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#1
08-13-04, 04:38 AM
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international consensus statement on adhd
International Consensus Statement on ADHD
January 2002 We, the undersigned consortium of international scientists, are deeply concerned about the periodic inaccurate portrayal of attention deficit hyperactivity disorder (ADHD) in media reports. This is a disorder with which we are all very familiar and toward which many of us have dedicated scientific studies if not entire careers. We fear that inaccurate stories rendering ADHD as myth, fraud, or benign condition may cause thousands of sufferers not to seek treatment for their disorder. It also leaves the public with a general sense that this disorder is not valid or real or consists of a rather trivial affliction. We have created this consensus statement on ADHD as a reference on the status of the scientific findings concerning this disorder, its validity, and its adverse impact on the lives of those diagnosed with the disorder as of this writing (January 2002). Occasional coverage of the disorder casts the story in the form of a sporting event with evenly matched competitors. The views of a handful of non-expert doctors that ADHD does not exist are contrasted against mainstream scientific views that it does, as if both views had equal merit. Such attempts at balance give the public the impression that there is substantial scientific disagreement over whether ADHD is a real medical condition. In fact, there is no such disagreement --at least no more so than there is over whether smoking causes cancer, for example, or whether a virus causes HIV/AIDS. The U.S. Surgeon General, the American Medical Association (AMA), the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry (AACAP), the American Psychological Association, and the American Academy of Pediatrics (AAP), among others, all recognize ADHD as a valid disorder. While some of these organizations have issued guidelines for evaluation and management of the disorder for their membership, this is the first consensus statement issued by an independent consortium of leading scientists concerning the status of the disorder. Among scientists who have devoted years, if not entire careers, to the study of this disorder there is no controversy regarding its existence. ADHD and Science We cannot over emphasize the point that, as a matter of science, the notion that ADHD does not exist is simply wrong. All of the major medical associations and government health agencies recognize ADHD as a genuine disorder because the scientific evidence indicating it is so is overwhelming. Various approaches have been used to establish whether a condition rises to the level of a valid medical or psychiatric disorder. A very useful one stipulates that there must be scientifically established evidence that those suffering the condition have a serious deficiency in or failure of a physical or psychological mechanism that is universal to humans. That is, all humans normally would be expected, regardless of culture, to have developed that mental ability. And there must be equally incontrovertible scientific evidence that this serious deficiency leads to harm to the individual. Harm is established through evidence of increased mortality, morbidity, or impairment in the major life activities required of one's developmental stage in life. Major life activities are those domains of functioning such as education, social relationships, family functioning, independence and self-sufficiency, and occupational functioning that all humans of that developmental level are expected to perform. As attested to by the numerous scientists signing this document, there is no question among the world's leading clinical researchers that ADHD involves a serious deficiency in a set of psychological abilities and that these deficiencies pose serious harm to most individuals possessing the disorder. Current evidence indicates that deficits in behavioral inhibition and sustained attention are central to this disorder -- facts demonstrated through hundreds of scientific studies. And there is no doubt that ADHD leads to impairments in major life activities, including social relations, education, family functioning, occupational functioning, self-sufficiency, and adherence to social rules, norms, and laws. Evidence also indicates that those with ADHD are more prone to physical injury and accidental poisonings. This is why no professional medical, psychological, or scientific organization doubts the existence of ADHD as a legitimate disorder. The central psychological deficits in those with ADHD have now been linked through numerous studies using various scientific methods to several specific brain regions (the frontal lobe, its connections to the basal ganglia, and their relationship to the central aspects of the cerebellum). Most neurological studies find that as a group those with ADHD have less brain electrical activity and show less reactivity to stimulation in one or more of these regions. And neuro-imaging studies of groups of those with ADHD also demonstrate relatively smaller areas of brain matter and less metabolic activity of this brain matter than is the case in control groups used in these studies. These same psychological deficits in inhibition and attention have been found in numerous studies of identical and fraternal twins conducted across various countries (US, Great Britain, Norway, Australia, etc.) to be primarily inherited. The genetic contribution to these traits is routinely found to be among the highest for any psychiatric disorder (70-95% of trait variation in the population), nearly approaching the genetic contribution to human height. One gene has recently been reliably demonstrated to be associated with this disorder and the search for more is underway by more than 12 different scientific teams worldwide at this time. Numerous studies of twins demonstrate that family environment makes no significant separate contribution to these traits. This is not to say that the home environment, parental management abilities, stressful life events, or deviant peer relationships are unimportant or have no influence on individuals having this disorder, as they certainly do. Genetic tendencies are expressed in interaction with the environment. Also, those having ADHD often have other associated disorders and problems, some of which are clearly related to their social environments. But it is to say that the underlying psychological deficits that comprise ADHD itself are not solely or primarily the result of these environmental factors. This is why leading international scientists, such as the signers below, recognize the mounting evidence of neurological and genetic contributions to this disorder. This evidence, coupled with countless studies on the harm posed by the disorder and hundreds of studies on the effectiveness of medication, buttresses the need in many, though by no means all, cases for management of the disorder with multiple therapies. These include medication combined with educational, family, and other social accommodations. This is in striking contrast to the wholly unscientific views of some social critics in periodic media accounts that ADHD constitutes a fraud, that medicating those afflicted is questionable if not reprehensible, and that any behavior problems associated with ADHD are merely the result of problems in the home, excessive viewing of TV or playing of video games, diet, lack of love and attention, or teacher/school intolerance. ADHD is not a benign disorder. For those it afflicts, ADHD can cause devastating problems. Follow-up studies of clinical samples suggest that sufferers are far more likely than normal people to drop out of school (32-40%), to rarely complete college (5-10%), to have few or no friends (50-70%), to under perform at work (70-80%), to engage in antisocial activities (40-50%), and to use tobacco or illicit drugs more than normal. Moreover, children growing up with ADHD are more likely to experience teen pregnancy (40%) and sexually transmitted diseases (16%), to speed excessively and have multiple car accidents, to experience depression (20-30%) and personality disorders (18-25%) as adults, and in hundreds of other ways mismanage and endanger their lives. Yet despite these serious consequences, studies indicate that less than half of those with the disorder are receiving treatment. The media can help substantially to improve these circumstances. It can do so by portraying ADHD and the science about it as accurately and responsibly as possible while not purveying the propaganda of some social critics and fringe doctors whose political agenda would have you and the public believe there is no real disorder here. To publish stories that ADHD is a fictitious disorder or merely a conflict between today's Huckleberry Finns and their caregivers is tantamount to declaring the earth flat, the laws of gravity debatable, and the periodic table in chemistry a fraud. ADHD should be depicted in the media as realistically and accurately as it is depicted in science -- as a valid disorder having varied and substantial adverse impact on those who may suffer from it through no fault of their own or their parents and teachers. Sincerely, Russell A. Barkley, Ph.D. Professor Depts. Of Psychiatry and Neurology University of Massachusetts Medical School 55 Lake Avenue North Worcester, MA 01655 , Edwin H. Cook, Jr., M.D. Professor Departments of Psychiatry and Pediatrics University of Chicago 5841 S. Maryland Ave. Chicago, IL Mina Dulcan, M.D. Professor Department of Child and Adolescent Psychiatry 2300 Children’s Plaza #10 Children’s Memorial Hospital Chicago, IL 60614 Susan Campbell, Ph.D. Professor Department of Psychology 4015 O’Hara Street University of Pittsburgh Pittsburgh, PA 15260 Margot Prior, Ph.D. Professor Department of Psychology Royal Children’s Hospital Parkville, 3052 VIC Australia Marc Atkins, Ph.D. Associate Professor University of Illinois at Chicago Institute for Juvenile Research Department of Psychiatry 840 South Wood Street, Suite 130 Chicago, IL 60612-7347 Christopher Gillberg, M.D. Professor Department of Child and Adolescent Psychiatry University of Gothenburg Gothenburg, Sweden Mary Solanto-Gardner, Ph.D. Associate Professor Division of Child and Adolescent Psychiatry The Mt. Sinai Medical Center One Gustave L. Levy Place New York, NY 10029-6574 Jeffrey Halperin, Ph.D. Professor, Department of Psychology Queens College, CUNY 65-30 Kissena Ave. Flushing, NY 11367 Jose J. Bauermeister, Ph.D. Professor, Department of Psychology University of Puerto Rico San Juan, PR 00927 Steven R. Pliszka, M.D. Associate Professor and Chief Division of Child and Adolescent Psychiatry University of Texas Health Sciences Center 7703 Floyd Curl Drive San Antonio, TX 78229-3900 Mark A. Stein, Ph.D. Chair of Psychology Children’s National Medical Center and Professor of Psychiatry & Pediatrics George Washington Univ. Med. School 111 Michigan Ave. NW Washington, DC 20010 John S. Werry, M.D. Professor Emeritus Department of Psychiatry University of Auckland Auckland, New Zealand Joseph Sergeant, Ph.D. Chair of Clinical Neuropsychology Free University Van der Boecharst Straat 1 De Boelenlaan 1109 1018 BT Amsterdam The Netherlands Ronald T. Brown, Ph.D. Associate Dean, College of Health Professions Professor of Pediatrics Medical University of South Carolina 19 Hagood Avenue P. O. Box 250822 Charleston, SC 29425 Alan Zametkin, M.D. Child Psychiatrist Kensington, MD Arthur D. Anastopoulos, Ph.D. Professor, Co-Director of Clinical Training Department of Psychology University of North Carolina at Greensboro P. O. Box 26164 Greensboro, NC 27402-6164 James J. McGough, M.D. Associate Professor of Clinical Psychiatry UCLA School of Medicine 760 Westwood Plaza Los Angeles, CA 90024 George J. DuPaul, Ph.D. Professor of School Psychology Lehigh University 111 Research Drive, Hilltop Campus Bethlehem, PA 18015 Stephen V. Faraone, Ph.D. Associate Professor of Psychology Harvard University 750 Washington St., Suite 255 South Easton, MA 02375 Florence Levy, M.D. Associate Professor School of Psychiatry University of New South Wales Avoca Clinic Joynton Avenue Zetland, NSW, 2017, Australia Mariellen Fischer, Ph.D. Professor, Department of Neurology Medical College of Wisconsin 9200 W. Wisconsin Avenue Milwaukee, WI 53226 Joseph Biederman, M.D. Professor and Chief Joint Program in Pediatric Psychopharmacology Massachusetts General Hospital and Harvard Medical School 15 Parkman St., WACC725 Boston, MA 02114 Cynthia Hartung, Ph.D. Assistant Professor Oklahoma State University 215 North Murray Stillwater, OK 74078 Stephen Houghton, Ph.D. Professor of Psychology Director, Centre for Attention & Related Disorders The University of Western Australia Perth, Australia Gabrielle Carlson, M.D. Professor and Director, Division of Child and Adolescent Psychiatry State University of New York at Stony Brook, Putnam Hall Stony Brook, NY 11794 Charlotte Johnston, Ph.D. Professor Department of Psychology University of British Columbia 2136 West Mall Vancouver, BC, Canada V6T 1Z4 Thomas Spencer, M.D. Associate Professor and Assistant Director, Pediatric Psychopharmacology Harvard Medical School and Massachusetts General Hospital 15 Parkman St., WACC725 Boston, MA 02114 Thomas Joiner, Ph.D. The Bright-Burton Professor of Psychology Florida State University Tallahassee, FL 32306-1270 Rosemary Tannock, Ph.D. Professor of Psychiatry, Brain and Behavior Research Hospital for Sick Children 55 University Avenue Toronto, Ontario, Canada M5G 1X8 Adele Diamond, Ph.D. Professor of Psychiatry Director, Center for Developmental Cognitive Neuroscience University of Massachusetts Medical School Shriver Center Trapelo Rd. Waltham, MA Carol Whalen, Ph.D. Professor Department of Psychology and Social Behavior University of California at Irvine 3340 Social Ecology II Irvine, CA 02215 Stephen P. Hinshaw, Ph.D. Professor, Department of Psychology #1650 University of California at Berkeley 3210 Tolman Hall Berkeley, CA 94720-1650 Herbert Quay, Ph.D. Professor Emeritus University of Miami 2525 Gulf of Mexico Drive, #5C Long Boat Key, FL 34228 John Piacentini, Ph.D. Associate Professor Department of Psychiatry UCLA Neuropsychiatric Institute 760 Westwood Plaza Los Angeles, CA 90024-1759 Philip Firestone, Ph.D. Professor Departments of Psychology & Psychiatry University of Ottawa 120 University Priv. Ottawa, Canada K1N 6N5 Salvatore Mannuzza, M.D. Research Professor of Psychiatry New York University School of Medicine 550 First Avenue New York, NY 10016 Howard Abikoff, Ph.D. Pevaroff Cohn Professor of Child and Adolescent Psychiatry NYU School of Medicine Director of Research NYU Child Study Center 550 First Avenue New York, NY 10016 Keith McBurnett, Ph.D. Associate Professor Department of Psychiatry University of California at San Francisco Children’s Center at Langley Porter 401 Parnassus Avenue, Box 0984 San Francisco, CA 94143 Linda Pfiffner, Ph.D. Associate Professor Department of Psychiatry University of California at San Francisco Children’s Center at Langley Porter 401 Parnassus Avenue, Box 0984 San Francisco, CA 94143 Oscar Bukstein, M.D. Associate Professor Department of Psychiatry Western Psychiatric Institute and Clinic 3811 O’Hara Street Pittsburgh, PA 15213 Ken C. Winters, Ph.D. Associate Professor Director, Center for Adolescent Substance Abuse Research Department of Psychiatry University of Minnesota F282/2A West, 2450 Riverside Ave. Minneapolis, MN 55454 Michelle DeKlyen, Ph.D. Office of Population Research Princeton University 286 Wallace Princeton, NJ 08544 Lily Hechtman M.D. F.R.C.P. Professor of Psychiatry and Pediatrics, Director of Research, Division of Child Psychiatry, McGill University, and Montreal Childrens Hospital. 4018 St. Catherine St. West., Montreal, Quebec, Canada. H3Z-1P2 Caryn Carlson, Ph.D. Professor Department of Psychology University of Texas at Austin Mezes 330 Austin, TX 78712 Donald R. Lynam, Ph.D. Associate Professor University of Kentucky Department of Psychology 125 Kastle Hall Lexington, KY 40506-0044 Patrick H. Tolan Ph.D. Director, Institute for Juvenile Research Professor, Department of Psychiatry University of Illinois at Chicago 840 S. Wood Street Chicago, IL 60612 Jan Loney, Ph.D. Professor Emeritus State University of New York at Stony Brook Lodge Associates (Box 9) Mayslick, KY 41055 Harold S. Koplewicz,M.D. Arnold and Debbie Simon Professor of Child and Adolescent Psychiatry and Director of the NYU Child Study Center New York, NY Richard Milich, Ph.D. Professor of Psychology Department of Psychology University of Kentucky Lexington, KY 40506-0044 Laurence Greenhill, M.D. Professor of Clinical Psychiatry Columbia University Director, Research Unit on Pediatric Psychopharmacology New York State Psychiatric Institute 1051 Riverside Drive New York, NY 10032 Eric J. Mash, Ph.D. Professor Department of Psychology University of Calgary 2500 University Drive N.W. Calgary, Alberta T2N 1N4 Russell Schachar, M.D. Professor of Psychiatry Hospital for Sick Children 555 University Avenue Toronto, Ontario Canada M5G 1X8 Eric Taylor Professor of Psychiatry Institute of Psychiatry London, England Betsy Hoza, Ph.D. Associate Professor Department of Psychology, #1364 Purdue University West Lafayette, IN 47907-1364 Mark. D. Rapport, Ph.D. Professor and Director of Clinical Training Department of Psychology P.O. Box 161390 University of Central Florida Orlando, Florida 32816-1390 Bruce Pennington, Ph.D. Professor Department of Psychology University of Denver 2155 south Race Street Denver, CO 80208 Anita Thapar MB BCh, MRCPsych, PhD Professor, Child and Adolescent Psychiatry Section Dept of Psychological Medicine University of Wales College of Medicine Heath Park, Cardiff CF14 4XN United Kingdom Ann Teeter, Ed.D. Director of Training, School Psychology University of Wisconsin – Milwaukee Milwaukee, WI 53201 Stephen Shapiro, Ph.D. Department of Psychology Auburn University 226 Thach Auburn, AL 36849-5214 Avi Sadeh, D.Sc Director, Clinical Child Psychology Graduate Program Director, The Laboratory for Children's Sleep Disorders Department of Psychology Tel-Aviv University Ramat Aviv, Tel Aviv 69978 ISRAEL Bennett L. Leventhal, M.D. Irving B. Harris Professor of Child and Adolescent Psychiatry Director, Child & Adolescent Psychiatry Vice Chairman, Dept. of Psychiatry The University of Chicago 5841 S. Maryland Ave. Chicago, IL 60637 Hector R. Bird, M.D. Professor of Clinical Psychiatry Columbia University College of Physicians and Surgeons 1051 Riverside Drive (Unit 78) New York, NY 10032 Carl E. Paternite, Ph.D. Professor of Psychology Miami University Oxford, OH 45056 Mary A. Fristad, PhD, ABPP Professor, Psychiatry & Psychology Director, Research & Psychological Services Division of Child & Adolescent Psychiatry The Ohio State University 1670 Upham Drive Suite 460G Columbus, OH 43210-1250 Brooke Molina, Ph.D. Assistant Professor of Psychiatry and Psychology Western Psychiatric Institute and Clinic University of Pittsburgh School of Medicine 3811 O'Hara Street Pittsburgh, PA 15213 Sheila Eyberg, PhD, ABPP Professor of Clinical &Health Psychology Box 100165 1600 SW Archer Blvd. University of Florida Gainesville, FL 32610 Rob McGee,PhD Associate Professor, Department of Preventive & Social Medicine, University of Otago Medical School, Box 913 Dunedin, New Zealand. Terri L. Shelton, Ph.D. Director Center for the Study of Social Issues University of North Carolina – Greensboro Greensboro, NC 27402 Steven W. Evans, Ph.D. Associate Professor of Psychology MSC 1902 James Madison University Harrisonburg, VA 22807 Sandra K. Loo, Ph.D. Research Psychologist University of California, Los Angeles Neuropsychiatric Institute 760 Westwood Plaza, Rm 47-406 Los Angeles, CA 90024 William Pelham, Jr., Ph.D. Professor of Psychology Center Children and Families State University of New York at Buffalo 318 Diefendorf Hall 3435 Main Street, Building 20 Buffalo, NY 14214 J. Bart Hodgens, Ph.D. Clinical Assistant Professor of Psychology and Pediatrics Civitan International Research Center University of Alabama at Birmingham Birmingham, AL 35914 Terje Sagvolden, Ph.D. Professor Department of Physiology University of Oslo N-0316 Oslo, Norway Thomas E. Brown, Ph.D. Asst. Professor Dept. of Psychiatry Yale University School of Medicine New Haven, CT Daniel F. Connor, M.D. Associate Professor Department of Psychiatry University of Massachusetts Medical School 55 Lake Avenue North Worcester, MA 01655 Daniel A. Waschbusch, Ph.D. Assistant Professor of Psychology Director, Child Behaviour Program Department of Psychology Dalhousie University Halifax, NS B3H 4R1 CANADA Kevin R. Murphy, Ph.D. Assistant Professor Dept. of Psychiatry University of Massachusetts Medical School 55 Lake Avenue North Worcester, MA 01655 Michael Aman, Ph.D. Professor of Psychology and Psychiatry The Nisonger Center Ohio State University 1581 Dodd Drive Columbus, Ohio, U.S.A. Blythe Corbett, Ph.D. M.I.N.D. Institute University of California, Davis 4860 Y Street, Suite 3020 Sacramento, CA 95817 Deborah L. Anderson, Ph.D. Assistant Professor Department Pediatrics Medical University of South Carolina Charleston, SC 29425 Lisa L. Weyandt, Ph.D. Professor, Dept. of Psychology Central Washington University 400 East 8th Avenue Ellensburg, WA 98926-7575 Michael Gordon, Ph.D. Professor of Psychiatry Director, Child & Adolescent Psychiatric Services, & Director, ADHD Program SUNY Upstate Medical University 750 East Adams Street Syracuse, NY 13210 Lawrence Lewandowski, Ph.D. Meredith Professor of Teaching Excellence Department of Psychology Syracuse University Syracuse, NY Erik Willcutt, Ph.D. Assistant Professor Department of Psychology Muenzinger Hall D-338 345 UCB University of Colorado Boulder, CO 80309
__________________
"come to the edge,' he said. they said: 'we are afraid.' 'come to the edge.' they came. he pushed them...and they flew." (apollinaire) "what do we know but that we face one another in this place?" (yeats) 
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#2
04-28-12, 12:22 AM
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Re: international consensus statement on adhd
Dear Gabriela, thank you so much for taking the time and trouble to post this consensus. Right at this moment I am very, very over being misunderstood, dismissed, etc etc etc so I found this post very reassuring in a nice, comfy, scholarly, no bs kind of way!
Cheers to you 
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mctavish23 (08-09-12), stacypcruz (02-06-13) | ||
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