View Full Version : Ongoing increases in ADHD diagnoses in the USA


Kunga Dorji
12-04-13, 07:33 PM
http://www.jaacap.com/article/S0890-8567%2813%2900594-7/fulltext

Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated Attention-Deficit/Hyperactivity Disorder: United States, 2003–2011

Some Key Points:


In 2011, 11% of children/adolescents aged 4 to 17 years had ever received an ADHD diagnosis (6.4 million children). Among those with a history of ADHD diagnosis, 83% were reported as currently having ADHD (8.8%); 69% of children with current ADHD were taking medication for ADHD (6.1%, 3.5 million children). A parent-reported history of ADHD increased by 42% from 2003 to 2011. Prevalence of a history of ADHD, current ADHD, medicated ADHD, and moderate/severe ADHD increased significantly from 2007 estimates. Prevalence of medicated ADHD increased by 28% from 2007 to 2011.

Approximately 2 million more U.S. children/adolescents aged 4 to 17 years had been diagnosed with ADHD in 2011, compared to 2003. More than two-thirds of those with current ADHD were taking medication for treatment in 2011. This suggests an increasing burden of ADHD on the U.S. health care system. Efforts to further understand ADHD diagnostic and treatment patterns are warranted.

The demographic and state-based patterns for current ADHD were generally consistent with those observed for ever-diagnosed ADHD, although current ADHD estimates were approximately 20% to 25% lower than ever-diagnosed estimates[/URL]. State-based estimates of current ADHD ranged from 4.2% in Nevada to 14.6% in Arkansas and 14.8% in Kentucky.

The epidemiological profile for ADHD diagnosis and treatment continues to evolve. Based on parent-reported indicators of health care provider–diagnosed ADHD diagnosis and treatment, more than 1 in 10 school-aged children (11%) had received an ADHD diagnosis by a health care provider by 2011, representing more than 6.4 million children nationally. Nearly 1 in 5 high school boys and 1 in 11 high school girls had been diagnosed with ADHD.

The parent-reported indicators have not been clinically validated; however, a recent analysis indicated that parent-reported survey data produced similar estimates as those from insurance claims data, providing evidence of convergent validity for parent-reported ADHD diagnosis by a health care provider.


So previous trends of an increase in rate of diagnosis, and of substantial geographical differences in incidence continue.
Both of these trends are hard to reconcile with predominantly genetic causation of ADHD.

I borrow here from the article that Peripheral quoted on Play and ADHD:

[url]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242642/ (http://www.jaacap.com/article/S0890-8567%2813%2900594-7/fulltext#tbl1)

In sum, the increasing diagnosis of ADHD may reflect, in part, a cultural illness rather than any biological disorder (Panksepp, 1998b (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242642/#b27-ccap16_2p057)). This concept may help us understand why more than 10 million American children are presently being chronically medicated with psychostimulants, at the highest rate of any country in the world.


This is not conclusive of course, but is of significant concern given suggestions that psychostimulants may suppress playful behaviour.
However it does tie in the the epidemiological evidence of increasing rates of diagnosis and treatment in the US.

Kunga Dorji
12-04-13, 07:37 PM
A natural question to ask here is
"Are social conditions in low ADHD states like Nevada more conducive to free play?"


More natural play may facilitate the growth of pro-social brains and minds and keep the incidence of ADHD to a minimum (Panksepp, 1998b (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242642/#b27-ccap16_2p057), 2001 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242642/#b28-ccap16_2p057)).

meadd823
12-08-13, 03:06 AM
While I can understand the curiosity one must also consider other factors behind diagnosing any condition - While a more tolerant culture regarded play might be a cause of fewer diagnosis being made a less tolerant culture toward seeking help for behavioral difference may also be a causative factor.

When reading any ones research papers or scientific conclusion I always look into the back ground of said professional to get a feel for where they are approaching the question from for there is really no such thing as a truly objective point of view.

The human brain the only organ known to attempt to research itself while dulluding itself to believe it is capable of true objectiveness.


Jaak Panksepp, Ph.D. (http://www.vetmed.wsu.edu/research_vcapp/panksepp/)



...

mildadhd
12-08-13, 04:25 AM
Jaak Panksepp, Stephen Asma, Glennon Curran, Rami Gabriel & Thomas Greif

The Philosophical Implications of Affective Neuroscience (http://www.psychologytoday.com/files/attachments/109303/jcs-articlefinal.pdf)

Cognitive Science Society (CogSci10)
Portland, Oregon, 12 August 2010


I feel/think the link above is a relatively short, easy to read introduction, to Affective Neuroscientific perspectives.




Table 1 and Figure 1 , are very helpful to me.

Please see..

Table 1. Brain 1) Tertiary Cognitive, 2) Secondary Learning & Memory, and
3) Primary Emotional-Affective Processing Systems.

Figure 1. A conceptual summary of hierarchical bottom-up ‘nested’ and
top-down (circular) causation that presumably operates in every primal
emotional system of the brain

Kunga Dorji
12-08-13, 05:43 AM
While I can understand the curiosity one must also consider other factors behind diagnosing any condition - While a more tolerant culture regarded play might be a cause of fewer diagnosis being made a less tolerant culture toward seeking help for behavioral difference may also be a causative factor.

When reading any ones research papers or scientific conclusion I always look into the back ground of said professional to get a feel for where they are approaching the question from for there is really no such thing as a truly objective point of view.

The human brain the only organ known to attempt to research itself while dulluding itself to believe it is capable of true objectiveness.


Jaak Panksepp, Ph.D. (http://www.vetmed.wsu.edu/research_vcapp/panksepp/)



...
Corection meadd-- the "Western acculturated human mind" is the only phenomenon capable of believing it has sufficient objectivity to research itself.

The Eastern perspective is one of "intersubjectivity" - a perspective that understands that the polar extreme of perfect objectivity is as absurd and unbalanced as the concept of perfect subjectivity.

There is always a "Middle Way", and polar extremes are almost always a caricature of reality.

ginniebean
12-08-13, 09:21 AM
Corection meadd-- the "Western acculturated human mind" is the only phenomenon capable of believing it has sufficient objectivity to research itself.

The Eastern perspective is one of "intersubjectivity" - a perspective that understands that the polar extreme of perfect objectivity is as absurd and unbalanced as the concept of perfect subjectivity.

There is always a "Middle Way", and polar extremes are almost always a caricature of reality.

Are there no scientists in the east? Let's at least be clear what is actually being said. Western science vs eastern mysticism. Eastern science is identical to western science because they're both the same thing. Western mysticism has much in common with eastern mysticism for the same reason.


This east/west is a marketing trope. Not any sort of fact.

Dizfriz
12-08-13, 11:19 AM
http://www.jaacap.com/article/S0890-8567%2813%2900594-7/fulltext
So previous trends of an increase in rate of diagnosis, and of substantial geographical differences in incidence continue.
Both of these trends are hard to reconcile with predominantly genetic causation of ADHD.


Something to keep in mind, the study (as you reported) does not address the rate of kids actually diagnosed with ADHD but the rate that parents report that a medical person told them that the child was ADHD.

I very much suspect that this could result in an over reporting of the incidence rate greater than the actual diagnosis rate.

Considering this, the rate from the survey may not be very much different that the 5-8% or so reported in the literature on actual diagnosis by a clinician.

Without question, there has been an increase of ADHD diagnosis in the last decade or so but the question continues, how much is an increase in awareness of the disorder and how much is an increase in the actual rate of ADHD in the population? I am not all that sure that the actual rate of ADHD in the pediatric population has increased all that much but the evidence is still open on this as far as I know.

So in my opinion, discussion of any changes of rates of ADHD based on the CDC survey have to understood for what it is-good information but not definitive and any conclusions based on the CDC statistics have to be looked at in that light.

As an aside: I would like to see a study of a selective sample comparing the actual diagnosis rate and the reported rates of the children in the survey. It may have been done so if anyone has anything on this I would be interested.

Dizfriz

ginniebean
12-08-13, 11:38 AM
Something to keep in mind, the study (as you reported) does not address the rate of kids actually diagnosed with ADHD but the rate that parents report that a medical person told them that the child was ADHD.

I very much suspect that this could result in an over reporting of the incidence rate greater than the actual diagnosis rate.

Considering this, the rate from the survey may not be very much different that the 5-8% or so reported in the literature on actual diagnosis by a clinician.

Without question, there has been an increase of ADHD diagnosis in the last decade or so but the question continues, how much is an increase in awareness of the disorder and how much is an increase in the actual rate of ADHD in the population? I am not all that sure that the actual rate of ADHD in the pediatric population has increased all that much but the evidence is still open on this as far as I know.

So in my opinion, discussion of any changes of rates of ADHD based on the CDC survey have to understood for what is are-good information but not definitive and any conclusions based on the CDC statistics have to be looked at in that light.

As an aside: I would like to see a study of a selective sample comparing the actual diagnosis rate and the reported rates of the children in the survey. It may have been done so if anyone has anything on this I would be interested.

Dizfriz

This survey has a number of problems including that right before it asks whether a medical authority told them the child had ADHD the question is asked if a teacher suggested a child may have adhd. For many people a teacher suggested is equivalent of "the teacher diagnosed my child".

You hear that often enough.