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Attention deficit hyperactivity disorder controversies

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PET scans show which parts of the brain are being used at a particular moment. In this example, the parts of the brain being used by someone diagnosed with ADHD are compared to the brain activity of a person not diagnosed with ADHD when both have been assigned a task requiring attention. While seemingly illustrative of a biological difference in the two brains, it is not. It simply shows that the person with ADHD is not attending to the assigned task

Attention-deficit hyperactivity disorder (ADHD) is a developmental, neurobehavioural disorder, widely recognized by the medical and scientific community as causing impairment, especially in children. Attention deficit–hyperactivity disorder (ADHD) remains a controversial disorder, despite it now being a well validated clinical diagnosis.[1] Continued claims that the diagnosis and treatment of the disorder deserve greater scrutiny are made by some news sources, social critics, religions, and individual medical professionals. The United Kingdom's "Every Child Matters" websites states that ADHD is a "controversial diagnosis". [2] . Ethical and legal issues with regard to treatment have been key areas of concern for these critics. [3]

While stimulant medications are widely considered safe when used as prescribed, critics point to the the UN's International Narcotics Control Board issued warnings in 1996 and the dramatically increased use of methylphenidate at that time in the United States although the use of medication has since leveled off.[4] There was also concern that the use of Ritalin was being actively promoted by an influential parent association, which had received significant financial contributions from the preparation's leading United States manufacturer.[citation needed]

These critics contend that ADHD can be better explained by other theories such as the Hunter vs. farmer theory. Other critics such as those critics who believe in the social construct theory of ADHD disagree over the cause of ADHD, question research methodologies[5] are skeptical toward its classification as a mental disorder,[6] and wonder about the effects of diagnosis on the mental state of patients.[7][8] Critics point to changing standards of diagnosis, such as the American Academy of Pediatrics (AAP) issuing a more careful set of standards in 2000 to aid clinicians than merely using DSM-IV.[9] Certain religions and groups, especially Scientology also hold fringe viewpoints about the disorder. Scientologists are against almost all aspects of psychiatric practice, and are highly skeptical that the diagnosis denotes a genuine impairment. Those critical of Scientology believe that much of the controversy generated about ADHD is manufactured.

Concerns about medication

Main article: Attention-deficit hyperactivity disorder treatments

The National Institute of Mental Health states that, "stimulant drugs, when used with medical supervision, are usually considered quite safe".[10] PBS believes that, "stimulants, unlike most psychiatric medications, are very well-studied drugs and, at this point, well-trusted by doctors"[11]. Still, individual parents and individual professionals have raised questions about the side effects of drugs and their long term use.[12]

One concern about these drugs is, that they are sometimes resold by patients as a recreational drug. The may also be taken in other (often dangerous) ways than oral, in order to deliberately create an overdose (Ritalin in overdose has effects similar to cocaine or amphetamines). Another concern is the use for improving concentration in people without an ADHD diagnosis (see for example http://edition.cnn.com/2001/HEALTH/children/01/08/college.ritalin/ )

Concerns over funding of ADHD doctors and lobby groups

In 2008 it was revealed that Joseph Biederman of Harvard, failed to report to Harvard that he had received 1.6 million dollars from drug companies between 2000 and 2007.[13] E. Fuller Torrey, executive director of the Stanley Medical Research Institute which finances psychiatric studies, said “In the area of child psychiatry in particular, we know much less than we should, and we desperately need research that is not influenced by industry money.”[14]

Alternative theories concerning ADHD

Main article: Attention-deficit hyperactivity disorder

There are several fringe theories that have attempted to explain ADHD. The most popular theory is the Hunter vs. farmer theory which believes that those with ADHD still have older "hunter characteristics". The Neurodiversity theory believes that ADHD is a term that describes a difference of behavior and that this difference should be celebrated. Those who believe in the social construct theory of ADHD question everything about ADHD and believe the disorder was fabricated. [citation needed]

Overdiagnosis/Underdiagnosis

Much of the criticism does not reject the concept of ADHD as a valid disorder, but alleges, that children with problematic behaviour are often diagnosed with ADHD, while they, in reality have a different more complex problem or the problem is one of the environment, not the child itself, or the child is normal but just not the way the responsible adults want it. The fact that schools receive extra money for children with ADHD is often brought up as a motivator to diagnose as many children as possible. Another point often brought up is that, while ADHD may be overdiagnosed in children who are a problem in the classroom or at home, it may be missed in those who would fit the diagnosis but do not create problems for the adults around them.

Public views on ADHD

There are many misconceptions that most[who?] people have about ADHD, among them, "Having ADHD means the person is lazy or dumb."[citation needed] Teachers will sometimes disregard a diagnosis of ADD, accrediting a student's lack of motivation to mere laziness.[15][16] The misconception of a someone with ADHD as the equivalent of someone who is intellectually deficient, is so common that many[who?] would argue that it is a hegemony among the public.[clarification needed]


Media Coverage of the ADHD Controversy

The media has reported on various ADHD controversies and on the views of individuals and organisations who have controversial opinions.

In 2001 PBS' Frontline ran a five part TV series entitled "Medicating kids".[17] The program included a selection of interviews with representatives of various points of view. In one segment, entitled backlash, ADHD critics Fred Baughman and Peter Breggin, who PBS described as "outspoken critics who insist [ADHD is] a fraud perpetrated by the psychiatric and pharmaceutical industries on families anxious to understand their childrens' behavior,"[18] were interviewed on the legitimacy of the disorder. Russell Barkley and Xavier Castellanos, then head of ADHD research at the National Institute of Mental Health (NIMH), defended the viability of the disorder. In Castellanos interview he stated how little is scientifically understood.[19] Lawrence Diller was interviewed on the business of ADHD along with a representative from Shire Plc.

A number of notable individuals have given their opinion on ADHD. Scientologist Tom Cruise's interview with Matt Lauer was widely watched by the public. In this interview he spoke about postpartum depression and also referred to Ritalin and Adderall as being "street drugs" rather then as ADHD medication. In England Baroness Susan Greenfield, a leading neuroscientist,[20] wanted a wide-ranging inquiry in the House of Lords, into the dramatic increase in the diagnosis of ADHD in the UK and possible causes[21] following a BBC Panorama programme which highlighted US research (The Multimodal Treatment Study of Children with ADHD by the University of Buffalo showing treatment results of 600) suggesting drugs are no better than therapy for ADHD in the long-term. Other notable individuals such as Terence Kealey, a clinical biochemist, have written for newspapers on ADHD.[22] Newspaper columnists such as Benedict Carey have also written critical articles on ADHD.[23][24]

Religious and Social critics

According to an article in the Los Angeles Times, "the uproar over Ritalin was triggered almost single-handedly by the Scientology movement."[25] The Citizens Commission on Human Rights, an anti-psychiatry group formed by Scientologists in 1969, conducted a major campaign against Ritalin in the 1980s and lobbied Congress for an investigation of Ritalin.[25]. Scientology publications identified the "real target of the campaign" as "the psychiatric profession itself" and claimed the campaign "brought wide acceptance of the fact that (the commission) [sic] and the Scientologists are the ones effectively doing something about [...] psychiatric drugging".[25] Scientology states "the controversy over the many deaths and irreversible damage caused by psychiatric drugs prescribed for children labeled with... ADHD continues to grow".[26] The church contends that mental disorders are a "fraud"[27], "mental and behavioral problems are largely incorrect diagnoses that cover symptoms and don't handle the real problems, which may be physical or spiritual". The Desert Morning news states that, "Scientologists are not afraid of hyperbole".[28]

Critics from the Anti-Psychiatry movement such as Fred Baughman and Peter Breggin[29][30][31][32] have extensively used the popular media to criticize ADHD and medications used for ADHD. They have also testified at Congressional hearings on the use of Ritalin and supported legal challenges such as the Ritalin class action lawsuits. Both doctors had associations with Scientology in the past but neither belongs to the church.[33][34][35][36][37][38] There is an antipsychiatry movement that often refers to their writings, but in contrast to scientolgists, they are not "anti-psychiatry," but critics of some of its practices.

See also

Notes

  1. ^ Attention deficit hyperactivity disorder: legal and ethical aspects - Foreman 91 (2): 192 - Archives of Disease in Childhood
  2. ^ everychildmatters.gov.uk
  3. ^ Attention deficit hyperactivity disorder: legal and ethical aspects - Foreman 91 (2): 192 - Archives of Disease in Childhood
  4. ^ PBS - frontline: medicating kids: backlash: united nations' warnings on ritalin
  5. ^ http://www.psychminded.co.uk/news/news2006/feb06/Disordered%20thinking.htm Comment by James, Adam, “Disordered thinking?” Psychminded 14 Feb. 2006.
  6. ^ name="Tim&Rad">Timimi, Sami & Radcliffe, Nick. “The Rise and Rise of ADHD.” Making and Breaking Children's Lives. Ed. Craig Newnes. Ross-on-Wye: PCCS Books, 2005. 63-70.
  7. ^ name="Tim&Rad"
  8. ^ Article for Ethical Human Sciences and Services
  9. ^ PBS - frontline: medicating kids: adhd: american academy of pediatrics' guidelines
  10. ^ NIMH · ADHD · The Treatment of ADHD
  11. ^ http://www.pbs.org/wgbh/pages/frontline/shows/medicating/etc/adhdupdate.html
  12. ^ Lakhan SE; Hagger-Johnson G. http://www.cpementalhealth.com/content/3/1/21 The impact of prescribed psychotropics on youth. Clinical Practice and Epidemiology in Mental Health 2007;3(21).
  13. ^ http://www.nytimes.com/2008/06/08/us/08conflict.html?ex=1213502400&en=23737184f344c4ca&ei=5070&emc=eta1
  14. ^ http://www.nytimes.com/2008/06/08/us/08conflict.html?ex=1213502400&en=23737184f3044c4ca&ei=5070&emc=eta1
  15. ^ Misconceptions about attention deficit hyperactivity disorder (ADHD) - MSN Health & Fitness - Health Topics
  16. ^ For Adults, ADHD Can Stunt Life
  17. ^ http://www.pbs.org/wgbh/pages/frontline/shows/medicating/adhd/ Medicating Kids
  18. ^ http://www.pbs.org/wgbh/pages/frontline/shows/medicating/backlash
  19. ^ PBS - frontline: medicating kids: interviews: xavier castellanos, m.d
  20. ^ Baroness Susan Greenfield
  21. ^ BBC NEWS | Health | Peer calls for ADHD care review
  22. ^ Boisterous boys are too much like hard work, so we drug them into conformity | Terence Kealey - Times Online
  23. ^ Parenting as Therapy for Child's Mental Disorders - New York Times
  24. ^ What’s Wrong With a Child? Psychiatrists Often Disagree - New York Times
  25. ^ a b c Sappell, Joel (1990-06-29). "Suits, Protests Fuel a Campaign Against Psychiatry". Los Angeles Times. p. A48:1. Retrieved 2006-11-29. {{cite news}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help) Backup copy link here
  26. ^ Real-Life Horrors Fuel Growing Outrage Over Deadly ADHD Drugs
  27. ^ http://dir.salon.com/story/news/feature/2005/07/01/sci_psy/
  28. ^ Deseret News | Scientology: Church now claims more than 8 million members
  29. ^ Talking Back to Ritalin-New Breggin Book Excerpts
  30. ^ An Anti-Psychiatry Reading List
  31. ^ Online Dictionary of Mental Health
  32. ^ TOC - Antipsychiatry Reading Room
  33. ^ Kurt Cobain - Citizens Commission on Human Rights
  34. ^ Psychiatric Drugs
  35. ^ Error
  36. ^ Why are Scientologists opposed to the use of Ritalin? The President of the Church of Scientology Answers Your Questions
  37. ^ Ritalin Information: Side Effects, Cautions, Alternatives, ADD, ADHD
  38. ^ The Child Protection Racket; Freedom Magazine

Further reading

  • Armstrong, Thomas "The Myth of the A.D.D. Child. 50 Ways to Improve your Child's Behavior and Attention Span Without Drugs, Labels or Coercion. (1995) New York: Penguin Group.
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