Monday, April 6, 2020

Comments by Craig B. Wiener, EdD

Showing 3 of 3 comments.

  • Robert,
    I want to get your thoughts.
    Often when applying for disability, people seek psychiatric medication because it substantiates the severity of their suffering. While these medications might in fact create more disability, there is also the possibility that people go on these medications to help promote a disability claim. The correspondence between disability and psychiatric medications (could in part) relate to this pattern. Also, if people are anxious about having their disability end, people will stay on medication (to emphasize that they are still disabled) and they will not show improvement. It will look like medications are not helping and leading to long-term disability, but the desire to retain disability is fostering the kinds of outcome data between psychiatric medication and disability reported in your article.

  • Dr. Berezin
    I agree with you. The brain does not cause behavior; brain operation is a function of what is being done. If you change the way a person is responding, you change the way the brain is responding. While particular biology may increase the probability of learning particular behaviors, functional and structural differences observed within the “diagnosed” population may be understood as a consequence of the co-occurrence of biology with behavior over periods of time.

  • I greatly enjoyed your analysis of this study. In my book “ADHD a Return to Psychology (2007), I also commented on the finding that people diagnosed with ADHD drive poorly. Here is a quote from the book.

    To continue our list of laboratory findings, we observe that diagnosed persons (as an aggregate) also express difficulty with the task of driving an automobile (actual and lab-simulated) compared to non-diagnosed persons (Barkley, 2004; Barkley, Murphy, and Kwasnik, 1996; Barkley, Guevremont et al., 1993). Barkley (2000) points to biological determinism as causal for this outcome because diagnosed persons have problems with interference control, impulsivity, distractibility, and the anticipation of the future, which all contribute to their high accident rates. Clumsiness with car pedals and controls is also seen as consistent with their fine motor sequencing problems.
    However, observations of driving difficulties can be accounted for very differently; driving can also be construed as a social behavior, not solely as a manifestation of neurobiology. Driving requires coordination with others, turn taking, and acquiescence. Not everyone is conditioned to operate acceptably as drivers. When persons are reinforced to take risks, or that they must be first relative to others (even at the expense of others), such individuals are likely to speed and suffer accidents. Individuals showing this patterning may be less obliging, not only to other people, but also to the physical limitations of the car, pedals and other controls (even without delays in coordination).
    They might be insensitive with the controls in the same ways that they bang, provoke, intrude, or behaved boisterously in social situations. These behaviors need not be neurologically delayed. Many of these children have obtained benefits throughout childhood when not heeding parental instruction to be careful with themselves and with objects in their environments. A case could be made that diagnosed persons simply repeat conditioned social behaviors while operating a vehicle. Since diagnosed persons are frequently not integrating their actions with the perspective of others, and often doing behavioral acts that require others to accommodate to them, one might claim that they are not conditioned to be collaborative out of the car, in the car, or with the car.
    Craig Wiener