by telling me I'm wrong." It is accepted by every science that "There's no demonstrated benefit of A over B" is equivalent to saying "There's no significant difference between A and B". That's not patronizing you, no matter how much you complain that it is. It's a fact. It doesn't matter whether you say "behavioral management offers no benefits over stimulants" or "stimulant use offers no benefits over behavioral management"; neither of those statements puts one or the other treatment "in a bad light"; it simply says that neither has been shown to be better than the other. As for the title of the section, as I'm writing this the title is not "Why do people think ADHD medication is bad?"; it's "Concerns about side effects and long term effectiveness". I have concerns about giving children immunizations for tetanus because of the extremely remote chance the child can have a seizure. That is not the same as saying that "Immunizations are bad".

Let's see if anyone agrees with you on that point because, so far, no one has. Now, I don't intend to go back and forth with you endlessly by repeating the same thing over and over. You can rant to your heart's content about your scientific expertise and being patronized, just don't make changes to the article on these issues without consensus, and there is no such thing as a consensus of one. Unless there are other opinions expressed on this matter I'm finished with this exchange with you. Cresix (talk) 15:15, 21 October 2010 (UTC)

Going to cut it down to one point, so that you can't ignore it again.

If the article had read, "Studies have shown that behavioral management offers no benefits over stimulants...", that would give the completely opposite connotation from the original statement, and puts behavioral management in a bad light.

We have:

1. "There's no demonstrated benefit of A over B"
2. "There's no demonstrated benefit of B over A"
3. "There's no significant difference between A and B"

If you claim otherwise, you are claiming that the first statement, since it's equivalent to the third, is also (by symmetry) equivalent to the second, and so the first and second statement are, according to you, equivalent. Do you agree or disagree? --68.161.150.135 (talk) 08:17, 22 October 2010 (UTC)

"If the article had read, "Studies have shown that behavioral management offers no benefits over stimulants...", that would give the completely opposite connotation from the original statement, and puts behavioral management in a bad light.": You are wrong (again).

"1. There's no demonstrated benefit of A over B"

"2. There's no demonstrated benefit of B over A"

"3. There's no significant difference between A and B"

All three statements are statistically equivalent, and none of the statements puts A or B "in a bad light". Do not change the article without consensus. End of discussion unless other editors express opinions. I have no obligation to repeat myself again and again to your repetition of the same argument over and over. In case you missed it: End of discussion between you and me. Cresix (talk) 15:13, 22 October 2010 (UTC)

• This isn't a statistics article written for statisticians. It should be written for the layman, and "no benefit of A over B" is "A is less than or equivalent to B".
• Even ignoring that, show me a source for how you can say something like this is "statistically equivalent". "Equivalent" means that they're interchangeable, and I find it hard to believe that statisticians use the three equivalently in a technical sense.
• I've edited the article three times, and only the first edit is related to this discussion. It's bad enough you act like you have superior knowledge of science and, I guess, statistics. Stop pretending I'm edit-warring with you. (And no, while you haven't said anything that would unambiguously accuse me, your unnecessary repetition imply (there's that word again) that I'm still editing the article.) --74.73.95.226 (talk) 08:18, 8 November 2010 (UTC)

Ugh, I probably have to prove to you that they're not equivalent in English.

1. Statement P := "A has no benefit over B".
2. Statement Q := "B has benefits over A".
3. Statement R := "A has benefits over B".
4. Statement S := "B has no benefits over A".

You claim that P and S are equivalent. But {P,Q} is consistent (i.e. having both statements presents no contradiction), and {R,S} is consistent, while {P,R} and {Q,S} are both inconsistent. How can a statement be equivalent to another statement if they have different sets of consistent statements? --74.73.95.226 (talk) 08:24, 8 November 2010 (UTC)

Already answered in full, several times. Discussion is finished between you and me; and, in fact, you can rant all you wish, this is my last message to you. I will respond if other editors comment here. Do not change the article without a consensus; there is no consensus at this time. Cresix (talk) 16:03, 8 November 2010 (UTC)

You can say that you've already said it all you want, but you still haven't, at all, addressed how your claim of equivalence is logically consistent. To reiterate: Show how {P,Q} is consistent and {S,Q} isn't if P=S. --68.161.152.132 (talk) 07:02, 6 December 2010 (UTC)

Already answered in full, several times. Discussion is finished between you and me; and, in fact, you can rant all you wish, this is my last message to you. I will respond if other editors comment here. Do not change the article without a consensus; there is no consensus at this time. Cresix (talk) 16:06, 6 December 2010 (UTC)

Your Third Opinion

Hi, I'm here to give your third opinion.

• Both sides should remember that the goal is to write a neutral encyclopedia article, not further one side of the debate.
• Some of 68.161.150.98's edits seem to be appropriate, removing POV statements that do not add much to the article. On the other hand, the large addition here amounts to an essay pushing the POV that ADHD can't be faked easily.
• It looks to me that the material that Cresix reverted to re-add that started this does have some weasel elements. It's weaselly to say "Studies have shown" when there have been other studies that contradict those studies. It implies a sort of scientific consensus where one clearly does not exist, since the mainstream view is that medication is an effective treatment for ADHD.
• As I alluded to, our article should reflect mainstream views when speaking in Wikipedia's voice. If a particular claim is controversial within credible sources, it needs to be specifically attributed to who said it. Since this article is a "controversy" fork, most of the statements in it should be specifically attributed to who said them, rather than written in the neutral voice. For example "Gigs, et al in a single-blind study of 30 children found that eating sweet-tarts was an effective treatment for ADHD. This result was replicated by Bob Russo in 1998." rather than "Studies have shown that sweet-tarts are just as effective at treating ADHD as stimulants"

Hope this helps. Gigs (talk) 14:14, 18 October 2010 (UTC)

I only made three edits to the article, from what I can see in the history. Only one (consecutive pair) was controversial, whereas the other was maintenance. I went to the talk page rather than reverted.

My issue is that I don't think the article IS being neutral, and using the source in a way that does not convey the intent of the study (i.e. saying that drugs aren't better than behavioral management when the source also says that behavioral management isn't better than drugs either). --67.243.1.227 (talk) 12:57, 21 October 2010 (UTC)

Out of date ref and cited improperly to make an incorrect and uncited statement.

The reference listed for "However, methylphenidate, the most commonly used pharmacological treatment for ADHD has not been evaluated in controlled clinical trials for longer than 4 weeks." Is extremely out of date (10 years) and cited incorrectly. The article states that "Moreover, we were unable to demonstrate that the methylphenidate effect is maintained beyond 4 weeks" meaning that this specific study, did not include any studies in their meta-analysis that had placebo-controlled studies lasting longer than 4 weeks.

This SAME EXACT PAPER goes on to state "The recently completed MTA trial,68 though lacking a placebo group, may address some of the concerns identified in this meta-analysis regarding long-term treatment. It was methodologically sound and had sufficient power to detect the superiority of medical management (with 73.4% of participants maintained on methylphenidate at study end) over a relatively long-term period (i.e., 14 months) in a comprehensively assessed patient population." (http://archpsyc.ama-assn.org/cgi/content/full/56/12/1073?ijkey=007cc629e52685a2458e29978adfe35259d2f48e)

While lacking a traditional controlled placebo the study does contain "A group of 579 children with ADHD Combined Type, aged 7 to 9.9 years, were assigned to 14 months of medication management (titration followed by monthly visits); intensive behavioral treatment (parent, school, and child components, with therapist involvement gradually reduced over time); the two combined; or standard community care (treatments by community providers)."

It goes on to state that "For ADHD symptoms, our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication. Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms, but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes."

I believe this give sufficient proof of long term efficacy. Since this 2nd article was already published at the time of the original, this wikipedia statement should never have been made (or at least stated in the way it is).

In the interest of not starting an edit war I'll leave AS IS for comments for a week then deleting.75.72.127.125 (talk) 05:27, 6 April 2011 (UTC)

Just simply based on the date of the study, I agree that sentence needs to go. If someone can cite more recent research on the efficacy of (or lack thereof) methylphenidate, that would be helpful. But the current source is sufficiently outdated (and not very conclusive) such that any statements in the Wikipedia article derived from it are not appropriate. Cresix (talk) 16:56, 6 April 2011 (UTC)

Imaging and other pathophysiology

I'm surprised that no one has mentioned the extremely obvious bias in the imaging and other pathophysiology here and in the main ADHD article. Both fail to mention the fact that researchers conveniently (and gleefully in most cases) ignore the fundamental scientific fact that correlation does not imply causation and that any correlated pathophysiological finding may be effect rather than cause. In fact, there is STRONG scientific evidence that many of the chronic disorders of today triggered, if not in some cases completely caused by, ineffective sleep leading to downregulation by the amygdala of nonessential areas of the brain (prefrontal cortex, etc), and upregulating the hypothalamic-pituitary-adrenal axis, leading to chronically increased adrenalin, chronically increased cortisol, chronic dysregulation of grehlin and leptin, etc. See textbooks of pharmacology written by Stephen Stahl, et al. Jkhamlin (talk) 20:40, 23 July 2011 (UTC)

First, I don't think I've ever read a journal article that concluded any neurological/psychiatric disorder was "completely caused" by anything. At our present state of scientific knowledge, especially in an area as fantastically complex as the human brain, claiming to have found a single, smoking-gun source of all of our problems is going to make people skeptical. Especially without any sources that can be easily verified by other editors.

With that said, what is your suggestion here? You list those four hormones, only one of which has any proposed connection with ADHD, and implicate "ineffective sleep." It's certainly possible, even likely, that sleep issues have some bearing on the disorder, but please provide specifics. Drake144 (talk) 12:57, 24 July 2011 (UTC)

Move tag

Could the tagger please give some details of what is wanted and why. If the tagger intends to make the changes soon then we don't need many details. If it is to be left to someone else then a lot more information would be required. Op47 (talk) 20:43, 27 July 2012 (UTC)

The social science perspective

Recently, a paragraph was added about the social science perspective. I see many problems with this text. Here it comes, in pieces.

• The social science perspective challenges the biomedical view on the cause of ADHD symptoms. Symptoms are seen by this perspective as a consequence of normalisation; where it has been constructed in culture/society that it is normal to be focused/well-behaved/patient etc. and therefore abnormal to act differently.
  

The problem with this sentence: Google book search of the word ADHD in this book gives one result and doesn't cover this sentence. A search of the word normalization in this book gives a couple of more results but not in connection with ADHD or with being "focused/well-behaved/patient" etc.

• Ruth Benedict argues that in most modern cultures normal is associated strongly with being good, whereas abnormality usually carries bad connotations.

The problem with this sentence: Ruth Benedict's arguments are from 1934 and therefore say nothing about "modern" cultures or ADHD - diagnosis didn't exist yet

• These 'abnormal' symptoms have therefore succumbed to medicalization; where the tendency for abnormality is labelled as a disease (that requires treatment). Although some argue that the medicalization of what is constructed as socially detrimental behaviours would alleviate patients of responsibility for their actions, others insist that it merely permits health professionals to exert influence over the care and management of such individuals.

The problem with this sentence: A general text from 1972. Also not about ADHD.

• In addition, although medicalization may be liberating for some, it can be oppressive to others. Medicalization of ADHD and its biomedical treatment can lead to iatrogenesis (medical treatment-caused symptoms) and added complications for the individual.

The problem with this sentence: Google book search of the word ADHD in this book gives NO results.

• Therefore not only do social science perspectives challenge the validity of the 'disease' but they also highlight the negative social and medical aspects associated with treating the 'symptoms'.

The problem with this sentence: unsourced.

Please comment! Lova Falk talk 10:36, 6 May 2013 (UTC)

I agree that this is all problematic content. It should probably be deleted.--MrADHD | T@1k? 19:42, 6 May 2013 (UTC)

I have now deleted this text. Lova Falk talk 21:56, 22 May 2013 (UTC)

Women with ADHD

In the 'Over/under diagnosis' section, I feel more information on the issue of women's under-diagnosis is necessary. There has been quite a lot of research done on this controversy, and this article really downplays the significance of the underrepresentation of women with ADHD. Characterization of ADHD has been suggested to be more applicable to men, causing many women with ADHD to go undiagnosed. This has had serious consequences, as untreated ADHD women are prone to suicide and self-injury. PARossignol (talk) 00:05, 21 April 2014 (UTC)

 Done

Recent changes

@Lova Falk:, I am concerned about the large scale changes you have made to this article. You appear to have removed MEDRS compliant sources in your edits such as here here. Your edit summary seems to indicate you are removing any material that does not have a negative conclusion about medication side effect/effectiveness, which is creating a gross violation of WP:DUE by presenting only one side. While there are controversies in this area, we have to include the mainstream medical opinion on these matters (i.e. that methylphenidate is considered safe). You have also introduced poor medical sources such as old editorial or primary animal studies against WP:MEDRS. Yobol (talk) 19:11, 14 May 2014 (UTC)

Hi Yobol! Thank you for talking to me, and I understand why you are concerned. However, this is not the article ADHD, not Methylphenidate. This is an article about controversies around ADHD. The section is called: concerns about medication. So it should in a neutral way describe the concerns - rather than in a neutral way describe the long-term effects of the medication. Such a description belongs to Methylphenidate - where you can find it. With friendly regards! Lova Falk talk 19:38, 14 May 2014 (UTC)

And PS: It's night now in Sweden, and tomorrow I'll be at work, so it'll take some time before I can continue our discussion. Lova Falk talk 19:38, 14 May 2014 (UTC)