Talk:Attention deficit hyperactivity disorder controversies

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Status as a disorder

Scientific researchers have found ADHD causes impairment in life functioning and that behaviour associated with ADHD has been clinically shown to be abnormal in those with ADHD.[7]. - The citation doesn't match what is stated. Mimi ^(yack) 17:10, 10 February 2008 (UTC)

All the subsections of DESCRIPTION AND DIAGNOSIS cover the behaviors and processes which are impaired or shown to be altered in those with ADHD. Executive level control deficits, inattention, and impulse control to name a few are often altered between normal children and ADHD children. These manifest as inability to controlling themselves or being unable to stay on task both of which are important life skills. The top part of etiology of [1] touches on some of the altered behaviors as well. Maybe can you elaborate on what your concern is? I am going to readd the section. Sifaka ^talk 07:37, 18 February 2008 (UTC)

Hi Sifaka, I maintain my position and obviously don't want to edit war so have removed it while we discuss. This looks the same ref I used before. Here it doesn't seem to me to match what is stated; "Scientific researchers have found ADHD causes impairment in life functioning" - well ADHD doesn't kill you and 'impairment in life functioning' seems to refer to the difficulties of modern western living which are argued to not produce 'abnormality' but discontent and protest in some. Hence the controversy, and rather than illustrate that controversy the section seemed to be a statement of the irrefutable truth of ADHD. There is no clinical evidence that objectively tests for the presence of ADHD and the presence of ADHD cannot be shown, it is a subjective diagnosis, hence the controversy. As this article is to detail that controversy I think that section would be better in the ADHD article. Regards, Mimi ^(yack) 01:25, 19 February 2008 (UTC)

The diagnosis of most disorders is subjective including migraines. Do migraines not exist? Or Autism? Or Tourettes? Or Parkinsons? All have a subjective diagnosis. When you look at the hyperactive diagnosis of ADHD...it has a remarkable predictive value and life outcomes are significantly impaired in many areas including school, work, family life...you name it.--scuro (talk) 03:08, 19 February 2008 (UTC)

Discussion above seems off the point. ADHD is defined by a set of symptoms, most of which are some sort of dysfunction or other. This statement is a tautology: "Scientific researchers have found ADHD causes impairment in life functioning and that behaviour associated with ADHD has been clinically shown to be abnormal in those with ADHD."

To consider it other than a tautology, we have to believe that there is some specific thing other than a mere diagnostic category that is "ADHD." Perhaps there is such a thing, but this hasn't been clearly demonstrated, it still is true that ADHD is a diagnostic category and, as such, it is a set of symptoms, found in association, most of which show some kind of "impairment in life functioning," and "abnormal behavior." Not terribly abnormal, and often simply developmentally abnormal, but this is still true. There is also a detail: Mimi, above, challenged this text saying that the source did not say what was taken from it. That's a serious defect, if true, and it was not addressed except by denial when Scuro reverted Mimi's removal. I could look up the text myself, but .... don't edit war. I took the text out until it's established here as legitimate. Quote the source! --Abd (talk) 03:18, 19 February 2008 (UTC)

I did just look at the source, and a source like that cannot be cited en masse; it should be easy for a reader to verify the claim that is based on the source, and it surely is not. Do we have to read a whole tome to find that part of it which is relevant? The course appears to be, as it were, a textbook, but it, in the beginning, notes that it presents the author's theory about ADHD. If this source is going to be used, exact quotes *must* be given here to support text in the article, and I rather doubt that there is anything there that belongs in the controversies article. What's the controversy? So even if the source is good, what is taken from the source, as presented, isn't. --Abd (talk) 03:31, 19 February 2008 (UTC)

• ADHD is defined by a set of symptoms - ADHD is defined by impairment. No impairment no disorder and it has to be in two settings.
• This statement is a tautology: "Scientific researchers have found ADHD causes impairment in life functioning and that behaviour associated with ADHD has been clinically shown to be abnormal in those with ADHD." - can we not use plain English? I know you write for those "few" who get you, but pragmatically speaking, are we not here to communicate to the whole community?
• ''To consider it other than a tautology, we have to believe that there is some specific thing other than a mere diagnostic category that is "ADHD. Perhaps there is such a thing, but this hasn't been clearly demonstrated, " - If you knew more on the topic, your point wouldn't be an issue.
• Mimi, above, challenged this text saying that the source did not say what was taken from it. That's a serious defect, if true, and it was not addressed except by denial when Scuro reverted Mimi's removal. I could look up the text myself, but .... don't edit war. -if you're not willing to do the reading then really why are you butting in?
• I took the text out until it's established here as legitimate. Quote the source! - even a bigger mistake...deleting sourced material based on an assumption.

Here is the Reader's Digest condensed notes on the topic for those who don't like to read. http://www.cdc.gov/NCBDDD/adhd/dadburden.htm If this source is not acceptable simple ask, more sources like this can be found. --scuro (talk) 03:49, 19 February 2008 (UTC)

My, my, a lotta words for nothing accomplished. ADHD is defined by impairment. So we would say that "ADHD causes impairment"? It is impairment, a specific collection of impairments or abnormal behaviors as defined by DSM or another standards manual. Is there some text, supported by source, proposed to be inserted? I did not see the text from the CDC to support the text removed. Interpretation of source isn't allowed, unless it is not controversial, is mere paraphrase. Further, I don't see this text as at all necessary or appropriate for this article. Pap.

How about "ADHD is a disorder, resulting in disordered behavior. Scientists have proven that abnormal behavior is not normal." Is that really any worse? --Abd (talk) 03:59, 19 February 2008 (UTC)

• So we would say that "ADHD causes impairment"? you got it Pontiac.
• It is impairment, a specific collection of impairments or abnormal behaviors as defined by DSM or another standards manual. - Impairment in life functioning .......as was noted in the text before you removed it. But you knew that already or you wouldn't have removed the text. Impairment is defined by subjective assessment by the assessor. I would say no friends and failing several subjects in school would do it for most who assess the disorder, especially if the subject had average to above average intelligence. Now don't get your knickers in a knot here. A good assessor would not make an assessment based on the DSM symptoms and impaired setting alone. They would look further. Some may choose a more formal adaptive assessment and look at other angles.
• Is there some text, supported by source, proposed to be inserted? I did not see the text from the CDC to support the text removed. Interpretation of source isn't allowed, unless it is not controversial, is mere paraphrase. Further, I don't see this text as at all necessary or appropriate for this article. Pap. Thank you for your opinion. It would be a pleasant surprise if you could be a little more accommodating...especially if you are the one asking questions for understanding.
• How about "ADHD is a disorder, resulting in disordered behavior. Scientists have proven that abnormal behavior is not normal." Is that really any worse?- and now you are just being facetious.--scuro (talk) 04:21, 19 February 2008 (UTC)

Here is a definition right from the source provided earlier. "The domains of impairment in ADHD include: academic achievement/school performance, family life, peer/social interactions, self-esteem/perceptions, and accidental injuries and adaptive functioning".--scuro (talk) 04:32, 19 February 2008 (UTC)

Scuro - I agree that hyperactivity/symptoms of ADHD make functioning in society very difficult and frustrating and I'm not saying these symptoms don't exist. All I'm mindful of is that part of the controversy is that these symptoms can be caused by a variety of reasons, and are sometimes normal behaviours for the causation, yet currently they are treated as one syndrome that predominantly attracts one treatment. Part of the controversy is that treatment; drugs, and also the failure to investigate or recognise at patient interface the causes of such behaviours, such as diet, environment, trauma etc. and treat accordingly. I don't think this article is the correct place for the section in question, as stated above, I think it should be moved to the ADHD article. This one should focus on the controversy - there's an entire article claiming that ADHD exists without question and the controversy article states from the off that "Attention-deficit hyperactivity disorder (ADHD) is a developmental neurobehavioural disorder widely recognized by the medical and scientific community as causing impairment, especially in children." I see no reason to repeat that. The controversy article should focus on the controversy. Mimi ^(yack) 11:28, 19 February 2008 (UTC)

I agree with you on all the points you made. Thanks for being a considerate voice of reason. It would be best if a very thorough assessment were done in every case by well trained personal. After all these kids are having difficulty...sometimes great difficulty functioning in life. If you are going to label someone you better be sure that you have the label correct and that there is appropriate service available. Keep in mind though that medication works for many who don't have ADHD but have brain trauma or other causes of ADHD symptoms...after all the same areas of the brain have often been put under stress.

What I think should happen is that the valid points made in this article belong in the main article. This article is in major flux...as a sign of good faith we can leave it out and reconsider, if necessary, when the article is more stable and accurate. That is, if other editors have no problem with this.--scuro (talk) 12:25, 19 February 2008 (UTC)

Scuro - I agree with the comments you've made and have no problem with your suggestion.

I am concerned that an 'unverified claims' tag is on the 'Alternative theories concerning ADHD' section. Both yourself and Snailgoop did some good work on that section. I wonder if perhaps we could all work together to sort that problem out? I'll check sources when I can. Regards, Mimi ^(yack) 14:56, 19 February 2008 (UTC)

Sure I can help. I think the first thing that needs a template to let people know that this page is a work in progress. That way they will be more forgiving. Is this the right one? Template:Isrev

The social construct theory may go back a way to Thomas Szasz and beyond. That stuff looks to be on the antipsychiatry article. Why reinvent the wheel? If there are articles on things like hunter/gatherer lets link out. If there is a large section like social construct...find a link out, trim, or create an article to link out. What I see as a problem is undue weight for sections where previous editors have a major interest and have created a lot more content...as compared to other equally or more important areas that have less info because editors were not as interested in that topic. How does this approach sound? Focus on the alternative theories perhaps everyone working on one.--scuro (talk) 20:59, 19 February 2008 (UTC)

I'll leave the template choice up to you but the idea sounds constructive for that section, also an invite to Snailgoop and maybe Barrylb? I think if an editors work is destined for change it's nice to give them an opportunity to do that. Something has cropped up I need to deal with Scuro, can you drive this for a while until I can help further? Hope so, I'll be able to help in a little while. Linking out rather than repeating sounds good if there is an article but some repetition may be necessary to make a point - I'm just concerned a reader would be landed with a lot of links to follow in order to understand a point but as long as the point is clear then I think it a good suggestion. Regards, Mimi ^(yack) 19:22, 20 February 2008 (UTC)

I'm just going to slowly work on the Hunter/gatherer section.--scuro (talk) 04:34, 21 February 2008 (UTC)

which article?

Does this belong here in the controversy article or be better in the ADHD article do you think?

Genetic basis of ADHD
Research indicates that there is a highly probable link between genetics and ADHD. Research suggests that ADHD is a heterogeneous disorder and that a large majority of ADHD arises from a combination of various genes.[15] Dr. Joseph Glenmullen has focused his criticism based on the single gene theory, "no claim of a gene for a psychiatric condition has stood the test of time, in spite of popular misinformation". Although many theories exist, there is no definitive biological, neurological, or genetic etiology for "mental illness."[citation needed]

Miamomimi (talk) 17:26, 10 February 2008 (UTC)

It belongs on the controversy page. There already is a causes i.e. etiology section in the ADHD article which goes over the most likely genetic theories. The first sentence is irrelevant because no single gene is implicated in ADHD. Rather the main viewpoint is that "ADHD does not follow the traditional model of a "genetic disease" and is better viewed as a complex interaction among genetic and environmental factors," and "although several genome-wide searches have identified chromosomal regions that are predicted to contain genes that contribute to ADHD susceptibility, to date no single gene with a major contribution to ADHD has been identified."

My interpretation of the second sentence is that it is basically saying "Although there are many biological, neurological, and genetic theories on what causes a specific mental illness, none of them have been proved." Assuming I have interpreted it correctly this statement is confusing the common and scientific definitions of "theory" and "proof". Strict "proof" only exists in mathematics, so it is not possible to "prove" anything is science. Rather there are "theories" which in their scientific sense are simply an explanation or model that makes testable predictions and has not been falsified. It seems the second statement is trying to capitalize on the colloquial definition of the the word "theory," falsely characterizing it as a matter of opinion rather than of fact or evidence.

I should probably include this response in this quotes section, post modification. Sifaka ^talk 02:23, 18 February 2008 (UTC)

Sifake - ok no worries. BTW, I've taken out this edit: "However, not all hyperactivity in children is due to ADHD, and dietary factors have not been implicated in ADHD etiology. " as that was kinda the point I was making and it looks as if it's a direct rebuttal of my previous edit but it's a good ref and I'd like to re-insert it with another of mine own (have found the copy I needed) and see what you think if thats ok? I have an errand to do that can't wait but will do this tonight and as it's here I won't forget it. Regards, Miamomimi (talk) 15:18, 18 February 2008 (UTC)

No problem, the article isn't going anywhere. It's good that you are checking the sources to see if they actually source what they are actually supposed to source by the way. Cheers, Sifaka ^talk 18:53, 18 February 2008 (UTC)

Ok Sifaka, it's up, though I'll probably re-read tommorow - I thought that ref of yours was useful as it highlighted a tension in the genetic argument yet I wanted to use it in its current location as it demonstrated current medical guidelines. Sadly the one I quote from isn't online :-( regards, Miamomimi (talk) 23:51, 18 February 2008 (UTC)

Clinical Research Involving Children split into a new article

I am concerned that this paragraph is not sufficiently specific to ADHD. It may be more appropriate to create an separate article for the topic since I can't find an article or a section of an article on WP at the moment that deals with the topic of children in clinical research. There is also the possibility that it could me merged into an already existing article like the ethical conduct section of clinical research, but I think there is enough debate on this matter to warrant a full article. Sifaka ^talk 08:23, 18 February 2008 (UTC)

Potential re-organization of the alternative theories section

I originally wrote this on the ADHD discussion page but I thought I would move it here, elaborate, and see if this proposal generates any interest. In order to clean up and organize the Alternative Theories section, it might be nice to structure each theory by issues. Potential issues might be

• What is ADHD? a disorder (i.e. a brain malfunction), a distinct phenotype within the normal range of human behavior, non-existent?
• What causes ADHD?
• How should ADHD be treated, if at all. With stimulant meds? Psychological therapy? A good wallop to the behind?
• Should there be accommodations/special aid for people with ADHD?

This might make the essentials of each theory easier to understand and could make it simpler to compare viewpoints with each other and mainstream scientific theory. Each viewpoint would be structured sort of like this:

Small introduction to each Alternative theory's basic premise/proponents

stance on issue 1

stance on issue 2

stance on issue 3...

theory specific issues (i.e. is the premise plausible etc...)

Any interest? Sifaka ^talk 20:22, 18 February 2008 (UTC)

If this is going to be a lengthy thing, shouldn't it be a separate article?--scuro (talk) 04:27, 19 February 2008 (UTC)

reworking article so as to combine two articles together?

Simply what I am proposing is prune this article until it is lean and pure for the purposes of moving all or most of it onto the main article. There is no way that we can move most of this stuff over now because of undue weight. One way to do that is to link out of the article. There is a hunter vs. farmer theory article. If you folks agree, I'll trim the Hartmann stuff on the article with a link out, so you can see where we should go with this. --scuro (talk) 03:28, 20 February 2008 (UTC)

Combining the articles has always seemed sensible to me, however, when you say "prune this article until it is lean and pure for the purposes of moving" it rings alarm bells! If this article is factual and backed up with references and the facts presented are consistent with the subject then those facts shouldn't be pruned for the purposes of moving. If opposition is likely, due to the opinion of undue weight, then perhaps a mention of the main points of the controversy could be put in the ADHD article, linking to the 'controversy' article for greater detail. I think that would be a good idea as someone has lately missed the link to the controversy in the ADHD article, which may have prompted your suggestion. I agree with your suggestion that explaining a theory that is detailed in it's own article is misplaced here and linking out seems sensible to me. (also, pls see last comment in 'Status as a disorder' section) Mimi ^(yack) 19:35, 20 February 2008 (UTC)

Well lets look at Hunter Gatherer theory. It has reached the mainstream population, it can be well referenced, but it is neither majority or minority opinion. It does deserve mention, but truncated mention. It deserves a few sentences at best, on the main page with a link out to the article H&G. The same goes for a lot of stuff in this article. The meatier issues deal with medication and they would most likely be longer on the main article because they may be minority or even majority opinion. But I'm not going to research and find great citations for the fun of it. The purpose of merging this article is to eliminate it. No other mental disorder also has a controversy article and this article has taken on the role of coatrack for a good deal of it's existence. I'm not going to expend a great deal of energy to edit and refine controversial viewpoints and then merge them into the main article to have the controversy page stand. It would be coatrack waiting for a new closet full of POV pushing edits. The choice is yours.--scuro (talk) 04:30, 21 February 2008 (UTC)

Thank you Mimi. You are new here but if you take the time to go over what has been deleted and which links removed (by the mysterious person suggesting we do the "pruning") you will get a great education in this person's disingenuous motives. I urge you to take a look at his history and how he manages to make critics out to be members of the lunatic fringe. I have recently made explicit the position of an Oxford Professor, winner of the yearly Faraday award from the Royal Society , for her contributions to the scientific education of the English. She is very concerned about what is going on with ADHD. I'll bet he will remove it and leave criticism from the Scientologists, thereby continuing the myth that critics are antipsychiatrists or members of cults. That he continues to rule here is amazing. He wears down his critics who have better things to do then go on and on and on with him. The time he spends on this article has made me wonder whether he does this for a living. I know that sounds paranoid but I have seriously begun to wonder about him. I have asked him repeatedly to identify himself, but he refuses--Ss06470 (talk) 18:09, 1 March 2008 (UTC)

Ss, you are aware that you are breaking wiki guidelines, and I ask to what end? ( WP:NPA. "Do not make personal attacks anywhere in Wikipedia. Comment on content, not on the contributor. Personal attacks will not help you make a point; they hurt the Wikipedia community and deter users from helping to create a good encyclopedia". ) Mimi is fully aware that my viewpoint is radically different from yours or hers, yet refreshingly she seeks to work together to seek consensus. She doesn't assume bad faith and nor should anyone. If you believe an editor truly is gaming the system, seek help or make a formal complaint. Otherwise what you post will simply be seen as flaming, very off topic, and bad form. I hope to work with you in the future to change the article for the better.--scuro (talk) 22:47, 1 March 2008 (UTC)

To what end? To alert her to the history of seemingly innocent editing that always has the same result, the elimination or trivialization of serious criticism of current dogma and practice--Ss06470 (talk) 23:38, 1 March 2008 (UTC)

Are you helpless? Can you not point out the specific edits and discuss in talk why they should not be removed, changed, or added.... as other editors do? Could you be assuming bad faith on my part, by not to follow wiki guidelines, and seek to eliminate a viewpoint that is foreign to yours by building me up as a strawman? Have not other editors supported your viewpoint? Please stick to content, your approach is making talk highly personal and I do not not appreciate it at all. Please desist in this practice immediately. Make a complaint if you have any solid ground to believe that I am not following guidelines. Please don't waste everyones time by focusing on contributors instead of content on the talk page. Can I be anymore clear? WP:NPA --scuro (talk) 05:56, 2 March 2008 (UTC)

I am willing to cut and paste huge tracts of debate (and ad hominum attacks on your part!!) that have been a part of the discussion here with me and many others who have disagreed with you. That is why I asked her to review your history. I did so and it is amazaing how you use the same tactics. Despite being corrected by me and others you invariably manage to place critics as "antipsychiatry" belonging to scientology, Breggin supporters or Fred Baughman's dupes. You use that again and again. You have managed to chase away, in complete frustration , person after person with your inability to hear what they were saying. For example: http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=115437334&oldid=115435277

Give it up User:68.35.248.242 Give it up User:68.35.248.242. Your viewpoints belong in the controversy of adhd article. "extensive conflicts of interests" could come right off Fred Baughman's website. Again it doesn't matter what you believe, Wiki wants reliable citations. Virtually every researcher and all the US national institutions that deal with ADHD would not see it that way. Yours isn't even the minority viewpoint of experts but rather the controversial viewpoint.

Your NIH point is just another in a long line of red herrings not ment to improve the article. The 1998 consensus was about diagnosis and treatment, hence the title, "Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder (ADHD)". The later and international consensus clearly makes the link between ADHD, the brain, and genetics. --scuro 12:47, 15 March 2007 (UTC)

last word, wrong I believe you are incorrect. Here is why.

The viewpoints of others are irrelevant to what I am saying and I believe those that author and edit this site frequently write off any criticism as coming from a radical point of view and do not stop to consider the validity of claims. I am not Fred Baughman...

Here is a note from someone else who gave up. Dr. Sobo, I am glad to see a new voice of reason and science on here. With even the admins vandalizing articles, we need experts on here to stand up to the zealots. Thank you for your comments on my page and your work in the field of psychiatry. Jkhamlin 03:38, 16 May 2007 (Jkhamlin is a medical student)

One...more...time. I have no need to prove anything. It is the defenders of this ridiculous piece of pseudo-scientific hogwash ( and of the laughably coy article about 'controversy' in which every gigantic doubt is followed by by a slippery 'but' qualification in no wise equal to the doubt expressed) who need to provide proof. It is precisely because they can't that they want to suppress the truth that there is some doubt about it. Whatever would happen if the uninformed got hold of that piece of knowledge? The 'single point' I wish to pick, and have picked, and propose to stick to, is that the diagnosis is controversial, a statement of the blindingly obvious ( for which I have provided ample evidence even for those unable to see the blindingly obvious). This 'single point' was censored from the article within hours of my placing it there, by its righteous self-appointed guardians, and would be so censored again, along with pious warnings about my misbehaviour, should I do so again. You can put it back whenever you like, using the references and links I provide in the draft I wrote. No need to trouble me. But you won't. You're not even remotely paying attention to what I say. This change, a statement that 'ADHD' is a controversial diagnosis is an incredibly minor one compared with what I would be entitled to do in a fair forum. The advocates of the existence of 'ADHD' need to prove it exists, and haven't done so because they have no proof that it does, and know they have no proof. That's settled, I think. None of you has offered any such proof or evidence despite my repeated urgings for you to do so. Having swallowed the flabby camel of 'ADHD', they now strain at the gnat of admitting that Terence Kealey and Susan Greenfield and the latest Buffalo University study are evidence of doubt about the diagnosis. If I 'write well' (and thanks so much) it is because I tell the truth. I'll stick to making sure the warning label remains until such time as this pernicious rubbish goes the way of pre-frontal lobotomies. PH signed in as Clockback (talk) 23:04, 13 January 2008 (UTC)

.

---

The reason you and some of your allies are the issue is that you manage to prevail, not by logic but persistence. You leave absurd statements on the page by all kind of fringe groups but not statements and arguments that are more reasonable. It drives reasonable people to fury, and finally they leave. This is just a quickly put together sampling, but if you want the whole thing I will be more than happy to document your pattern and the insults you have regularly directed at your opponents It is almost laughable that you regularly warn others of not sticking to the task at hand and insulting you.

Finally, in reviewing a good number of the debates you have entered into, the key one appears to be whether ADHD is or is not a predominantly biological condition. This is the issue that the pharmaceutical industry has spent undue energy trying to end all debate about. As evidence of this assertion I will post something from Professor Pelham who changed from a paid "expert" to a staunch opponent of the drug industry (I, by the way do not believe all of the problems come from corrupt "experts" in the hire of drug companies, but I know they have an absurd influence See the editorial by Marica Angell, former editor of the New England Journal of Medicine Is Academic Medicine for Sale)

"It Was Like A Whitewash"

Enter Dr. William Pelham, director of the Center for Children and Families at State University of New York at Buffalo (SUNY). A leading ADHD researcher for 30 years, Pelham is a former member of the scientific advisory board for McNeil Pharmaceuticals, which produces Tylenol and markets Concerta, a popular stimulant medication trademarked by Alza Corp. of Mountain View, Calif. Over his career, Pelham has penned over 250 research papers on ADHD, many with industry grants. In 2002, he was given a lifetime achievement award by the world's largest ADHD patient advocacy group, Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). In interviews with AlterNet, Pelham provided glimpses into the dubious methods drug maker McNeil-Alza uses to ensure that studies it funds produce favorable results for its ADHD medications. Between 1997 and 1999, he was paid by McNeil to conduct one of three studies used to get FDA approval. The company currently uses the three studies to claim that 96 percent of children taking Concerta experience no problems in appetite, growth, or sleep. But Pelham says the studies were flawed. The original intent of the studies was to measure both side effects and main effects of the drug. But two of the three studies, including Pelham's, required that the subjects had to already be taking MPH and responding well to it in order to enter the study. In other words, by stacking the studies with patients already successfully taking stimulants, McNeil ensured the subjects would be unlikely to register side effects, Pelham says.

"It's really misleading and I'm surprised the FDA is letting them use the studies to advertise no side effects," he says. "They had no side effects because they took only people with only a positive history of medication. This is really pushing meds without telling the full picture." There was also pressure from the company to tweak the findings, he says. Part of Pelham's study involved "providing parent training to parents, having a simple behavioral program in place on Saturday lab days, and establishing simple behavioral programs in the children's regular school classrooms." When his paper was in the galley proof stage at the medical journal Pediatrics, Pelham says he joined a conference call with a number of senior people from the corporation who lobbied him to change what he had written in the paper. "The people at Alza clearly pushed me to delete a paragraph in the article where I was saying it was important to do combined treatments (medication and behavioral)," he says, adding that they also pushed him to water down or eliminate other sentences and words that did not dovetail into their interests. "It was intimidating to be one researcher and have all these people pushing me to change the text." McNeil offered no direct response to the allegations.

"We cannot comment on unsubstantiated allegations," says Gary Esterow, a spokesman for McNeil Consumer & Specialty Pharmaceuticals, in a written statement. "The protocols and full study reports for these clinical trials were reviewed by the FDA, and provided the basis for FDA approval. Prior to publication, there was ample opportunity for full discussion of the data among the investigators. Publication of the findings reflect the prevailing opinion of the authors and is further supported by the peer review process of the scientific journals in which these studies appear." Pelham says McNeil didn't stop there. The company commissioned a follow-up study on the conversion study mentioned above. This time McNeil did the data analysis and coordinated the paper writing. "I insisted on seeing the analyses and having major inputs into the manuscript and it was like pulling teeth to get wording and analyses changed," he says. "It was like a whitewash, a praise to Concerta." Pelham says the company submitted the paper twice to the Journal of the American Academy of Child and Adolescent Psychiatry. Drafts were sent to Pelham several times but he says he never returned anything with his signature. In the end, however, he says the paper was accepted without his knowledge and published with his name on it).

My assumption for the reason Pelham was pressured to remove the paragraqh emphasizing the importance of combined treatments (medication and behavioral) is that this would expose the limitations of pediatricians, who would be required to meet this standard of care. By far, the biggest presecribers of Concerta is pediatricians. Use would go radically down if the pediatricians could not believe that they were giving appropriate care based on reasoning that they were simply fixing the chemical imbalance.

Dubious tags

Scuro has put some tags on this section

"The argument in regard to ADHD derives from a serious concern that medical professionals in cooperation with the education system are driving a dangerous trend; namely, that children with ADHD are mentally ill[dubious – discuss], abnormal, disabled, maladaptive, etc., because they do not conform to a standard that has been socially constructed[citation needed], and is ultimately dominated by the interests of a multi-billion dollar pharmaceutical industry[dubious – discuss]."

IMO, the information isnt't exactly dubious, but the section could use a less POV rewrite, particularly the last part.

Perhaps

"The argument in regard to ADHD derives from concerns that medical professionals and individuals within the USA education system are pushing a dangerous viewpoint; namely, that children with ADHD are mentally ill, abnormal, disabled, maladaptive, etc., because they do not conform to a socially constructed norm. Some people have suggested that this viewpoint is ultimately being pushed by the pharmaceutical industry in order to sell Anti-ADHD drugs[citation needed]."

would be better?

Restepc (talk) 18:35, 20 February 2008 (UTC)

Sounds good to me Restepc. Mimi ^(yack) 19:36, 20 February 2008 (UTC)

Generally the whole section looks to have a lot of OR going on. To me the bigger issue is attribution. Where are these ideas coming from? It's okay if they are POV as long as it is attributed and they don't receive undue weight...after all this is a controversy article.--scuro (talk) 04:05, 21 February 2008 (UTC)

Well I've certainly heard those opinions expressed before, so I can't imagine it'll be hard to find sources, I'll find a few and put them in when I switch the current version to my suggestion (assuming no-one has a problem with my suggestion between now and then) Restepc (talk) 18:56, 21 February 2008 (UTC)

Switched it, put in a (obviously biased, but that's the point in this case) source, I'll leave this for a week or so in case anyone else has any comments then if not I'll scrap this section of the talk page....assuming that's what's done on wikipedia with discussions which have completely finished with no real disagreements??? Restepc (talk) 09:44, 2 March 2008 (UTC)

No, you don't eliminate anything in talk. It's a record and a potential shortcut for editors seeking change to a section. You can't use an obviously biased source, and a personal website...that is unless you were, to say...use a direct quote from the individual and attribute that quote to the individual.--scuro (talk) 15:28, 2 March 2008 (UTC)

Page numbers, please

I put a couple of tags in the Social construct section (possibly not the right tags) because I would like page numbers for the bits where Timimi talks about "right wing capitalist ideology" and "should favor boys over girls". This is not requested in time-wasting spirit, but because these bits seem not quite to tally with what Timimi says elsewhere.Ancadi (talk) 11:22, 21 February 2008 (UTC)

Diet section

I moved a part discussing the role of diet in ADHD from the "skepticism towards diagnosis" section to a newly created subsection which I uncreatively called "Dietary Link to ADHD" under the newly created major section which I even-more-uncreatively called "Debate About the Causes of ADHD." Feel free to improve upon the names.

The largest change between the content was to find references for and elaborate on both sides of the debate over whether hyperactivity is exacerbated due to certain foods or additives and whether dietary restrictions mitigate ADHD symptoms. I changed the line "After leading the first study of its kind into food additives" to "After leading a study into food additives." The reason for this is that there were several studies into the same food additives previously using similar methods. I also found the ref for the study. I added a citation needed tag to Professor John Warner's quote because quotes should be sourced. (I looked for it but couldn't find it). Finally I removed the line "Eminent practitioners in the field have questioned the rising number of diagnoses of ADHD and its variants" because it doesn't fit in with the diet themed section. If someone wishes to move it elsewhere, fine by me. I think that covers it. Sifaka ^talk 03:06, 23 February 2008 (UTC)

My quote was sourced, there was nothing wanting in the work I provided, I will restore the removed material when I can. If you choose to change the position and thereafter the subject/focus of the sourced work provided, that could be construed as censorship by stealth to suit your POV, which should not occur. Mimi ^(yack) 14:28, 1 March 2008 (UTC)

removing multiple citations that often don't support the point they are citing

I have eliminated a few citations behind statements where the citations do not support what is stated in the sentence.--scuro (talk) 06:28, 2 March 2008 (UTC)

These should be examined closely. --Abd (talk) 17:05, 2 March 2008 (UTC)

I did, you are welcome to double check what was done. If you disagree you know the channels to follow.--scuro (talk) 18:26, 2 March 2008 (UTC)

Reversion of Scuro revert due to "personal web site" argument

We've discussed this issue many times, Scuro should know better. This is a controversies article. Breggin is a noted critic. His opinions may be cited and sourced from his web site. Don't like it, RFC it. I think it would be a waste of time.--Abd (talk) 17:07, 2 March 2008 (UTC)

That was a different time when personal judgments and attacks were mixed in with talk. Because I did not respond to posts which appeared to contain flamebait, doesn't mean that I conceded any point on this issue. Having said that, I think this should be looked at by a case by case basis. Here is my take on the issue. Generally personal websites should be avoided like the plague. If a personal website is being used to illustrate a controversial and fringe viewpoint, quotes should be used which can be directly attributed to the owner of the website and the quote. The author of the quote should be notable and the quote should attributed to the author. Most importantly such a segment should not undermine undue weight. --scuro (talk) 18:34, 2 March 2008 (UTC)

No concession was implied, rather only prior notice, and there are no formal charges here making it necessary to claim lack of proper notice. "plague" is not mentioned in the guidelines, and personal websites of an expert or person otherwise of note may be, explicitly, cited as evidence that the person actually expressed the argument. Now, a series of requirements were stated. If the material in the article isn't a fair and accepted summary of the point made in the source, that is grounds for correcting it or removing it. Clearly, an editor who placed the source believed that the source was appropriate. What was done here was to remove the source, based on the "personal website" claim, yet now the argument shifts, apparently. Now, it's not the personal website -- because this has just been acknowledged as appropriate for sourcing an opinion by a notable author -- it's, I must guess to some degree, that there is no "direct attribution," but, presmably, an indirect implication. I.e., Breggin didn't say, perhaps, exactly what is in the article -- I have not researched that -- or perhaps there is doubt as to whether or not material on the site may be attributed to him. Wikilawyers could argue for centuries over this, but, bottom line, the text either fairly represents what is on Breggin's web site, or it doesn't. In the former case, the citation is appropriate and has nothing to do with "personal web site" -- which was Scuro's summary of cause for reversion -- or it is not appropriate synthesis and the entire thing should be removed, not just the source. If the substance is correct, and the details wrong, the details should be fixed. --Abd (talk) 21:26, 2 March 2008 (UTC)

Yes, the research is once again lacking, and as in the past, it may be better to properly investigate something before one unilaterally changes someone else's edit. They may have done the homework. One could argue that an editor who does not do even the most basic investigation, and make changes based on nothing but pure assumption, shows a marked degree of arrogance. I presume the proper attribution would be to Baughman. If you would like to contribute, please be a little more thorough. I look forward to your future input in this regard.--scuro (talk) 22:14, 2 March 2008 (UTC)

Removing Susan Greenfield from intro

I removed the following

"The most prominent of these critics is Oxford professor Dr. Susan Greenfield, winner of the yearly Faraday award from the Royal Society, for her contributions to the scientific education of the English. Dr. Greenfield called on ministers to examine how ADHD is diagnosed and treated in the UK."

)

The reason I did this is because it did not contribute to the content of the opening paragraph other than adding someone's name and achievments. The purpose of the intro is to give an overview of the topic at hand. ADHD controversy goes above and beyond one critic in the UK. Why include this one person and not any of the others? It would be best not to mention anyone specifically in the intro rather than flood the intro with many names. Secondly I have issues with calling her the most prominant ADHD critic. That point is certaintly debateable. She is just one person so giving her such a prominant mention in the beginning may violate the undue weight policy. If we need to make an international section to discuss ADHD by region then someone with more knowledge than I should do it. Sifaka ^talk 22:37, 2 March 2008 (UTC)

I understand and can not really argue with this edit. The reason it was placed there was the original section and other sections (as ususual) made critics seem like a bunch of nuts or antipsychiatrists

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a term consistently used by Scuro to describe critics

My statement about Scuro's unrelenting bias have apparently been removed, but fortunately they have been read and I feel encouraged that the group here will guard important passages in the article itself I have added a section on media attention to the ADHD controversy. While it is true the media can and do get a lot of things wrong, this article is about the ADHD controversy and the references there are a fair representation. They also are a rich source of links to a diversity of opinions and cannot help but move a reader to a better understanding of the issues. I ask that responsible editors guard that section because if things go like they have in the past some technicality will be used to remove them, and opposing viewpoints will again be relegated to the Scientology crazy category. Removal of Dr. Greenfield accomplishments in the first paragraph of the article is fine, but here it is crucial that the status of those with opposing viewpoints be noted. Lastly I would like to add a section which specifically addresses the ADHD biology issue, and provides an alternate paradigm. It is not the viewpoint of mainstream thinking but it is a reasonable alternative, which a thoughtful person might consider in thinking about the issues. I am posting it here first for comments. (I can't help but remark that the section on biological changes in the brain as a result of behavior a crucial piece in a readers ability to interpret biological findings was removed from the article in the past by you know who)

Is ADHD a biological condition?

One of the most controversial issues regarding ADHD is whether it is wholly or even predominantly a biological illness, a defect in the brain. The current predominance of opinion in medicine is that this is the case, but the fact is that the cause of ADHD remains unknown. For example there are radically different opinions about whether there is a genetic basis. For example the statement that there is a highly probable link between genetics and ADHD. Disorder: Nature, Course, Outcomes, and Comorbidity|last=Barkley|first=Russel A.|accessdate=2006-06-itle Contradicting this is the opinion of Dr. Jay Joseph. (THE MISSING GENE Psychiatry, Heredity, and the Fruitless Search for Genes Jay Joseph, Psy.D. Algora Publishing, January, 2006) Joseph Glenmullen, M.D., from Harvard Medical School had this to say "no claim of a gene for a psychiatric condition has stood the test of time, in spite of popular misinformation". (Glenmullin, Joseph (2000). Prozac Backlash. New York: Simon & Schuster, 192-198) While there have been hundreds of articles citing physical differences in the brain of those with ADHD, most of these have not stood up. Xavier Castellanos MD, then head of ADHD research at the National Institute of Mental Health (NIMH), and firmly convinced that ADHD is a biological illness, acknowledged this in an interview with Frontline Castellanos interview. Critics of Dr. Castellanos’ own research have pointed out that the differences he was claiming to exist could have been the result of medication taken. ( He has since been working on eliminating this variable) However, even if differences in the brain will be found, an important issue is that the brain can be physically changed by patterns of behavior. Thus learning Braille causes enlargement of the part of the motor cortex that controls finger movements. [2] After they have passed their licensing exam, London taxi drivers have been found to have a significantly enlarged hippocampus compared to non-taxi drivers[3][4]. Patients abused during their childhood with post traumatic stress disorder will have a flattened out hippocampus. [5] Professional musicians have brains that are different from non-musicians. [6] Monks who meditate show measurable differences in their prefrontal lobes.) [7][8][9]

So diminished concerted effort when confronted with tasks thought to be drudgery (homework, paying attention to teachers, and the like) even if not caused by differences in the brain, could have brain changing effects. In “Rethinking ADHD: International Perspectives” ed Timini 2008 Palgrave Macmillan an alternative paradigm for ADHD argues that while biological factors may obviously play a large role in difficulties sitting still and/or concentrating on schoolwork in some children, the vast majority of children do not have a biological deficit. For a variety of reason they have failed to integrate into their psychology the ability to work at chores that are expected of them. Their restlessness and daydreaming is similar to the behavior of other children when they are not engaged, and are bored and trapped by circumstances. Characteristically, children with ADHD/ADD have no difficulty concentrating on activities that they find to be fun, for example video games which require enormous attention skills. When they are taught by a charismatic entertaining teacher, they similarly can concentrate. As a reward chemical the usefulness of stimulants with these children may be due to their ability to make drudgery engaging. It does this for both ADHD children and adults and people without this diagnosis (note: I will be happy to provdide documentation of this interpreation of why stimulants work)--Ss06470 (talk) 22:44, 2 March 2008 (UTC)