Talk:Adult attention-deficit disorder
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[edit] AADD as a gift
I use my AADD to be creative, and have become a major contributor for Wikipedia in areas which interest me. I have become an administrator which gives me some extra tools, but does not represent any duties or work as such. Wikipedia is purely a voluntary thing. Shedding some light on Adult ADD is one of the benefits for me. Wikipedia articles often turn up on search engines such as Google and Yahoo. (Just try a search on adult ADD, ADD, or ADHD (each spelled out) if you want to see what I mean).
As the creator of this article, I want to say that I personally like to emphasize the philosophy of viewing AADD as a gift. Of course, that is subject to debate. I would like to think that this is good place for such a discussion, and that we can improve this article. There are more comments about my AADD at my user page which is User:Vaoverland. Mark In Richmond.
[edit] blurb for Did You Know section of Wikipedia
... that Adult attention-deficit disorder (AADD) affects an estimated 30% of children who had Attention-deficit hyperactivity disorder. Often accompanied by hyperfocus, AADD is thought to have been a gift for historic figures and persons currently well-known in a wide range of fields.
(Did You Know is a Main page feature of Wikipedia to draw attention to new articles). Vaoverland 07:54, Mar 31, 2005 (UTC)
[edit] You are right can you change the home page?
I added some comets second ago but there ware cutted out althou content leaved was a lot more as POV.
If that question "did you know and ADHD", on the home still there be an people would read that, and many young people!!!!! and read that this is some knowledge and assume that this is true althou its just some made up bunch of words that psychiatryst
made to make more money , that would mean one that this wikipedia is an boolshet, and if it would be just boolshet it would be cool, your boolshet, but you refference wikipedia as 'free ancyclopedia that is made to achive the highest possible quality to every single person on the planet in their own language', yeah.
==And please returne input (question asked)
I made that POV request and some furhter notes:
* may be perceived as aloof and arrogant or tiresomely talkative and boorish
I persive you-the reader, aloof and arrogant, do you have ADHD? No
*compulsive joking, often about personal life history and feelings
Does Jay Leno, Connen O'brien, are ill? No
*Pressured rapid-fire speech, seemingly random and aimless hopping from one topic to the next
Every lawyer would love to do that!!
*difficulty starting tasks
How often you go out to clean garbage, or stay in to wash dishes?
*tasks or book reading begun but not finished
Isn't the Wikipedia the bigges unfinieshed book on planet, and doestn't 1000's of wikiepdians start some taksks and don't finish them?
*Before new projects or new books are started, leaving a never-ending to-do list
Whats the species.wikipedia.org??
*unmet high personal expectations
And this is the higest POV sentence i ever read in Wikipedia.
*hunter vs. farmer theory,
Why in wikiepdia there was a place for theory and other POV and guesses and just a little paragraph about doing somthing?
Does it mean that this whol article is bulls##t worth and eighter aoutors of it and precursors didn't new and don't know how change people they describe?
Besides vaocabulary that was used by othor of that page is as wide range about people as word "America" or "Europe" about land.
[edit] sources seem rather limited
As it stands, the article seems not so much non-neutral as very limited. It worries me that all the references seem to be (going by the titles) self-help "sales pitches" of one kind or another. I'd like to see input from someone familiar with the professional literature. -- Danny Yee 07:38, 3 Apr 2005 (UTC)
I just looked up the http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders guidelines for normal ADHD: http://www.behavenet.com/capsules/disorders/adhd.htm. It might prove a good starting point for factual information, given that the DSM-IV is pretty highly respected as a set of clinical guidelines for diagnosis.
I think it's important to seperate out what AADD is, as it is defined, and the arguement about whether it's actually a "disorder", or simply "boredom" (or whatever else you want to attribute it to). I think the article does a passable job at the former, but doesn't really address the later. --Travlinscotty 08:15, 3 Apr 2005 (UTC)
[edit] Comments
We used to call it "boredom", and boring teachers. As children that is.
The teachers just called it "disobedience".
The guys who make the "cure" no doubt call it a "profit".
Fact is people in a dull environment are going to have an "attention deficit", if they found it "exciting", it would be even more worrying.
- Perhaps if you would like to actually debate the issue instead of just making anecdotal pot-shots, you might actually sign your name. -- Darco
[edit] improving the article
I am reading the comments about the article and would like to improve it. The books by Hallowell and Ratey are not "self-help" books. Have you read them? The one by Hartmann is controversial. Much of the information came from the National Institute of Mental Health and from the existing article of ADHD.
I will work on more content and sources for the information. It is unfortunate that the drug company's profits and advertising both contribute to speculation that ADD/ADHD doesn't exist.
I am not clear on what facts or statements in the article are disputed, and it would help to known more about what is wrong with them.
I would also comment that it is true that all children get bored at times, all classes get disruptive, etc. I have worked with school buses for over 35 years. Some educators, parents, and school bus drivers would probably advocate some form of stuff in an aerosol can that your could just spray over a class to get the behavior you want. That is of course, BS. Likewise, we are not talking about the typical boredom or inattention when we look at an individual with ADD/ADHD.
However, within almost any group of kids, good teachers will tell you that they can spot the children who may have ADD/ADHD after some time working with them. A good teacher looks to the cause of behavior, not just the symptom which may be displayed. The fact is that many kids with ADD/ADHD became much happier, productive, and well-adjusted with proper help (which doesn't always include medication), get along better with their peers, and most don't need to stay on meds as adults. Most adults who get and ADD/ADHD diagnosis benefit immediately just from a sense of knowing that behavior which has troubled them all their lives may not have been simply poor choices or lack of self-control.
The point of the list of famous people is not that any of them are "ill". The whole point is that ADD/ADHD is a condition which can be used as an advantage. Jay Leno's rapid-fire speech is hardly the point. Take a look a his interests and life for the indicators.
There is great harm in a child believing he/she is bad when they really can't sit still. The prisons and rehab centers are full of adults who got no help with their problems as kids. That doesn't mean everyone could have been helped. The challenge, of course, is to do what we can. Vaoverland 08:00, Apr 3, 2005 (UTC)
[edit] Criteria
I just read over the criteria at the link provided. I will add this to the article's references ASAP and work to incorporate some of it into the article. One comment which is germane to the discussion is that you will find that the word "often" is used in most items of the behavior criteria and that more than 1 setting in needed (ie home, work, play, school etc.). With those two limitations, you should be able to weed out the fact that a whole class or almost everyone is bored at times (causes: general mood, weather, teacher, lunch, etc.) or simply a school-only situation.
It is true that most people as children called such times at school boring, and that at times, most classes are disobedient as a whole. However, the whole point is that most children and not routinely and continually bored by most teachers, and that most classes are not generally disobedient. We are discussing perhaps at the high side less than 5% of school children who are though to have ADD/ADHD to a diagnosis level. That means only 1 or 2 on a class of 30-40 children on average.
One reason it is often first spotted at school is that teachers have both their own experience and training and many non ADD/AHDH children to help in comparison. Another factor is that the problem is almost certainly hereditary. Any group of educators will tell you about meeting the parents of ADD/ADHD children, and being struck by similarities of symptoms in some instances. In my personal experience, that included very successful parents. Vaoverland 08:36, Apr 3, 2005 (UTC)
[edit] About ADD and new tag in wikipedia.
In short, add a feature, to wikipedia that would show somehing like: THIS IS THEORY ONLY or INTERPETATION, IT CAN BE WRONG.
Couse while articles like ADHD are in 'did you know', then pepole can read this as some knowledg and assume that this is true while it only interpretation.
I'm concerend about that there is an easy way to interpretate someone as ADHD'ed becous language used in description is wide range: from [ADHD] " tasks or book reading begun but not finished before new projects or new books are started, leaving a never-ending to-do list" (its description of wikipedia)
or may be perceived as aloof over talkative? and wikiepdians was helping to spread thoes interetations.
When in wikiepdia there'll and visibe note that 'THIS is theory, CAN BE MADE UP' in all theries (like ego, high counscious, sub councious, religions, ADHD, end especialy about threatments for kids when i read TREATMENT: PROZAC work after 4 months, this are only speculations.
You go it? Its like talking that wikipedia was made becouse Galile discoverd some planets, other guy invented puzzles and know there is wikipedia with eartch like puzzle logo, irrevelat, seperated.
When wikipedians will add that feature i metniond then wikipedia will be sit that one can reffer, check up what true and practice and what is theory only.
I hope i are aware of pater, first some made up word ADD, then others made somthing positive from that while still beliving that they got somthing like ADD.
same: ego, super ego, alter ego, councoius, subcouncius, cosmic councious, all are banch of words and theories, and if in wikipedia there would be tag a every therory page this are only interpretation then wikipedia would be great.
Please do what you can to implement tag i mention and change wiki home page (add or delet ADHD links and notis)
[edit] Comments
I have added and will continue to add information about the controversial aspects of ADD/ADHD. I will also review the source and presentation of the hallmarks you found offensive.
I would respectfully point out that an ADD/ADHD diagnosis can only be made by licensed professional and that the article states this. I have added the specific criteria they must follow as provided by another user. A reevaluation is required every 6 months, because people's brains change. I have personally seen many ADD/ADHD children diagnosed and treated and transformed into much happier and well-adjusted children, and go on to success as adults. Some of the school bus drivers I worked with have noted the changes and the found out the child was under treatment, since bus drivers generally don't get such information, and usually can only focus on problem kids. I have worked with crack-addicted babies and severally disabled children and adults. As para-professional educators, it is seldom we transport folk see success stories as good as those with ADD kids. Like Head Start, another program I strongly believe in, the cost of treatment is a great investment in saving money on prisons later.
Notwithstanding my personal POV, I will try to keep the article POV. Vaoverland 09:09, Apr 3, 2005 (UTC)
.......
THIS IS AN EDIT.....
All the naysayers would realy do well to aquaint themselves with the true science on the subject- which includes everyting from actual brain scan studies, to longitudinal behavioral studies. As a former teacher, I understand why some people are tempted to posit that what we are doing is merely labeling kids who hate school and show it as ADD. As a person with the diagnosis myself (garnered at age 22), and can tell you that it is much more complex and subtle that all of that. Thos diagnosing AND criticizing on these grounds alone are equally ignorant. Sorry.
My diagnosis was a result of several days of intense neuro-psychological testing by an accomplished neuro-psycho-pharmocologist (afdvance degrees in all fields). In the end what emerged was a fairy clear picture. Together with months of counseling and a complete historical profile, a diagnosis was arrived at. Concede- all diagnoses of this kind boil down to behavioral observations, or in other words- there is no petri-dish proof of ADD. But the very same can be said about depression, or bipolar disorder, and only the most idiotic critics are still walking around saying neither of the 2 exist.
There is enough data to tell us SOMETHING is going on biologically. In this respect it is totally unlike what others have meakly compared it to- imagined psycho-mechanisms such as the id or superego. These people generally have read next to ZERO of the science, and as such can be confidently ignored.
[edit] removed npov
I have removed the hallmarks list which was flagged as NPOV. I have also editied the lead and several other sections to add content and sources as suggested.
I am sorry that one commentor is in the camp that thinks that ADD/ADHD is non-existant. I have added this aspect under controversies. Any other suggestion ro comments? Vaoverland 10:08, Apr 3, 2005 (UTC)
[edit] ADD and asthma
If I've heard the argument once, I've heard it a thousand times: "There's clearly no such thing as ADD/ADHD. Everyone has days when they're off in a fog, or too impulsive, or hyperactive. Therefore, this whole 'ADHD' thing must be a myth cooked up by the drug industry / politicians who want to drug our kids into stupor with the stimulant drug Ritalin / other bogeyman."
Everyone gets short of breath sometimes. Does that fact "prove" that there is no such thing as asthma? -- Antaeus Feldspar 23:09, 7 Apr 2005 (UTC)
Not to go off-topic here, but is anyone familiar with studies regarding rates of asthma comorbidity in ADHD people? The medicine Tianeptine, which works by lowering the level of extracellular serotonin, can improve some forms of asthma greatly. Hyperserotonemia (excessive levels of extracellular serotonin) is a common condition with ADHD and autism-spectrum disorders. It would be interesting to see if there is a higher rate of asthma in these disorders than in the general population.
[edit] Diagnosis Criteria
I agree with Antaeus Feldspar 23:09, 7 Apr 2005 (UTC) . On the talk page for ADHD, I have tried to make this same point. For an ADD diagnosis, in addition to the checklist criteria and more than one seeting, (home work, etc.) the symptoms must be causing functional impairment within past 6 months. So, if you have the symptoms, but have adapted somehow so that you are functioning OK, then technically you wouldn't qualify for a diagnosis. However, many people with the symptoms and in multiple setting and functional impairment can benefit from a wide range of treatment options and deserve the chance to do so. ADD/ADHD is no myth. A diagnosis is an explanation and the start to a better life for many people. It's too bad that may have been some over diagnosis done by some doctors. That doesn't mean it isn't real for many others correctly diagnosed. Vaoverland 23:23, Apr 7, 2005 (UTC)
[edit] hallowell center is for proffit? why are we using their criteria list?
Isn't the hallowell center for-profit, and private? why are we using their ridiculous criteria list? i propose its immediate removal, and will do so if no one objects. --Johnjosephbachir 23:30, 7 May 2005 (UTC)
I assume you have a POV complaint. The vast majority of doctors and medical professionals in the United States are organized to operate as "for profit" organizations. I object to your changes, as well as your "ridiculous criteria list" comments. The facts and research stand in conflict with your assertions. I suggest you state your opinion under the Controversy section if you feel it is relevant, and somewhere else is an appropriate place for discussion of socialization of medical care. Vaoverland 23:42, May 7, 2005 (UTC)
- I highly object to your proposed removal, JJB. You've shown no good reason why the criteria list is "ridiculous" or should be removed. The genetic fallacy that the Hallowell Center's work is somehow invalidated because they don't work for free is no good reason. -- Antaeus Feldspar 02:26, 9 May 2005 (UTC)
I see both of your points. But I see no rationalization in the article of why Dr. Hallowell's list is a good one. Can any physician publish a list of such criteria and be suitable for publishing in Wikipedia? if there is a specific reason this list is being used, i think that should be explicitly articulated. I am not saying all for-profit medicine is suspect, but Dr. Hallowell in particular is profiting heavily off of the concept of ADD. He is the author of "driven to distraction" which is about adults with ADD (i believe the list in question is a subset of a bigger list in the book). DON'T GET ME WRONG, i have a good friend with ADD who really likes that book, and i'm sure the Hallowell center has helped a lot of people. Still though, it is UNDENIABLE that dr. hallowell directly profits from the notion that being creative and disorganized is a mental deficiency, and this list exemplifies that.
Ideally we would use some list created by either a governmental health agency or an academic society. YES, i realize that there will always be industry influence in such things. But i think taking a list directly off of a company's website is not the way forward as far as POV, especially with such a controversial topic.
(btw, i scored a full 21 on this list. i've tried caffeine and had a prescription to ritalin, they don't help me. various anti-anxiety substances do help very much though. so what do we call that?)
--Johnjosephbachir 18:59, 10 May 2005 (UTC)
- No, it is quite deniable, because "creative and disorganized" is not the same thing as ADD. The reason Dr. Hallowell's list is being used is because Dr. Hallowell is a highly respected researcher in the field of ADD, and yes, it would certainly be "suitable" for any physician who is similarly respected in their field to be quoted. Accusations that some person's research is suspect because they are not practicing for free is still committing ad hominem circumstantial. -- Antaeus Feldspar 23:36, 10 May 2005 (UTC)
- I agree with Antaeus Feldspar. Nobody that I have ever read said that creative and disorganized is the same thing as ADD. There is plenty of room to present controversy if you feel that it is worthy, but there is nothing wrong with using Dr. Hallow ell's list as an example of criteria used by accepted medical practice. I respectfully remind you that all sources, including Hallow ell's refer to diagnostic criteria which are subjective and variable with every single individual. And there is no one treatment which works for everyone "magic bullet" claimed by anyone either. Vaoverland 03:50, May 11, 2005 (UTC)
Whether or not the entity in question is working "for free" has nothing to do with what I am talking about. I am talking about a direct correlation between widespread diagnosis and personal financial gain. If this isn't a cookie cutter case of conflict of interest I don't know what is. --Johnjosephbachir 09:34, 11 May 2005 (UTC)
- I think the answer is you don't know what is. -- Antaeus Feldspar 23:44, 11 May 2005 (UTC)
-
- Are we in some kind of a loop here? I see no conflict of interest, am not a patient of Dr. Hallowell, and after being diagnosed aith AADD at age 44, benefit from anti-depressants to help manage symptoms. In my book, all medicine is too expensive (since I struggle without health insurance), and caffeine in moderation does work for me, as does a favorable working environment. Seems like we've covered all this. If you are critical of Hallowell, make a comment in controversy section. Why the obsesssion with Hallowell? The list almost exactly mirrors to the official DSM but is a little easier to understand. How does you doctor diagnose you (JHB) as a basis for your anti-anxiety meds? I strongly doubt that he thinks you have ADD/ADHD/AAAD. Vaoverland 02:51, May 12, 2005 (UTC)
While I object strenuously to Johnjoseph's original tone and approach -- using verbiage like "ridiculous criteria list" is not going to bring light to the debate, only heat -- I think he has a point worth some consideration. What about the Hallowell list makes it canonical? Hallowell's reputation in the field? Well, fine -- but it's still fair to say that a more plainly objective list should be substituted if we can locate such. The onus may fall primarily on JJ as the primary objector, but any of us who wants to improve the article can look for such.
Vaoverland and A. Feldspar are correct that not all research done with a profit motive is inherently shoddy, any more than selling someone a car with a profit motive is inherently dishonest. The research stands or falls on its own merits, and I'm just becoming up-to-speed on Dr. Hallowell's credentials. Seems to me to be a question of sourcing and authority -- the attribution to Hallowell is clear enough, but what makes us think his opinion is authoritative? I may realize that he has X years of experience in the field or whatever, but that needs to be clearer in the article (although I'm sensitive to the appearance that the article's already close to an advertisement for the Hallowell Center as it is).
In general I think the presentation of the Self Test for Adults or Hope sections could be improved -- the present tone is that of a self-help book, not an encyclopedia. As I have time I'll try rewriting them and see what the community thinks.
Cheers,
PhilipR 18:40, 8 Jun 2005 (UTC)
[edit] What is an adult?
This article seems to me to be missing a definition of when it ceases to be ADD simply, and becomes adult ADD. Which would probably be something worthwhile putting in.
- Two people were talking one day. Person A said, "Did you know I have ADD?" Person B replied, "Blimey! I thought ADD was something talkative children had!" Person A stated, smuggly, "No, it's adult ADD. It's not just for children anymore!" --24.217.183.224 17:33, 26 August 2005 (UTC)
[edit] Article on "Adult ADD" should be dropped, with pieces moved to "ADHD"
Taking a U.S.-only perspective in my argument:
1. Attention-Deficit Disorder ("ADD") is obsolete terminology
2. Attention-Deficit Hyperactivity Disorder ("ADHD" or "AD/HD") is the official (APA DSM-IV) replacement term.
3. ADHD is not limited to children.
4. The time when ADHD, ADD, and their precursor, "Minimal Brain Damage" excluded adults has clearly passed.
5. There is not that much valid material in the "Adult ADD" article that does not heavily overlap the ADHD article.
6. It should be fairly easy to salvage the valid material.
ADHD in adults IS probably under-diagnosed and under-researched. These thoughts are worth mentioning and documenting in the ADHD article.
I would be interested in non-U.S. views, especially on the terminology, because I would really like to make the change I propose. User:DCDuring
- If you believe that "'ADD' is obsolete terminology" I would rather that you focused your efforts on documenting that premise and incorporating it into this article rather than initiating a difficult page merge based on that premise. -- Antaeus Feldspar 17:31, 3 October 2005 (UTC)
- I strongly believe that Adult attention-deficit disorder should remain a separate article. The biggest reason is that the main ADHD article is already too large for Wikipedia standards, which call for subarticles to be created, which is essentially exactly what was done when we started this one.
- Also, the ADHD article is heavily focused on children. The realization that the condition continues into adulthood for many is comparatively new. More importantly, many of the manifestations and remediation for adults are different.
- Please do not act unilaterally and combine or merge the adult add article into the main ADHD article. If you still want to take the action you suggest, there is a WP process for proposing merges, and the arguments above can be debated and hopefully a consensus, or at least majority opinion can be reached. Vaoverland 21:09, 30 September 2005 (UTC)
[edit] separate Adult ADD article, pros/cons
I object to separate "Adult ADD" article. I am an adult diagnosed with ADHD, who coaches adult ADHDers, is attempting to form an adult ADHD support group in my area, and participates actively in face-to-face and online ADHD groups.
I think it is a mistake to present "Adult ADD" as a separate entry. "ADD" is an obsolete term, that warrants no treatment different from other obsolete terms.
(sorry, but if you've never met folks with an ADD minus the H diagnosis, but they most decidedly do exist, and I am one of them. You can split hairs all day long using the DSMV (latest), but if they attempt to blot out that distinction, they do so at truth's expense. A "daydreamer" kid with diminished attentional capacities is very different from one who is hyperactive...this is obvious on its face. If you wish yourself to create 2 distinct diagnostic categories, go for it. But the reality is that these are two like disorders, and the name-game is useless at best.)
"Adult ADD" corresponds to no external official category and little external reality. ADHD is an officially recognized disorder that can occur in children and adults. The battles about whether adults can have ADHD (or its DSM predecessors, ADD and MBD) and the diagnostic criteria, though certainly worth mentioning, are officially over, though they may recur for DSM-V.
The many substantive controversies concerning ADHD, including those about whether ADHD is a single disorder, how much of it is genetic, how it should be diagnosed, whether it is over- or under-diagnosed or over- or under-medicated generally or in specific populations (including adults), which non-medication therapies are effective, which medications are effective, whether ADHD is a real disorder, and even whether ADHD might not be a good thing [Hartmann and others], need to be located in a single article that is located under a term that is generally accepted, where Wikipedia users would most likely expect to find it. ADHD is that term.
I would be happy to work with you to try to improve the "ADHD" article by merging "Adult ADD" into it.
dcduring@gmail.com
-
- Dear User: DCDuring,
-
- I do not necessarily disagree with your points, but, beside the size issue in the main ADHD article, another reason the adult article was started was that adult issues where frequently deleted or minimized in the overwhelming interest in ADHD in children. I have heard unconfirmed reports that ADHD in adults will be more specifically addressed in the next Diagnostic and Statistical Manual of Mental Disorders. I recently read in the news that adults who are taking meds for the condition have increased by 400% in past ten years. The children, children, children and hyperactivity emphasis ADHD gets publicly and in WP detracts from the adult aspect, which is much less well-known.
-
- I personally feel the separate article increases public awareness and that of persons who may be undiagnosed and suffering. A lot of us have met that last criteria.
-
- If you cannot live with the current separate article, what about a compromise? perhaps we can revamp the adult article, removing a lot of the duplicate material and condense it into a much shorter one, referring readers to main article ADHD? Keep the external links which are to adult-related sites. And join the edit wars on the ADHD article on behalf of adults.
-
- Also, I urge you to look into the Yahoo group for adults and get on the email list for messages. It is growing and there may be additional support for your efforts to be found there. The link is: http://health.groups.yahoo.com/group/aadd/
-
- One final thought. Web search engines such as Google and Yahoo search are now getting lots of hits on the current adult article, which increases public awareness. Merging the article will largely destroy this value we have accomplished.
-
- I would like to see input from other editors before we take such a drastic measure as a merge.
Comments, anyone?
Mark in Historic Triangle of Virginia, Vaoverland 21:44, 1 October 2005 (UTC)
Vaoverland 21:31, 1 October 2005 (UTC)
[edit] Reducing Size of ADHD article
If the ADHD article is too long by wikipedia standards, how can we reduce to a more appropriate size ? Consider the following attacks on the problem:
1. Make ADHD article solely about the DSM diagnosis and its history (including controversy), etiology, prevalence, and treatment. This should include only material relevant for both adults and children and some brief discussion of the relationship between adult and childhood ADHD.
2. Make new article on "ADHD in Children". This could include references to psychological therapies and approaches used most often for children, for example, behavior modification. Also material on parenting and teaching.
3. Edit "Adult ADD" to parallel "ADHD in Children" as much as possible. Should include references to psychological therapies, such as cognitive behavioral therapy and self-modification/self-management approaches.
4. Make separate short article on hyperkinetic disorder and explain difference from DSM ADHD there.
5. Make a separate article about "Attention Deficit" or "Attention Deficit Syndrome" ("ADS") with material about current research that does not fit in other articles. [Query: does this kind of material belong in an encyclopedia at all ?] Also references to general research on attention.
Include only consensus material in bulk of article (NO one-study material). Try to use current cognitive-science and psychology survey articles as sources to introduce judgement of those familiar with the full range of scientific literature into Wikipedia articles.
As I see it this would mean:
1. Moving all but a stub of the Testing section to "ADS", because it is not integral to the ADHD diagnosis.
2. Moving almost all of the Causes section except a stub to "ADS".
3. Shortening the Treatment section on medications, adding a stub on psychotherapy, retaining a stub on alternative treatments. Moving most of existing alternative treatments to "ADS".
4. Move Parenting to ADD in Children article.
5. Move all of Evidence for ADHD as an organic phenomenon section to "ADS".
6. Move Positive Aspects section to "ADS".
7. Move "hunter vs. farmer" to "ADS"
8. Move all of history section, except a stub, to "ADS"
[edit] Reorganizing the ADHD article
First of all, I don't know why you'd want to move much of the information currently in the main ADHD article to one entitled "Attention-deficit syndrome." It basically seems you want to move all research and conjecture there and basically leave the main ADHD article only to what's in the DSM-IV-TR itself. While reorganizing this article is probably a good thing, using an obselete synonym (ADS) to do it probably isn't. I do not agree that ADHD should be a flat display of the DSM-IV-TR diagnosistic criteria for ADHD. All the research done that you suggest be moved to the ADS article is researched under the name ADHD; it makes no sense to use that name.
Your suggestion for two parallel articles about the clinical presentation and treatment of ADHD in adult and children populations is sound, however. The current Adult ADD should be rewritten to remove all the redundant information that's already in the main ADHD article, though. My opinion on what should remain in the Adult ADD article or what should be there is this: an introduction noting that at least a residual ADHD remains in many adults and that more adults than ever are being diagnosed with ADHD for the first time; typical manifestations of ADHD signs and symptoms in adults (the DSM-IV-TR criteria are somewhat skewed to diagnosing young children, by the way); common treatment plans for adults; etc. Discussion of ADHD as a normal variation in human temperament along with the adaptations that come with this variant should remain in a broader ADHD article.
The history and various names for ADHD (including the ICD-10's nosological category of hyperkinetic disorders) should be moved to an article charting the history of this psychiatric concept. The term hyperkinetic disorders does not need its own article because it is simply another nosological system's name for the same psychiatric disorder. Yes, there are differences in criteria, but these don't need their own article.
An article should be made discussing theories about ADHD: neurochemical (dopamine, neuropeptine or however it's spelled), cortical arousal (including the thalamus and RAS), hunter-farmer theory, and minimal brain dysfunction. Testing and assessment for ADHD should remain in the main ADHD article, however. If someone wishes to write in great depth about computerized cognitive tests for ADHD, physiological (skin conductance tests) tests, and that sort of thing, though, an additional article should be created.
The treatment section could probably be rewritten and shortened. The two main treatment options are psychopharmaceuticals (e.g., Ritalin and Adderall) and psychotherapy (e.g., congitive therapy, behavior modification). Suggested treatments lacking in scientific consensus (e.g., diets) could probably be briefly summarized or removed entirely, in my opinion.
24.217.183.224 05:45, 15 October 2005 (UTC)
[edit] Is ADHD an Institutional or Scientific Reality ?
I have a few problems with simply equating DSM-defined ADHD with the scientific reality that we can view slowly emerging in the distance.
My thinking about attention-deficit syndrome (ADS) is that it incorporates all instances of the symptoms that would diagnose ADHD were it not for the fact that another diagnosis was deemed to have caused them. A relatively clear-cut case might be organic brain damage.
Perhaps ADHD does not really include all the fundamentally related disorders that it should. ADHD symptoms co-occur with symptoms of other diagnoses for fundamental, not accidental reasons. Genetic research seems to be pointing toward reasons that LDs and Autism are often co-morbid with ADHD.
Perhaps ADHD is itself a complex of three or more distinct attention problems that tend to often co-occur. Different brain circuits appear to be implicated in different subsets of ADHD symptoms, which in turn often respond differentially to available medications.
The instability of the DSM terms is itself troubling. Perhaps I just wish that the ADHD reality was a little more on all fours with the reality of the hard sciences. DCDuring 02:03, 17 October 2005 (UTC)
[edit] National Resource Center on AD|HD - excellent Info & Resource Sheets on Adult ADHD
The National Resource Center on AD|HD (sic) is "A Program of CHADD". On its website are very good "Information and Resource Sheets" of great use to those interested in ADHD in adults. The two of greatest interest to those working on this article are "Diagnosis of AD/HD in Adults" (2003) and "Medication Management for Adults with AD/HD" (2004). The medication management article is heavily footnoted, the diagnosis article less so. These two articles and all the others on the site that I've examined so far were prepared for the NRC on ADHD under a CDC grant by the Attention Deficit Disorder Association (ADDA). They were also approved by CHADD's Professional Advisory Board. With this pedigree they are close to being official statements on Adult ADD. They are, I believe, in the public domain.
CHADD has fact sheets that are as current, focusing more on children, but they are not in the public domain.
It seems to me that we can benefit from making sure that the Wikipedia article is at least as current and well-referenced as these documents. Any departures from the meaning of these articles should be justified by references.
http://www.help4adhd.org/en/about
DCDuring 01:29, 17 October 2005 (UTC)
[edit] Do ADHD adults have a culture?
Autistic adults (at least those who are able to express their views verbally or in writing) generally have strong views about their condition. They, for example, tend to believe their condition is just the way they are, different brain wiring, not a pathology. See, for example, autism rights movement. Is there anything like that in the ADHD community? The impression I get is that ADHD adults do buy into the idea of pathology, which is kind of paradoxical considering how much more typical ADHD behavior is compared to autism. Neurodivergent 01:15, 6 November 2005 (UTC)
[edit] Step back from modern psychiatry
I think we might be buying into the assumptions of modern psychiatry too easily. Yes there are formal studies of "attention deficit" and formal criteria for treatment. But Wikipedia is not a medical journal and it does not need to get into the gritty details of psychiatry, at least not in every article. Perhaps we should not populate Wikipedia with institutional realities. Instead, maybe we should ask, what are the characteristics we are discussing? If the topic was red hair for example, we would not need to present the topic as the subject of formal studies, at least not exclusively. There are many interpretations of red hair historically and culturally. See the red hair article. oneismany 15:01, 20 November 2005 (UTC)
Also see human skin color. See nigger. To me personally, 'adhd' is equivalent in its context to 'nigger' in its context. There is some characteristc or set of characteristics under discussion, but it is not 'adhd' or 'add' or 'aadd' or any psychiatrist doublespeak. At the same time, these terms are psychiatric realities and must be discussed. But we would not discuss brown skin color under the topic 'nigger' on Wikipedia, as that would be clearly POV. I say we take a step back from the formalism of psychiatry and the institutional realities that currently surround this topic. How can we discuss it without involving POV terms? (And mention the POV terms as POV.) oneismany 15:01, 20 November 2005 (UTC)
Maybe (as mentioned above) there is more than one characteristic. I have tried to take this approach with one 'symptom' of ADHD in the hyperfocus article, although this is just a beginning and criticism and other input is certainly welcomed. (See also the discussion currently on the ADHD talk page.) Are there other characteristics identified as 'symptoms' of ADHD that might be mentioned as topics in their own right? As I see it we need to separate the treatment and the 'disorder' language from the individual subjects of discussion (although of course the treatments and the 'disorder' identifications are topics too). oneismany 15:01, 20 November 2005 (UTC)
Current discussion and formal research of personality are dominated by many dogmas, not the least of which is the neurochemical approach, of which pharmaceuticals are the primary treatment for abnormalities. But abnormalities are only 'disorders' if they are taboo. Witness many taboo behaviors in Western culture that are normal behaviors in other cultures, not regarded as 'disorders' at all. Consider that computer science is on the verge of generating intelligent personalities without any organic components at all. If an AI developed conflicts of personality, would we say it needed drugs for its 'disorder'? I realize that this is an entirely theoretical, and perhaps fantastical scenario, but it cannot be ruled out as a possibility. oneismany 15:01, 20 November 2005 (UTC)
- The short stature article is also a good analogy, i.e. at which point does it warrant injecting human growth hormone in kids? Neurodivergent 15:15, 20 November 2005 (UTC)
[edit] reading
scary, me no likey
[edit] Clarity regarding ADHD (adult only)
Anyone who wants to to seriously discuss this issue should, at very least, read Barkley's textbook on ADHD (I believe it is in it's third edition), ADHD and Self Control also by Russell Barkley, and of course be conversant with the lastest edition of the DSM (DSM-IV TR). It should be clear from the outset that the DSM (Diagnostic and Statistical Manual of the Americal Psychiatric Association) does not give criteria for adults, and ADHD is classified among disorders that must be present in childhood.
The research of Biederman's group at Harvard clearly shows that ADHD (a disorder that must be present in childhood) persists into adulthood in many people. However, the person who was never diagnosed as a child but seeks a diagnosis as an adult is very different from the person who has had the diagnosis lifelong. It is very difficult to make a diagnosis in the later group. Historically, adult ADHD was never an issue until Hollowell's book was published (Driven to Distraction). Now, adult ADHDers are everywhere. I think Wikipedia ought to acknowledge the following in its discussion of this topic: 1. The diagnosis of adult ADHD requires childhood ADHD symptoms. 2. One must be able to document those symptoms. 3. ADHD is not a good thing (there are of course many good things about people with ADHD), but psyychiatric disorders can only be assigned if there is functional impairment associated with condition (or as Jerome Wakefield calls it "harmful dysfunction.") 5. The US uses more stimulants than the rest of the world combined (we use 90% of the ritalin, for example) 6. Sometimes, response to treatment can help with diagnosis. This is often not true with potential adult ADHD, because everyone's attention improves with stimulants (some people call them "cognitive steroids").
This is a controversial issue. Lets keep zealotry out of what should be a scholarly discussion.
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- I began this article and I basically agree with the preceding. However, I just want to make a couple of comments in response.
- 1. I enjoy working on WP history and biography articles partially because the subjects are usually not evolving. Recognizing AADD (or whatever you wish to call it) is relatively new. AADD certainly is both new and evolving, at least in the medical community and in general understanding.
- 2. The comment: "Adult ADHD was never an issue until Hollowell's book was published (Driven to Distraction). Now, adult ADHDers are everywhere." Just because medical science didn't recognize a condition doesn't mean it wasn't there. We don't use our own experiences in WP, but for the sake of this Talk discussion, I would like to share that working with ADD children in the 1970s, the professionals in some schools I had contact with began recognizing the symptoms in parents. (I worked with school bus transportation). I am aware of some whole families with functional problems who found improvments, and not always with medication.
- 3. Treatment / remediation for adults are not limited to stimulant medications. Simple understanding, coping skills, group sharing etc. can do a world of good. Just working on these WP articles has helped with my own understanding of my AADD and helped me meet less of the non-functional diagnostic criteria.
- 4. Children may not be mature enough to realize the need for improvments in daily life functioning. Many adults are relieved at realizing what has been going on in their lives and that there are some solutions available.
- 5. While we agonize over the expense of treatment, let us consider the cost to society of non-treatment (jails, divorce, unemployment, etc.). I believe that reasonable attention to ADHD related needs could be considered a conservative investment not unlike Head Start programs.
- 6. I certainly hope the next DSM addresses some of these controversial items, and that we can keep up with the evolving situation with this article and the other related ones.
- I began this article and I basically agree with the preceding. However, I just want to make a couple of comments in response.
I am adding this to the lead: This article is intended to focus on an evolving medical science and understanding. Both recognizing and treating the condition in adults is much more recent than with children.) Thanks for contributing folks. Mark in Historic Triangle of Virginia Vaoverland 08:01, 18 March 2006 (UTC)
[edit] Proposal: merger of Controversy sections
Both this article and ADHD have a section titled "Controversy". Both address similar points concerning whether or not ADHD really exists. The subject of both is not one that is likely to be of interest to those who came here to read the rest of the page, and vice versa. Neither is really specific to childhood or adult forms of the condition. The main ADHD article is too long. For these reasons, these sections should both be merged into a single article (I'd suggest Controversies about Attention Deficit Hyperactivity Disorder with a redirect from Controversies about ADHD) which can then be linked in (perhaps with a brief summary) from each article.
How does that sound? JulesH 08:21, 13 May 2006 (UTC)
Just noticed that there already is an article Anti-ADHD (which has a redirect from Controversy about ADHD) which would do the job. I think it needs renaming so that it sits at the second of those pages not the first, as the current title is dreadful, but otherwise should be suitable. I'd suggest merging content from here to there, including a brief summary and link and leaving it at that? JulesH 08:32, 13 May 2006 (UTC)
[edit] Removal of material not specific to ADHD in adults
I trimmed the fat of this article and removed or abbreviated things already mentioned in the main attention-deficit hyperactivity disorder article. I also did some minor grammatical and style editing. The focus of this article is the unique way ADHD affects adults. Anything that is generalizable to the condition as a whole should go in the main article or be given brief mention if pertinent with the appropriate hyperlink to the section in the main article.
If anyone feels the need to retrieve any lost information from the history, please consider incorporating it into the main ADHD if it is not already there as it is most likely more relevant there. If the information is felt to be relevant here, consider specifically addressing it in the context of adults with ADHD.--NeantHumain 07:45, 6 July 2006 (UTC)
