View Full Version : I think ADHD inattentive and SCT are the same.


mildadhd
09-04-17, 01:45 AM
I cannot find any differences between what is being called ADHD inattentive (aka ADD DSM IV) and what is being called SCT.

Please do not include ADHD hyperactive/impulsive or ADHD combined types in this thread discussion.

This thread is meant to compare any differences between what is being called ADHD inattentive and what is being called SCT only.


If anybody has any evidence that ADHD inattentive and SCT are not relatively the same thing would be appreciated.

I can't find any general differences?




M

daveddd
09-04-17, 02:17 AM
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494999/

this study supposedly lays out a clinical picture of someone with SCT vs ADHD

the conclusion leaves me just as confused about this being a separate disorder

mildadhd
09-04-17, 03:03 AM
Discriptions like daydreaming, lack of concentration, lack of focus, lack of attention, confused, mental fog, slow doing tests..etc, all describe ADHD inattentive very well.

In other words, any description of so called SCT that I can find, already describes ADHD inattentive.





M

aeon
09-04-17, 10:45 AM
Sluggish cognitive tempo (SCT) is a cluster of symptoms that may comprise a novel attention disorder which is distinct from ADHD.

Originally, it was thought that only a subset of the inattentive type of ADHD manifested SCT and that it was apparently incompatible with hyperactivity. But new research showed that SCT is also frequently seen in the combined type, in some with the hyperactive-impulsive type and in individuals who would not receive an ADHD diagnosis.

Those with SCT symptoms may show a qualitatively different kind of attention deficit that is more typical of a true information input-output problem, such as poor focusing of attention on details or the capacity to distinguish important from unimportant information rapidly. In contrast, people with ADHD have more difficulties with persistence of attention and action toward goals coupled with impaired resistance to responding to distractions. Unlike SCT, they also have no difficulty processing information or selecting and filtering sensory input. Instead, those with classic ADHD have problems with inhibition.

ADHD Inattentive symptoms:


fails to give close attention to details
has trouble holding attention on tasks
does not listen when spoken to directly
does not follow through on instructions
has trouble organizing tasks
is reluctant to do tasks which require mental effort
often loses things necessary for required tasks
easily distracted
forgetful in daily activities


SCT symptoms:


Daydreaming excessively
Easily confused
Spacey or 'in a fog'
Mind seems to be elsewhere
Stares blankly into space
Slow moving or sluggish
Lethargic or more tired than others
Trouble staying awake or alert in boring situations
Underactive or less energetic than others
Sleepy or drowsy during the day
Gets lost in own thoughts
Apathetic or withdrawn, less engaged in activities
Loses train of thoughts
Forgets what he/she was going to say
Hard time putting thoughts into words
Processes information not as quickly/accurately


Interesting...not a single symptom presentation in common with ADHD, Inattentive or otherwise.


Cheers,
Ian

Lunacie
09-04-17, 10:56 AM
I cannot find any differences between what is being called ADHD inattentive (aka ADD DSM IV) and what is being called SCT.

Please do not include ADHD hyperactive/impulsive or ADHD combined types in this thread discussion.

This thread is meant to compare any differences between what is being called ADHD inattentive and what is being called SCT only.


If anybody has any evidence that ADHD inattentive and SCT are not relatively the same thing would be appreciated.

I can't find any general differences?




M


Someone who displays only inattentive symptoms, along with a few other
distinct and separate symptoms, would seem to have a different disorder
than ADHD.

Things like being lethargic, less active, sleepy or drowsy are not symptoms
of ADHD.


Misdiagnosis is common, unfortunately. Since SCT is not an officially
recognized disorder, it's possible that many who are diagnosed as having
Inattentive ADHD actually have SCT.

mildadhd
09-04-17, 10:58 AM
Daydreaming excessively, Easily confused, Spacey or 'in a fog', Mind seems to be elsewhere, Stares blankly into space, Slow moving or sluggish, Lethargic or more tired than others, Trouble staying awake or alert in boring situations, Underactive or less energetic than others, Sleepy or drowsy during the day, Gets lost in own thoughts, Apathetic or withdrawn, less engaged in activities, Loses train of thoughts, Forgets what he/she was going to say, Hard time putting thoughts into words, Processes information not as quickly/accurately,

Everyone of these descriptions could describe a person with "ADHD inattentive".





M

aeon
09-04-17, 11:33 AM
Everyone of these descriptions could describe a person with "ADHD inattentive".

I'm ADHD-PI, so inattentive with impulsive presentation as well.

Not every one of those descriptions would describe me, not even clise.


Cheers,
Ian

mildadhd
09-04-17, 11:47 AM
I'm ADHD-PI, so inattentive with impulsive presentation as well.

Not every one of those descriptions would describe me, not even clise.


Cheers,
Ian

Please read the opening post.

This thread discussion is focusing on comparing ADHD inattentive and so called SCT only.




M

mildadhd
09-04-17, 12:11 PM
It was hard for me to accept "ADHD inattentive" in the newest DSM, but then I realized that activity could possibly be internalized.

I now prefer "ADHD inattentive", compared to ADD.





M

mildadhd
09-04-17, 12:29 PM
Perceived or real, the FEAR/freeze hypo response may have been the response during early development for some? (During the critical developmental period of implicit self regulation)

Individual specifics depend on inherited temperament and individual circumstances.




M

aeon
09-04-17, 12:52 PM
Please read the opening post.

This thread discussion is focusing on comparing ADHD inattentive and so called SCT only.

Okay, disregard that.

But by all means, respond to my post with quotes from Wikipedia, and provide evidence which supports your opinion, or I might have to dismiss it as the vagaries of someone confused.

Really, please, show me the error of our collective ways. Convince us.


Waiting,
Ian

daveddd
09-04-17, 01:00 PM
i think adhd without any type of hyperactive or impulsive is what barkley is calling it's own disorder

these symptoms have been around forever

lot of money to be made if they make it a whole new disorder instead of an adhd subtype

sarahsweets
09-04-17, 02:13 PM
Please read the opening post.

This thread discussion is focusing on comparing ADHD inattentive and so called SCT only.




M

But Aeon just said he has PI adhd.

sarahsweets
09-04-17, 02:14 PM
They did away with the subtypes anyway, I wonder if thats even helpful.

daveddd
09-04-17, 04:14 PM
But Aeon just said he has PI adhd.



im not taking sides, its too heated for me

but he actually said with impulsive , so that's combined

Little Missy
09-04-17, 04:19 PM
I don't even know which kind I have. The kind where walking dogs and buying chips for LOL is a big deal, I reckon.

daveddd
09-04-17, 04:21 PM
its fair that a consensus hasnt been reached that this is a stand a lone disorder, though it needs looking into

something that stands out to me on wiki is it seems to be different assessment models between adhd and sct

one is outward focused, sct seems more inward (something pdocs normally leave out)





"it is interesting to consider whether SCT may be useful as a transdiagnostic construct as opposed to a disorder per se, much like emotion regulation is not itself a disorder but is nonetheless critically important for understanding psychopathology across the life span”"

from the study

this sparked my interest , the symptoms seem like they can be a result as opposed to a disorder

something similar to a emotional inhibition , avoidance, alexthymia type thing

daveddd
09-04-17, 04:22 PM
I don't even know which kind I have. The kind where walking dogs and buying chips for LOL is a big deal, I reckon.

thats actually being looked at as another distinct disorder

WDABC

aeon
09-04-17, 04:57 PM
he actually said with impulsive , so that's combined

Inattentive + impulsive = predominantly inattentive

Inattentive + hyperactive = combined

I have no presenting hyperactivity.

Regardless, anything outside a rigid and narrow framework in support of the original non-evidence-based assertion will be ignored and/or dismissed, so no matter really.

We've seen this all before, and we'll see it again...and it will be just as tedious as it was the last dozen times.


Cheers,
Ian

daveddd
09-04-17, 04:59 PM
Inattentive + impulsive = predominantly inattentive

Inattentive + hyperactive = combined

I have no presenting hyperactivity.

Regardless, anything outside a rigid and narrow framework in support of the original non-evidence-based assertion will be ignored and/or dismissed, so no matter really.

We've seen this all before, and we'll see it again...and it will be just as tedious as it was the last dozen times.


Cheers,
Ian

i dont want in

i just remember barkley saying this new disorder was one that present without hyperactivity or impulsiveness

mildadhd
09-04-17, 05:52 PM
Still waiting...

I mean, if you provide absolutely relevant content and it goes ignored, you know the thread starter was never actually serious about the topic or having a conversation to begin with.


Tap, Tap, Tap,
Ian

Your theory about why I was not replying today was flawed from the beginning.

I did not reply because I had visitors over for lunch.

Everything in those wiki quotes is open to international subjective opinion.

Examples

Before I was diagnosed with ADHD inattentive...

...my Ojibwa friends gave me the name "all confused"

My father would have described me has having sluggish tempo everyday when he asked me to help him work in the garage.

My teacher would often find me sleeping in a pile of coats in the coat room in grade two. (Being inside a classroom was boring, distressful and made me sleepy.)

Both wiki lists are all open to subjective opinion and alone not very scientifically convincing that ADHD inattentive and so called SCT are two separate disorders.

Maybe if there was some separate consistent biological or genetic factors would help your case but all you are relying on is parents subjective opinion.

My parents subjective opinion would have been to check the lazy option. Man where they wrong.












M

aeon
09-04-17, 05:59 PM
Everything in those wiki quotes is open to international subjective opinion.

And just like ********, everybody's got one.

So, more talking, but as usual, nothing showing.

The original Wikipedia entry has citations. The inattentive symptoms are from the DSM.

What do you have in support of your opinion?

And is there a specific reason you didn't apologize for your earlier trespass and disregard of personal boundaries? Just wondering.


Still Waiting,
Ian

mildadhd
09-04-17, 06:59 PM
In my opinion, everything described in both those wiki quotes mixed together, can describe ADHD inattentive.

Daydreaming excessively
Easily confused
Spacey or 'in a fog'
Mind seems to be elsewhere
Has trouble holding attention on tasks
Does not listen when spoken to directly
Stares blankly into space
Slow moving or sluggish
Lethargic or more tired than others
Trouble staying awake or alert in boring situations
Fails to give close attention to details
Often loses things necessary for required tasks
Underactive or less energetic than others
Sleepy or drowsy during the day
Gets lost in own thoughts
Apathetic or withdrawn, less engaged in activities
Loses train of thoughts
Does not follow through on instructions
Has trouble organizing tasks
Easily distracted
Forgetful in daily activities
Forgets what he/she was going to say
Hard time putting thoughts into words
Is reluctant to do tasks which require mental effort
Processes information not as quickly/accurately







M

aeon
09-04-17, 07:14 PM
In my opinion, everything described in wiki SCT quote, can describe ADHD inattentive.

Yet, absolutely none of those things are in the DSM entry for ADHD, inattentive presentation, so while your opinion is valid in and of itself, it is also, by definition, wrong.

And that's not my opinion...that's by the book by which ADHD, as a clinically-diagnosable disorder, exists at all...and there's nothing relative or subjective about that.


Cheers,
Ian

aeon
09-04-17, 07:18 PM
In my opinion, everything described in both those wiki quotes mixed together, can describe ADHD inattentive.

Changing what you said 13 minutes after posting won't save you.

That said, it will continue to give members here reason not to trust you.


Cheers,
Ian

mildadhd
09-04-17, 07:26 PM
Aeon, I am not really understanding our differences of opinion.


I guess we will just have to keep waiting.

Until then, I am checking ADHD inattentive on the paper work.

Take Care.


M

Lunacie
09-04-17, 07:32 PM
In my opinion, everything described in both those wiki quotes mixed together, can describe ADHD inattentive.


Daydreaming excessively
Easily confused
Spacey or 'in a fog'
Mind seems to be elsewhere
Has trouble holding attention on tasks
Does not listen when spoken to directly
Stares blankly into space
Slow moving or sluggish
Lethargic or more tired than others
Trouble staying awake or alert in boring situations
Fails to give close attention to details
Often loses things necessary for required tasks
Underactive or less energetic than others
Sleepy or drowsy during the day
Gets lost in own thoughts
Apathetic or withdrawn, less engaged in activities
Loses train of thoughts
Does not follow through on instructions
Has trouble organizing tasks
Easily distracted
Forgetful in daily activities
Forgets what he/she was going to say
Hard time putting thoughts into words
Is reluctant to do tasks which require mental effort
Processes information not as quickly/accurately


M

And yet, not all of those symptoms are used as diagnostic criteria for adhd.

aeon
09-04-17, 07:45 PM
Aeon, I am not really understanding our differences of opinion.

I don't have an opinion on this, so we can't have a difference of opinion.

You don't seem to understand the difference between opinion and clinically-verified, peer-reviewed criteria.

And as expected, you provided no evidence, and no apology.

I think you are being insensitive. But hey, no matter, that's just my opinion.


Cheers,
Ian

namazu
09-05-17, 06:53 AM
MODERATOR NOTE:

I have removed some off-topic posts and personal attacks from the thread.

All members are encouraged to review our etiquette guidelines (http://www.addforums.com/forums/announcement.php?f=75&a=90), particularly those about being respectful and avoiding personal attacks.

Please remember that you have the choice to participate in a thread (or not).

Don't make me come back there! ;)

Thanks.

mildadhd
09-05-17, 11:03 AM
I don't have an opinion on this, so we can't have a difference of opinion.

You don't seem to understand the difference between opinion and clinically-verified, peer-reviewed criteria.

And as expected, you provided no evidence, and no apology.

I think you are being insensitive. But hey, no matter, that's just my opinion.


Cheers,
Ian

I still do not understand your opinion?

Why do you keep asking for an apology?

Why are you in such a hurry?


I am learning to wait and process information before a reply.

Yesterday, I leave to go to the groceries store, cook my family lunch, say goodbye to my visitors, clean up and when I come back your talking bad about me, because I was not replying on your tap tap tap command?

Your being very impatient


Could we get back to comparing ADHD inattentive and so called SCT?





M

mildadhd
09-05-17, 11:23 AM
Originally Posted by Wikipedia
Sluggish cognitive tempo (SCT) is a cluster of symptoms that may comprise a novel attention disorder which is distinct from ADHD.


How do we determine ADHD inattentive is physically distinct from so called SCT?

I do not see any consistent physical evidence that ADHD inattentive is distinct from so called SCT?

Does anyone know of any consistent physical evidence that ADHD inattentive is distinct from so called SCT?



M

Lunacie
09-05-17, 12:15 PM
How do we determine ADHD inattentive is physically distinct from so called SCT?

I do not see any consistent physical evidence that ADHD inattentive is distinct from so called SCT?

Does anyone know of any consistent physical evidence that ADHD inattentive is distinct from so called SCT?



M

What do you mean by "physical evidence?"

Are you talking about things like fMRI brain scans?

This study does seem to find differences of brain activity between adhd and SCT.
http://www.sciencedirect.com/science/article/pii/S2213158215000996

One very recent study examined whether SCT fits better with the construct of a symptom domain within ADHD or a distinct factor separate from ADHD (Garner et al., 2014). Although SCT correlated strongly positively with inattention and negatively with hyperactivity/impulsivity, the best fitting model was one that represented SCT as structurally distinct not only from ADHD symptoms but an ADHD diagnosis itself.

daveddd
09-05-17, 01:03 PM
Interesting I just saw one that says it now is thought to hang out with hyperactive too

I can relate to it. It reminds me of me avoidant traits and atypical depression (they are now trying to create a new disorder of those too rejection sensitivity disorders)

mildadhd
09-05-17, 01:14 PM
5. Conclusion

The results from this study suggest that cognitive-control-related brain activity is distinctly related to SCT symptoms and inattentive symptoms within a group of adolescents with ADHD..

The study does not conclude that ADHD inattentive and so called SCT are distinct of the other.






M

Lunacie
09-05-17, 02:14 PM
The study does not conclude that ADHD inattentive and so called SCT are distinct of the other.


5. Conclusion

Quote:
The results from this study suggest that cognitive-control-related brain activity is distinctly related to SCT symptoms and inattentive symptoms within a group of adolescents with ADHD..

M

Inattentive symptoms ... not Inattentive ADHD.

The sentence right after that one says:

We argue that this represents a first step towards defining SCT as having a distinct neural signature from more traditionally defined ADHD symptomatology.

Which seems to indicate that inattention is part of SCT, but SCT is different
in other ways than Inattentive ADHD.

mildadhd
09-05-17, 02:46 PM
It is a first step in more research, not concluding they are distinct.






M

Lunacie
09-05-17, 02:59 PM
It is a first step in more research, not concluding they are distinct.



M

Right, it doesn't prove that they are different disorders, but it does strongly
suggest that they are different while sharing some of the same symptoms.
Just as autism shares some symptoms with adhd, and bipolar does as well.

You didn't ask for a conclusion one way or the other.

This thread is meant to compare any differences between what is being called ADHD inattentive and what is being called SCT only.

mildadhd
09-05-17, 04:52 PM
Right, it doesn't prove that they are different disorders, but it does strongly
suggest that they are different while sharing some of the same symptoms.
Just as autism shares some symptoms with adhd, and bipolar does as well...

ADHD is a bottom up morbidity of autism.

ADHD is a bottom up morbidity of bipolar.

I think my ADHD is a bottom up morbidity of separation anxiety.

Are these three examples of ADHD separate distinct disorders from each other?




M

mildadhd
09-05-17, 05:52 PM
ADHD is a bottom up morbidity GRIEF/separation anxiety

ADHD is a bottom up morbidity of FEAR/anxiety







M

Lunacie
09-05-17, 06:45 PM
ADHD is a bottom up morbidity GRIEF/separation anxiety

ADHD is a bottom up morbidity of FEAR/anxiety


M

I'm not sure how you're using the word "morbidity" here. Please clarify?

peripatetic
09-05-17, 07:49 PM
ADHD is a bottom up morbidity of autism.

ADHD is a bottom up morbidity of bipolar.

I think my ADHD is a bottom up morbidity of separation anxiety.

Are these three examples of ADHD separate distinct disorders from each other?




M

i'm confused here... in a previous thread you clarified for me that (roughly)

bottom up=primary feelings
top down=tertiary thoughts about feelings

and by morbidity you are talking about comorbid conditions (co-existing conditions).

i think that in order to make the claim that any of these things are bottom up, one would have to know more about the causes and natures of what are essentially symptoms gathered together to create criteria.

as for the adhd being three distinct disorders...no, because they all meet criteria for a standalone differential diagnosis.

i have neither bipolar nor autism, so it's harder for me to speak to those diagnoses, but there are, just as criteria must be met, there are exclusion factors for some diagnoses. neither autism nor bipolar *exclude* adhd and the adhd diagnosis doesn't *exclude* autism or bipolar. which is a longwinded way of saying that you can have both.

the person who has both autism and adhd or bipolar and adhd don't have different disorders, with respect to adhd, though they may lead very different lives or meet criteria for adhd differently. last i recall there are maybe 9 inattentive symptoms and, let's say, a roughly equal number of h/i symptoms. you don't have to have every symptom for a diagnosis though, so while the disorder is the same, the presentation can be different.

in a similar fashion, a person could have a co existing condition and meet criteria for that and have adhd "present" differently. or even the same person could have it appear to present differently as a child than as an adult...but the diagnosis is consistent.

mildadhd
09-06-17, 12:06 AM
I'm not sure how you're using the word "morbidity" here. Please clarify?

i'm confused here... in a previous thread you clarified for me that (roughly)

bottom up=primary feelings
top down=tertiary thoughts about feelings

and by morbidity you are talking about comorbid conditions (co-existing conditions).

i think that in order to make the claim that any of these things are bottom up, one would have to know more about the causes and natures of what are essentially symptoms gathered together to create criteria.

as for the adhd being three distinct disorders...no, because they all meet criteria for a standalone differential diagnosis.

i have neither bipolar nor autism, so it's harder for me to speak to those diagnoses, but there are, just as criteria must be met, there are exclusion factors for some diagnoses. neither autism nor bipolar *exclude* adhd and the adhd diagnosis doesn't *exclude* autism or bipolar. which is a longwinded way of saying that you can have both.

the person who has both autism and adhd or bipolar and adhd don't have different disorders, with respect to adhd, though they may lead very different lives or meet criteria for adhd differently. last i recall there are maybe 9 inattentive symptoms and, let's say, a roughly equal number of h/i symptoms. you don't have to have every symptom for a diagnosis though, so while the disorder is the same, the presentation can be different.

in a similar fashion, a person could have a co existing condition and meet criteria for that and have adhd "present" differently. or even the same person could have it appear to present differently as a child than as an adult...but the diagnosis is consistent.

I agree.

ADHD is the same but may present differently.


When I discuss about co existing morbidity in regards to ADHD.

Most everyone thinks of top down morbidity.

Example.

The 3 most common ADHD top down comorbidities are anxiety, depression and addiction.(partly due to living with top down cognitive disorder like ADHD)

But the brain does not develop from the top down.

The brain develops from the bottom up first.

Our bottom up primary-secondary implicit affective controls mature very early in life before our top down explicit tertiary-secondary cognitive controls mature on top.

(As we mature, top down cognitive controls take control of bottom up affective control, when not chronically distressed)



When a child has a bottom up separation anxiety disorder before they have ADHD.

The ADHD is the bottom up co existing morbidity.
(Partly due to living with affective bottom up separation anxiety disorder)

I write bottom up morbidity and top down morbidity, partly to specify the difference between bottom up anxiety and top down anxiety.


Roughly, I will submit this now with the idea that we continue the discussion.

I really appreciate you interest.



M

daveddd
09-06-17, 10:05 AM
I feel at time my ADHD is a top down from a bottom up anxiety.

Think millons bio social

Even Thomas brown tap dances around this idea a bit with anger and fear

peripatetic
09-06-17, 10:36 AM
I agree.

ADHD is the same but may present differently.


When I discuss about co existing morbidity in regards to ADHD.

Most everyone thinks of top down morbidity.

Example.

The 3 most common ADHD top down comorbidities are anxiety, depression and addiction.(partly due to living with top down cognitive disorder like ADHD)

But the brain does not develop from the top down.

The brain develops from the bottom up first.

Our bottom up primary-secondary implicit affective controls mature very early in life before our top down explicit tertiary-secondary cognitive controls mature on top.

(As we mature, top down cognitive controls take control of bottom up affective control, when not chronically distressed)



When a child has a bottom up separation anxiety disorder before they have ADHD.

The ADHD is the bottom up co existing morbidity.
(Partly due to living with affective bottom up separation anxiety disorder)

I write bottom up morbidity and top down morbidity, partly to specify the difference between bottom up anxiety and top down anxiety.


Roughly, I will submit this now with the idea that we continue the discussion.

I really appreciate you interest.



M

i *think* i'm following what you're saying here.

my concern with the examples you used before, of autism and bipolar...and fear and anxiety... i don't know that those conditions can be called entirely bottom up or top down.

so, like...it does seem to me that if we're accepting the medical model (which i am NOT saying i generally speaking DO accept the medical model of mental illness), then there are some things that have a strong heritable component and some things that are maybe latent until sparked and some things that are situational.

so...where do those things lie and how does that interface with this bottom up/top down stuff?

it seems to me that fear/anxiety is more often, despite you saying it's bottom up, that it's more often top down...as in introduced environmentally and/or sparking of a heritable propensity.

whereas something like autism, i can see the bottom up part because it does not, and fortune could correct me on this, appear to be introduced environmentally. bipolar is tricky...is it known to be entirely one or the other? i think maybe it's a combination.

again, though, we're talking about condition i don't have.

were we to discuss conditions i do have, i think adhd is going to be "bottom up" and perhaps the amount of impairment is sparked by environment, but the neurological differences are there from the start.

with OCD...i really don't know on this one. my main presentation of it is intrusive thoughts. i take two medication specifically...well...and sorta three...for these thoughts, which they do reduce. but where did it originate? that's unclear to me.

and the last one...you know the one... that's a highly heritable condition. i don't know that i believe i have a brain disease. i think it's difficult for me because my "insight" isn't thought to be great on the subject. most people believe it is something that is somewhere between bottom up and top down.

and that's where i feel like it's challenging to say that something is entirely one or the other. maybe something VERY cut and dry...like, epilepsy...seems like it's bottom up. but everything else... i think we don't know. because if we did, we would be better equipped to deal with it and people wouldn't suffer so much.

it's like type 1 versus type 2 diabetes. i have a friend with type 1 and i know people with type 2. what "caused" the type 1? was it bottom up? probably i guess as much as anything is. and is type 2 top down? ok...maybe. but are both treated with insulin? and how do we decide how to categorize someone as diabetic? there's something that's not happening on a biological level that needs to be supplemented. even that, though...we can give insulin, say keep your weight in check, avoid sugary things...but we can't FIX it. and if we knew all of the causes and all of the natures of it, that would inform the management and treatment to make it so people wouldn't suffer from it.

i just don't think the concrete knowledge that X disorder has Y foundation and Z development possibilities exists. i think it's in flux and all "still to be determined". we find genetic components. we find people who have predispositions but don't develop things and people without seeming predispositions or family histories that do develop them.

all we really have are the DSM five or the ICD 10 criteria. and if we deviate from that common language, either everything is up for question because everything manifests in a person and it's all different because we are all individuals or nothing is up for question because we're just setting fixed points where we want according to what we've read or haven't read.

i think the problem, further, is that both the DSM and ICD are working guidelines. they offer criteria, but they're subject to revision. so, do we accept them or not? if we do, then it doesn't matter where the starting point is apart from exclusion criteria. if we don't, then we aren't speaking a common language anymore.

does that make sense?

Lunacie
09-06-17, 10:56 AM
I agree.

ADHD is the same but may present differently.


When I discuss about co existing morbidity in regards to ADHD.

Most everyone thinks of top down morbidity.

Example.

The 3 most common ADHD top down comorbidities are anxiety, depression and addiction.(partly due to living with top down cognitive disorder like ADHD)

But the brain does not develop from the top down.

The brain develops from the bottom up first.

Our bottom up primary-secondary implicit affective controls mature very early in life before our top down explicit tertiary-secondary cognitive controls mature on top.

(As we mature, top down cognitive controls take control of bottom up affective control, when not chronically distressed)



When a child has a bottom up separation anxiety disorder before they have ADHD.

The ADHD is the bottom up co existing morbidity.
(Partly due to living with affective bottom up separation anxiety disorder)

I write bottom up morbidity and top down morbidity, partly to specify the difference between bottom up anxiety and top down anxiety.


Roughly, I will submit this now with the idea that we continue the discussion.

I really appreciate you interest.



M

I was confused about your use of the word "morbidity." That's why I put it in
quotes in my request for clarification.

I've never seen "morbidity" used in the same sense as "comorbidity."
That's what was so confusing to me.

I have only seen "morbidity" used in the sense as "diseased" or "dying."
I'm not sure you're using it correctly.

mildadhd
09-07-17, 01:25 PM
i *think* i'm following what you're saying here.

my concern with the examples you used before, of autism and bipolar...and fear and anxiety... i don't know that those conditions can be called entirely bottom up or top down.

so, like...it does seem to me that if we're accepting the medical model (which i am NOT saying i generally speaking DO accept the medical model of mental illness), then there are some things that have a strong heritable component and some things that are maybe latent until sparked and some things that are situational.

so...where do those things lie and how does that interface with this bottom up/top down stuff?

it seems to me that fear/anxiety is more often, despite you saying it's bottom up, that it's more often top down...as in introduced environmentally and/or sparking of a heritable propensity.

whereas something like autism, i can see the bottom up part because it does not, and fortune could correct me on this, appear to be introduced environmentally. bipolar is tricky...is it known to be entirely one or the other? i think maybe it's a combination.

again, though, we're talking about condition i don't have.

were we to discuss conditions i do have, i think adhd is going to be "bottom up" and perhaps the amount of impairment is sparked by environment, but the neurological differences are there from the start.

with OCD...i really don't know on this one. my main presentation of it is intrusive thoughts. i take two medication specifically...well...and sorta three...for these thoughts, which they do reduce. but where did it originate? that's unclear to me.

and the last one...you know the one... that's a highly heritable condition. i don't know that i believe i have a brain disease. i think it's difficult for me because my "insight" isn't thought to be great on the subject. most people believe it is something that is somewhere between bottom up and top down.

and that's where i feel like it's challenging to say that something is entirely one or the other. maybe something VERY cut and dry...like, epilepsy...seems like it's bottom up. but everything else... i think we don't know. because if we did, we would be better equipped to deal with it and people wouldn't suffer so much.

it's like type 1 versus type 2 diabetes. i have a friend with type 1 and i know people with type 2. what "caused" the type 1? was it bottom up? probably i guess as much as anything is. and is type 2 top down? ok...maybe. but are both treated with insulin? and how do we decide how to categorize someone as diabetic? there's something that's not happening on a biological level that needs to be supplemented. even that, though...we can give insulin, say keep your weight in check, avoid sugary things...but we can't FIX it. and if we knew all of the causes and all of the natures of it, that would inform the management and treatment to make it so people wouldn't suffer from it.

i just don't think the concrete knowledge that X disorder has Y foundation and Z development possibilities exists. i think it's in flux and all "still to be determined". we find genetic components. we find people who have predispositions but don't develop things and people without seeming predispositions or family histories that do develop them.

all we really have are the DSM five or the ICD 10 criteria. and if we deviate from that common language, either everything is up for question because everything manifests in a person and it's all different because we are all individuals or nothing is up for question because we're just setting fixed points where we want according to what we've read or haven't read.

i think the problem, further, is that both the DSM and ICD are working guidelines. they offer criteria, but they're subject to revision. so, do we accept them or not? if we do, then it doesn't matter where the starting point is apart from exclusion criteria. if we don't, then we aren't speaking a common language anymore.

does that make sense?



There are 3 types of feelings.

-Emotional affects
-Sensory affects
-Homeostatic affects

(focusing on primary emotional-affective response systems in this thread because of their psychological survival values built genetically in our brains')

All mammals including humans are born with genetic unconditioned primary emotional-affective response systems

In the beginning during our preverbal implicit early stages of development, unconditioned emotional stimuli (outside our brain) stimulates bottom up unconditioned primary emotional-affective response systems (inside our brain) developing the preverbal foundation for bottom up conditioned secondary emotional learning and emotional memories and tertiary emotional awareness and emotional communication.

"The emotions (affective consciousness) are lower down in the brain.

Thoughts (cognitive consciousness) higher in the brain, regulate and control what the emotions are saying" as cognitive consciousness matures.

(The brain develops from the bottom up) (affective control is more mature than cognitive control during the first few years of life)

Communication is preverbal emotional.

Conscious affective control is most observable in early life, before explicit conscious cognitive control matures. (paraphrasing Panksepp)

(rough)

(I understand I did not address all the topics in your post, I will stop here, see if we are on semi similar page so to speak )



M

mildadhd
09-07-17, 09:04 PM
Unconditioned primary brain operating systems are strongly genetic.

Conditioned secondary brain processes (learning and memories), and, conditioned tertiary brain processes (emotional awareness and cognitive control) are strongly epigenetic.












M

mildadhd
09-07-17, 11:38 PM
http://i1.wp.com/the-mouse-trap.com/wp-content/uploads/2010/05/emotions.png

http://journals.plos.org/plosone/article/figure/image?size=medium&id=info:doi/10.1371/journal.pone.0021236.g003

peripatetic
09-08-17, 12:17 AM
i don't believe that chart at all. i think that's a gross oversimplification and attribution of mental illness labels to being these basic emotion pushes. that'd be nice, because i think it'd be a lot easier to manage...but ...yeah, that just doesn't match my experiences at all and i'm on there in three places over two categories and they contradict one another in ways.

it's like myers briggs...it's just not so simple...sorry.

i think it's especially that i find this to be not the case given my affect is flat as a ****in board right now and i can't imagine being any of those things.

if only it were that purely based, i think it wouldn't've gotten to this point. that chart just doesn't represent my experiences as an actual person with three DSM diagnoses.

mildadhd
09-08-17, 12:41 AM
i don't believe that chart at all. i think that's a gross oversimplification and attribution of mental illness labels to being these basic emotion pushes. that'd be nice, because i think it'd be a lot easier to manage...but ...yeah, that just doesn't match my experiences at all and i'm on there in three places over two categories and they contradict one another in ways.

it's like myers briggs...it's just not so simple...sorry.

i think it's especially that i find this to be not the case given my affect is flat as a ****in board right now and i can't imagine being any of those things.

if only it were that purely based, i think it wouldn't've gotten to this point. that chart just doesn't represent my experiences as an actual person with three DSM diagnoses.

I am not understanding your interpretation/response, but to each their own.






M

mildadhd
09-08-17, 02:17 AM
http://m.youtube.com/watch?v=3pwI8ti6Jhk

Lunacie
09-08-17, 12:26 PM
Hmmmmm ... for many years these disorders were called "behavioral" as if we
were making choices in our behaviors. And we were shamed for our "choices"
and our behavior.

More recently these disorders were called "emotional" as if our emotions are
somehow stronger versions of what is typically felt. And we are pitied for being
over-emotional.

That list from Panksepp is over 2 decades old and we have learned a LOT about
about the nature of these disorders in that time.

It is believe these disorders are neuro-biological, they are a short-circuit in our
neural wiring. We are no more to blame or be shamed than someone who is
born color-blind or with a club foot.

mildadhd
09-08-17, 02:03 PM
Hmmmmm ... for many years these disorders were called "behavioral" as if we
were making choices in our behaviors. And we were shamed for our "choices"
and our behavior.

More recently these disorders were called "emotional" as if our emotions are
somehow stronger versions of what is typically felt. And we are pitied for being
over-emotional.

That list from Panksepp is over 2 decades old and we have learned a LOT about
about the nature of these disorders in that time.

It is believe these disorders are neuro-biological, they are a short-circuit in our
neural wiring. We are no more to blame or be shamed than someone who is
born color-blind or with a club foot.

Lunacie,

I was born with club feet.

I think it would be better to look at the discussion neurologically.

If we start a thread focusing on discussing the neurology of ADHD.

Could you explain to me neurologically where we disagree?






M

mildadhd
09-08-17, 02:15 PM
i don't believe that chart at all. i think that's a gross oversimplification and attribution of mental illness labels to being these basic emotion pushes. that'd be nice, because i think it'd be a lot easier to manage...but ...yeah, that just doesn't match my experiences at all and i'm on there in three places over two categories and they contradict one another in ways.

it's like myers briggs...it's just not so simple...sorry.

i think it's especially that i find this to be not the case given my affect is flat as a ****in board right now and i can't imagine being any of those things.

if only it were that purely based, i think it wouldn't've gotten to this point. that chart just doesn't represent my experiences as an actual person with three DSM diagnoses.

I agree it is not that simple, it's complex (understatement), but you asked me to simplify.

Top down functions are also represented.

I am sorry, but I still do not understand where we are disagreeing?



M

mildadhd
09-08-17, 02:23 PM
Our neurological brain functions mature from the bottom up, right?








M

Lunacie
09-08-17, 02:24 PM
Lunacie,

I was born with club feet.

I think it would be better to look at the discussion neurologically.

If we start a thread focusing on discussing the neurology of ADHD.

Could you explain to me neurologically where we disagree?






M

If you want to look at this issue from a neurological perspective, why did you
copy Panksepp's list of emotional disorders?


SCT isn't even on that list because no one really knew anything about SCT
20 years ago, so how was it supposed to further the discussion?

mildadhd
09-08-17, 03:03 PM
If you want to look at this issue from a neurological perspective, why did you
copy Panksepp's list of emotional disorders?


SCT isn't even on that list because no one really knew anything about SCT
20 years ago, so how was it supposed to further the discussion?

Are you interested in bottom up affective neuroscience and top down cognitive neuroscience?

Or just top down cognitive neuroscience?




M

mildadhd
09-08-17, 03:25 PM
Affective neuroscience is the study of the neural mechanisms of emotion. This interdisciplinary field combines neuroscience with the psychological study of personality, emotion, and mood.[1]


http://en.m.wikipedia.org/wiki/Affective_neuroscience


Example

ADHD is a bottom up morbidity of FEAR/Anxiety, involving the SEEK and PLAY system circuitries.

(Capitalized type FEAR system means it is a homologous primary unconditioned genetic behavior system, evolved to promote survival)

Uncapitalized fear is a secondary conditioned emotional feeling.




M

Lunacie
09-08-17, 03:33 PM
Are you interested in bottom up affective neuroscience and top down cognitive neuroscience?

Or just top down cognitive neuroscience?




M

You answer my questions by asking ME questions?

That isn't the way a real discussion works though.

mildadhd
09-08-17, 04:21 PM
You answer my questions by asking ME questions?

That isn't the way a real discussion works though.

Your posts show me you are just interested in cognitive neuroscience.

Your lack of interest in affective neuroscience, explains to me why you are misinterpreting me.

Until you include bottom up affective neuroscience and top down cognitive neuroscience, how can you judge what I am presenting?





M

peripatetic
09-08-17, 05:15 PM
I am not understanding your interpretation/response, but to each their own.


M

The problem is if I believed that chart then I'd discontinue all of these antipsychotics and just go to therapy for my "seeking" issues. I believe, I have to in order to stay on my meds and stay alive, I'm working on believing the bottom up cognitive neuroscience model that contemporary psychiatry presents. Saying it's affective sounds anti psychiatry to me

Lunacie
09-08-17, 05:32 PM
Your posts show me you are just interested in cognitive neuroscience.

Your lack of interest in affective neuroscience, explains to me why you are misinterpreting me.

Until you include bottom up affective neuroscience and top down cognitive neuroscience, how can you judge what I am presenting?




M

If you feel I'm misinterpreting your posts, why didn't you say that instead of
asking me questions that don't answer the questions I asked you?

I don't understand your style of communication apparently. I don't think that
has anything to do with whether the topic is affective neuroscience or
cognitive neuroscience.

Lunacie
09-08-17, 06:59 PM
Your posts show me you are just interested in cognitive neuroscience.

Your lack of interest in affective neuroscience, explains to me why you are misinterpreting me.

Until you include bottom up affective neuroscience and top down cognitive neuroscience, how can you judge what I am presenting?





M

You assume that I have a lack of interest in affective neuroscience when
actually I think affective and cognitive neuroscience overlaps making it
pointless to make a distinction between them or try to separate them.

I have never quite understood your point in posting so much about top-down
and bottom-up ... whatever. I don't feel you make your point entirely clear.

Little Missy
09-08-17, 07:03 PM
I don't know, but what I DO know is that I've been reading, seeing the same charts, in colours, the same videos and what-not for the last three years.

I'm always wondering what exactly is the bottom line?

peripatetic
09-08-17, 07:54 PM
I think affective and cognitive neuroscience overlaps making it
pointless to make a distinction between them or try to separate them.

I think I actually agree with this more than what I said above.

Lunacie
09-08-17, 08:12 PM
I think I actually agree with this more than what I said above.

If we compared human life to architecture, the foundation of a building doesn't
determine the final shape, although it may limit the final shape.

mildadhd
09-09-17, 12:56 AM
The problem is if I believed that chart then I'd discontinue all of these antipsychotics and just go to therapy for my "seeking" issues. I believe, I have to in order to stay on my meds and stay alive, I'm working on believing the bottom up cognitive neuroscience model that contemporary psychiatry presents. Saying it's affective sounds anti psychiatry to me

I am not recommending you stop taking your medication.

I am focusing on bottom up affective and top down cognitive development throughout different stages of life.

In the past we were discussing how having a affective disorder like anxiety could influence the presentation of the ADHD.

I thought it might help to have a list of bottom up disorders with related interconnectedprimary neurological pathways, to consider how each may influence presentation of a bottom up morbidity like ADHD.

Maybe different types of affective disorders may influence the differences being observed in presentation of ADHD?

Example

I experienced GRIEF/separation anxiety, I have ADHD inattentive (including so called SCT symptoms)

I do not think ADHD inattentive and SCT are separate disorders, I think the type of anxiety I experienced influenced the presentation and severity of my ADHD inattentive symptoms.



Take Care.




M

mildadhd
09-09-17, 12:54 PM
A person who has genetic type diabetes, should never stop taking insulin.

A person who has epigenetic type diabetes, may never need to take insulin.





M

Lunacie
09-09-17, 01:59 PM
A person who has genetic type diabetes, should never stop taking insulin.

A person who has epigenetic type diabetes, may never need to take insulin.





M

Those with genetic adhd may benefit from stimulant meds, or may not need them.

Those with epigenetic (aquired) adhd may benefit from stimulant meds, or
may not need them.

Not like diabetes type 1 where the person has to have supplemental insulin.

My niece has aquired adhd from a car crash. She finds Pilates and CBD (hemp oil) to be helpful.

mildadhd
09-09-17, 02:35 PM
it's like type 1 versus type 2 diabetes. i have a friend with type 1 and i know people with type 2. what "caused" the type 1? was it bottom up? probably i guess as much as anything is. and is type 2 top down? ok...maybe. but are both treated with insulin? and how do we decide how to categorize someone as diabetic? there's something that's not happening on a biological level that needs to be supplemented. even that, though...we can give insulin, say keep your weight in check, avoid sugary things...but we can't FIX it. and if we knew all of the causes and all of the natures of it, that would inform the management and treatment to make it so people wouldn't suffer from it.

Sorry I forgot to post the quote above, that was partly replying to in the quote below.

A person who has genetic type diabetes, should never stop taking insulin.

A person who has epigenetic type diabetes, may never need to take insulin.


M

My point is also that some conditions especially cases that are strongly genetic must take medication.

Some severe conditions require taking medication as doctor prescribed.




M

mildadhd
09-09-17, 09:58 PM
Also..

In my experience, if there were any slight differences in ADHD inattentive symptoms and so call SCT symptoms it would be the presentation of so called SCT symptoms occurred earlier in my life.

Dr. Barkley does his so called SCT research on younger children, than he did his ADHD research.

Presentation of ADHD changes with age.

Dr. Barkley should be comparing ADHD inattentive research with SCT research of people the same age, not different ages.

Because the ADHD presentation may be different at different ages and stages of development.

He should be comparing ADHD and SCT research occurring during the same ages and stages, not different.




M

daveddd
09-09-17, 10:23 PM
Those with genetic adhd may benefit from stimulant meds, or may not need them.

Those with epigenetic (aquired) adhd may benefit from stimulant meds, or
may not need them.

Not like diabetes type 1 where the person has to have supplemental insulin.

My niece has aquired adhd from a car crash. She finds Pilates and CBD (hemp oil) to be helpful.

Not sure epigenetic and genetic ADHD are different. Epigenetic wouldn't represent acquired ADHD In the sense you're describing

Just in case that may have been causing a disconnect in communication

Lunacie
09-09-17, 10:31 PM
Not sure epigenetic and genetic ADHD are different. Epigenetic wouldn't represent acquired ADHD In the sense you're describing

Just in case that may have been causing a disconnect in communication

Sorry, what I really meant was non-genetic refers to aquired adhd.

I'm not quite clear on what the difference is between genetic and epigenetic,
but mild is convinced there is a difference.

daveddd
09-09-17, 10:35 PM
Sorry, what I really meant was non-genetic refers to aquired adhd.

I'm not quite clear on what the difference is between genetic and epigenetic,
but mild is convinced there is a difference.

Yea. I only mentioned it cause I saw you guys saying you misunderstood each other

Nobody at this point in time can give a definitive difference in genetic or epigenetic ADHD

Cool subject though how ADHD can shaped through a family and the changed presentation can be passed down without changing the gene. (In theory)

mildadhd
09-10-17, 05:56 AM
Primary unconditioned emotional response systems are more genetically "wired".

Secondary conditioned emotional responses are more epigenetically "wired".






M

Lunacie
09-10-17, 10:31 AM
Yea. I only mentioned it cause I saw you guys saying you misunderstood each other

Nobody at this point in time can give a definitive difference in genetic or epigenetic ADHD

Cool subject though how ADHD can shaped through a family and the changed presentation can be passed down without changing the gene. (In theory)

I keep sharing facts and ideas that may not agree with mild's opinions so that
those new-to-the-diagnosis can read and compare.


Fact: there is definitely a genetic or hereditary component to adhd.

Not known: exactly what that component is.

Not known: IF there is an epigenetic component involved.

Many epigenetic factors have been studied, but none have been confirmed.

mildadhd
09-10-17, 02:25 PM
I keep sharing facts and ideas that may not agree with mild's opinions so that
those new-to-the-diagnosis can read and compare.


Fact: there is definitely a genetic or hereditary component to adhd.

Not known: exactly what that component is.

Not known: IF there is an epigenetic component involved.

Many epigenetic factors have been studied, but none have been confirmed.

I would be really interested in a thread discussion about epigenetic inheritance and ADHD, if you really are?



M