In Grimm’s fairy tale Rumpelstiltskin, an impish little man helps a girl spin straw into gold. This story seems an apt metaphor for how legitimate neuroscience research can become transformed into sensationalist claims regarding the causes and treatment of ADHD.
As Robert Whitaker pointed out in a Mad in America article, biological psychiatry has recently changed its story about ADHD. The myth of the “brain chemistry” cause of ADHD has become transformed into a new narrative that invokes the parlance of “neuroscience,” the alluring scientific model du jour. As Whitaker observes, biological psychiatrists are now trying to frame ADHD as a deficiency in brain development. The stimulant drugs typically prescribed for ADHD are now purported to somehow target this “abnormality” and help children’s brains develop normally. Adopting the language of neuroscience has given the biological model of ADHD, with its claims about the efficacy of pharmaceutical cures, new credibility in the eyes of doctors, parents and the general public.
We must question, however, whether biological psychiatry’s new garb is based in the gold standard of authentic scientific research, or whether it is just one more version of the emperor’s new clothes. Pertinent to this is a survey paper that I read recently, “Misrepresentation of Neuroscience Data Might Give Rise to Misleading Conclusions in the Media: The Case of Attention Deficit Hyperactivity Disorder.” The paper is authored by neuroscientists Francois Gonon et al, of the University of Bordeaux and the French National Center for Scientific Research. The paper illuminates how legitimate neuroscience research becomes distorted through a cascade of successive misinterpretations. With each communication—from the actual data, to articles in scientific journals, to blog sites, to headlines in the popular press, and finally to clinicians and parents—information can become transformed, misrepresented, and amplified in a kind of telephone game.
The paper details a number of ways in which scientific data are misrepresented, and to do justice to the author’s extensive survey would take more than the space of this article. Inevitably, I must oversimplify by limiting myself to only one example of data distortion. The paper demonstrates how inconsistencies within a study lead to inflated claims in the conclusion that are not supported by the original data.
In one study of stimulant treatment for ADHD, for example, school aged children who had been diagnosed with ADHD were divided into two groups. One group was given stimulant medication, and the other was not. “The average reading score at the time of the last assessment was similar between the groups of cases that were treated versus not treated with stimulants…The proportion of school dropout was similar between treated and not treated cases.” The claim in the article was “this study supports the hypothesis that treatment with stimulant medication is associated with more favorable long term school outcomes for children with ADHD.” The reported results of this study clearly do not support the claims since both the treated and untreated groups of children did equally well.
In the Washington Post, September 21, 2007, the conclusion in this study was transformed to “ADHD drugs help boost children’s grades.” A reporter who skimmed the research paper to write a newspaper article obviously came away with a false impression of the efficacy of stimulants for ADHD. This misrepresentation gets passed on in turn to the reader of the newspaper. Finally, at the end of this chain of communication, clinicians and parents are left with the conviction that stimulant drugs will help improve ADHD children’s grades and keep them in school. The survey paper observes that the comparatively few studies with internal inconsistencies (only 2 articles out of the 360 articles examined) are unfortunately the ones predominantly cited in the media.
It especially struck me that neuroscientists themselves are examining the process by which research data in their own field are reported and sometimes distorted in the process of communication. This kind of analysis is quite different from a motley bunch of anti-psychiatrists shouting “foul play.” It is a case of scientists reflecting on their own field in order to maintain its integrity. This is especially important with high profile and high-profit issues like ADHD. “Quis custodiet ipsos custodes? Who will guard the guardians? The only ones who can are the scientists themselves.