It's a rhetorical question but I wonder if anyone can tell us what does "pure" ADHD look like? Is there such a thing as pure ADHD? and if there is, define it.

I don't have a clue, but I'll check back here soon to see if anyone else knows :-)

BTW..what exactly do you mean by "pure" ?

Good question. ADHD often pairs up with other things. We know that emotional expression, anxiety, and even depression are scored higher on behaviour check lists for ADHDers. Are those behaviours part of being ADHD or are they "side kicks"?

What I am asking is, if you stripped everything away, what would pure ADHD look like?

I have often wondered this too. It kind of goes back to the "Which came first ..." saying.

Do you have ADHD because of social/general anxiety or do you have social/general anxiety because of the ADHD?

Do you "learn" to be anxious at a young age because of your parent's social/general anxiety? It has been stated that children of parents with an anxiety disorder will have a higher chance of also developing a similar disorder. Now is this genetic or conditional?

Great question Scuro.:)

do you mean with the absence of a co-existing diagnosis or substance abuse???

Do you have ADHD because of social/general anxiety or do you have social/general anxiety because of the ADHD?

I read somewhere that if you show symptoms of anxiety before you show the symptoms of ADHD its probably because you have an anxiety disorder like GAD or SAD because they show some of the symptoms that can be seen in someone with ADHD. However, if someone has ADHD symptoms they may develop anxiety due to all the negative feedback they have received.

Im not sure whether it is true or not and I dont know if it was any help, but I thought I'd try. :)

Oh and sorry if none of that made sense lol.

We think you’d have to first decouple the symptoms from the underlying mechanisms. Then you could speculate what those mechanisms would look like in a context free from the effects that give rise to the symptoms.

We have yet to examine an AD/HD symptom that we can’t plausibly derive as arising from the interaction of one or two basic mechanisms within the social context. We haven‘t looked in detail at many of the co-morbid disorders, but those we have examined also seem to arise as a consequence of interaction with the social context.

The problem, of course, is the social context can’t be discarded arbitrarily without generating something strongly resembling severe autism. So it’s likely the only way we’ll ever ‘see’ pure AD/HD is in a social context uniquely adapted to the underlying mechanisms.

Scuro,
You make me smile. (0:

What does 'anyone' specific behavior 'look like', when they're behaving in any manner ?

I think human beings are a 'melting pot' of behavior. Some learned, some self-created, and some that are yet to be learned or self-created.

I know this didn't exactly answer your question...not in the way you needed an answer...but I'm unable to 'separate' an individual or identify them, solely, by a few behavioral traits, that they exhibit. (0:


Nova

Pure ADD is sort of a hypothetical construct I'd imagine. How does one define the ranges of behaviors in a "syndrome"? Some of the behaviors express in very opposite ways, so you'd be hard pressed to define it as "Having all the ADD characteristics". Because some of them would cancel each other out.

I think Pure ADD is about as real and solid a concept as "normal" is. Which is to say it doesn't seem to make much sense and would mean different things to different people.

I'll venture a guess! It looks like a toddler. Lack of impulse control, lots of tantrums due to being misunderstood and not understanding the rules, and brilliantly amusing in turns.

Just a theory.

Oddly enough there is actual evidence to support that. At least parts of it.

-like a toddler- Hey Crazy, written from the perspective of the 30-something ADDult - but as you say, sure like a toddler.
I'm looking at one or two as I type ...:-)...
So ... '30something' or 'toddler' ... a drive to learn, listening without prejudice, questioning anything which cannot be easily understood, a drive to learn, tendency to cross the line of social niceties, hyperfocus at the drop of a hat to anything which captures the attention and is -fun-, drive to learn, loss of connection to time, tendency towards learning, drive to learn, gravitation away from 'classical' group activities ... bars, drinking, possessed by learning where learning isn't anything to do with diplomas.

SB.

I've been thinking about this for a couple hours. :faint:

ADHD is a diagnostic title, like "Congestive Heart Failure". We don't usually refer to someone as "Congestive Heart Failure", like we say that person is "ADHD".

Remember, ADHD is only a disorder when it effects a persons life negatively.

Maybe we shouldn't look at the symptoms (negative), but look at the characteristics (positive).

Personally, I see one main characteristic is having the ability to think in "parallel". Not being able to cope or control this ability, plus outside variables, could cause the symptoms of ADHD, which could lead to the diagnosis of ADHD.

As the physiological aspects of an ADHD person's brain functions are more understood, a physical symptom could be included.

Actually Tim, based on the things they are learning about ADD/ADHD, they are considering changing the diagnostic criteria in the DSM-V when it comes out. The change would include removing the requirement for a negative impact on two or more areas of function and also to providing solid criteria for testing adults. At present the children's criteria are used for testing adults and agreed upon guideline changes for adults are used to augment them. By DSM-V they hope to have agreement on a full and separate set of criteria for adult patients as well.

ADD unlike congestive heart failure does affect character and general presentation of the patient, so it's not unusual to me that it gets turned into an adjective. I don't think clinicians typically use it that way, but the general populace and patients like us do. Gotta love the constantly changing nature of spoken language! WOOT!

WOOT!
cha' bet you!

SB.

Hey Crazy, written from the perspective of the 30-something ADDult - but as you say, sure like a toddler.
I'm looking at one or two as I type ...:-)...
So ... '30something' or 'toddler' ... a drive to learn, listening without prejudice, questioning anything which cannot be easily understood, a drive to learn, tendency to cross the line of social niceties, hyperfocus at the drop of a hat to anything which captures the attention and is -fun-, drive to learn, loss of connection to time, tendency towards learning, drive to learn, gravitation away from 'classical' group activities ... bars, drinking, possessed by learning where learning isn't anything to do with diplomas.

SB.It was my own toddler and the memories of others that sparked the thought for me SB :D.

Well I did say "Considering". Hee hee. Reason being, of course, is some folks want it to be looked at as a "contextual" disorder. Frankly I agree with that with one caveat. That is that the evidence should support it. To my mind it does, but I am not aware of every piece of the puzzle (although I sure would like to be). Things may come to light that cast doubt upon this.

Of course, that would also mean we'll know more. It's okay to be wrong in science. Provided you admit the possibility and are willing to integrate new evidence into your thought process (whether you necessarily like it or not).

From: http://www.ncpamd.com/ADDComorbidity.htm

Attention Deficit in Adults: It Rarely Travels Alone

Glenn Brynes Ph.D., M.D. (http://www.ncpamd.com/brynes.htm) and Carol Watkins, M.D. (http://www.ncpamd.com/Watkins.htm)





Adults have lived longer than children, and thus have had more time to develop other psychiatric disorders. In children with AD/HD, the existence of a comorbid condition is correlated with greater likelihood that the symptoms will persist into adulthood. As the child moves from adolescence to adulthood, the predominant symptoms of AD/HD tend to shift from external, visible ones to the internal symptoms. There seems to be a decrease in observable symptoms of AD/HD with age. Although a given adult may not meet DSM-IV criteria for full AD/HD any longer, he or she may still experience impairment in certain aspects of life. The individual’s perception of his or her degree of impairment can vary. Depending on occupation or domestic situation, the adult may need to deal with higher-level issues that involve executive function.



There has been increasing awareness that many adults and children with AD/HD may also meet criteria for one or more other psychiatric diagnoses. (Comorbidity means having two or more diagnosable conditions at the same time) There is some evidence that the incidence of comorbidity is somewhat higher in adults than in children. However, many of the studies looking at the issue of comorbidity are difficult to compare. Studies used different criteria for AD/HD and bipolar disorder, and sometimes got their subjects from different populations. For example, one might expect to see more complex types of AD/HD in specialized hospital clinics than one would see in a door-to-door survey or in a primary care physician’s office. Despite the differing criteria across studies, and the lack of large general population studies of adult AD/HD, there still convincing data that several other psychiatric diagnoses are common among adults with AD/HD.



Substance Abuse: (Abuse of or addiction to alcohol or drugs) Adult attention deficit disorder seems to be related to earlier onset of substance abuse, a longer period of active abuse, and a lower rate of recovery. (Wilens, Biederman and Mick, Am J Addict 1998) The risk of substance abuse (in an adolescent prospective study) may be higher if the individual has conduct disorder in addition to the AD/HD. Conduct Disorder is a persistent pattern of violating rules, laws and the rights of others. (Milberger, Biederman, Faraone, Wilens, Chu, Am J Addict 1997) A study by Biederman et al (Am J Psychiatry 1995) suggested found that 52% of adults (versus 27% of controls) with AD/HD met criteria for substance abuse. Other studies have found slightly lower but still significantly elevated rates of abuse and addiction in AD/HD adults. AD/HD by itself increased the chance of substance abuse, but if the AD/HD were combined with another disorder such as Antisocial Personality Disorder, Anxiety, Depression or Bipolar Disorder, the rates increased further. It is possible that adults have the higher rate of substance abuse because their AD/HD might not have been treated when they were children. A recent study in Pediatrics showed that AD/HD children and adolescents treated with stimulant medication were less likely to develop later problems with drugs or alcohol.



Antisocial Personality Disorder: This is a personality style characterized by a tendency to violate the rights of others, to flout societal rules, and to lack remorse for misdeeds. About 18-25% of AD/HD 25-year-olds studied were found to have this disorder. Only 2% of the general population has Antisocial Personality Disorder (ASPD.) Children who have AD/HD accompanied with aggressive destructive tendencies seem to be the ones most likely to develop adult ASPD. AD/HD children lacking those tendencies do not seem to have a greatly increased risk of developing ASPD. The individuals with AD/HD and ASPD may end up in the penal system. An impulsive individual might be more likely to get caught than one who plans his criminal activity more carefully.



Learning Disabilities are present in Adults as well as children. Often they are less evident when an individual leaves school and finds a career that matches his or her strengths and weaknesses. However, some individuals continue to experience the effects of learning disabilities in college and at work.



Mood disorders: Mood Disorders include Major Depression, Dysthymia (Chronic low-level depression) and Bipolar Disorder (Manic Depressive Disorder.) These are present in many individuals with AD/HD. Usually, depression starts later than the first onset of the AD/HD. There has been some debate about the incidence of Bipolar Disorder in individuals with AD/HD. Some might say that rapid mood shifts and frequent irritability are characteristics of AD/HD. Others diagnose a rapid cycling mood disorder. Recurrent major depression is more common in adults with ADHD than in non-ADHD adults. However, one must also be aware that depression can be a side effect of stimulants and several other medications. Because stimulants have been known to exacerbate depression and mania, one should usually treat the mood disorder before treating the AD/HD.



Diagnosing AD/HD in adults can be quite complicated. In order to meet criteria for the diagnosis, one should have evidence of symptoms dating back to age seven. It may be difficult for some individuals to give an accurate, unbiased history of these early events. Often it is useful to get outside corroboration on childhood behavior. The high incidence of comorbid disorders also complicates the picture. Inattention itself is a fairly non-specific finding. Even when the diagnosis of AD/HD is clear, one must be alert for other disorders. One study found that only 12% of adults referred to their clinic had pure AD/HD without any other major psychiatric diagnoses.

Copyright © 2004 Northern County Psychiatric Associates
Last modified: January 09, 2005

Good info Auntchris. :-)

I often have difficulty explaining to folk how my anxiety, ADD, and depression are all interrelated.

Yeah, I understand what you mean E-boy. I have a difficult time expressing myself verbally in a social situation. My word that I want to say to seem to come out the way I am think in my head. Thanks for the confidence .... that site above is a good one.... worthy of bookmarking it.

If I was to seperate out all my other disorders and describe only my ADHD, I would say it's like having someone flick a hand full of cards in your face.
Constant interruption, fluttering mind, inability to focus.

I don't know about "pure" adhd but if you think of it in terms of purity, I am conceptualizing only here - a "daydreamer" adhd girl, would be a less pure than a hyperactive, impulsive adhd boy.

I think of myself as definitely more toward the "pure" end of this paradigm, if not actually pure. Complete lack of selective attention, extreme hyperfocus when I am task focussed, also I am very athletic and have 20/10 vision. I agree more or less with the Thom Hartmann idea that "adhd" is really a normal thing, that just not everybody has (but it was advantageous to have maybe 10,000+ years ago). Some of us are more wired like hunters, and most are "farmers". And some are REALLY wired like hunters. I personally don't think my vision or to put it another way the harmony of physical characteristics with my ADHD is a coincidence at all, because my ADHD meshes so perfectly with it. I feel a natural affinity or understanding, of animals like cats - because of it.

We think you’d have to first decouple the symptoms from the underlying mechanisms. Then you could speculate what those mechanisms would look like in a context free from the effects that give rise to the symptoms.

We have yet to examine an AD/HD symptom that we can’t plausibly derive as arising from the interaction of one or two basic mechanisms within the social context. We haven‘t looked in detail at many of the co-morbid disorders, but those we have examined also seem to arise as a consequence of interaction with the social context.

The problem, of course, is the social context can’t be discarded arbitrarily without generating something strongly resembling severe autism. So it’s likely the only way we’ll ever ‘see’ pure AD/HD is in a social context uniquely adapted to the underlying mechanisms.

First thoughts here....

Stabile, do you honestly believe that in the end all symptoms are that strongly influenced by social interaction?

I'd be foggy in any social context....and thats at 45. I'm sure others would also suggest that no perfect social context would eliminate their disorders. This isn't a learned disorder, this isn't DADD as Breggin suggested. We are not the way we are because Dad didn't love us and pay attention to us.

For me I think it's feeling mostly happy when I'm 'not supposed to be happy'. I get blamed for things that seem to be out of my control but they should not be. I think it boils down to being misunderstood -- but for some reason when someone like me is misunderstood it tends to suck more purely than an average person having been misunderstood.

Pure ADHD can only exist in infants! 2 weeks old max!
The depression, anxiety and all other "comorbid" conditions come with years and years of trying to fit YOUR round peg into a smaller SQUARE hole.

One study found that only 12% of adults referred to their clinic had pure AD/HD without any other major psychiatric diagnoses I was pretty oblivious to my ADHD for most of my life...it wasn't until a few years ago I thought about it seriously...Then I had a certain friend who felt the need to keep saying to me in front of people "Tracy, yohoo...wakey wakey..what did I just say?" or "Tracy, repeat back what we were talking about!!" :(
I was like OMG!!! and only then did I start to get a bit anxious in social settings, and try to pay more attention etc
If I left it any longer, then the second problem may have evolved over time.
I guess I should be grateful to her for saying that, or I would have kept plodding along oblivious, in my own little world..

So, what I am trying to say, I only have ADHD, and no other co-existing condition..:faint: (that I know of!)

I think I can figure out were my anxiety and depression come from....
for starters constant negative talk ( lazy, messy, and os on...) from my family and failure of expectations ...
I was told that because I was somewhat smart and gifted I should become little miss perfection. Of course that in between my ADD and me, I fail far from being miss perfection. On the other side I always wanted to please the ones I love so I took their negative speach and my failure quite bad.
So while I started to develop something that might be called self-awarnes IO started to worry more abut my mistakes, my appearence , my constant "puting my foot in my mouth", my failures...that happend during elementary school.
I can say I was thaught anxiety, I was thaught to worry about tye consequences of my actions, my image, abut failing...and anxiety became my ADD control mechanism- If my ADD pushes me to climb on rocks( while I am nothing of a rock climber) or buy all those shiny,colorful, usless things from stores -my anxiety kicks back in an instant-I start to worry about safety, money....If a I have to finish a project and my ADD drives me away to a newer , more interesting prospect my fear of failure will kick in an instant and drive me until it is all finished.-and I read recently that since worry is one of the strongest thoughts one can have it attracts the ADD mind , so no wonder why I can't relax until I'm finished....

As a teenager, and even more as an adult , collecting on failed attempts and trying to deal with the other issues in my familly, depression came as a "natural" consequence....

[QUOTE=scuro all symptoms are that strongly influenced by social interaction?[/QUOTE]
Perhaps not influenced by interaction but as found in Kleinman's grondbreaking study of depression in China, all symptoms are understood in a social context.
We are ADHD because our baseline behaviors fall outside the norm as dictated by our culture. But in my family, I am not ADHD because that is the norm. (Yup diagnosis made a LOT of my aunts and uncles uneasy about their kids)

And by pure ADHD, could that be if you no longer have any other coexistant disorders?

What does it look like ?.....- where is a recent photo of me that I can post :D

What does it look like ?.....- where is a recent photo of me that I can post :DLOL :p

[QUOTE=scuro all symptoms are that strongly influenced by social interaction?
Perhaps not influenced by interaction but as found in Kleinman's grondbreaking study of depression in China, all symptoms are understood in a social context.
We are ADHD because our baseline behaviors fall outside the norm as dictated by our culture. But in my family, I am not ADHD because that is the norm. (Yup diagnosis made a LOT of my aunts and uncles uneasy about their kids)

And by pure ADHD, could that be if you no longer have any other coexistant disorders?[/QUOTE]

My two daughters are in more of a "fog" them I am, does that negate my fogginess? No. That is part of my impairment. Sure you can understand that "fog" by comparing it to others but in the end, it is your personal impairment. No impairment, no disorder...the reverse also holds true.

And by pure ADHD, could that be if you no longer have any other coexistant disorders?

Two questions:
1)what is coexistent behaviour and what is inherent behaviour for the disorder? For instance, is a low frustration tolerance part of the disorder?
2)what is universal for all who have the disorder? I agree, the comment about child like behaviour is closer to the mark then what you would at first think.

One study found that only 12% of adults referred to their clinic had pure AD/HD without any other major psychiatric diagnoses.


....So, what I am trying to say, I only have ADHD, and no other co-existing condition..:faint: (that I know of!)

That is funny and true for a number of people. That 12% number is startling although I am sure it would be higher for general referrals.

However, if someone has ADHD symptoms they may develop anxiety due to all the negative feedback they have received.

Im not sure whether it is true or not and I dont know if it was any help, but I thought I'd try.

You make most excellent scene made You are correct it is often the frustrations caused by being different the negative feed back that creates the anxiety, ODD and other behavioral co-morbinds they are not necessarily the ADD in and of it self.



those we have examined also seem to arise as a consequence of interaction with the social context.

Agreed.




So it’s likely the only way we’ll ever ‘see’ pure AD/HD is in a social context uniquely adapted to the underlying mechanisms.

Now that would be nice sooooooooooo let’s ditch the boxes!!!

The world does seem to be becoming more ADD with multi tasking, everything is now or yesterday, more people able to do work from their own homes via computer,





but I'm unable to 'separate' an individual or identify them, solely, by a few behavioral traits, that they exhibit.

I see an individual as the whole of there being. I guess because I am ADD I have no predetermined expectation of “proper” I simple accept as is and their personhood is either toxic, fortifying or neutral.

A lot of people have ADD like traits and many do not have ADD.




Maybe we shouldn't look at the symptoms (negative), but look at the characteristics (positive).

Love it!! Couldn’t agree more! I think this is a more productive approach by far.




The change would include removing the requirement for a negative impact on two or more areas of function and also to providing solid criteria for testing adults

E-Boy you are soo smart . . . .

My doctor did not diagnosis as much by traditional “impaired” he went by loss of potential=impaired. If some one was not living up to their potential and if this was apparent to the person and to him then this was considered as “impaired” even if the person was “functioning” according to social standards. I think is a more personal approach to the diagnostic procedure. With me diagnosis was easy I was bouncing all over his office . . .like a kangaroo at 29 no less!


I would be pure ADD if I did not have dyslexia, I will mention I do not think my dyslexia effected my behavior near as much as my daughters ODD combined with her ADD effected her behavior. ODD was greatly helped over the years by the treatment of her bi-polar which was discovered a few years later. So her ODD was caused by her un-diagnosis bi-polar NOT her ADD!

Now that she is out of school as long as her bi-polar is treated she is fine . . .not treating her bi-polar is like AHHHHHHH when the mania sets in. The hardest thing now is convincing her to return to school to get a degree or profession of sorts.

My other daughter is ADD and she is “spacey” but not a behavior problem. She has friends, no social problems she has always been pretty well adjusted except she would have lost her head had it not been attached, the poor child couldn’t keep up with squat. I have seen her loose things she was holding in her hand-lol So “pure” ADD looks like my daughter Samantha!




Gotta love the constantly changing nature of spoken language! WOOT!

Agreed and there are so many variations there of!

I don't know about ADD...but ADHD prolly 'looks like' a combo of the RoadRunner and Daffy Duck !!!


Nova (0:

Actually Tim, based on the things they are learning about ADD/ADHD, they are considering changing the diagnostic criteria in the DSM-V when it comes out. The change would include removing the requirement for a negative impact on two or more areas of function and also to providing solid criteria for testing adults. At present the children's criteria are used for testing adults and agreed upon guideline changes for adults are used to augment them. By DSM-V they hope to have agreement on a full and separate set of criteria for adult patients as well.
I have read this, as well. I can't wait to see if they change the name again.

Currently, if I were to use a title to describe my diagnosis it would be "managed AD/HD".

2 1/2 years ago before my diagnosis, it would have just been AD/HD. Notice the font size and color. :eek:

I don't know about ADD...but ADHD prolly 'looks like' a combo of the RoadRunner and Daffy Duck !!!


LOL- Yea this is pretty close .. .. .. ..my daughter Samantha had a touch of the "air head" flavoring thown in .. . .. . .. . .. . .. so it was daffy duck gettting lost at road runner speeds!

I was hyper but not a behavior problem like ODD I was "active" but pleasent. I would say I am closer to being difficult now than I was as a child. Getting cranky in my old age. That and the meds some time have an "opposing" effect; I can remember what I am annoyed about longer-(not necessarily a good thing-lol)

I looked in the mirror this morning and I saw what ADD looks like! So I said, "D*** E-boy! You are one sexay ADD B******!" :-)

http://www.urbandictionary.com/define.php?term=woot 'WOOT' had to find out what it meant...

air head, space cadet. I saw my friend, a dental hygenist who is normally methodical, making margaritas. She was literally throwing all the stuff into the blender, dripping it all over the counter and floor - and ignoring it. Hyper in a sense. I didn't know she had ADD. I thought it was bizarre - considering I'm a clean freak normally.

These food examples are short and convenient. I was making dinner, doing my 'mindfullness' excersizes and concentrating on making the slices. Randy, my husband, starts to watch me, and I go into haphazard, wacking. He says, 'you got bored? didja?' Some things cannot be done in remote control.

Maybe pure ADD is the inability to time share across tasks efficiently - like mind sharing, if you will.
Multi-tasking. One event distracts you from the previous, and you can't recover. And you can't control it.
Is that hyper ADD?

I've been degrading, meds and all, and I'm aware that I'm losing the ability to control these chaotic periods.
Not just control, but awareness of being in the midst of one. Normally you can watch yourself being a bimbo, and maybe you can and sometimes cannot control yourself. But when you lose the cognitive ability to differentiate between normal and impaired function....that's scary.

So what is pure, unadulterated ADD? Good question. I believe I've had the propensity, more like familial predisposition towards many of these behaviors right outta the box.
Environmental influences and social feedback pushed those tendencies - some towards adaptation of the norm, and some against the norm. Trial and error and we drift towards what works for us in the moment.

...mirror...Psychiatric care workers are becoming increasingly alarmed at the rise in prevalence of ADDers impulsively stopping in front of mirrors in shopping malls, across Europe and dancing the 'robot' whilst chanting (robotically) 'meee gladdddd, meee addddd, meee (also quite) baddddd.'
...:-)...

SB.

Such is the hysteria surrounding this unprecedented behaviour, that leading clothing retailers have begun a complete removal of all of their changing-room (and otherwise) mirrors. In their place, recruitment is currently underway for individuals, who it is intended, will be embedded within store changing-rooms, and whose job it'll be to provide you with earnest advice on whether you're looking mighty fine.
...:-)...

Remind me never to go into those stores...let alone their changing rooms. (0:


Nova

I'll venture a guess! It looks like a toddler. Lack of impulse control, lots of tantrums due to being misunderstood and not understanding the rules, and brilliantly amusing in turns.

Just a theory.

theory sounding quite good sounds like me on a bad day or good day if i think about it. lol

My two daughters are in more of a "fog" them I am, does that negate my fogginess? No. That is part of my impairment. Sure you can understand that "fog" by comparing it to others but in the end, it is your personal impairment. No impairment, no disorder...the reverse also holds true. I didn't mean to negate any personal experience (apologies if that happened) I can only speak from the cultural/ social level of things becuase thats where my training as an anthropologist is focused. When it comes to personal experiences, that's a bit out of my realm.

While it is true that there needs to be impairment for a symptom to be considered part of a disorder. There is also an overlap between arenas in interrpretation. In my example, I tried (not well, evidently) to show that while my hyperactivity and distracted nature are indeed problematic in the wider world (college was ****), within my own family I do not feel that there are problems becuase everyone behaves the same way. But for my friend, she feels it a lot in her family, even though their all ADD too. Sort of a macro/microcosim issue.

I never spell a word wrong. i dont think that's typical.

Two questions:
1)what is coexistent behaviour and what is inherent behaviour for the disorder? For instance, is a low frustration tolerance part of the disorder?
2)what is universal for all who have the disorder? I agree, the comment about child like behaviour is closer to the mark then what you would at first think.
1) I don't know the academic definition, so anyone who does please correct any mistakes I may make. A coexistant behavior is a behavior developed or adopted to help deal with/ in reaction to the underlying conditions, like my husband's poor organizational ability leading him to habitually use any flat surface as a filing drawer:). As to what is the inherent behaviors of ADHD, check the DSM-IV TR. These are what professionals have agreed upon and used to make a diagnosis of ADHD. But E-boy went into all the issues that particulalar book has way better than I can.

2)When you say universal, do you mean in Western-bases cultures or for humanity in general? Or do you mean universal as in what do all people with ADHD experience? In the first instance, it's what is listed in the DSM-IV (please no one come after me for that, I know that is WAY too simplified an answer). Two in humanity, there are very few universals, only ones I know of are the numbers 1,2,3 and the colors red, white and black. And finally for all ADDers, I don't think there is a universal behavior or experience. Our disorder, how we expereince it and how we manifest it, are all highly personalized. Sort of like variations on a theme.

Ok, I'm shutting up now. Promise.

Good characteristics, or bad symptoms...what is universal? I do like this post...and no it is not just a characteristic of hyper ADHD. It can be seen as an impairment or a strength. I think this is one unversial characteristic. The literature would back up this notion also.


Maybe pure ADD is the inability to time share across tasks efficiently - like mind sharing, if you will.
Multi-tasking. One event distracts you from the previous, and you can't recover. And you can't control it.
Is that hyper ADD?

Originally Posted by kvrrd
Maybe pure ADD is the inability to time share across tasks efficiently - like mind sharing, if you will. Multi-tasking. One event distracts you from the previous, and you can't recover. And you can't control it. Is that hyper ADD?

At a young age this might not be an issue. Maybe the ADHD "impairment" is a by-product of constantly being told to stay on track. This, in turn, produces a feeling of anxiousness that becomes a part of that person. Kind of a personality trait. Think of it as a type of conditioning. So at a young age a child is trying to fight "their" normal way of thinking.

I know when I started taking my medication, I was told I was not the same person anymore. While I was finally feeling great and in control of my life. Things just don't bother me like they did before taking medication. You can say I "didn't sweat the small stuff" anymore.

Maybe the ADHD "impairment" is a by-product of constantly being told to stay on track. This, in turn, produces a feeling of anxiousness that becomes a part of that person. Kind of a personality trait. Think of it as a type of conditioning. So at a young age a child is trying to fight "their" normal way of thinking.One of the best descriptions that there has been on-site (on-any-site) of the line between ADD as impairment and not.
Tim opens the door into ADD as the precursor to a contextual disorder, more importantly though, as a precursor to a contextual disorder which is felt based on hidden societal pressures (the context (of contextual disorder) being the individual's immediate ambient environment of societal pressures). The 'ADD-society' correspondence has been made, around five or six times thus far on this thread alone. ADD exists as a precursor to these adverse changes in the mental state (anxiety, depression ... ) of the ADDer and so, in my opinion, ADD should not, in itself, be considered a disorder ... instead, as the precursor to contextual disorder --- all dependent on the environment within which the child develops, teenager thrives and adult exists.
To be clear, I'm stating that ADD may exist without co-morbids, that ADD by its intrinsic nature will attract the co-morbids in ***current*** society, that ADD (in itself) is not a disorder per se (no matter how much it might appear to be irreversibly and intimately intertwined with contextual disorder) and that although 'society' and its pressures are all-pervasive, and these hidden pressures lead to the contextual disorder which is felt by ADDers ... that these pressures will be 'felt' by the ADDer, thence the co-morbids co-segregate, is *not* (by any means) ... a foregone conclusion.
ADD can exist in a purer form without contextual disorder, and it is my honest opinion that stimulants work for the pure ...:-)... of ADD, pretty much as one would expect ... as one would expect.

Interest then, I guess, turns to what is the fundamental difference between ADDer and non-ADDer? Now that we're effectively stripped back the layers of co-morbid contextual disorder which otherwise obscures our view of the centre of all of this. Whatever that fundamental difference within the mind of the ADDer might be, I'm guessing, will permit us to instantiate a picture of pure ADD (at the higher human behavioural level) ... the solution to the question under scrutiny in this thread.

SB.

I read somewhere that if you show symptoms of anxiety before you show the symptoms of ADHD its probably because you have an anxiety disorder like GAD or SAD because they show some of the symptoms that can be seen in someone with ADHD. However, if someone has ADHD symptoms they may develop anxiety due to all the negative feedback they have received.

Im not sure whether it is true or not and I dont know if it was any help, but I thought I'd try. :)

Oh and sorry if none of that made sense lol.
nice avatar! :D

Thanks for the credit, SB. :D
I might add ...

This could be some of the reasons why those diagnosed with ADHD:

- are "people pleasers"
- are ultra sensitive to criticism
- have the feeling of "impending doom"
- have the feeling of constantly being "misunderstood"
- are very good at reading people's feelings/facial expressions
- are constantly "on guard" to be prepared for a confrontation.
- have low self-esteem

Back to the "pure ADHD" discussion ...

We will need to look at a child.

This child has the all of the "thought patterns" that are similar to an adult diagnosed with ADHD.

One of two scenarios could happen to this child:

1.)they are allowed to be who they are and their way of thinking is supported by the family system

2.)they are constantly corrected and told to do things differently then they "thought"

These two scenarios can "shape/condition" this child. This child goes to school and is met by more of sceniaro #2.

Order and structure, standardized/timed tests and rote memorization are forced on this child.

For example, my son diagnosed with ADHD /with Hyperactivity is in 2nd grade. He is an A student, but when it comes to the timed math tests, that are a requirement, he gets nothing but F's becuase he doesn't finish. Every problem he finishes is correct and he knows the material. This really troubles him and we tell him it is OK, but we know it is effecting him.
The child is told to not question authority. When all the child wants to do is express their ideas and the way they think. This way of thinking doesn't fit the majority and we know the majority rules.

Pure ADD is not an "Attention Deficit", because we all know about hyperfocus. :)

I will continue this later.

I'm back.:D

To see pure ADHD "thinking", we should look at the mind of a person diagnosed with ADHD.

Here are some characteristics:

- ability to process ideas in parrellel, instead of serially.
- the mind is constantly going. (i.e. waking up in the middle of the night with a solution to a problem)
- ability to answer a question correctly without working through and showing the steps involved
- quick witted
- understand the concept of "self-awareness" at a young age
- constantly seeking stimulation (knowledge, excitement)
- ability to hyperfocus on a something that is of interest

Maybe, if the young mind of a child is just given the opportunity to "be" these characteristics and not have to fit to another's expectations, then they might not develop these things called "co-morbids". Of course, then they wouldn't be "co-morbids".

This could be why we are seeing an increase in the ADHD diagnosis. Society is becoming more structured, which in turn causes these "ADHD thinkers" to not be able to cope.

Maybe the public education system has contributed to the increase in the diagnosis of ADHD. This statement is not directed to teachers in anyway. It's directed to the method's used by the public education system. The teachers have to follow a curriculum that is set forth by the government. Maybe this is why the US one of the highest nations diagnosing ADHD. :confused:

Look at the response "they just need to be disciplined more". Maybe they just need to be allowed to "be". They need to be "nurtured" more. I am not saying "spoiled". They need to be allowed "to be heard and understood".

Also, it's not pure ADHD "thinking", if it is caused by a head injury or other outside force. Pure ADHD "thinking" is genetic and physiological. It is something you're born with. It's a part of your make up.

I've felt the ADD characteristics timh listed all my life and never thought I was out of the ordinary or 'impaired.' NEVER. Nor did I ever feel special or smart. I just was. I always felt I was missing something.
I was invisible and never belonged, never got fully engaged with anything. And hated any kind of attention. I was lost until my mid-twenties when I switched from medicine to engineering.
OMG - computers, digital logic - ahhhhhhhhh.
Being able to see and CHANGE the big picture - especially with systems and finding holes in logic and interpreting specifications and all that gobbly-gook. I could recall conversations from years back and freak people out. Technical details - became a part of me. I was very good at what I did and I was rewarded.
But co-workers hated me and I was pretty much oblivious to them. I never made bridges to burn. I was impatient with people - they slowed me down. I felt secure financially and in my job and my matra was - you can hate me all you want, but you'll never be able to criticize my work. HA.

The reasons listed for a DX of ADHD - well...I was also never a people pleaser. That concept was foreign to me, which is why I've described myself as somewhat autistic - but I've come to learn Aspergers is a more appropriate approximation. I USED to be a walking people barometer - I could always tell when something was up, I could feel what other's were projecting. (Or I onto them?)
NOW, I can totally misread a situation, I mean completely. Circumstances have changed everything.
I feel really impaired and almost hopeless.
My impairments are these: no emotional control, I get so p***ed, that I start crying. Not good sobbing in the VP's office going, "it's ok I'm crying - I'm just frustrated and p**ssssssseedddd."
I found myself misinterpreting directions and making mistakes. Short term memory loss. Lack of focus on the tasks at hand - I end up chasing information and going off into the weeds. This scares the snot out of employers when you're new - especially at high specialist prices. I've lost my marbles. Then one job after the other. I found I couldn't remember the first part of a sentence I had just said, so how could I finish it?
That ol' spiral down the tubes...

Ok, I was depressed so I started anti-depressants. Then I felt angry with chronic indignation and so added a mood stabilizer. Eventually I had NO focus - an eggplant. Adderall brought me back to life. I've started to think that the various meds and doses caused a lot of these symptoms, along with menopause.

But what was the root cause of this slide into a quagmire of s***? A relentless series of life changing BAD events? My loss of status quo? Pressure from society? Menopause? Drugs? Spoiled brat having a 3 year hissy fit? Karma, from abusing my talents and strengths?
Did I diagnose myself and thus made myself 'sick?'

Sorry - I tend to 'journal' and I'm not even on close to the right thread...

KVRRD,

Ahhh, a fellow techie. :D AND, OR, NOT, NAND NOR, XOR, ADDER's, Gates, and Functions. It's as easy as 00000011.00000001|00000100 (I'm such a geek).

I was formally diagnosed at 32. This is also when I switched jobs and managers. This is when I started that "ol' spiral down the tubes". My way of thinking did not mesh with the way my manager thought and I was not able to cope.

You have included very valuable information. Thanks for posting.

nice avatar! :D
lol thanks! :D Yours is good too!

I'll venture a guess! It looks like a toddler. Lack of impulse control, lots of tantrums due to being misunderstood and not understanding the rules, and brilliantly amusing in turns.

Just a theory.
That sounds a little more like Borderline Personality Disorder to me.

That sounds a little more like Borderline Personality Disorder to me.
Interesting ... if this is the case then everyone is born to fit the BPD diagnosis. ;)

As a child grows up they should learn to control their impulses, communicate effectively so they can be understood, and follow the rules of society. If they achieve this, then they won't fit the BPD diagnosis.

I know BPD and ADHD have a lot of similarities.

--*--*--*--
Substitute the words 'transmissible familial' for 'genetic', and the idea that an overly structured learning environment leads to an increase in prevalence of the contextual disorder (and not the precursor ADD) ... and we're in violent agreement.
--*--*--*--
As a corollary to my previous post ... 'ADD as a disorder' arises by virtue of the failure to effectively separate ADD (within diagnostic criteria) from its co-morbids. The diagnostic criteria for ADD is perhaps best described as a pragmatic mêlange.
So ... is this a problem?
~NO~
Not for the individual who is suffering ... the pained ADDer doesn't much care for the name of his or her condition, and cares only that the pain goes away.
However...
~YES~
Absolutely, when the question of ætiology of ADD arises.
Failure to realise that the diagnostic criteria is a characterization of an ADDer with an unrelated but associated contextual disorder, leads to the mistaken assumption that ADD is a disorder (in its own right). It's not, even though it certainly does look it from certain perspectives.

Once again, the distinction which I'm underlining here, is not of any real importance to the clinical setting, *only* to the theoretical underpinnings of ADD ... which (it needs to be stated) ... is mine and perhaps many others (here) $6 million ...?...? ..?...
--*--*--*--
...people pleasers......never a people pleaser...ADD is filled with so many apparent contradictions. This would (superficially) appear to be yet another, until one identifies their particularly stark commonality -->-->-- that of *neither* being considered *'normal'* (behaviour); these two behaviours relate to the same underlying cause lying under our inability to espouse gently hypocritical rhetoric in standard social settings ... ... ... where gently hypocritical niceties of society are expected.
... raising the question 'Why can't we just tell little white pragmatic lies like 'everybody' else ...?... tell our friends that their bottoms are effectively obscured and peculiarly flattered by the cut of their clothes, go to parties and enjoy listening to inane drivel and feel satisfaction from time immersed within utter pointlessness..:-)...?'
--*--*--*--
...ability to hyperfocus on a something that is of interest......Lack of focus on the tasks at hand... ... raising the question 'where's the little chap in our heads who gets to make the call on what is of interest to us, and what might one believe to be his criteria for stamping either 'ACCEPTED' or 'REJECTED' in big letters across our next endeavour?'
--*--*--*--
...have the feeling of "impending doom"......the root cause of this slide...Yet another 'hi5' to Tim ... not often described here, this is a real big observation. This feeling of impending doom is not related to the hush-hush current NASA mission, launching Bruce Willis and Cybill Shepherd to the moon with a first edition Atari Asteroids video game console ... but *is* everything to do with the rrreality of being an adult ADDer ... ... ... ADDult rrreality.
... raising the well-stated and timely, evidently eminently appropriately constructed and elegantly eloquently razor sharp question of 'what???'
--*--*--*--

...:-)... [/url][url=""] ("")

SB.

'freakin' freaks - every freakin' last one of us' ...:-)...

freakin' flag flyer...

Interesting ... if this is the case then everyone is born to fit the BPD diagnosis. ;)

As a child grows up they should learn to control their impulses, communicate effectively so they can be understood, and follow the rules of society. If they achieve this, then they won't fit the BPD diagnosis.

I know BPD and ADHD have a lot of similarities.I think my toddler analogy was apt if not perfectly clear. I do not believe a toddler manipulates out of fear in quite the same way a BPD adult might.

I think my idea was expanded upon quite accurately by SB_UK. What he says? Is what I was trying to say. :-)

Then again you might take the Hunter Brain theory into consideration. Suppose the child is born into a so-called "primitive" society and raised in a culture that values the Hunter, who must constantly scan the surroundings, who must be able to hyperfocus during the hunt and change courses according to split-second decisions. Suppose nobody in that culture expects anything of the one born to Hunt other than the abilities that will make this child a great Hunter, and the person is never expected to be still, to think in a linear fashion, to attend to boring tasks?

If the person is ADD in a society that values those traits, is it then a disorder? Or is it a valuable trait that brings to them great honor?

0xdeadbeef ... yum! :-)

Is there a such thing as pure ADD? How can one separate ADD from self? To even start, one would need to know what ADD actually is (not welcoming a heated debate, of course :)) Even assuming standards, is it ADHD-PI, C, or HI? If ADHD-PI == SCT and SCT := A true attention disorder, then wouldn't that really mean that ADHD-PI == ADD and ~ADHD-PI == HKT (Hyperkinetic tempo). Or is ADHD-HI == HKT, PI == SCT, and C == HK/SCT?

Even if we stated that pADD == pSCT (Pure ADD, Pure Slow Cognitive Tempo) is true, how can it be separated from other disorders or even personality characteristics? The only real way to know pure ADD is to know ADD.

what is pure adhd??? then expalmesss plasees if threre any known thanks dorm

If ADHD is a contexual disorder then the enviornment that you grow up in should make a significant difference.

Barkley on the Twin studies and ADHD.

Twin Studies.

Since the last edition of this text, the number of twin studies of ADHD and its underlying behavioral dimensions has increased markedly. More exciting has been the striking consistency across all of these studies. This research strategy provides a third avenue of evidence for a genetic contribution to ADHD. But it also provides a means of testing any competing environmental theories of the disorder (e.g., that ADHD is due to poor parenting, adverse family life, excessive TV viewing, etc.). That is because twin studies can not only compute the proportion of variance in a trait that is genetically influenced (heritability), but also the proportion that results from common or shared environment (things twins and siblings have in common growing up in the same family) and that which results from unique environment (all non-genetic factors or events that are unique or specific to one child and not to others in the family) (Plomin, Defries, McClearn, & Rutter, 1997).

Early research on ADHD using twins looked only at twin concordance (likelihood of twins sharing the same disorder) and did not compute these estimates of heritability, shared, and unique environment. These early studies demonstrated a greater agreement (concordance) for symptoms of hyperactivity and inattention between monozygotic (MZ) compared to dizygotic twins (DZ) (O'Connor, Foch, Sherry, & Plomin, 1980; Willerman, 1973). Studies of very small samples of twins (Heffron, Martin, & Welsh, 1984; Lopez, 1965) found complete (100%) concordance for MZ twins for hyperactivity and far less agreement for DZ twins. For instance, Gilger, Pennington, and DeFries (1992) found that if one twin was diagnosed as ADHD, the concordance for the disorder was 81 percent in MZ twins and 29 percent in DZ twins. Sherman, McGue, and Iacono (1997) found that the concordance for MZ twins having ADHD (mother identified) was 67 percent versus 0 percent for DZ twins.

Later research has computed heritability and environmental contributions to ADHD. One such study of a large sample of twins (570) found that approximately 50 percent of the variance in hyperactivity and inattention in this sample was due to heredity while 0-30 percent may have been environmental (Goodman & Stevenson, 1989). The relatively limited number of items assessing these two behavioral dimensions, however, may have reduced the sensitivity of the study to genetic effects. Later and even larger twin studies have found an even higher degree of heritability for ADHD, ranging from .75 to .97 (see Levy & Hay, 2001; Thapar, 1999 for reviews) (Burt, Krueger, McGue, Iacono, 2001; Coolidge et al., 2001; Gjone, Stevenson, & Sundet, 1996; Gjone, Stevenson, Sundet, & Eilertsen, 1996; Hudziak, 1997; Levy, Hay, McStephen, Wood, & Waldman, 1997; Rhee, Waldman, Hay, & Levy, 1995; Sherman, Iacono, & McGue, 1997; Sherman, McGue, & Iacono, 1997; Silberg et al., 1996; Thapar, Harrington, & McGuffin, 2001; Thapar, Hervas, & McGuffin, 1995; van den Oord, Verhulst, & Boomsma, 1996). Thus, twin studies indicate that the average heritability of ADHD is at least 0.80, being nearly that for human height (.80-.91) and higher than that found for intelligence (.55-.70). These studies consistently find little, if any, effect of shared (rearing) environment on the traits of ADHD while sometimes finding a small significant contribution for unique environmental events. In their totality, shared environmental factors seem to account for 0-6 percent of individual differences in the behavioral trait(s) related to ADHD. It is for this reason that I stated at the opening of this section that little attention would be given here to discussing purely environmental or social factors as involved in the causation of ADHD.

The twin studies cited above have also been able to indicate the extent to which individual differences in ADHD symptoms are the result of nonshared environmental factors. Such factors not only include those typically thought of as involving the social environment, but also all biological factors that are nongenetic in origin. Factors in the nonshared environment are those events or conditions that will have uniquely affected only one twin and not the other. Besides biological hazards or neurologically injurious events that may have befallen only one member of a twin pair, the nonshared environment also includes those differences in the manner in which parents may have treated each child. Parents do not interact with all of their children in an identical fashion and such unique parent-child interactions are believed to make more of a contribution to individual differences among siblings than do those factors about the home and child-rearing that are common to all children in the family. Twin studies to date have suggested that approximately 9-20 percent of the variance in hyperactive-impulsive-inattentive behavior or ADHD symptoms can be attributed to such nonshared environmental (nongenetic) factors (Levy et al., 1997; Sherman, Iacono et al., 1997; Silberg et al., 1996). A portion of this variance, however, must be attributed to the error of the measure used to assess the symptoms. Research suggests that the nonshared environmental factors also contribute disproportionately more to individual differences in other forms of child psychopathology than do factors in the shared environment (Pike & Plomin, 1996). Thus, if researchers were interested in identifying environmental contributors to ADHD, these studies suggest that such research should focus on those biological and social experiences that are specific and unique to the individual and are not part of the common environment to which other siblings have been exposed.


and from his SF lecture

Okay, we’re going to take thousands of twins, which we have done, in the United States, Norway, London, every twin in Australia has participated in a study because Australia has a twin registry, where all twins born are registered and they become available for scientific research. So that you can, with permission, of course, measure AD/HD among all of these twins. We’re going to compare fraternal twins to identical twins and maybe if we can find some twins reared together and twins reared apart because of adoption, we’re going to do all those studies, and out of those studies we’re going to be able to calculate three numbers mathematically. The first number is known as heritability. How much does genetics contribute to the trait? The second number is called rearing environment, shared environment. How much of the trait is due to the common environment shared by the twins and siblings you’re studying? And number three, how much is due to unique environment, environmental effects that have affected only one twin and not the other? One twin had a different peer group. One twin went to a different school. One twin ate lead paint. One twin fell off their bike. Notice, environments can also be biological hazards. The term environment in twin studies refers to nongenetic. It can be biological as well.

All right, what do we find in studies? Well for comparison, let me give you some statistics. The genetic contribution to IQ is .55. The genetic contribution to human height is .81. The genetic contribution to AD/HD is .80 to .97. The smaller number is from studies done back in the ’70s that didn’t use DSM criteria. If you use the DSM list of criteria, the heritability of AD/HD is 97 percent. This trait is more inherited than human height. This trait is more inherited than any dimension of human personality. This trait is more inherited than any other psychiatric disorder. The only other disorder that is this genetically affected is autism.

Now, we can then go out and calculate the shared environment. If Rosemond is right, if Breggin is right, if Scientologists are right that there is no disorder here, it is all due to environment, if the dietitians are right that’s it all due to sugar being eaten by the child, because that’s an environmental explanation, we should see huge numbers associated with the environmental calculations. Zip. None. Rearing environment makes no contribution to this disorder. So let’s just get over this idea that AD/HD comes out of the family, and you didn’t raise your child properly and you didn’t teach them self-control, and you’re a bad mother, and you let him watch too much television, and you fed him too much sugar.

(I'm such a geek).
I was formally diagnosed at 32.
Can they do that now?
Clever innovative little medical establishment.

SB ...:-)...

What kind of doctor does that?

Wonder what the diagnostic code for "geek" is?

What kind of doctor does that? Semantic Ontologists

Wonder what the diagnostic code for "geek" is?'run'

[i]SB. ...:-)...

0xdeadbeef ... yum! :-)
Typical Novell server "Internal IPX Network Number" (for all you Network Administrators out there).:D

You are a trip, S !!

Love ya sense o' humor !

What kind of doctor does that?

Wonder what the diagnostic code for "geek" is?
300.02 - Generalized Anxiety Disorder
314.9 - Attention Deficit/Hyperactivity Disorder NOS
802.11b - Geek Disorder :D

Actually 802.11b is the 11 MB WiFi - IEEE Standard :rolleyes:

Now, we can then go out and calculate the shared environment. If Rosemond is right, if Breggin is right, if Scientologists are right that there is no disorder here, it is all due to environment, if the dietitians are right that’s it all due to sugar being eaten by the child, because that’s an environmental explanation, we should see huge numbers associated with the environmental calculations. Zip. None. Rearing environment makes no contribution to this disorder. So let’s just get over this idea that AD/HD comes out of the family, and you didn’t raise your child properly and you didn’t teach them self-control, and you’re a bad mother, and you let him watch too much television, and you fed him too much sugar. Excellent information. :) The Twin DB is really valuable. Imagine the opposition to something like this in the US.:eek:

I think we were trying to say the "co-morbids" could be contextually influenced. Not ADHD itself. If you remove these symptoms will you be able to see the more "pure ADHD" traits?

If you are a believer that the likelihood of a person to be diagnosed with ADHD is genetic/biological (I believe this), then we should be looking at the physiological charateristics first. This may help us paint the picture of "pure ADHD physical makeup".

Is there a such thing as pure ADD? How can one separate ADD from self? To even start, one would need to know what ADD actually is (not welcoming a heated debate, of course :)) This would make things so much easier.:D

...(o:...!...:-)...S

'co-morbids could be contextually influenced. Not ADHD itself.'

'we should be looking at physiological [and not pathophysiological] characteristics first'

' would make things so much easier [if] one knew what ADD actually is'
Figure it's just plain easier to follow Tim around A'copying some A'his A'grade ideas.

.................................................. ..[i]...:-)...
..............................,,,,,,,,,,,,,,,SB.

[edited to include Crazy's advice from the future - yes - ~ADDers can look into the future~]
'run ... Tim ... run, run like the wind, geek is gonnagetcha'


To qualify with final flourish, I'm pretty sure that any environmental factors promoting first expression of ADD will prove to be diametrically opposed in essence to factors promoting the later appearance of co-morbid disorders (should they arise).

'run'

SB. ...:-)...Heeheeheeeeeeeee! I am so glad :D since the child and I use the phrase "Let's RUN!" to indicate that we are ready, willing and able to go on a metaminded, ADD-mentality spree just for the sheer joy of it all!

All are welcome to run with us or get out of the way. If it strikes our fancy then run we do *grins*

*spies butterfly...and runs...*

If ADHD is a contexual disorder then the enviornment that you grow up in should make a significant difference.

Barkley on the Twin studies and ADHD.


A) that would assume that the environmental factors are quite specific. They don't have to be. For example, if the society at large has a given common bent (IE a leaning towards certain ways of doing things), and ours does, home environment isn't going to significantly change the outcome. I'd be interested to see if the twin studies in question have any twins with ADD raised in europe and america respectively (where there is a qualitative difference in environment, at least in the educational system).

B) ADD/ADHD has already been rather conclusively shown to be environmentally sensitive in addition to being heritable. Two persons in the same family may have a diagnosis (presumably due to the same genetic factors as the people looked at are typically parent and child) for ADD, with VERY different expressions/subtypes diagnosed. My father for example who is the most solidly ADD contributor to my backround (they think my mother MIGHT have it as well) had the highly structured symptomology. I'm mixed type. My father could function quite well in the very environment that's making my life miserable right now.

I was just going to chime in YEah me- but i have ADhd and Dyslexia :)

Interesting ... if this is the case then everyone is born to fit the BPD diagnosis. ;) Everyone is.

BPD is a failure to develop a stable sense of self.


I know BPD and ADHD have a lot of similarities.All psychological disorders have similarities.

BPD symptoms may overlap with a few symptoms, but I'd hardly call them similar.

A) that would assume that the environmental factors are quite specific. They don't have to be. For example, if the society at large has a given common bent (IE a leaning towards certain ways of doing things), and ours does, home environment isn't going to significantly change the outcome. Differences in home environments (within countries) are MUCH greater than differences in cultural environments of countries. In addition, this "proximal" environment has a much greater influence on stress levels than the more distal.



B) ADD/ADHD has already been rather conclusively shown to be environmentally sensitive in addition to being heritable. Two persons in the same family may have a diagnosis (presumably due to the same genetic factors as the people looked at are typically parent and child) for ADD, with VERY different expressions/subtypes diagnosed. At this time, it's estimated that approximately 15-25% of the diagnosis is attributable to environmental factors. That's high for random effects, but extremely low for psychological disorders.

The differences in dx of subtype and manifestation of symptoms are most likely due to vast differences in brain structure between individuals. This is indeed more likely to be environmentally-based, but it is not likely related to whether or not one manifests the disorder, just how.

I just got the results, actually just the interpretation, of my MMPI-2. This test, I was told, was the premier test of tests that the court system and other public services use for evaluating personalities. Not a peep about about any kind of attention deficity is mentioned.

'Individuals with this profile tend to be considered neurotic and receive diagnoses such as Dysthymic or Anxiety Disorder. They may also receive an Axis II diagnosis of Dependent or Compulsive Personality Disorder.'

Does this mean that the test does not have a series of questions pertaining specifically to ADD or
that they do not recognize ADD as a testable disorder or
that I do not have significant or mentionable ADD characteristics?

I just got the results, actually just the interpretation, of my MMPI-2. .......Does this mean that the test does not have a series of questions pertaining specifically to ADD or that they do not recognize ADD as a testable disorder or that I do not have significant or mentionable ADD characteristics?The MMPI simply isn't designed to test for ADD.

AD/HD is a cognitive disorder; the primary characteristics are performance issues. Personalities are not a factor, either, which is (as you mentioned) what the MMPI does best.

Yes, it's the gold standard for a number of diagnoses. This is mostly due to the fact that there is an extremely large database of scores that can serve as comparison.

But, it doesn't test for everything.

There's no "set of questions" or single test that can identify ADHD.

I think we were trying to say the "co-morbids" could be contextually influenced. Not ADHD itself. If you remove these symptoms will you be able to see the more "pure ADHD" traits?
Yes I agree with you completely here but I think some want to believe that ADHD is contexual too. That is, that under perfect conditions there would be no ADHD, no working memory deficits, no impulsivity, no difficulty in getting things done, no difficulty with planning into the future...and finally that we would all would have complete control of our emotions. Now as you think about yourself, you may think that this is plausible. Perhaps, now think of yourself as a child of say 10 before you found coping mechanisms.

If you are a believer that the likelihood of a person to be diagnosed with ADHD is genetic/biological (I believe this), then we should be looking at the physiological characteristics first. This may help us paint the picture of "pure ADHD physical makeup".

This would make things so much easier.:D
Here is a post that starts to address that issue. http://www.addforums.com/forums/showpost.php?p=301794&postcount=47

Barb,

The educational environments between the U.S. and Europe is substantially different in many ways. My cousin in Ireland's household is substantially more different than mine in comparison to any neighbors I've ever had. Your data on differences between groups being smaller than differences within them sounds remarkably like population genetics though (which you have to admit is an interesting coincidence in the current discussion).

I never claimed ADD was a result of the environment, only that it's particular expression might be. Differences in symptomology and subtype between parent and child are not at all unusual. Which clearly points to more than just genes being at work.

Barb,

Not trying to goad you. Just trying to get more info out of you. I know that personal experience doesn't necessarily shed much light on humanity in general. :-)

One thing you said really did grab my attention and that was the bit about home environments within countries being more different than cultural differences between countries. It's not an exact match to population dynamics but close enough to be intrigueing (There is more variation within a population of a given species than there is between them). So, now I want more info so I can figure out what to make of that.

Bullet-pointed
lists
of'under pefect conditions'


...:-)...
...there would be ADD
...there would be the same apparence of working memory deficits as is currently made (inability to remember certain events, on account of one's mind being otherwise engaged elsewhere, where-else-where was more 'fun')
...there would be impulsivity (closer connection between our feelings and actions ... 'swept up by it all' instead of *repressing* our natural urge to soar)
...there would be difficulty in getting (brain-bogglingly tedious tasks) done
...there would be more living for the present instead of frittering away the present in the future. A converse exaggerated but similarly rooted idea is expressed by the stoic chant of the hope less ... 'maybe in the next life' (...:-)...planning well, perhaps a little too well, into the future ...:-)...)
... ... ... and finally, and just as it has always been ... our emotions would control us (albeit with sizeable 'twist' relating *not* to our thread(s) of conscious awareness (thought), but instead to that other -thing- ...:-)... (http://%3Cfont%20color=%22SlateGray%22%3E%3Cb%3E%3Ci%3E%3 Cfont%20size=%221%22%3E%3Cfont%20color=%22Silver%2 2%3E...:-%29...%3C/font%3E%3C/font%3E%3C/i%3E%3C/b%3E%3C/font%3E) (whatever that might be ...?...) which *actually* serves to define our emotional state ... the 'twist' being that *it*, I believe, will itself change'under perfect conditions' Such a pretty story I hear you sigh ...yay!... and it'll be such a pretty reality too, when (not if) it happens (...and it *is* happening...); it's a tale of modern man, evolutionary psychology and 'agape'.



...:-)... SB.

LOL LOL..I love it..barbyma Resident Blabbermouth-Know-It-All

:D :D :D
hehehe...when did you change it??

Yes I agree with you completely here but I think some want to believe that ADHD is contexual too. That is, that under perfect conditions there would be no ADHD, no working memory deficits, no impulsivity, no difficulty in getting things done, no difficulty with planning into the future...and finally that we would all would have complete control of our emotions. Now as you think about yourself, you may think that this is plausible. Perhaps, now think of yourself as a child of say 10 before you found coping mechanisms.Hmmm. :eyebrow: I think symantics could be causing some confusion.

Maybe we should group the "reactionary" or "coping" characteristics, as well. These would not be part of "pure ADHD thinking", because the are things that allow a person to adapt or compensate.
I am going to go "techie" for a bit. So bear with me. :faint:

The Windows NT operating system is not a true multi-tasking operating system. Meaning multiple processes running at the same time within the CPU. It's considered a "preemptive multitasking" operating system. It operates by queuing and cycling through processes giving each process a slice of CPU time. This is done for each process until it is complete.

Maybe the brain of a person diagnosed with ADHD operates in a "preemptive multitasking" fashion, but the physical makeup of the brain causes the queuing mechanism to not function correctly (rushing thoughts). Hence, when a stimulant is introduced the queuing mechanism starts working better.

It's possible that if the person diagnosed with ADHD would have had the ability to:

- sit still
- stay on track
- control verbal impulses

at a young age they might not have been subjected to the constant discipline and criticisms by adults and peers. Which in turn created the symptoms of the ADHD diagnosis (negative aspects).

Long story short, yes the diagnosis of ADHD is contextual, but "pure ADHD thinking" should not be contextual.

Maybe we should have someone summarize the big ideas. This might help get us back on track.

Scuro,

I believe that under "perfect" conditions, I'd still have difficulty with distractions, impulsivity, pattern sleep disturbances, etc... "normal" people have difficulties too (you don't have to be ADD to be bad at math, or have a poor memory). It doesn't make them crippled. I just think an ADD friendly environment would rid us of much of the crap that accompanies ADD and allow us to capitolize on our gifts and downplay our less than great symptoms.

Differences in neurological function, metabolizm, and any number of other traits sometimes translate into Pro's and Con's in the real world. That's normal. Defining ADD by only the deficits is like defining people by only their negative character traits. It paints a very ugly picture, and one that isn't necessarily accurate.

Human beings in general are, as I've mentioned before, pretty crappy logicians without formalized procedure and training to lean on. This isn't because we're stupid, or broken. It's just a consequence of how we're wired. We work around it. When I think of ADD as contextual, I'm not suggesting that the differences in functionality aren't there. Only that our society tends to work in ways that make our shortcomings even more of a problem for us, and also makes it difficult for us to use our strengths to compensate.

I don't believe being ADD makes me "Special". I also don't believe it makes me a cripple (though lord knows I've felt like one from time to time). Just as everyone else on earth there are things I'm good at and things I'm bad at. ADD just makes for different gifts and deficits than are common in the general population. It's a mistake to think of it as a pathology. By the same token it would be a mistake to not recognize the need for treatment. Ideally, treatment wouldn't be necessary because society would be more flexible, but that's not gonna happen any time soon.

Genetic (intrinsic?) effects versus environmental (extrinsic?) effects.

There's an argument (bear with me --- it'll feel as though I'm frying your brain) ... but not so ..:-)...the argument that the constituent bases (A, G, C and T) (which make up DNA) and the gene (as distinct from its component parts), themselves, are a product of the environment (contextual) ... the converse however, is *clearly* not true, although the gene(-ome) ultimately instantiates life, which (at whichever point on the evolutionary ladder one decides to pause) --- one will find (even if only in some minor way), some attempt at altering its (immediate, immediately extended) environment.

The reason then for making this comment, is that we need to consider what we consider the environment to be ... before making any comments over its effects on X, Y or D.
( ..:-)...No matter how much Sesame Street attempts to indoctrinate us --- Z will forever by Zed, will never be Zee..:-)... )

Strike II.

So, in the question at hand ... the question of environmental factors which expose ADD (event#1), and the other set of environmental factors which push the ADDer into contextual disorder ... in these 2 *separate* cases .. what do we believe these environmental factors to actually *be*?
In a sense, we might make certain unintuitive observations, if we were to take this route.
For instance, I wrote (above) that the environmental factors (I believe to the point of near certainty), in these 2 separate events (#1,#2) will be 'diametrically opposed' in essence; however, if the second event occurs as a consequence of the first, then in a way, the environmental factors of event#1 (pure ADD) are working in parallel with their anti-parallel (diametrically opposed) environmental factors of event II (contextual disorder). Except, the consequence of event#2 is disorder, permitting us to reverse the logic of this argument into the ***clash*** between env. factors of #1 and env factors of #2 ->->->- generating ->->->- contextual disorder.
Examine all of the many examples of env. factors (event #2) suggested here, in this thread, for example, and they will either prove to be immediately obviously 'bad' (unpleasant, unsatisfying to one and all) or 'bad' folowing just superficial scrutiny.
To qualify, my previous post on 'impulsive', 'planning into the future' ... was simply geared towards identifying that certain of those supposed 'orders' which define our 'disorder' tag ... are simply 'bad' (latter sub-type, that is, 'following just superfic...' ..:-)...).

So, to end, should the all-pervasiveness of environmental factor effect whether one needs consider that environmental factor, as factor ...?... and secondly, isn't it possible that an all-pervading factor might effect people to different extents - since even all-pervading may be graded ...?...

Examples of the first and second ... (not on the subject of ADD) ...
-air
-food

SB.

I never claimed ADD was a result of the environment, only that it's particular expression might be. Differences in symptomology and subtype between parent and child are not at all unusual. Which clearly points to more than just genes being at work.

My two sisters, are ADDers, and I'm an ADHDer.
I've observed how they have tendencies for being more 'subtle' in their ADD-ness, than I do.

They still have the same basic ADD behavioral traits, but they lack outwardly aggressive (not as in hostile, but as in the flagrant behavior) displays, in restlessness, boredom, etc.


Nova

Only that our society tends to work in ways that make our shortcomings even more of a problem for us, and also makes it difficult for us to use our strengths to compensate.

I don't believe being ADD makes me "Special". I also don't believe it makes me a cripple (though lord knows I've felt like one from time to time). Just as everyone else on earth there are things I'm good at and things I'm bad at. ADD just makes for different gifts and deficits than are common in the general population. It's a mistake to think of it as a pathology. By the same token it would be a mistake to not recognize the need for treatment. Ideally, treatment wouldn't be necessary because society would be more flexible, but that's not gonna happen any time soon.


I think about all the people, I've known, ADD/HDers and non-ADD/HDers alike.

Every single one of them, are gifted and deficient, in some 'areas'.
And most of them, recognize their own gifts/acknowledgements, as well as their deficiencies.

But...some focus more on their 'gifts', and are prone to recognizing the same in others, and some focus on their deficiencies, and are prone to recognizing deficiencies in others.

And some, are capable of recognizing how others have the 'gifts and deficiencies', just as they, in being human, do.


Until the entire world population, becomes a 'member' of the last 'category' I mentioned, there's always going to friction and inflexibility, among its members.


Nova

There's an argument (bear with me --- it'll feel as though I'm frying your brain) ... but not so Scrambled or over easy? :faint: I choose scrambled.:D

I need to let this soak in a little. I'll be back.

Scrambled or over easy?ADDers choose *scrambled* every time.
So what happens when outmoded Institutions buried anachronistically in history resist purchasing a 'scrambler', and take the 'over-easy' option.
A legion of young ADDers going hungry from lack of nourishment, unable to keep their over-easy 'sunny-side' down helpings down, down from their persistent contextual abuse from an 'over-easy' establishment resisting change, preferring the over-easy option, and then complaining when it begins to fail.
'What do you expect?" asks the young ADDer dude "What did you think taking the over-easy option would accomplish?"

Over-easy is b-o-r-i-n-g
b-o-r-i-n-g is bad
bad is b-a-d

One should avoid being tied to the tracks of a logical train of events; that'd be just be so 'Captain, that is illogical' ... {tender geek moment} ...

...:-)...SB...:-)[/url] ("][url=")

Lets get back on track. First I believe there are a few homogenous traits that all ADHDers share. Then there are homogenous traits that heterogeneous subgroups of ADHDers share.

Kvrdd identified what I believe to be a universal trait amongst ADHDers. The inability to stay on task, or for you "glass half full types", gifted in the department of spontaneity. :) Every ADHDer has that, even the SCTers. There may be a few other traits we also all share.

It seems like recent research is pointing to distinct groupings under the umbrella of ADHD. For instance there are a group of foggy ADHDers who are clearly different from the other ADHDers and deserve there own criteria. These subgroupings may have their own homogenous traits.

For instance, we shouldn't jump the gun and believe that all externalizing behaviour is the result or ADHDers reaction to the environment ...ie I feel bad therefore I lash out at the world. Folks like Dr. Breggin the quack antipsych put it that way.

DAD ATTENTION DEFICIT DISORDER (DADD) and TADD

In my clinical experience, most so-called ADHD children are not receiving sufficient attention from their fathers who are separated from the family, too preoccupied with work and other things, or otherwise impaired in their ability to parent. In many cases the appropriate diagnosis is Dad Attention Deficit Disorder (DADD) (Breggin, 1991).

The "cure" for these children is more rational and loving attention from their dads. Young people are nowadays so hungry for the attention of a father that it can come from any male adult. Seemingly impulsive, hostile groups of children will calm down when a caring, relaxed, and firm adult male is around. Arlington High School in Indianapolis was canceling many of its after-school events because of unruliness, when a father happened to attend one of them (Smith, 1993):

" That evening there was an odd quietness on [the father's] side of the auditorium. It turned out that when he would tell his group to settle down, some students would second him. One said: "That's Lena's father. You heard him. Be quiet; act right."" (p. 5)

Since then the school has begun to enlist volunteer dads for its after-school events.

At other times, the so-called disorder should be called TADD: Teacher Attention Deficit Disorder. Due more to problems in our educational system than to the teachers themselves, few students get the individualized educational programs that they need.


Instead, I think that you can argue that behaviour is controlled more by genetics then by the environment. Furthermore, you can argue that significant impairing behaviour is much more likely to be the result of a disorder then by the environment. Scattered signature states it well. "
"OF COURSE it can be connected to ADD !!!!!! Uncontrollable ANYTHING -- moving -- talking -- daydreaming -- fantasizing -- that's what ADD's about! The lack of inhibition!"--John Ratey" If you can't control your emotions (or for you "glass half full types" vibrant emotional expression :)) you are going to get mad much more often. This will happen with your spouse, your teachers, your dad, that stupid car in front of you....why did that jerk make a right without a signal? Beeeep Beeeeeeep!

Consider that life is not a Steven Speilburg movie...and it's not all dad's fault. We don't have to spend the rest of our lives chasing for his love to become whole. Those of us who are drama queens are just as likely to be that way because of the bit of genetic code we inherited. It can be a highly significant impulse problem that is impairing. Smiling loving handlers won't solve that problem, they may simply decrease the amount of emotional outbursts. So we could have lots of loving handlers and that would much better, until you step out into the real world and you are not the center of the universe.

Kvrdd identified what I believe to be a universal trait amongst ADHDers. The inability to stay on task, or for you "glass half full types", gifted in the department of spontaneity. :) Every ADHDer has that, even the SCTers. There may be a few other traits we also all share. Let's take this trait and ask the question,

"Why can't we focus and stay on task?"

Is it the anxiety (contextual) or the way the brain operates (physiological)?

Let's take this trait and ask the question,

"Why can't we focus and stay on task?"

Is it the anxiety (contextual) or the way the brain operates (physiological)?

What would cause the anxiety unless there is a real difference in us? If we are almost the same as "norms" we shouldn't get major anxiety to the point that we can't even stay on task in our daily routines. Even some the worst straight anxiety kids I see everyday have much better focus then the severe ADHD kids. Anxiety kids fail because high anxiety makes them drop out. ADHD kids fail because they don't get the work done and eventually fail too many courses. They are also expelled.

Interestingly the associtation between combo/hyperactive ADHD and anxiety is generally not too significant...especially when compared to ADHD/ ODD.

May be we can't focus because we see red all the time. :mad: :mad: ;) ;)

o.k can i come in here and put my 2 penny's worth in, i find it hard to stay on task and focus unless 1 i like it or 2 i'm under immense pressure!

So how come i find it takes all day to do one load of washing

But when my son took an overdose the other week, i could fully function my head was together immediatley.

When some kind of crisis happen i seem to work, what's that all about?

about?... all about intrinsically knowing what's important and what is not.
And being better able to do what's important and less able to do what is not.
And that is a part of ADD, though of course is also more general, though to be clear, I am stating that knowing what's actually important (over what we are told is important), an increased capacity for discriminating between the two (though importantly ostensibly on the subconscious level), is an important piece of the puzzle (the basis of ADD).

Really hope kiddy is OK ...

SB.

Well, if it were an issue of anxiety, then the disorder would be Anxiety, not ADHD. It is known that Anxiety causes ADHD-like symptoms. It is also known that those with ADHD are at risk for developing anxiety as well, but we're on the topic of pure-ADHD. Both anxiety and ADHD are physiological, and according to accepted standards, due to neurochemical imbalances.

Looking at this from a multitasking standpoint (using the Windows NT analogy), I think we may be truely multitasking in some ways. Are tasks attached to consoles (like in Unix) allowed to happen at the same time, though (sensory input), or are they more like Overlapped IO or one big sensory input demultiplexed by the brain (than multiple processes)? The brain isn't a sequential processing machine (at the base neurological level), so it would seem that multitasking would be possible (viewing it from a certain perspective, not necessarily multiple sequential processors running at the same time), though there always has to be limits. Foreground tasks, however, seem more like preemptive multitasking, with a very creatively designed "scheduler" to switch from task to task. That's at least from my highly subjective perspective.

But are our brains like non ADD brains, except we're locked out of the Task Manager and cannot kill processes or set process scheduling priorities? Are we missing features? Or are they like ADDers, but with a primitive operating system like DOS, which the remembering of appointments is implemented through Terminate and Stay Resident programming? Or are they more like real-time data acquisition systems?

Not trying to goad you. Just trying to get more info out of you. I know that personal experience doesn't necessarily shed much light on humanity in general. :-)Oh, E-boy.... I don't ever take you as "combative". You're not only open-minded (a true skeptic), but you're also tactful and don't seem to misunderstand my direct manner. I'm never bothered by "what about.....?" in response to my posts. Even as argumentative as Scuro gets, I know he's debating & discussing, not just being antagonistic. (a little ODD in there, Scuro?;))



It's not an exact match to population dynamics but close enough to be intrigueing (There is more variation within a population of a given species than there is between them). So, now I want more info so I can figure out what to make of that.I really think there's something to that analogy, and it's one I thought of myself. I was an anthropology minor as an undergrad and have always been interested in the social construct we call "race" and its effects on development.

I also know some people that have spent the past few years working on the race-bias issue & seem to have teased out something that I've been saying for nearly a decade -- that what's being measured and called "race-bias" is not actually a result of race differences. It's an ingroup-outgroup bias. Outgroup members are always less likely to be preferred, regardless of what characterizes them as an outgroup member.

I wish I had citations handy for intra-culture environmental differences, but I just don't and I don't have time to dig them up. I'm really sorry. If I think of anything, I'll post it.

LOL LOL..I love it..barbyma Resident Blabbermouth-Know-It-All

:D :D :D
hehehe...when did you change it??As soon as I hit 2000!


"The-WASHING-Loving-Moderator"

Let me guess: OCD? :p

I just think an ADD friendly environment would rid us of much of the crap that accompanies ADD and allow us to capitolize on our gifts and downplay our less than great symptoms.You know, there's been a lot of talk about this on the ADDF. Many have suggested that a "more ADD-friendly" school environment would work, too.

What I haven't seen, though, is any discussion of just what that environment would be like.

How would a school or work environment "take advantage" of ADD?

My guess: there is no way to do this. Just like all of our impairments are different, our "benefits" are different.


Defining ADD by only the deficits is like defining people by only their negative character traits.Agreed, but are there positive characteristics (common enough to be diagnostic tools)? I believe that what some are able to take advantage of are hinderances to others.

Just an example: I'm able to get a lot of information from a cursory read of most material. As a result (at least pre-meds) I am able to do about 10 times the amount of work as others in a given time frame.

For most people, however, a deeper understanding requires attention to detail. I could not stay on task, so if I needed that much detail I would never have made it through school. In fact, I wouldn't have passed my qualifying exams (for PhD) without meds because too much of the information was relatively new to me; I needed more detail.


I also don't believe it makes me a cripple (though lord knows I've felt like one from time to time). Perhaps if I never experienced the hormone drops that come with age I'd feel the same way. The behaviors I engaged in during my 20s that I now attribute to ADHD were irritating, but not crippling.

Now, however, I am certainly crippled without Adderall. I couldn't function.


Ideally, treatment wouldn't be necessary because society would be more flexible, but that's not gonna happen any time soon.
Perhaps it's because I live in southern californa, but my environment is pretty flexible. There is absolutely nothing I can think of, though, that "society" could do to relieve my impairments other than what society has done - developed medication to treat it.

Differences in symptomology and subtype between parent and child are not at all unusual. Which clearly points to more than just genes being at work.

Well does it?...and how can you be so darn sure? A study related to the issue.

http://www.blackwell-synergy.com/links/doi/10.1111%2Fj.1469-7610.2004.00248.x

Familial clustering of latent class and DSM-IV defined attention-deficit/hyperactivity disorder (ADHD) subtypes
Erik R. Rasmussen1, Rosalind J. Neuman1, Andrew C. Heath1, Florence Levy2, David A. Hay3, Richard D. Todd1

Background: Findings from family and twin-based studies of Attention Deficit/Hyperactivity Disorder (ADHD) have indicated that inattentive and combined subtypes cluster together among sibling pairs who both express ADHD symptoms. The current report examines the familial clustering of ADHD subtypes, defined according to latent class and DSM-IV criteria, in a general population sample of 2,848 Australian twins, 1,013 of their non-twin siblings and 4,036 female twins from Missouri, USA. Significant clustering of DSM-IV inattentive and combined subtypes, and significant clustering of the same latent classes among siblings was predicted.

Method: Logistic regression was used to assess 1) the clustering of same and different subtype combinations among twin and twin-sibling pairs and 2) whether genetic influences contribute significantly to the observed patterns of subtype combinations among siblings.

Results: With the exception of the DSM-IV hyperactive-impulsive subtype and the severe hyperactive-impulsive latent class, all other sibling DSM-IV and latent class ADHD subtypes consistently exhibited significant same-subtype clustering with MZ probands, DZ probands and their siblings in both samples. Furthermore, a significant genetic influence contributing to subtype concordance was detected for every DSM-IV subtype excluding hyperactive-impulsive, and for all eight latent classes. While some instances of significant different-subtype clustering among siblings was observed across both classification systems and samples, the particular subtype combinations involved were largely inconsistent across samples and no significant genetic influences contributing towards these discordant subtype combinations were detected.

Conclusions: For both DSM-IV and latent class subtypes, the overall pattern of findings in both samples indicated significant familial clustering of same-subtype combinations and significant genetic influences contributing to these patterns of subtype concordance, despite important sample differences. These findings further extend previous work and are most consistent with the presence of multiple independent forms of ADHD.

(a little ODD in there, Scuro?;))
They talk about different characteristics coming out at different times in childhood and that these times are even further delayed for the inattentive subtype. I was such a sweet boy...oh no, that PROVES the contexual "disorder" theory!! :eek: :rolleyes: ;)

You know, there's been a lot of talk about this on the ADDF. Many have suggested that a "more ADD-friendly" school environment would work, too.

What I haven't seen, though, is any discussion of just what that environment would be like.

How would a school or work environment "take advantage" of ADD?

Perfect teaching environment for an ADHDer...highly stimulating, with frequent immediate rewards. Think video game....lots of bells and whistles going off with beautiful graphics or dead bodies flying over the hood. Many visual changes...but better than that, you get power packs and points constantly. Funny thing, I read a recent study where I believe it said that ADHDers don't even score higher on those games compared to norms. This point leads nicely into the next.



Agreed, but are there positive characteristics (common enough to be diagnostic tools)? I believe that what some are able to take advantage of are hinderances to others.
Interesting concept which is being peddled around in the PC self-help section of your neighbourhood coffee/book store. If ADHDers had a positive trait that was really measurably superior, it would have happened already. That characteristic would be in the DSM4. Take a look at the studies in the creativity thread. No significant difference in creativity between norms and ADHDers.




Just an example: I'm able to get a lot of information from a cursory read of most material. As a result (at least pre-meds) I am able to do about 10 times the amount of work as others in a given time frame.
Barb, I'm usually with you all the way until you get into the personal anecdote. I don't know how you got swayed into doing that as a basis for make a point. Must be all the gripping stories you have read on ADDF. ;) Besides that, you of all people should know, you are not the typical ADHDer.

They talk about different characteristics coming out at different times in childhood and that these times are even further delayed for the inattentive subtype. I was such a sweet boy...oh no, that PROVES the contexual "disorder" theory!! :eek: :rolleyes: ;)
Or perhaps it's some emerging property?? :p:D;)

Perfect teaching environment for an ADHDer...highly stimulating, with frequent immediate rewards.
I can certainly see this as better, but I think it would be more ideal for all children. What can be done that benefits ADHDers differently?



If ADHDers had a positive trait that was really measurably superior, it would have happened already. That characteristic would be in the DSM4. Take a look at the studies in the creativity thread. No significant difference in creativity between norms and ADHDers. I'm not disagreeing with you on this.

But, I do believe that there are minority clusters of people that benefit from some ADHD symptoms. In fact, I believe this is true for many (perhaps even most) disorders. The reason correlations don't show up may be that these few positives are balanced by many severe negatives, so there may be more variance (nobody's looked at variance that I know of), but the mean isn't different.

The only disorder that I know of that has correlated with anything positive is bipolar disorder, and there are still plenty of sufferers that experience absolutely nothing positive.



Barb, I'm usually with you all the way until you get into the personal anecdote. I don't know how you got swayed into doing that as a basis for make a point.You keep mistaking my examples for evidence. :rolleyes: I wasn't providing evidence with the anecdote, just illustrating my hypothesis with an example.

And, no, I don't see myself as typical. I think my example also provides a pretty clear explanation for why it was an advantage for me and not others.

The hypothesis isn't easily testable, but I think it's interesting and examining it helps me to better understand my own difficulties & successes, stregths & weaknesses.

Or perhaps it's some emerging property?? :p:D;)

This is off topic but for fun, lets look at me and ODD

* frequent temper tantrums
* excessive arguments with adults
* refusal to comply with adult requests
* always questioning rules; refusal to follow rules
* behavior intended to annoy or upset others, including adults
* blaming others for his/her misbehaviors or mistakes
* easily annoyed by others
* frequently has an angry attitude
* speaking harshly, or unkind
* deliberately behaving in ways that seek revenge

I wouldn't have ever qualified for this diagnosis although I do have some mild ODD like tendencies. What the symptoms speak too is poor emotional regulation (one of the executive functions) and you can have difficulties in this area and never be ODD. It's absolutly remarkable that 60% of the hyper and combos would qualify for this diagnosis at some point in their childhood.

But, I do believe that there are minority clusters of people that benefit from some ADHD symptoms. In fact, I believe this is true for many (perhaps even most) disorders. The reason correlations don't show up may be that these few positives are balanced by many severe negatives, so there may be more variance (nobody's looked at variance that I know of), but the mean isn't different.

The only disorder that I know of that has correlated with anything positive is bipolar disorder, and there are still plenty of sufferers that experience absolutely nothing positive.
I know of another disorder, Barb. There is a movement among the people with severe dissociative orders for what is called "Functional Multiplicity". If a person with MPD, now called Dissociative Identity Disorder, can get the system of alternate personalities to cooperate internally (IE not in control of the body), these groups can then each handle some type of task while the external self works on something else. Kind of like a computer running several programs at once.

And it has been proven to be possible for a small portion of those with DID, and that skill might be a positive trait in this society. Of course I would not be able to provide statistics or studies on this phenomena, I can only offer this information up as an example of "Disorder Gone Right". :)

It's absolutly remarkable that 60% of the hyper and combos would qualify for this diagnosis at some point in their childhood.I don't see it as all that extraordinary. The brain is a VERY complex system. Problems in one area will undoubtably affect other areas. If those areas start in the tails of a distribution, the influence can put them over the edge.

A good analogy is the biosystem. If, for some reason, the temperature changed drastically in one of the Earth's oceans, everything on the planet would be affected. If salt doesn't sink to the bottom, it won't influence the flow. If the flow changes course, the weather changes. If algae were to die because of temperature changes, we'd be in trouble because they produce 80% of the oxygen we breathe (trees really aren't that valuable for this purpose).

At least 50% of bipolars qualify for ADHD dx, but that comorbidity is only one-way. Anxiety seems to be comorbid with as many disorders as ADHD is (alth