View Full Version : "Aberrant Normalcy Syndrome”


Don S.
07-09-11, 11:28 AM
In a recent post regarding Tourette’s Syndrome, I noted the proliferation of new afflictions within DSM over the last several decades. Within it, I rather sarcastically inquired if there was anyone left who might be characterized as being “normal.” Apparently, I’m not the first person who has made this observation as indicated within the following article.

http://m.theglobeandmail.com/life/health/mental-health-experts-ask-will-anyone-be-normal/article1653548/?service=mobile (http://m.theglobeandmail.com/life/health/mental-health-experts-ask-will-anyone-be-normal/article1653548/?service=mobile)

Perhaps this calls for yet another new personality affliction to be entered into the canon of recognized psychiatric maladies. Perhaps it could be labeled: “Aberrant Normalcy Syndrome” and defined as follows:

“Thought to be a very rare disorder, it is characterized by an individual’s intractable inability to be classified as having any of the myriad mental health afflictions into which the vast majority of the general population falls. Victims of this disorder are noted for their insufferable sense of smugness and sadistic tendencies as exhibited by their making others feel normal in contrast to their abnormal normality. Because of this sociopathic threat to the well being of society (and the pecuniary interests of medical and mental health professionals), immediate institutionalization is recommended.”

Rest assured that your precious tyke is not a brat. He or she is the victim of “Toddler Tantrum Disorder,” caused by an acute sense of anxiety at being age two.

Abi
07-09-11, 11:33 AM
Im not impressed

Don S.
07-09-11, 11:47 AM
Im not impressed

No, and you probably wouldn’t have appreciated Jonathan Swift either. In the wake of his classic satire A Modest Proposal, in which he suggested the expedient solution to overpopulation and starvation in the Ireland of his day that Irish children should be eaten, he was made into a pariah for a period by people who had actually taken him seriously.

It comes with the territory.


P.S. Swift was an Anglican clergyman and a great humanitarian. He had been frustrated by the appalling conditions he found in p<?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comhttp://www.addforums.com/forums/ /><st1:country-region alt=</st1:country-region><ST1:place in Ireland and tried to focus attention on the problem in the hope of enlisting aid from people of good will.

Fortune
07-09-11, 02:31 PM
If only there were evidence for so much misdiagnosing of autism and ADHD? I don't know a lot about the childhood bipolar disorders.

The article itself seems to be concern trolling on the basis of a slippery slope argument. What you (and the alarmist writer) ignored is that just about every diagnosis in the DSM includes the caveat "Causes significant impairment in two or more areas (work, school, home)" or a variation of that phrase. If someone is not impaired, they don't have a diagnosable disorder.

This isn't very Swiftian at all. What it looks like is another article that builds up to "Look at how those pharmaceutical companies want to more people to be diagnosed with ADHD to sell their stimulants!" That's not satire, that's just the typical ignorance about ADHD.

Don S.
07-09-11, 02:58 PM
If only there were evidence for so much misdiagnosing of autism and ADHD? I don't know a lot about the childhood bipolar disorders.

The article itself seems to be concern trolling on the basis of a slippery slope argument. What you (and the alarmist writer) ignored is that just about every diagnosis in the DSM includes the caveat "Causes significant impairment in two or more areas (work, school, home)" or a variation of that phrase. If someone is not impaired, they don't have a diagnosable disorder.

This isn't very Swiftian at all. What it looks like is another article that builds up to "Look at how those pharmaceutical companies want to more people to be diagnosed with ADHD to sell their stimulants!" That's not satire, that's just the typical ignorance about ADHD.

I wasn’t focusing on ADHD in particular. The people quoted within the article are professionals within the mental health communities themselves and refer to others who feel as they do. Therefore, the article is worth noting even for people who are great believers in credentialism.

I would like to add that Dr. Wakefield (whose now infamous study had been published in Lancet (Lancet!)) was not ultimately exposed by fellow medical professionals, but rather by a tenacious reporter (without a medical background) who just happened to have been given the assignment of looking into Dr. Wakefield’s work by his editor. Dr. Wakefield’s fraudulent study not only harmed the reputation of medicine and science in general, but put real flesh-and-blood kids unnecessarily at risk (which continues to this day). There have been many instances in the past where science has been corrupted by politics, ideology and money.

No! professional field of endeavor has some ordained right from above to be beyond scrutiny by any other than its peers. Many of us have a legitimate interest in the goings on within various professions.

Fortune
07-09-11, 03:15 PM
I didn't say anything was beyond scrutiny, and I have no idea where you got that impression.

I don't see the relationship of this to Dr. Wakefield.

I never claimed medicine hasn't been "corrupted" by politics, ideology, and money. In fact, I feel that this concern trolling over the DSM-V adding new categories is, itself a matter of politics, ideology, and money, as is likely the addition of these new diagnoses. My point - that you apparently missed - is that for a diagnosis to be necessary, the behavior in question needs to be impairing and possibly cause distress.

It is functionally inaccurate to say that normal behaviors are being pathologized when someone who is simply not impaired by those behaviors can't be diagnosed for them.

I should also note that there are professionals in the mental health field who do not believe in ADHD, who do not believe that adult ADHD is real, who refuse to diagnose people because "They don't believe in labels" even if that diagnosis may be necessary to getting vital assistance. There are professionals whose diagnostic criteria for Asperger's Syndrome is measuring how similar you are to Rain Man. There are professionals who are willing to take a set of traits out of context and deliver a poorly fitting diagnosis because it is the most expedient choice.

And it most certainly does not help their case that they refer to factual inaccuracies (ADHD and autism are not being globally overdiagnosed). It does appear that childhood bipolar disorder is being overdiagnosed - so one claim of three is factual, and the other two are political and ideological without any factual grounding.

I am not even saying that the diagnoses in question are beyond criticism.

I do not dispute whether you have a legitimate interest in the goings on within various professions. I think you are leaping to conclusions if you think I have no interest in developments within psychiatry and psychology. However, I find it difficult to accept something at face value when it uses false information as talking points.

meadd823
07-09-11, 04:31 PM
One sided article that reads anti-meds almost anti-psychiatry Just because one has a blood sugar does not make him/her a diabetic only when the blood sugar is abnormally high {interfering with the body's ability to function} does it become a problem - So toddler tantrums are not a problem as long as the frequency and intensity of said tantrums are about the same as every other toddle on the face of the planet - it is when the frequency or intensity of the behavior reaches an extreme level interfering with the child's ability to develop in other areas would the tantrums be considered a diagnosable condition!

Don S.
07-09-11, 06:48 PM
Fortune:

I’m sure you have better things to do with your time than read my short story. However, if that were not the case then you would soon discover that I would be the last person to assert that ADHD is not real. In fact, I consider my challenges with this affliction to have been more responsible for my severe childhood social problems than TS had been.

What I have difficulties with comes down to what the word “real” means in regard to many DSM listed afflictions. Personality traits are most certainly real, as are physical traits. These are genetic at birth (and can later be influenced by environmental factors as well). What exactly at birth (barring in-vitro insults) is there about our bodies and brains that was not the result of our genes? Eye, hair or skin color? Innate intelligence, musical or mechanical aptitude? Are personality traits any different?
Now, when personality traits become pronounced to the point where they interfere with a person functioning at optimal (or even close to it) potential, then it becomes a “disorder” and is given a name by way of identification. We seem to be agreeing here and if this qualification is in effect for most DSM listed mental health afflictions, then I would agree there is not a great problem with affliction inflation regarding DSM. However, the mental health professionals reported upon within this article seem to disagree with you on this point. Perhaps you are correct and they are not.

My major point of concern is that this qualification was discontinued in regard to Tourette’s Syndrome in 2000. Moreover, for over forty years now TS has been classified as a “neurological disorder” caused by some as yet (still, even after over four decades!) unknown anomaly within the central nervous system. If this paradigm is indeed correct in fact, then TS is “real” in the same sense that cancer, mumps, measles, diabetes, etc are real; that is, there are physical pathogens or organic abnormalities which account for the diseases.

In some instances of such afflictions, medications can indeed at least mitigate the symptoms of these afflictions (as with anxiety disorders) by chemically restraing the brain so that the symptoms become repressed. This is no different than tying a smoker’s hands behind his or her back to prevent his or her indulging. That would, of course, not prove that his or her hands are the cause of his or her urges to smoke and chemically restraining the production or reception of certain hormonal influences does not prove that there is a physical anomaly that causes the aberrant hormonal release.
<?XML:NAMESPACE PREFIX = O /><O:p< font>
This is clearly seen in the case of panic attacks where large infusions of adrenaline occur as the result of the person’s panic. Panic attacks do not occur because of abnormal releases of adrenaline. To hold to that (in this case—absurd) contention would confuse cause with effect, which is exactly the case with TS when many hold that an excess of dopamine is responsible for TS tics. Dopamine might prove to be the chemical agency which gives the metaphorical order to tic, but that does not necessarily mean that there is a dopamine surge due to some physical abnormality within the CNS.

I disagree with this paradigm regarding TS and some other (though not all) mental afflictions. Inherited personality traits—even when pronounced to the point of becoming burdensome—are not caused by a physical abnormality any more than there is a physical abnormality to account for why some have tremendous (indeed, one might say “abnormal”) intelligence, musical or mechanical abilities. In regard to mental afflcitions, personality traits and tendencies become pronounced as a result of repetitious behavior and subsequent habituation.

My point about the fiasco of Dr. Wakefield’s MMR and autism study was meant as an example of why professions (especially ones which influence public policy decisions) cannot be trusted to entirely police themselves any more than, sadly, could the Catholic laity depend upon the clergy to do likewise. Thus, DSM is open to scrutiny and criticism, especially when it involves so much that is inherently subjective in nature. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>
<o:p></o:p>
<o:p></o:p>
</O:p<>

Rebelyell
07-09-11, 06:50 PM
WHo the hell tourettes or otherwise wants to be normal?

Fortune
07-09-11, 07:21 PM
Fortune:

I’m sure you have better things to do with your time than read my short story. However, if that were not the case then you would soon discover that I would be the last person to assert that ADHD is not real. In fact, I consider my challenges with this affliction to have been more responsible for my severe childhood social problems than TS had been.

Thank you for the reply and explanations.

For what it's worth, I did not think you were saying ADHD doesn't exist or is overdiagnosed, I was responding to the article.

sarahsweets
07-09-11, 08:15 PM
Being "abnormal " makes you hot. ;)

Abi
07-09-11, 11:50 PM
Rebelyell the Tourette's Gifter.

I think I have voluntary Tourette's

Hahahaha

****ers

Don S.
07-10-11, 12:07 PM
i disagree with this paradigm regarding ts and some other (though not all) mental afflictions. Inherited personality traits—even when pronounced to the point of becoming burdensome—are not caused by a physical abnormality any more than there is a physical abnormality to account for why some have tremendous (indeed, one might say “abnormal”) intelligence, musical or mechanical abilities. in regard to mental afflcitions, personality traits and tendencies become pronounced as a result of repetitious behavior and subsequent habituation.

</O:p

I want to add a point here.

As I have noted in other posts, I hold that all afflictions that once were (or should have been) or would have been (had the nomenclature not been discontinued before certain diagnoses were formulated) classified under the broad category of “neurotic” are related (which is why there is such a high comorbidity rate among them) and are caused by chronic anxiety which is the result of what I term to be “acute self-awareness," an evolutionary process where the instinct to survive has become so pronounced as to be counterproductive to an individual’s functioning at optimal potential.

This is not the same thing as an affliction caused by an organic anomaly (usually positioned to be within the central nervous system (presumably the brain)). I consider my belief to validated by many common sense observations and the fact that after decades of searching for these alleged physical abnormalities, researches have still come up blank. I assert that the reason for this is that these alleged organic abnormalities do not exist, at least in regard to “neurotic” afflictions which involve no true mental impairments (such as seizures, hearing voices and other delusions and hallucinations, paranoia and suicidal or homicidal tendencies).

I further hold as proof of my assertion to be the most encouraging reports regarding treating such afflictions (especially OCD and TS (two very closely related afflictions)) with cognitive behavioral therapies. Indeed, this is why these reported results have been derided by some within the TS “community.” It is a threat to their organic paradigm. The reasoning is obvious: Quite simply, there is no way to account for how any sort of talk therapy could havie any efficacy in the treatment of organic diseases or afflictions.

Behavioral therapies have efficacy in treating behavioral problems, not organic ones.

Dizfriz
07-10-11, 03:40 PM
Don, it is hard to get a handle on what points you are trying to make but I think I am getting a little closer.


Nor, might one add, does the fact that that the alleged organic abnormalities within the central nervous system have yet to be found prove that they exist! You seem to be asking for something you will not get-"Proof". Science does not do proof. There is always left open the possibility that a piece of information can come in which will change the picture. That is a basic part of science. Science can disprove and support and that is it. As the old saying goes "Proof is for math and booze, not science."


Please note that I am only taking a position on what were once referred to as “neurotic” afflictions. Could you unpack that a little? I am not sure what you mean by neurotic afflictions. Although I am uncertain, I believe that there is a high likelihood that such afflictions as schizophrenia and clinical depression (and bi-polar) are caused by an organic anomaly within the CNS.The evidence strongly indicates this.

Rather than rehashing the point here, please see my last two responses on the personality disorders thread that I recently initiated. The two threads seem to have become conflated. OK I am posting here then.



I want to add a point here.

As I have noted in other posts, I hold that all afflictions that once were (or should have been) or would have been (had the nomenclature not been discontinued before certain diagnoses were formulated) classified under the broad category of “neurotic” are related (which is why there is such a high comorbidity rate among them) and are caused by chronic anxiety which is the result of what I term to be “acute self-awareness," an evolutionary process where the instinct to survive has become so pronounced as to be counterproductive to an individual’s functioning at optimal potential. Could you give a sampling of some of these neurotic diagnosis? I, again, am not sure of what you mean though.

This is not the same thing as an affliction caused by an organic anomaly (usually positioned to be within the central nervous system (presumably the brain)). I consider my belief to validated by many common sense observations and the fact that after decades of searching for these alleged physical abnormalities, researches have still come up blank. For many issues we have some good indications of possible neurobiological causes. Until I have some idea of what you are discussing I cannot comment much. I assert that the reason for this is that these alleged organic abnormalities do not exist, at least in regard to “neurotic” afflictions which involve no true mental impairments (such as seizures, hearing voices and other delusions and hallucinations, paranoia and suicidal or homicidal tendencies). Again I cannot comment as I really do not know what you are discussing.

I further hold as proof of my assertion to be the most encouraging reports regarding treating such afflictions (especially OCD and TS (two very closely related afflictions)) with cognitive behavioral therapies. CBT can work well with many disorders but not all. [quote] Indeed, this is why these reported results have been derided by some within the TS “community.” It is a threat to their organic paradigm.I cannot discuss this much due to a lack of knowledge of the TS community. It is not something I have been involved with. The reasoning is obvious: Quite simply, there is no way to account for how any sort of talk therapy could havie any efficacy in the treatment of organic diseases or afflictions.



Here you are quite wrong. CBT has been very successful with a number of issues. It only works with mental health issues and has been shown to be effective in helping people deal with a number of physical issues.

There is a new CBT therapy just out specifically designed for work with adult ADHD. I haven't looked at it yet but I did read some research on how it was developed and it looks interesting.

[quote]Behavioral therapies have efficacy in treating behavioral problems, not organic ones. And no one says it does. I can do nothing about a child's ADHD. I cannot do much about their height either but I can do quite of bit about helping them and their parents deal with the disorder and the effects.

Again, I am not very clear of the point you are trying to make but if you want certainty, science is not the place to look. All science is, by its nature, incomplete and is best seen as a work in progress.

If you are trying to make the point that these disorders do not exist then you have a high mountain of evidence to climb to support that view.

Could you clarify what you are trying to say a little. I really and truly cannot figure it out.

Dizfriz

Don S.
07-10-11, 05:11 PM
Dizfriz,

The related mental health disorders that I am referring to are: Tourette’s Syndrome; Obsessive-Compulsive Disorder; Anxiety Disorders (including panic attacks); and ADHD.

Science can and has proven a great many things. For example, the cause of AIDS is the HIV.

No sort of talk therapy can have any efficacy in treating AIDs because it cannot expunge the HIV from the patient’s body and because the patient has no control over such. The AIDs patient cannot be taught how to dispel the virus from his or her system. The HIV is a physical pathogen.

<?XML:NAMESPACE PREFIX = O /><O:p< font>With the afflictions I mentioned above, I hold there is no pathogen or organic abnormality which causes them. Rather, they are caused by learned behaviors, repetition and reinforcement and ultimate habituation. Therefore, behavioral therapies can be effective in treating them. They could not be effective if the causes of these afflictions were physical as is the case with AIDs.

Aside from this, there are many common sense indicators that would belie the notion that Tourette’s is physical. If you or any are interested, please read the second and third articles I have written on TS as listed on my website. They are based upon my own experiences with TS and ADHD. Towards the end of the third one, I list five criteria which apply to TS and ask if anyone can name any physical afflictions that would meet all of them. No one has as yet.
</O:p<>

Fortune
07-10-11, 05:19 PM
<!--?XML:NAMESPACE PREFIX = O /--><o:pWith the afflictions I mentioned above, I hold there is no pathogen or organic abnormality which causes them. Rather, they are caused by learned behaviors, repetition and reinforcement and ultimate habituation. Therefore, behavioral therapies can be effective in treating them. They could not be effective if the causes of these afflictions were physical as is the case with AIDs.

Aside from this, there are many common sense indicators that would belie the notion that Tourette’s is physical. If you or any are interested, please read the second and third articles I have written on TS as listed on my website. They are based upon my own experiences with TS and ADHD. Towards the end of the third one, I list five criteria which apply to TS and ask if anyone can name any physical afflictions that would meet all of them. No one has as yet.</o

Can you account for observed neurological differences in people diagnosed with ADHD? All evidence points toward it not being behavioral. I believe similar is true of Tourette's Syndrome.

Common sense is rather meaningless, as people routinely describe coming to false conclusions by way of it. I have seen more than a few people assert factually wrong conclusions that they assume are obvious because to them "common sense would indicate it to be so."

Don S.
07-10-11, 05:35 PM
Can you account for observed neurological differences in people diagnosed with ADHD? All evidence points toward it not being behavioral. I believe similar is true of Tourette's Syndrome.
"

Please elaborate on your statement of “observed neurological differences.” Are your referring to EEGs? Can you link to an article for me to read and then comment upon by way of an answer?

In the meantime, here is a link to one of many articles referencing behavioral therapies and ADHD:

http://www.additudemag.com/adhd/article/651.html (http://www.additudemag.com/adhd/article/651.html)\ (http://www.additudemag.com/adhd/article/651.html)

Can you explain how if ADHD is physical (neurological), behavioral therapies could possibly have any efficacy? Talking to a patient can somehow cure some presumed neurological abnormality or instruct him or her how to?

Thank you. <O:p

Fortune
07-10-11, 05:42 PM
Please elaborate on your statement of “observed neurological differences.” Are your referring to EEGs? Can you link to an article for me to read and then comment upon by way of an answer?

Here's one (http://www.medscape.com/viewarticle/564917):


October 26, 2007 (Boston) — Converging early data from magnetic resonance imaging (MRI) studies show that compared with controls, adults with attention-deficit/hyperactivity disorder (ADHD) have structural and functional abnormalities in brain areas related to executive function and attention control.

This was discussed in a symposium on the neuroanatomy of ADHD at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry.


Three speakers in the symposium presented 3 studies in adults with ADHD that revealed volumetric brain abnormalities in ADHD, brain differences in ADHD vs bipolar disorder, and altered cortical networks in ADHD.

"There's a great deal of advancing knowledge in the brain mechanisms that underlie ADHD or are associated with it, but it's too early to know whether or how that will have clinical applications," Larry J. Seidman, PhD, from Harvard Medical School, in Cambridge, Massachusetts, told Medscape Psychiatry. He cautioned that it is premature to speculate whether clinicians will be able to use this knowledge in their practice.And this for TS (http://jcn.sagepub.com/content/21/8/672.abstract):

Traditional neuropathologic methods have provided only limited insight into the central nervous system abnormalities underlying Tourette syndrome. In the past 20 years, investigators have turned increasingly to in vivo neuroimaging approaches to localize, quantify, and characterize neuroanatomic, functional, and neurochemical distinctions in living subjects with Tourette syndrome. Research methods have included aggregate measures of cerebral energy metabolism, assessments of cerebral structure and size, and highly specific assessments of neurochemical markers of select neurons and synapses. Although the available data have important limitations, an encouraging convergence of findings implicates abnormal function in the Tourette syndrome striatum and in associated limbic and frontal cortical systems. (J Child Neurol 2006;21:672—677; DOI 10.2310/7010.2006.00162). In the meantime, here is a link to one of many articles referencing behavioral therapies and ADHD:

http://www.additudemag.com/adhd/article/651.html (http://www.additudemag.com/adhd/article/651.html%5C)\ (http://www.additudemag.com/adhd/article/651.html)

Can you explain how if ADHD is physical (neurological), behavioral therapies could possibly have any efficacy? Talking to a patient can somehow cure some presumed neurological aberration or instruct him or her how to?

Thank you. <o:pYou should read about neuroplasticity (http://www.refocuser.com/2009/05/neuroplasticity-your-brains-amazing-ability-to-form-new-habits/).

Behavioral therapy does not mean behavioral disorder. Autism is also clearly understood to be neurological in origin, but much of the treatment focuses on behavior.

And I believe that refers to the behavior modification techniques that only work for people with ADHD for as long as they're maintained. Once the behavior modification stops, so do the benefits.</o

Fortune
07-10-11, 05:44 PM
Weird how it keeps adding extraneous quote tags after "behavioral therapies and ADHD"

Fortune
07-10-11, 05:46 PM
It's also interesting that ADHD, Tourette's Syndrome, OCD, etc. all seem to be heritable:

http://www.sciencedirect.com/science/article/pii/S0890856710007811

Simenora
07-10-11, 05:52 PM
Please elaborate on your statement of “observed neurological differences.” Are your referring to EEGs? Can you link to an article for me to read and then comment upon by way of an answer?

In the meantime, here is a link to one of many articles referencing behavioral therapies and ADHD:

(http://www.additudemag.com/adhd/article/651.html)http://www.additudemag.com/adhd/article/651.html (http://www.additudemag.com/adhd/article/651.html%5C)\ (http://www.additudemag.com/adhd/article/651.html)

Can you explain how if ADHD is physical (neurological), behavioral therapies could possibly have any efficacy? Talking to a patient can somehow cure some presumed neurological abnormality or instruct him or her how to?

Thank you. <o:p</o

CBT can help make positive changes because of brain neuroplasticity. My son (with TS) was 5th percentile fine motor until grade 3. I put him in cello lessons.I am certain that we have bypassed the original connections because his fine motor has improved exponentially. It is a slow process, he couldn't write or print at all until 2 years ago(9yrs old) Now both are legible. Oh ya, cello is not bad either, the first year was torture until we got a new teacher who now understood that cello virtuosity was not what we were after.

Don S.
07-10-11, 06:10 PM
Fortune,

I’m well aware of all the claims made from various brain scanning techniques and TS. For years it has been the basal ganglia which has been alleged to harbor the presumed neurological abnormality. More recently, a study concludes that it is not the BG but rather the prefrontal cortex region. What will be the next suspected villain in this seemingly never ending saga?

Here is my response to brain imaging studies:

http://wwwdnschneidercom.xbuild.com/#/ts-and-adhd-19/4539428707 (http://wwwdnschneidercom.xbuild.com/#/ts-and-adhd-19/4539428707)

I am far less familiar with brain imaging studies regarding ADHD. However, I suspect they follow much in the same vein as those with TS. That is, they are “suggestive,” yet somehow cannot be used to objectively diagnose the affliction on a blind basis. Unfortunately, your link apparently requires a subscription to access. However, I shall look for articles on the subject on my own.

The article you linked to regarding neuroplasticity seems most interesting. I have printed it out to read tonight. However, from a cursory reading of it thus far it would seem to be more helpful to my case than yours. I shall see.

Don S.
07-10-11, 06:13 PM
It's also interesting that ADHD, Tourette's Syndrome, OCD, etc. all seem to be heritable:

http://www.sciencedirect.com/science/article/pii/S0890856710007811

I have never denied that TS has an inherited, genetic basis. Because one inherits great musical talent from a parent hardly means that the mechanism that manifests that ability is an organic abnormality.

Fortune
07-10-11, 06:23 PM
Fortune,

I’m well aware of all the claims made from various brain scanning techniques and TS. For years it has been the basal ganglia which has been alleged to harbor the presumed neurological abnormality. More recently, a study concludes that it is not the BG but rather the prefrontal cortex region. What will be the next suspected villain in this seemingly never ending saga?

Here is my response to brain imaging studies:

http://wwwdnschneidercom.xbuild.com/#/ts-and-adhd-19/4539428707 (http://wwwdnschneidercom.xbuild.com/#/ts-and-adhd-19/4539428707)

I am far less familiar with brain imaging studies regarding ADHD. However, I suspect they follow much in the same vein as those with TS. That is, they are “suggestive,” yet somehow cannot be used to objectively diagnose the affliction on a blind basis. Unfortunately, your link apparently requires a subscription to access. However, I shall look for articles on the subject on my own.

The fact is that they found differences in ADHD brains, developmental differences, which certainly suggests neurological involvement. For your theory that it's all behavioral to work, you need to account for these variations.

I am uncertain as to why a brain imaging study needs to establish differences that could be used to directly diagnose such conditions, and it seems to me that the whole idea that "there's no objective test to diagnose these conditions, thus they cannot be organic" is nothing more than a red herring. That is applying far more rigor than is necessary - many studies find differences caused by existing disorders that are not sufficient for the purposes of diagnosis, but this lack is not seen as necessarily changing the nature of those disorders.

Also, regarding your disdain because opinions shifted from the basal ganglia to the prefontal cortex, it should be pointed out that opinions shifted within the brain, not to some other cause.

I have never denied that TS has an inherited, genetic basis. Because one inherits great musical talent from a parent hardly means that the mechanism that manifests that ability is an organic abnormality.

So are you seriously suggesting that behaviors are inherited but that those behaviors have no neurological basis?

What kind of basis could they possibly have?

Fortune
07-10-11, 06:43 PM
Wow, our positions are so different as to be irreconcilable:

What is often lost sight of in such arguments concerning mental illnesses such as TS is that those who hold to the “brain = mind” theory in the brain/mind duality debate seek to position an entirely mechanical explanation for our mental existences, the same as for our physical ones. To such advocates, there is no such thing as a “controller” (mind) apart from the brain who makes decisions on an entirely volitional basis. To their way of thinking, all of our actions can be reduced to strictly physical mechanisms within the brain and central nervous system; a view that would seem to leave no real place for the field of psychology.I don't think there's any point to me attempting further discussion here.

Don S.
07-10-11, 06:46 PM
You said:

"I am uncertain as to why a brain imaging study needs to establish differences that could be used to directly diagnose such conditions, and it seems to me that the whole idea that "there's no objective test to diagnose these conditions, thus they cannot be organic" is nothing more than a red herring. That is applying far more rigor than is necessary - many studies find differences caused by existing disorders that are not sufficient for the purposes of diagnosis, but this lack is not seen as necessarily changing the nature of those disorders."

<!--><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> I do insist on such rigor due to the concept of the researcher’s bias. If researchers are looking at imagings from brain scans knowing they are looking within the brains of people diagnosed with TS and/or ADHD; and the purpose of their study is to look for neurological abnormalities, then it is not surprising they will find such.

The television show [I]60 minutes once did an expose where they told private polygraph companies that they were from a company with (I think) ten employees. Someone was stealing. Although they were not certain, they strongly suspected so-an-so. You want to guess what the results of the polygraph tests were in regard to who the guilty party was in every single case?

If TS and/or ADHD have some unique signatures indicating a neurological abnormality then have professionals on a blind basis read the imagings of 100 people so diagnosed against a hundred people with no histories of such symptoms and see how much above chance they can get in their identifications of the TS/ADHD-diagnosed subjects.

Don S.
07-10-11, 06:53 PM
Wow, our positions are so different as to be irreconcilable:

I don't think there's any point to me attempting further discussion here.

<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> For you to assert that leads me to believe you didn’t understand what I was saying regarding your quote from my article. I was not deriding psychology. I was defending it against those who maintain that the mind is synonymous with the brain. However, you are, of course, free to leave the discussion if you wish and thanks for your insights to date!

Best regards.

Don

Fortune
07-10-11, 06:55 PM
<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> For you to assert that leads me to believe you didn’t understand what I was saying regarding your quote from my article. I was not deriding psychology. I was defending it against those who maintain that the mind is synonymous with the brain. However, you are free to leave the discussion if you wish and thanks for your insights to date!

Best regards.

Don

Just to be clear, I didn't think you were deriding psychology.

Trooper Keith
07-10-11, 07:29 PM
Edit: nevermind, this is more involved than I feel like getting into.

I will come out and say that many psychiatric disorders, in fact, probably most of them, are psychologically derived. That is, they do not necessarily have a physical cause. There is this malignant push from the psychiatric community to define all psychological malady in terms of physical (neurological) difference, and I do not believe the evidence supports this view.

However, that a disorder is psychologically, rather than neurologically, derived does not mean that it is any less real. It simply means that treatment ought to be psychologically, rather than neurologically, based.

As for ADHD, even the psychoanalytic crowd with which I affiliate is in general consensus that it is only with medication that any progress can be made on the disorder.

Dizfriz
07-11-11, 08:36 AM
I am uncertain as to why a brain imaging study needs to establish differences that could be used to directly diagnose such conditions,

There is a lot of work being done on this but, as of yet, neuroimaging based diagnosis does not have a lot research to back it up.

One, but not the only, problem is that the imaging research is done on groups and they do show a significant difference between ADHD and non ADHD populations in that respect. The issue here is that the individual variation within groups is larger than the variation between groups. Scans are great research tools but not all that good for individual diagnoses. That does not mean that it may not turn out to be but as for now, it is not.

The EEG based diagnostic tools, I feel, show greater promise. They are still in the research and validation stages but I have some hope for them.

A good article on the state of different diagnostic methods is this article at http://www.russellbarkley.org/images/McGough%20Barkley%20Adult%20ADHD%2011-04.pdf

Good question and one that I often go back and re-ask.

Dizfriz

Dizfriz
07-11-11, 10:47 AM
Dizfriz,

The related mental health disorders that I am referring to are: Tourette’s Syndrome; Obsessive-Compulsive Disorder; Anxiety Disorders (including panic attacks); and ADHD.

Science can and has proven a great many things. For example, the cause of AIDS is the HIV.

No sort of talk therapy can have any efficacy in treating AIDs because it cannot expunge the HIV from the patient’s body and because the patient has no control over such. The AIDs patient cannot be taught how to dispel the virus from his or her system. The HIV is a physical pathogen.

With the afflictions I mentioned above, I hold there is no pathogen or organic abnormality which causes them. Rather, they are caused by learned behaviors, repetition and reinforcement and ultimate habituation. Therefore, behavioral therapies can be effective in treating them. They could not be effective if the causes of these afflictions were physical as is the case with AIDs.

Aside from this, there are many common sense indicators that would belie the notion that Tourette’s is physical. If you or any are interested, please read the second and third articles I have written on TS as listed on my website. They are based upon my own experiences with TS and ADHD. Towards the end of the third one, I list five criteria which apply to TS and ask if anyone can name any physical afflictions that would meet all of them. No one has as yet. <>

Thanks for responding. I reread both threads and did go to your site and read your article on ADHD and TS. I think I am beginning to understand what you are getting at a little better although I may not agree.

With the afflictions I mentioned above, I hold there is no pathogen or organic abnormality which causes them. Rather, they are caused by learned behaviors, repetition and reinforcement and ultimate habituation. Therefore, behavioral therapies can be effective in treating them. They could not be effective if the causes of these afflictions were physical as is the case with AIDs. As far at TS, I cannot comment as I do not have all that much experience with this.

As far as ADHD I do know more. I can say fairly definitively that this is not the case with ADHD. It is well established as caused primarily by neurobiological factors involving a genetic base. The expression however can be very involved with learned behaviors. This is what behavior management for children is based on.

What you may be running into here is oversimplification. Just because ADHD is not a result of any brain abnormality (in some cases, like brain injury, it is) does not mean that it does not have a neurological basis. We cannot do anything about the neurological aspect but we can do quite a bit about the expression. The only currently validated treatments for childhood ADHD is medication and Behavior management specifically designed for this purpose. Those have been shown by overwhelming evidence to be effective. Medications address the neurobiological aspects and behavior management the learned factors.

Just as a baseline to help communication, ADHD is normally not seen as an abnormality. It is best viewed as primarily a developmental disorder that has it strongest impact on the parts of the brain involved with the executive functions. There are some other issues involved but this is a good description of the current consensus on ADHD.

From that, your contention that ADHD is not a result of a brain abnormality is correct. Your contention that ADHD is learned behavior is not supported by the evidence. The evidence very strongly indicates that is not the case.

I hope I am correctly addressing your points at least on ADHD. Let me know if I am misinterpreting.

Now back to the discussion on science (one of my favorite topics).

Again science does not do proof. This is not meant in the way the general public uses the word similar to the way the public uses the term theory to mean a general guess.

In science these things have very specific meanings. Instead of proof we use the terms such as supported or confirmed.

As Stephen Jay Gould said In science, 'fact' can only mean confirmed to such a degree that it would be perverse to withhold provisional assent. That is the best we can get.

Dizfriz

Don S.
07-11-11, 11:38 AM
Edit: nevermind, this is more involved than I feel like getting into.

I will come out and say that many psychiatric disorders, in fact, probably most of them, are psychologically derived. That is, they do not necessarily have a physical cause. There is this malignant push from the psychiatric community to define all psychological malady in terms of physical (neurological) difference, and I do not believe the evidence supports this view.

However, that a disorder is psychologically, rather than neurologically, derived does not mean that it is any less real. It simply means that treatment ought to be psychologically, rather than neurologically, based.

As for ADHD, even the psychoanalytic crowd with which I affiliate is in general consensus that it is only with medication that any progress can be made on the disorder.

You mean I actually found a kindred spirit here? Might I respond with the proverbial “Wow!”?

I agree with everything you wrote in this post including that the use of medications can be most therapeutic in treating psychological afflictions (though I believe their usage should be reserved for more severe cases). In my third article on TS, I thanked (the memory) of Dr. Shapiro for having been a pioneer in the usage of medications for TS patients and improving their quality of life even though I emphatically disagree with his organic paradigm.

I have explained many times why I hold that the fact that medications can have efficacy in regard to psychological afflictions does not necessarily prove that these afflictions have an organic basis. Medications in these cases address the symptoms of said afflictions and not their cause. This is no different than the use of palliative drugs for those afflicted with physical illnesses such as cancer.

I also completely concur that the underlying issues and points of disagreement here are very complex; so much so that at times I think it is difficult for opponents on this issue to even understand what the other side is talking about.

And yes, psychological afflictions are certainly real. So is a great singing voice.

Thanks again. Your post was my thoughts from your brain!<O:p

Abi
07-11-11, 11:49 AM
I'm surprised that Keith is sideing with this clown.

Nothing personal, Keith, but yeah.

Don S.
07-11-11, 12:02 PM
I'm surprised that Keith is sideing with this clown.

Nothing personal, Keith, but yeah.

I would call you an idiot were I not afraid of a defamation suit from some organization representing them.

Abi
07-11-11, 12:05 PM
Yeah I was reading Swift, Dickens etc. when my age was in the single digits and I graduated summa cum laude with a 3.8 GPA despite untreated GAD and depression.

I would call you an idiot but it's against forum rules. :D

Don S.
07-11-11, 12:10 PM
Yeah I was reading Swift, Dickens etc. when my age was in the single digits and I graduated summa cum laude with a 3.8 GPA despite untreated GAD and depression.

I would call you an idiot but it's against forum rules. :D

So you chose "clown" as an alternative? Ah, the spirit of the law!

Abi
07-11-11, 12:13 PM
Clowns are nice.

They provide entertainment; serve a useful purpose.

Trooper Keith
07-11-11, 01:56 PM
Abi, there's nothing clown-like going on here. Don is, as far as I can tell, and I admit I have not read his article, promoting the idea that psychological conditions are caused by, well, psychology. That is, it is not necessarily a brain disorder that causes major depression - sometimes someone's life just sucks. It's not necessarily a biological cause for obsessive-compulsive disorder, rather, the conditions are caused by the formation of an ego defense.

I'll use OCD specifically. OCD does not originate from some kind of malignancy of the brain, from some sort of pseudo-cancer or a hole in the brain or even the semi-mythological "chemical imbalance" people are so eager to tout. Instead, this disorder is caused by the formerly adaptive childhood defenses of obsession (intellectualization, rationalization, moralization) and compulsion (undoing) becoming malignant in the growth into adulthood. These defenses, being familiar and effective, are "reactivated" in the patient by acute stress, and then may or may not resolve after the stress leaves. Coupled with a generally anxious temperament, we find a person who is constantly ruminating and constantly acting in a way so as to "undo" the ruminations.

Now, naturally people will say "but there is a brain difference, the PET/CAT/SPECT scan shows it!"

The problem with this is that there is no way to say that this is causal. There is no evidence that the brain difference pre-exists the development of the defensive organization. And, as the same people amusingly remind us, the brain is extremely plastic. Therefore, the development of the neurological difference may very well be caused by the condition, rather than be the cause of the condition.

A careful study will find that similar causes can be found for the vast majority of psychiatric disorders.

And while we're at it, I will speak to the "genetics" hypothesis: remember that it is often the origin of the supposed genetic basis who is the primary caregiver, and that children, being very astute, learn most of their behaviors from their primary caregiver. A caregiver with schizophrenia, autism, or ADHD is likely to pass those behaviors on to the child by virtue of demonstrating those behaviors in front of the child, not necessarily by passing on genes. That they share genetic material only means that the predisposition to developing the disorder is there, not that the disorder necessarily springs from the womb.

I will, though, continue to go on record in saying that ADHD does not appear to be a learned behavior, as there is no evidence that it can respond to treatments based on unlearning behaviors and there is no theoretical foundational model which can explain it. ADHD does appear to be a true neurological condition. That said, I do believe the behavioral manifestations of ADHD are learned and reinforced the same way any behavioral quirk is learned.

Dizfriz
07-11-11, 03:13 PM
Keith, excellent post.

To weigh in, I think that what is inherited in many individuals in respect to many of the disorders in the DSM is a tendency or temperament that may make one more susceptible to certain patterns such as anxiety and depression. After that environment kicks in and triggers these issues. How much a trigger is needed is probably dependent on the degree that these are present in the makeup of the individual.

As you say though, not all who suffer from these issues have this susceptibility beyond a normal range but sometimes life happens and anxiety and depression are perfectly normal reactions to events.

This is not anything definitive but is the way I conceptualize the issues. Many clinicians use something similar as it gives a good framework for treatment.

Similarly with ADHD, if one thinks of ADHD as primarily neurobiological then you can focus on the expression of the disorder and not waste any time on dealing with causation except in an educational framework which in itself is therapeutic.

Just thoughts for whatever they are worth.

Dizfriz

Don S.
07-11-11, 03:25 PM
Diz,

Thank you for having taken the time to have read articles of mine at my website. It’s most appreciated. I’m gratified that you now profess a greater understanding of my arguments, even if you don’t necessarily agree with any or all of the conclusions I’ve drawn.

Although I suffered as kid with ADHD as comorbid with TS, I have never been as interested in that subject as I have been with TS.

(Which is odd, I must confess, in that, as I told Fortune, I believe ADHD was actually more responsible for my problems as a kid than had been TS per se.)

It therefore might be prudent for me to largely stick with discussing TS, though I am interested in learning more about ADHD as well. I have read your last post to me along with Keith’s and you seem to have diverging viewpoints to a certain extent. (You do apparently agree on some other points.) I shall mull that over and address some questions to Keith at a later time.

Perhaps you could discuss your differences with Keith while others evaluate your dialogue.

I suppose that because ADHD and TS are so very often comorbid I just assumed that they share the same etiology. I shall have to study the subject more extensively.
<?XML:NAMESPACE PREFIX = O /><O:p< font>
In regard to science being able to “prove" things, I’m still fuzzy as to what you mean when you seem to maintain that science can’t prove anything. Only those people with HIV in their systems develop AIDs. If that doesn’t constitute ”proof” that HIV is the cause for AIDs then the very word seems rather meaningless and perhaps more worthy to be discussed in a philosophy forum.

Thanks again.

P.S. I see that you have just answered Keith’s post. I shall have to read your response presently.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>
<o:p></o:p>
.<o:p></o:p>
<o:p></o:p>
</O:p<>

Don S.
07-11-11, 06:29 PM
Abi, there's nothing clown-like going on here. Don is, as far as I can tell, and I admit I have not read his article, promoting the idea that psychological conditions are caused by, well, psychology. That is, it is not necessarily a brain disorder that causes major depression - sometimes someone's life just sucks. It's not necessarily a biological cause for obsessive-compulsive disorder, rather, the conditions are caused by the formation of an ego defense.

OCD symptoms, such as bizarre rituals—which might be judged to be akin to superstition—, are defense mechanisms, exactly as you advise here. The symptoms are compulsive in an effort to dispel repetitive thought patterns bred from chronic anxiety. I argue that TS is simply a distinct variation of OCD; tics replace rituals.

I'll use OCD specifically. OCD does not originate from some kind of malignancy of the brain, from some sort of pseudo-cancer or a hole in the brain or even the semi-mythological "chemical imbalance" people are so eager to tout. Instead, this disorder is caused by the formerly adaptive childhood defenses of obsession (intellectualization, rationalization, moralization) and compulsion (undoing) becoming malignant in the growth into adulthood. These defenses, being familiar and effective, are "reactivated" in the patient by acute stress, and then may or may not resolve after the stress leaves. Coupled with a generally anxious temperament, we find a person who is constantly ruminating and constantly acting in a way so as to "undo" the ruminations.

I exactly agree. The compulsive defense mechanisms employed ultimately become habituated via repetition and reinforcement. Since chronic anxiety is the proximate cause, symptoms are aggrevated at more stressful times. (My own hypothesis, which you might not agree with, is that the root cause which engenders the chronic anxiety is what I term to be “acute self-awareness,” an evolutionary process in which the instinct to survive has become pronounced to the point of becoming counterproductive in terms of an individual’s ability to function at an optimal potential. If we are to believe <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comhttp://www.addforums.com/forums/ /><st1:City alt=</st1:City>Darwin’s theory, then has it ever occurred to you to inquire why we as a species have not evolved into a race of craven individuals afraid to take chances? Is not culling is a natural part of evolution?)


Now, naturally people will say "but there is a brain difference, the PET/CAT/SPECT scan shows it!"

The problem with this is that there is no way to say that this is causal. There is no evidence that the brain difference pre-exists the development of the defensive organization. And, as the same people amusingly remind us, the brain is extremely plastic. Therefore, the development of the neurological difference may very well be caused by the condition, rather than be the cause of the condition

A careful study will find that similar causes can be found for the vast majority of psychiatric disorders.

And while we're at it, I will speak to the "genetics" hypothesis: remember that it is often the origin of the supposed genetic basis who is the primary caregiver, and that children, being very astute, learn most of their behaviors from their primary caregiver. A caregiver with schizophrenia, autism, or ADHD is likely to pass those behaviors on to the child by virtue of demonstrating those behaviors in front of the child, not necessarily by passing on genes. That they share genetic material only means that the predisposition to developing the disorder is there, not that the disorder necessarily springs from the womb.

This is very well put! In my third article on TS, I note how confusing cause with effect had been responsible for the (apparently since abandoned!) hypothesis that an excess of dopamine production or reception is the cause of TS. (Poster) Fortune provided a link to an article on neuroplasticity. As she is an opponent of my psychological paradigm for TS and related mental health afflictions, I am puzzled. As I previously noted, it seems to buttress my case more than hers.

Your added observation that neuroplasticity seems to be a non sequitur in regard to an organic paradigm only reinforces that perception on my part. Indeed, within the article she referenced, it is noted that there are evident changes within the brains of people such as professional violinists which suggest that they have enlarged areas of their brains having to do with finger mapping. This noted change within violinists would hardly be thought of as an organic “abnormality." Once again, this consideration points to confusing cause with effect.

I will, though, continue to go on record in saying that ADHD does not appear to be a learned behavior, as there is no evidence that it can respond to treatments based on unlearning behaviors and there is no theoretical foundational model which can explain it. ADHD does appear to be a true neurological condition. That said, I do believe the behavioral manifestations of ADHD are learned and reinforced the same way any behavioral quirk is learned.

I’m uncertain if I agree or disagree with you here. My understanding of ADHD is far weaker than that of TS, and I'm not sure I am completely understanding you on this point. What is the distinction that you are making between the neurological cause of ADHD and its symptomatic manifestation via learned behavior and the etiology of similar afflictions which you hold to be strictly psychological and also manifest as learned behaviors?

Don S.
07-11-11, 06:59 PM
And while we're at it, I will speak to the "genetics" hypothesis: remember that it is often the origin of the supposed genetic basis who is the primary caregiver, and that children, being very astute, learn most of their behaviors from their primary caregiver. A caregiver with schizophrenia, autism, or ADHD is likely to pass those behaviors on to the child by virtue of demonstrating those behaviors in front of the child, not necessarily by passing on genes. That they share genetic material only means that the predisposition to developing the disorder is there, not that the disorder necessarily springs from the womb.
.

Your point concerning behavioral traits being learned via association with caregivers rather than being genetic is most interesting. However, from my personal experiences, I cannot agree with it.

Although my surname is German, I always tell people I’m Irish. The reason is that I take after my late mother in virtually every way and my late father in virtually none. (My brother, my only sibling, is the exact opposite. Indeed, some people have expressed skepticism that we’re related at all let alone full-blooded siblings!)

All of my personality traits and “neurotic" tendencies germinated from her, and the very course of my life has been startling akin to hers. Indeed, Keith, sometimes I grow despondent and sink into fatalism. Sometimes I think everything is decided as soon as the sperm hits the egg.

Having said this, I do think that close association with caregivers can aggravate natural personality traits and tendencies. Neither of my parents had TS, and did not appear to suffer from ADHD (though, of course, I didn’t know them when they were children). My mother’s naturally high-strung disposition and worrying ways might have indeed aggrevated the personality traits I inherited from her which resulted in TS and ADHD.

This is, of course, speculation.
<?XML:NAMESPACE PREFIX = O /><O:p< font>
On a final note, I find your intellectual faculties and innate perception to be brilliant. I take solace in the fact that you are so young. Although I never thought I would say this, I am beginning to have more respect for and faith in psychology than psychiatry. I wish you a long and productive career.

</O:p<>

Trooper Keith
07-11-11, 09:37 PM
[FONT=Arial]
I’m uncertain if I agree or disagree with you here. My understanding of ADHD is far weaker than that of TS, and I'm not sure I am completely understanding you on this point. What is the distinction that you are making between the neurological cause of ADHD and its symptomatic manifestation via learned behavior and the etiology of similar afflictions which you hold to be strictly psychological and also manifest as learned behaviors?

I suppose I can simplify and elucidate my point first by making a reasoned observation and then by instantiating the idea. A cause of an effect cannot itself be that effect. That is, X can cause Y, but if X causes Y, X cannot itself be Y. All effects have causes. My point, then, is that ADHD is a cause, not an effect. ADHD causes behaviors, those behaviors are the effects.

A person with ADHD might be extremely impulsive, and might, for example, have a tendency to blurt things out in a classroom. ADHD is not the blurting out, ADHD is the cause of the blurting out. The blurting behavior is a symptom that typifies ADHD, but the ADHD is not comprised of a cluster of behaviors, rather, the ADHD is a causal agent which leads to the behaviors.

At present, ADHD diagnosis is always inferred, never deduced. We look at a cluster of behaviors (effects) and see that those behaviors, taken together, indicate a common cause that might be ADHD. It could just as easily be poor parenting, or brain cancer, or a thyroid disorder, or a mood disorder, or anxiety, or whatever else, but it could be ADHD. The diagnostician's task, therefore, in diagnosing ADHD is to rule out other potential causes, not to establish ADHD as the principle cause. However, we must avoid making the mistake of throwing the baby out with the bathwater. It's a fine diagnostic line: we must assume that it is not ADHD until such a point as it is unreasonable to believe it is not ADHD. This can be readily apparent or very difficult to figure, depending on the behavior cluster.

I would say that many cases of ADHD are likely behavioral manifestations of intense infantile anxiety, but these would not be "typical." Instead, the "typical" ADHD child presents with a cluster of symptoms which characterize ADHD (impulsivity, inattention, and hyperactivity) and only those symptoms. I dislike diagnosis of ADHD as comorbid to, say, depression, because depression can in and of it itself cause the behavioral manifestations associated with ADHD. Until the depression (or anxiety, or whatever) is fully resolved, I do not believe it is possible to accurately diagnose ADHD.

Does that clarify my stance a little with regard to ADHD as a cause and not an effect? I got to rambling there for a while, but I felt it was mainly relevant.

Dizfriz
07-11-11, 10:04 PM
Perhaps you could discuss your differences with Keith while others evaluate your dialogue.

I do not know if Keith and I have ever disagreed. We sometimes see things from different viewpoints but we both pretty much work from the same general set of facts usually based on good science. His training is psychoanalytic and I used to work with children. His training is very good and while we do not always see the same dynamics, that is not a point of disagreement just theoretical orientation. His fits him as mine fits me. That is really all there is to it.

Trust me on this, Keith knows what he is doing.

Dizfriz

Kunga Dorji
07-11-11, 11:36 PM
In a recent post regarding Tourette’s Syndrome, I noted the proliferation of new afflictions within DSM over the last several decades. Within it, I rather sarcastically inquired if there was anyone left who might be characterized as being “normal.” Apparently, I’m not the first person who has made this observation as indicated within the following article.

http://m.theglobeandmail.com/life/health/mental-health-experts-ask-will-anyone-be-normal/article1653548/?service=mobile (http://m.theglobeandmail.com/life/health/mental-health-experts-ask-will-anyone-be-normal/article1653548/?service=mobile)

Perhaps this calls for yet another new personality affliction to be entered into the canon of recognized psychiatric maladies. Perhaps it could be labeled: “Aberrant Normalcy Syndrome” and defined as follows:

“Thought to be a very rare disorder, it is characterized by an individual’s intractable inability to be classified as having any of the myriad mental health afflictions into which the vast majority of the general population falls. Victims of this disorder are noted for their insufferable sense of smugness and sadistic tendencies as exhibited by their making others feel normal in contrast to their abnormal normality. Because of this sociopathic threat to the well being of society (and the pecuniary interests of medical and mental health professionals), immediate institutionalization is recommended.”

Rest assured that your precious tyke is not a brat. He or she is the victim of “Toddler Tantrum Disorder,” caused by an acute sense of anxiety at being age two.

Despite some of the comments on this thread- this is a very serious and real issue. There is real concern about where the DSM model is leading us.

Allen Frances, the editor of DSM IV has very much headed up this commentary and there are many excellent opinion pieces of his on the web.
A small example- note that he refutes the conspiracy theorists:

http://www.mindfreedom.org/kb/mental-health-abuse/psychiatric-labels/dsm-5/allen-frances-v-dsm

Experts have an almost universal tendency to expand their own favorite disorders: Not, as alleged, because of conflicts of interest -- for example, to help drug companies, create new customers or increase research funding -- but rather from a genuine desire to avoid missing suitable patients who might benefit. Unfortunately, this therapeutic zeal creates an enormous blind spot to the great risks that come with overdiagnosis and unnecessary treatment. This is a societal issue that transcends psychiatry. It is not too late to save normality from DSM-V if the greater public interest is factored into the necessary risk/benefit analyses.


( Now I know some will not like the source- but that article is the tightest summary of the issues that I have encountered
Really the process is at a crossroads- with a sharp division between those who favour categorical diagnosis and those who favour classification into "spectrums".

My own feeling is that the classification into spectrums - ie looking at a person's dysfunction in terms of how much each of the main symptom dimensions of depression, inattention anxiety, mood instability longstanding personality traits, and psychosis contribute to that individual presentation is intellectually more tenable than the categorical model of the current DSM.

This is very much a live and serious debate- and does fundamentally challenge the idea popular on this forum of ADHD as a discrete disease state.

We need to keep a close watch on this as the viability and appropriateness of stimulant treatment for ADHD is a completely different issue to the question of which intellectual basket we assign the condition to. This is highly relevant as the opponents of stimulant treatment tend to conflate these arguments, and are often successful in influencing public policy by so doing.

Kunga Dorji
07-11-11, 11:40 PM
I suppose I can simplify and elucidate my point first by making a reasoned observation and then by instantiating the idea. A cause of an effect cannot itself be that effect. That is, X can cause Y, but if X causes Y, X cannot itself be Y. All effects have causes. My point, then, is that ADHD is a cause, not an effect. ADHD causes behaviors, those behaviors are the effects.

A person with ADHD might be extremely impulsive, and might, for example, have a tendency to blurt things out in a classroom. ADHD is not the blurting out, ADHD is the cause of the blurting out. The blurting behavior is a symptom that typifies ADHD, but the ADHD is not comprised of a cluster of behaviors, rather, the ADHD is a causal agent which leads to the behaviors.

At present, ADHD diagnosis is always inferred, never deduced. We look at a cluster of behaviors (effects) and see that those behaviors, taken together, indicate a common cause that might be ADHD. It could just as easily be poor parenting, or brain cancer, or a thyroid disorder, or a mood disorder, or anxiety, or whatever else, but it could be ADHD. The diagnostician's task, therefore, in diagnosing ADHD is to rule out other potential causes, not to establish ADHD as the principle cause. However, we must avoid making the mistake of throwing the baby out with the bathwater. It's a fine diagnostic line: we must assume that it is not ADHD until such a point as it is unreasonable to believe it is not ADHD. This can be readily apparent or very difficult to figure, depending on the behavior cluster.

I would say that many cases of ADHD are likely behavioral manifestations of intense infantile anxiety, but these would not be "typical." Instead, the "typical" ADHD child presents with a cluster of symptoms which characterize ADHD (impulsivity, inattention, and hyperactivity) and only those symptoms. I dislike diagnosis of ADHD as comorbid to, say, depression, because depression can in and of it itself cause the behavioral manifestations associated with ADHD. Until the depression (or anxiety, or whatever) is fully resolved, I do not believe it is possible to accurately diagnose ADHD.

Does that clarify my stance a little with regard to ADHD as a cause and not an effect? I got to rambling there for a while, but I felt it was mainly relevant.

Keith- are you aware of Brown's argument that ADHD is the primary generative state that gives rise to the majority of psychopathology?
I think that there is a good deal in that argument.

Equally it is easy to see ADHD as a self maintaining state- as it creates so much chaos that a person can never stabilise and grow.

I would differ on one point though- if you take a good history it is often possible to identify depression as a complication of preexisting ADHD- so the diagnosis can be made in the presence of depression.

However it presents problems- if the current symptoms are predominantly depressive then treating the underlying ADHD first can present hazards. So Stahl etc recommend treating the most active process first.

Dizfriz
07-12-11, 10:27 AM
Don


I suppose that because ADHD and TS are so very often comorbid I just assumed that they share the same etiology. I shall have to study the subject more extensively. We know quite a bit about ADHD but little about TS. As far as I can tell, we know that ADHD and TS are connected but really don't know how. Considering the devastation it can cause on the lives of those with TS, we are badly lacking in research on this disorder.

In regard to science being able to “prove" things, I’m still fuzzy as to what you mean when you seem to maintain that science can’t prove anything. Only those people with HIV in their systems develop AIDs. If that doesn’t constitute ”proof” that HIV is the cause for AIDs then the very word seems rather meaningless and perhaps more worthy to be discussed in a philosophy forum. Good question. The issue of proof is very much a part of the philosophy of science and is one of the bedrock principles. What it means is that we have to always keep open that possibility that new information might come in that can change the picture. Science is primarily inductive and thus is provisional and never totally proven. So in that sense, the term proof is indeed meaningless in the context of science.

Why is this important and why do I stress it so much? When discussing ADHD some understanding of science is necessary. So often we see posters coming in and stating the some data can be ignored as it is not "proven" or something must be accepted because it is. You often run into this in the general public discussion on the kind of subjects we are involved with here and both viewpoints are wrong.

This objection is one that needs to be handled. One cannot reject nor advocate for something using the term proven to support an argument of science. It is inaccurate, very misleading and causes a lot of confusion in the discussion.

Using your example of AIDS and HIV. As Gould might put it, the idea that AIDS stems from HIV is so well supported that it would be perverse to withhold provisional assent. Note the term provisional. We might find tomorrow a case of AIDS that is not proceeded by HIV. That possibility cannot be rejected because it is "proven" that always AIDS is preceded by HIV.

Again, all scientific theories are provisional in nature. To not understand that is to not understand science. This understanding is often critical in the discussion of the scientific and practical aspects of ADHD therefore I stress accurate information on the nature of science.

It is a soapbox I admit but I think an important one.

Yours,

Dizfriz

Trooper Keith
07-12-11, 10:41 AM
Dizfriz lays it out exactly as it is: things are only proven until they are disproven, and, importantly, for any claim it must be possible to conceive of a situation in which it could be disproven. That is, a claim that there are invisible unknowable unicorns in the room that cannot be detected by mortal means cannot be disproven, and therefore does not constitute having been proven.

In the case of HIV and AIDS, I would point out that while the evidence there is extremely strong, we might find out tomorrow that HIV and AIDS are only comorbid in the presence of a third agent (say, a prion disease), and that HIV does not cause AIDS, but merely accompanies it. While this situation is extremely unlikely, it is certainly possible. There is no deduction in experimental science. Deduction is a philosopher's or theorist's tool. Science can only induce because we can only sample a small portion of the domain. We cannot, in science, assert anything that applies to the domain of all things, because (a) we cannot be sure, in this vast Cosmos, that we have accounted for all things, and (b) even if we could, it is improbable that we would be able to perform an experiment on all such members of the class. Because we can't sample the entire population, we can't make deductive statements that describe the entire population, as we can never be sure there isn't a black swan.

Edit: In essence, as I reference the black swan, the concept boils down to this: all scientific claims must be falsifiable. Tautological, universal claims are falsifiable only if there is an instance which can disprove them. Because we can't know the Universe, we can never be certain that there isn't something out there that can falsify the claim.

Don S.
07-12-11, 03:10 PM
I would say that many cases of ADHD are likely behavioral manifestations of intense infantile anxiety, but these would not be "typical." Instead, the "typical" ADHD child presents with a cluster of symptoms which characterize ADHD (impulsivity, inattention, and hyperactivity) and only those symptoms. I dislike diagnosis of ADHD as comorbid to, say, depression, because depression can in and of it itself cause the behavioral manifestations associated with ADHD. Until the depression (or anxiety, or whatever) is fully resolved, I do not believe it is possible to accurately diagnose ADHD.

Does that clarify my stance a little with regard to ADHD as a cause and not an effect? I got to rambling there for a while, but I felt it was mainly relevant.

What it sounds like to me is that you are saying that ADHD is not synonymous with its symptoms, whereas an affliction such as OCD is. Therefore, ADHD is the cause of various symptoms manifested as behaviors and therefore is an organic (presumably neurological) abnormality inherent within a person, presumably within the CNS; presumably within the brain. OCD, on the other hand, is a series of symptoms which might be characterized as a strictly psychological affliction, faulty thought processes.

Therefore, treating and eliminating the symptoms of OCD effectively eliminates the affliction (though, of course, recidivism is always possible). However, treating and eliminating the (behavioral) symptoms of ADHD (in accordance with your previous post), if possible at all, does not eliminate ADHD. In the latter case, one might say that the ADHD is in a dormant stage.

Does that correctly summarize your position?

Don S.
07-12-11, 07:37 PM
Despite some of the comments on this thread- this is a very serious and real issue. There is real concern about where the DSM model is leading us.

Allen Frances, the editor of DSM IV has very much headed up this commentary and there are many excellent opinion pieces of his on the web.
A small example- note that he refutes the conspiracy theorists:

http://www.mindfreedom.org/kb/mental-health-abuse/psychiatric-labels/dsm-5/allen-frances-v-dsm


( Now I know some will not like the source- but that article is the tightest summary of the issues that I have encountered
Really the process is at a crossroads- with a sharp division between those who favour categorical diagnosis and those who favour classification into "spectrums".

My own feeling is that the classification into spectrums - ie looking at a person's dysfunction in terms of how much each of the main symptom dimensions of depression, inattention anxiety, mood instability longstanding personality traits, and psychosis contribute to that individual presentation is intellectually more tenable than the categorical model of the current DSM.

This is very much a live and serious debate- and does fundamentally challenge the idea popular on this forum of ADHD as a discrete disease state.

We need to keep a close watch on this as the viability and appropriateness of stimulant treatment for ADHD is a completely different issue to the question of which intellectual basket we assign the condition to. This is highly relevant as the opponents of stimulant treatment tend to conflate these arguments, and are often successful in influencing public policy by so doing.

I’d certainly say that it is a real and serious issue when the chairman of the DSM-IV committee within the APA is expressing such concerns!

Thanks for the link and here is another one from a PBS interview with Dr. Frances and Dr. Alan Schatzberg, the president of the APA, discussing proposed revisiosns in DSM-V:

<O:p</O:phttp://summit-education.com/ce-news/dsm-v-interview-with-dr-alan-schatzberg-dr-allen-frances-on-pbs-newshour/ (http://summit-education.com/ce-news/dsm-v-interview-with-dr-alan-schatzberg-dr-allen-frances-on-pbs-newshour/)

Trooper Keith
07-12-11, 09:51 PM
What it sounds like to me is that you are saying that ADHD is not synonymous with its symptoms, whereas an affliction such as OCD is. Therefore, ADHD is the cause of various symptoms manifested as behaviors and therefore is an organic (presumably neurological) abnormality inherent within a person, presumably within the CNS; presumably within the brain. OCD, on the other hand, is a series of symptoms which might be characterized as a strictly psychological affliction, faulty thought processes.

Therefore, treating and eliminating the symptoms of OCD effectively eliminates the affliction (though, of course, recidivism is always possible). However, treating and eliminating the (behavioral) symptoms of ADHD (in accordance with your previous post), if possible at all, does not eliminate ADHD. In the latter case, one might say that the ADHD is in a dormant stage.

Does that correctly summarize your position?

I suppose it does. In this respect, the difference is that ADHD can be treated, but not cured, whereas OCD can be cured. One has a very real neurological disposition that leads to the condition manifesting, whereas the other has symptoms caused by psychological processes which can be cured psychologically. I'm not hard set in this stance, I advocate it only because the evidence currently does not support that ADHD has any psychological origins or any response to psychological treatments.

Kunga Dorji
07-12-11, 11:02 PM
I suppose it does. In this respect, the difference is that ADHD can be treated, but not cured,

You mistake the current fashion in medical thought for proven fact. Your comment is an assertion of an unproven idea.

Trooper Keith
07-13-11, 12:35 AM
You mistake the current fashion in medical thought for proven fact. Your comment is an assertion of an unproven idea.

I thought I made it fairly clear that my stance is based on the state of current research, and not a mistake for "proven fact." Amusing that you'd post this only a few posts aware from my discussing why there are no proven facts in science. You'll also notice that I specify exactly what my reasons are for asserting as I did. Just because something is "in fashion" doesn't make it wrong, nor does it make it right.

Kunga Dorji
07-13-11, 01:24 AM
I thought I made it fairly clear that my stance is based on the state of current research, and not a mistake for "proven fact." Amusing that you'd post this only a few posts aware from my discussing why there are no proven facts in science. You'll also notice that I specify exactly what my reasons are for asserting as I did. Just because something is "in fashion" doesn't make it wrong, nor does it make it right.

You have said that elsewhere- but your every statement outside that one post is expressed in dogmatic terms that simply do not reflect that attitude.

Given that the way you state things has real and measurable negative impact on the self image of any people diagnosed with ADHD I think you need to be more circumspect in your wording.

For every single one of us- our positivity and our ability to think well of ourselves is the most important asset we have in our quest to live a normal life. Yet you casually trample over and violate that in so many of your very black and white statements.

What I think we need to make clear is that this theory as to the causation of ADHD is an extrapolation- not a soundly based theory.

I have been on the trail of this for some years now- and all I ever find is various researchers saying "this is the accepted theory" and referring to what everyone else is saying.

The status of this theory is one of a series of Chinese Whispers. None of its proponents has ever addressed the many serious logical flaws in the theory.

What we all have to understand is there are many times when the accepted truth is not a soundly based and properly reasoned theory- but just a cluster of assumptions that has had reality breathed into it because everyone repeats it.

If you look at the links that were posted to Allen Frances discussions you will find that there is a very real and serious scientific debate going on that the whole structure of DSM is fundamentally unsound and all the diagnoses in it are just constructs that arise from a particular pattern of thinking.

Allen Frances classic statement is that "DSM has 100% reliability and 0% validity."
That is an intellectually tenable position.
Maybe the level of this conversation is just too abstract for you to even grasp what is being discussed here.

Don S.
07-13-11, 09:46 AM
I suppose it does. In this respect, the difference is that ADHD can be treated, but not cured, whereas OCD can be cured. One has a very real neurological disposition that leads to the condition manifesting, whereas the other has symptoms caused by psychological processes which can be cured psychologically. I'm not hard set in this stance, I advocate it only because the evidence currently does not support that ADHD has any psychological origins or any response to psychological treatments.

Keith,

Thank you very much for the clarification.

I have no firm convictions regarding the etiology of ADHD. As I have always been more interested in Tourette's and anxiety disorders, I need to do some serious reading before I would feel competent to even voice an intelligent opinion on this subject, especially at this level of discourse. Both the doctor and yourself voice (most) articulate and erudite arguments for your respective opinions.

I just have one final question for now of you, please. If ADHD is in fact an organic anomaly, then how do you account for all the children with it who “outgrow” it? (About a third according to the <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comhttp://www.addforums.com/forums/ /><st1:PlaceName alt=</st1:PlaceName>American <st1:PlaceType w:st="on">Academy</st1:PlaceType> of Family Physicians.) This is one of the considerations that led me to doubt that TS could possibly be organic in nature. What exactly happens to the anomaly upon reaching adulthood? Does it cease to exist (and if so, what is the mechanism for that), or is it still present and somehow loses its ability to produce symptoms (again, if so, why)?

Thanks much.

Don

Trooper Keith
07-13-11, 11:24 AM
[FONT=Times New Roman][SIZE=3]I just have one final question for now of you, please. If ADHD is in fact an organic anomaly, then how do you account for all the children with it who “outgrow” it?

As stated before, the brain is extremely plastic and undergoes vast changes from early childhood to adulthood. I see no reason to rule out the idea that children with ADHD can outgrow the condition through a reduction of symptoms that results in less reinforcement of the structures in the brain which give rise to the disorder.

Do you have any statistics on how many of that 30% that outgrow the disorder receive treatment? I'd be interested to see.

Maybe the level of this conversation is just too abstract for you to even grasp what is being discussed here.

Or, perhaps, you have once again hijacked a conversation, decided what the new topic was (usually something about how the current medical establishment is not acceptable), and then insulted everyone else for not conversing about your personal agendas with you. I'm not talking to you about this topic, I have no interest of talking with you about this in this thread, and so your insulting me as incapable of following your ineffable reasoning is unwarranted and unwelcome. I am answering Don's questions, and you are raving from the sidelines and then insulting me for not fully attending to you. I'm sick of it. **** off.

Lunacie
07-13-11, 11:47 AM
Keith,

Thank you very much for the clarification.

I have no firm convictions regarding the etiology of ADHD. As I have always been more interested in Tourette's and anxiety disorders, I need to do some serious reading before I would feel competent to even voice an intelligent opinion on this subject, especially at this level of discourse. Both the doctor and yourself voice (most) articulate and erudite arguments for your respective opinions.

I just have one final question for now of you, please. If ADHD is in fact an organic anomaly, then how do you account for all the children with it who “outgrow” it? (About a third according to the <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comhttp://www.addforums.com/forums/ /><st1:PlaceName alt=</st1:PlaceName>American <st1:PlaceType w:st="on">Academy</st1:PlaceType> of Family Physicians.) This is one of the considerations that led me to doubt that TS could possibly be organic in nature. What exactly happens to the anomaly upon reaching adulthood? Does it cease to exist (and if so, what is the mechanism for that), or is it still present and somehow loses its ability to produce symptoms (again, if so, why)?

Thanks much.

Don

It's my understanding, which could possibly be wrong, that those who "outgrow" ADHD actually had very mild symptoms and had good support in learning coping skills - and possibly found a job or profession where they could use their skills rather than battling with the remaining traits of ADHD. They are also usually those who have a higher-than-average intelligence to help them develop coping skills.

My own intelligence is higher-than-average but - because I got no support growing up and had more severe traits, I haven't had much luck in developing good coping skills. At the grand old age of 60 I am finally seeing a therapist and a psychiatrist and taking meds to help with my cormorbid Anxiety and Disorder, both of which have certainly made it more difficult for me to cope with the previously undiagnosed ADHD.

Don S.
07-13-11, 11:53 AM
As stated before, the brain is extremely plastic and undergoes vast changes from early childhood to adulthood. I see no reason to rule out the idea that children with ADHD can outgrow the condition through a reduction of symptoms that results in less reinforcement of the structures in the brain which give rise to the disorder.

Do you have any statistics on how many of that 30% that outgrow the disorder receive treatment? I'd be interested to see.

Keith,

Well, here is the article from which I derived the statistic:

http://www.additudemag.com/adhd/article/2515.html (http://www.additudemag.com/adhd/article/2515.html)

The purpose of my question was to inquire and not to debate with you. As I said, I need to do some serious reading before I voice any opinions on the subject, so I won’t take anymore of your time for now.

I could offer you my experiences with the affliction on an empirical basis as a kid but, as related within my thinly-veiled personal memoir short story, it was very much in accordance with what others relate. I often kid that I could have been the poster boy for it had the diagnosis been formulated then. I had been extremely hyperactive (is that redundant?) and was easily bored. Despite high intelligence, I generally performed mediocrely in school, except in certain subjects that intensively interested me. Like many ADHD kids, I tended to gravitate to escapist literature, The Hardy Boys and then SF. (Today I would imagine it is video games and the like.) Some might refer to this as a form of “self-medicating.”

Thanks for your input. It’s very much appreciated. I have derived some good beginning insights from you and others. It’s most appreciated.

Best regards,

Don

Trooper Keith
07-13-11, 11:56 AM
Keith,

Well, here is the article from which I derived the statistic:

http://www.additudemag.com/adhd/article/2515.html (http://www.additudemag.com/adhd/article/2515.html)

The purpose of my question was to inquire and not to debate with you. As I said, I need to do some serious reading before I voice any opinions on the subject, so I won’t take anymore of your time for now.

I could offer you my experiences with the affliction on an empirical basis as a kid but, as related within my thinly-veiled personal memoir short story, it was very much in accordance with what others relate. I often kid that I could have been the poster boy for it had the diagnosis been formulated then. I had been extremely hyperactive (is that redundant?) and was easily bored. Despite high intelligence, I generally performed mediocrely in school, except in certain subjects that intensively interested me. Like many ADHD kids, I tended to gravitate to escapist literature, The Hardy Boys and then SF. (Today I would imagine it is video games and the like.)

Thanks for your input. It’s very much appreciated. I have derived some good beginning insights from you and others. It’s most appreciated.

Best regards,

Don

I just want to say that I don't think of our discussion as a debate, nor do I think of it as you imposing on my time. I've enjoyed sharing perspectives with someone with somewhat similar views of psychology. Also, I read a lot of the Hardy Boys. Love it.

Lunacie
07-13-11, 12:09 PM
As a teen I read and enjoyed the Hardy boys series, also Nancy Drew. I'm still reading and enjoying mysteries. I also read a lot of scifi and fantasy. I thought of my reading as escapism from a difficult life, but it may also have been a form of self-stimulation.

Dizfriz
07-13-11, 01:10 PM
Keith,

Well, here is the article from which I derived the statistic:

http://www.additudemag.com/adhd/article/2515.html (http://www.additudemag.com/adhd/article/2515.html)

The purpose of my question was to inquire and not to debate with you. As I said, I need to do some serious reading before I voice any opinions on the subject, so I won’t take anymore of your time for now.

I could offer you my experiences with the affliction on an empirical basis as a kid but, as related within my thinly-veiled personal memoir short story, it was very much in accordance with what others relate. I often kid that I could have been the poster boy for it had the diagnosis been formulated then. I had been extremely hyperactive (is that redundant?) and was easily bored. Despite high intelligence, I generally performed mediocrely in school, except in certain subjects that intensively interested me. Like many ADHD kids, I tended to gravitate to escapist literature, The Hardy Boys and then SF. (Today I would imagine it is video games and the like.) Some might refer to this as a form of “self-medicating.”

Thanks for your input. It’s very much appreciated. I have derived some good beginning insights from you and others. It’s most appreciated.

Best regards,

Don


The stat that 30% outgrow ADHD (btw not found on the site you listed but no problem, I have familiar with this idea.) may be an artifact of the criteria. The current criteria is totally based on children and not all that applicable to adults. When the new DSM comes out we may be able to get a better handle on this issue.

What my current thinking is that the expression of ADHD changes with time and maturity. One very good possibility is that many change expression to where they no longer fit the criteria. That does not mean that the underlying condition is no longer present however.

Right now, we do not really know if anyone truly "outgrows" ADHD.

That is for research in the future.

On another point, I posted a lot of material on ADHD at http://www.addforums.com/forums/showthread.php?t=60130

Much of it is aimed primarily at children but the general principles also work for adults.

The essay on what ADHD is and how it affects people has a lot of resources for learning more about ADHD.

If you haven't looked at this, it might be worth your while.

Dizfriz

Dizfriz

Don S.
07-13-11, 03:03 PM
The stat that 30% outgrow ADHD (btw not found on the site you listed but no problem, I have familiar with this idea.) may be an artifact of the criteria. The current criteria is totally based on children and not all that applicable to adults. When the new DSM comes out we may be able to get a better handle on this issue.

What my current thinking is that the expression of ADHD changes with time and maturity. One very good possibility is that many change expression to where they no longer fit the criteria. That does not mean that the underlying condition is no longer present however.

Right now, we do not really know if anyone truly "outgrows" ADHD.

That is for research in the future.

On another point, I posted a lot of material on ADHD at http://www.addforums.com/forums/showthread.php?t=60130

Much of it is aimed primarily at children but the general principles also work for adults.

The essay on what ADHD is and how it affects people has a lot of resources for learning more about ADHD.

If you haven't looked at this, it might be worth your while.

Dizfriz

Dizfriz

Actually, I said “about a third…." Here is the quote from the article I referenced:

“Clinically, we have seen that some individuals do show enough improvement after puberty that they no longer need medication. But the <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comhttp://www.addforums.com/forums/ /><st1:PlaceName alt=</st1:PlaceName>American <st1:PlaceType w:st="on">Academy</st1:PlaceType> of Family Physicians reports that two-thirds of children with ADHD continue to grapple with the condition throughout adulthood.”

Technically, I guess, you’re correct. However, a little basic arithmetic will yield the one-third figure I cited.

Thank you for the link to the reference material regarding ADHD. As I said, I have a lot of reading to do on the subject.

Best regards,

Don

Lunacie
07-13-11, 04:51 PM
Actually, I said “about a third…." Here is the quote from the article I referenced:

“Clinically, we have seen that some individuals do show enough improvement after puberty that they no longer need medication. But the <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comhttp://www.addforums.com/forums/ /><st1:PlaceName alt=</st1:PlaceName>American <st1:PlaceType w:st="on">Academy</st1:PlaceType> of Family Physicians reports that two-thirds of children with ADHD continue to grapple with the condition throughout adulthood.”

Technically, I guess, you’re correct. However, a little basic arithmetic will yield the one-third figure I cited.

Thank you for the link to the reference material regarding ADHD. As I said, I have a lot of reading to do on the subject.

Best regards,

Don

Regardless of the quibble over two-thirds (33.3%) and at least 30%, the quote says some show enough improvement not to need meds anymore, not that they've "outgrown ADHD."

Considering that only about 50% of kids diagnosed with ADHD are taking any meds at all, I'm not sure whether the author of that article is saying that two-thirds of ALL kids with ADHD develop enough skills to no longer need meds, or that two-thirds of the kids who DO take meds during their childhood show enough improvement not to need meds any longer? :confused:

Kunga Dorji
07-13-11, 08:11 PM
T

Right now, we do not really know if anyone truly "outgrows" ADHD.



Dizfriz

What is interesting is that the orthodoxy has mutated from the idea that everyone grows out of it to the idea that nobody grows out of it.
Each position is equally absurd.
The concern as always is that the vast majority of commentators are simply prepared to reference other people's work and not consider the logical ramifications of what they are saying or how those statements fit in with knowledge from other traditions or areas.

While argument by appeal to authority is regarded as a serious error in clear thinking it is now de rigeur in professional circles.
The trouble is it is so prevalent it is starting to become accepted as appropriate.

Kunga Dorji
07-13-11, 08:49 PM
This is clearly seen in the case of panic attacks where large infusions of adrenaline occur as the result of the person’s panic. Panic attacks do not occur because of abnormal releases of adrenaline. To hold to that (in this case—absurd) contention would confuse cause with effect, which is exactly the case with TS when many hold that an excess of dopamine is responsible for TS tics. Dopamine might prove to be the chemical agency which gives the metaphorical order to tic, but that does not necessarily mean that there is a dopamine surge due to some physical abnormality within the CNS.


Quite- it is perfectly tenable to argue that the dopamine surge relates to a fixed subconscious patterning of holding the body and reacting to stress.

The theories that focus on neurotransmitters only entirely neglect the role of conscious and subconscious behaviours, and the way that these bahaviours are encoded and triggered by particular feeling states or even body movements or postures.

In this context the role of state specific memory is highly relevant. In many cases activation of a specific emotional state triggers old memories of trauma or stress.

This is why when we argue with our spouses we often lapse into absurd statements like "you always do this or that". What happens is that the current hyper-aroused state triggers memories of previous similar events.

Kunga Dorji
07-13-11, 08:53 PM
Regardless of the quibble over two-thirds (33.3%) and at least 30%, the quote says some show enough improvement not to need meds anymore, not that they've "outgrown ADHD."

Considering that only about 50% of kids diagnosed with ADHD are taking any meds at all, I'm not sure whether the author of that article is saying that two-thirds of ALL kids with ADHD develop enough skills to no longer need meds, or that two-thirds of the kids who DO take meds during their childhood show enough improvement not to need meds any longer? :confused:

NO- what it means is that 30% of kids diagnosed with ADHD no longer meet diagnostic criteria by adulthood. (This is well covered in the stats in Barkley's book ADHD in Adults.)


This has been got around by DEFINING those people as ADHD in partial remission. That however is a matter of definition and orthodoxy and has not been considered in enough depth to be considered a definitive statement at all.

Fortune
07-13-11, 09:58 PM
What is interesting is that the orthodoxy has mutated from the idea that everyone grows out of it to the idea that nobody grows out of it.
Each position is equally absurd.
The concern as always is that the vast majority of commentators are simply prepared to reference other people's work and not consider the logical ramifications of what they are saying or how those statements fit in with knowledge from other traditions or areas.

Not so. The former position was clearly informed by a lack of understanding of what ADHD is and how human brains mature over time. The latter position is based on data derived from longitudinal studies. The two are not equivalent. One is a position derived from a lack of data, while the other is a position derived from rather more extensive data.

While argument by appeal to authority is regarded as a serious error in clear thinking it is now de rigeur in professional circles.
The trouble is it is so prevalent it is starting to become accepted as appropriate.This is not an appeal to authority. An appeal to authority fallacy is referring to inappropriate appeals. If you say that Barkley is correct because he is Barkley then that is the fallacy you refer to. If you say Barkley is correct because he has researched and collated the data to support that position, that is not a fallacy. When people refer to current research and scientific knowledge, they're typically referring to the latter.

Kunga Dorji
07-13-11, 11:44 PM
Not so. The former position was clearly informed by a lack of understanding of what ADHD is and how human brains mature over time. The latter position is based on data derived from longitudinal studies. The two are not equivalent. One is a position derived from a lack of data, while the other is a position derived from rather more extensive data.

This is not an appeal to authority. An appeal to authority fallacy is referring to inappropriate appeals. If you say that Barkley is correct because he is Barkley then that is the fallacy you refer to. If you say Barkley is correct because he has researched and collated the data to support that position, that is not a fallacy. When people refer to current research and scientific knowledge, they're typically referring to the latter.

In the wider discussions that are being had about the manifest inadequacy of most scientific research the faith based reliance on the opinions of other authorities in science is a problem. This is especially so in biomedical science where the intellectual standards have raised the greatest concern.

Fortune
07-14-11, 12:30 AM
In the wider discussions that are being had about the manifest inadequacy of most scientific research the faith based reliance on the opinions of other authorities in science is a problem. This is especially so in biomedical science where the intellectual standards have raised the greatest concern.

But you referred to research that is not, in fact, accepted as a matter of faith. Rather, that data has been researched rather extensively - and inaccurately compared it to data that existed in the absence of research.

Lunacie
07-14-11, 10:44 AM
NO- what it means is that 30% of kids diagnosed with ADHD no longer meet diagnostic criteria by adulthood. (This is well covered in the stats in Barkley's book ADHD in Adults.)


This has been got around by DEFINING those people as ADHD in partial remission. That however is a matter of definition and orthodoxy and has not been considered in enough depth to be considered a definitive statement at all.

NO - the part I quoted said they no longer need meds, not that they no longer meet the diagnostic criteria. Not everyone who meets the diagnostic criteria takes meds or finds meds to be effective.

Kunga Dorji
07-14-11, 05:00 PM
NO - the part I quoted said they no longer need meds, not that they no longer meet the diagnostic criteria. Not everyone who meets the diagnostic criteria takes meds or finds meds to be effective.

Actually it is somewhat worse than that;

2007 statistics New South Wales Dept of Health- 0.08% of adults in NSW were taking stimulant medication for any reason that year.

Regardless of the fact that 30% of adult ADDers do not find medications helpful, and that some of us outgrow our need for medication- this is a serious indicator of the total failure of Australian Medicine to come to grips with the problem of ADHD.

Lunacie
07-14-11, 05:22 PM
Actually it is somewhat worse than that;

2007 statistics New South Wales Dept of Health- 0.08% of adults in NSW were taking stimulant medication for any reason that year.

Regardless of the fact that 30% of adult ADDers do not find medications helpful, and that some of us outgrow our need for medication- this is a serious indicator of the total failure of Australian Medicine to come to grips with the problem of ADHD.

I am thankful that there is ongoing research into the causes and treatment of ADHD. When I was a kid there was nothing at all. Now my grandkids can get a diagnosis and therapy. I can only imagine what I could have done if I'd had a diagnosis and therapy as a child.

Kunga Dorji
07-14-11, 10:41 PM
I am thankful that there is ongoing research into the causes and treatment of ADHD. When I was a kid there was nothing at all. Now my grandkids can get a diagnosis and therapy. I can only imagine what I could have done if I'd had a diagnosis and therapy as a child.

And that is the issue is it not- the damage that we have taken because of the willful stupidity of society.
In Australia it is really hot as there are very active political moves afoot to try and shut down diagnosis and treatment of ADHD.

Fortune
07-14-11, 11:10 PM
Could you link to something describing what's going on in Australia?

Simenora
07-14-11, 11:18 PM
Alberta Education rejected ADHD as a LD and accommodations are hit and miss.

Kunga Dorji
07-15-11, 01:40 AM
Alberta Education rejected ADHD as a LD and accommodations are hit and miss.

There should be a law against neurotypicals in positions of power- unfortunately they seem drawn to that type of position like flies to a dead animal!

Lunacie
07-15-11, 10:01 AM
And that is the issue is it not- the damage that we have taken because of the willful stupidity of society.
In Australia it is really hot as there are very active political moves afoot to try and shut down diagnosis and treatment of ADHD.

I don't know what society had to do with ignoring ADHD when I was a kid. Very few doctors knew anything about it, so how could we expect society to have any idea of what some of us were dealing with? :confused: