Welcome! This blog presents a psychological understanding of the diagnostic category “Attention Deficit Hyperactivity Disorder” (ADHD). Over the past decades, professionals have been informing the public about the neurobiological causes of the behaviors, and the necessity to medicate and stringently manage those who have been afflicted. This blog analyzes those claims.
While biological determinist assertions may continue to prosper there is increasing concern that we are positing the existence of a medical problem when there are no biological markers or dysfunctions that reliably correspond with the behavioral criteria.
Over the coming weeks, I will also present an alternative intervention that develops self-management in individuals who receive the ADHD diagnosis. This intervention is designed to replace traditional treatments that have been yielding very poor longer-term benefits.
The Logic of the ADHD Diagnosis
When constructing the ADHD diagnosis, progenitors essentially say, “Let’s study a group of people who do particular hyperactive, impulsive, and distracted behaviors that are associated with chronic and pervasive problems in school, social life, and work. If the person is an adult, the problems must be present in childhood and show consistency throughout development. We will call this group “ADHD” and study correlated biological characteristics and other associated difficulties. We will continue to tweak the criteria so that the diagnostic net falls on the people with the correlated dysfunctions and patterns of biology that we find in our research.
While not everyone in the designated group has every correlated problem (i.e. no correlated problem is useful for diagnostic purposes), researchers might find that people assigned to the ADHD diagnostic category have other problems in common. For example, (as a group) they might show driving problems, higher levels of anxiety, executive functioning difficulties, fine motor impairments, learning problems, failures to complete schooling, frequent divorce, “hotheaded” outbursts at work, problems doing homework, and atypical patterns of brain biology and molecular biology, etc.
Having ADHD vs. Doing ADHD
What goes unnoticed, however, is that “doing” the behaviors that qualify the individual for the ADHD diagnosis transforms into the individual “having ADHD.” Qualifying for the criteria, magically converts into “having” something even though nothing in that regard is identified other than meeting the behavioral requirements and showing (or not showing) correlated problems.
An Alternative Understanding
So when people say that ADHD is a chronic and pervasive developmental problem, of course it is. The criteria require it to be. And when we find that people qualifying for the criteria have other problems and traits in common, why are we surprised.
Quite often people behaving in similar ways develop a variety of shared “living in the world difficulties.” And quite often people behaving in similar ways share certain traits, talents and shortcomings.
For example, cab drivers in London are more likely to have a larger visual-spatial cortex because navigating the streets throughout the day develops that aspect of biology. They might also show impressive skill in learning navigation (or they would not be hired or be able to maintain employment), and they might share a variety of psychosocial problems as a function of dealing with city traffic and stringent time constraints throughout the day.
While we are willing to say that people “have ADHD”, it seems peculiar to say that people “have cab driving.” Yet similar to ADHD, cab drivers have a correlated biology that separates them from the masses and a unique array of psycho/social problems. The two groups differ in the social acceptability of their actions, but for both groups, we rely solely on behavioral criteria to determine category designation.
- People don’t do ADHD behavior because they have ADHD. More precisely, when people do ADHD behavior, we classify them as ADHD.
- ADHD is a category name, not an explanation even though people use it in that fashion.
- It is still a matter of debate as to why some people do ADHD behavior more often than others.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.