Ethnic and geographical hotspots of ADHD

[Overthesky1119]

Hey, I thought of opening this thread and starting with a BBC-documentary about ADHD in Egypt

http://www.youtube.com/watch?v=W-avhR0Vohg

I was told before (by well-renownend ADHD experts in Germany) that actually in Japan there is a higher prevalence of ADHD which is associated to the Hikikomori phenomenen in Japanese society and so on... additionally I asked if the Sinti and Roma can be considered an ethnic hotspot of ADHD which was answered with the same view ("...the Sinti and Roma, the Aborigines and the Apaches...")... of course this is all direction Thom Hartmann and Hunter Farmer Theory... I apoligize for my at some points perhaps insufficient English as I am not a native speaker and have also never written in English-speaking adhd forums (although much in German language ADHD forums)... what do you think about ethnic and geographic hotspots of ADHD?

[Overthesky1119]

The following applies only for cases of mild to middle-grade ADHD (severe cases of ADHD are indeed im many ways too deficient too take advantage of the ressources which are related to ADHD in the hunter-farmer-context):
But with the adequate stimulation for your ADHD-brain, you are able to achieve fantastic things. Sensation Seeking and so called Adrenaline-Junkies, there is a strong connection to ADHD.
Thom Hartmann issues (of course insufficiently) the advantages of the activation-dependent ADHD-brain in his book: "ADHD and the Edison Gene" e.g. with section: „…Cultural anthropologist Jay Fikes, Ph.D. , points out that members of traditional Native American hunting tribes normally behave differently from those who have traditionally been farmers. The farmers such as the Hopi and other Pueblo tribes are relatively sedate and risk-averse, he says, whereas the hunters, such as the Navajo, are „constantly scanning their environment and are more immediately sensitive to nuances. They´re also the ultimate risk takers. They and the Apaches were great raiders and warriors.“….“
When it matters most, when facing the most dangerous situations, as a person with (at least low- to middle-grade ADHD) ADHD one is performing better than normal people, be it as combattants in militia fighting in densely-build urban areas or Guerilla-warfare, be it as thieves (in my opinion there aren´t any better and more successful thieves than people with ADHD ), be it as a medic in emergency situations, be it as a Nescar-driver or be it, as it used to be in paleolithic ages, as a hunter hunting mammoths, deer and else.
Thom Hartmann issues the advantages of low- to middle-grade ADHD in nomadic hunting soscieties and I am linking this here: https://books.google.de/books?id=wmA...20adhd&f=false
In this context I also get thinking of Ninja and their Guerilla-warfare tactics as the ideal model of ADHD in medieval Japan versus their opponents without ADHD , the Samurai

[Little Missy]

Roll of the dice.

[Lunacie]

My opinion of how much of a percentage of the population in any location may
have ADHD depends mostly on how well it's recognized and diagnosed.

I don't think this is a racial or geographic trait by any means like some diseases
or disorders are. It may be amplified by the type of society in which a person
lives. Some societies accept people with different mental abilities while others
ostracize them and deem them un-fit.

And I simply don't buy the hunter/gatherer theory.

[Overthesky1119]

I admit that the Thom Hartmann Hunter Farmer Theory is a model which describes the complex reality only in a very incomplete und insufficient way... nevertheless there is a real core in the hunter farmer theory in my opinion... originally I wanted to open a topic about hotspots in frequency of ADHD in certain geographical locations or ethnicities in connection with evolutionary aspects of ADHD and not retell Thom Hartmann. There may be environmental circumstances which over the centuries may have proved as a positive evolutionary selective factor for ADHD genes (whereas other environments may have been an evolutionary disadvantage to ADHD genes)... of course I think of various formerly nomadic ethnicities everywhere on the world... I also think that geographic isolation over the centuries may have contributed to at some places higher prevalences of ADHD, in the context of geographical isolation and higher prevalences of ADHD I have been told Crete, Japan and Iceland... I admit that there is no real scientific proof for these assumptions but this should be seen as a contribution for discussion...

[20thcenturyfox]

e.g.
" The regions represented were Africa (four studies), Asia (15), Europe (32), the Middle East (four), North America (32), Oceania (six), and South America (nine). The main finding was that the variation in prevalence associated with the samples’ geographic origin did not fit a pattern consistent with the notion that ADHD is a byproduct of American culture. The North American rate (6.2%) only slightly exceeded the European rate (4.6%). The highest rates emerged from Africa (8.5%) and South America (11.8%). Corroboration comes from a dimensional ADHD scale used in 21 countries. Japanese and Finnish children scored lowest, Jamaican and Thai children scored highest, and American children scored about average (7) ."

from comment on: The worldwide prevalence of ADHD: a systematic review and metaregression analysis.
Polanczyk G1, de Lima MS, Horta BL, Biederman J, Rohde LA.
https://ajp.psychiatryonline.org/doi...2007.164.6.856

Conclusion BTW was that prevalence is roughly uniform, as apparent differences tend to disappear when differences in methods, sampling, definitions, etc are taken into account.

Further to your idea of hotspots, though, I would agree that grouping results by large regions would tend to obscure any really interesting differences arising from, say, fish consumption, pesticide exposure, refugee migrations, etc.

[20thcenturyfox]

Originally Posted by Overthesky1119

....
Thom Hartmann issues (of course insufficiently) the advantages of the activation-dependent ADHD-brain in his book: "ADHD and the Edison Gene" e.g. with section: „…Cultural anthropologist Jay Fikes, Ph.D. , points out that members of traditional Native American hunting tribes normally behave differently from those who have traditionally been farmers. The farmers such as the Hopi and other Pueblo tribes are relatively sedate and risk-averse, he says, whereas the hunters, such as the Navajo, are „constantly scanning their environment and are more immediately sensitive to nuances. They´re also the ultimate risk takers. They and the Apaches were great raiders and warriors.“….“
When it matters most, when facing the most dangerous situations, as a person with (at least low- to middle-grade ADHD) ADHD one is performing better than normal people, be it as combattants in militia fighting in densely-build urban areas or Guerilla-warfare, be it as thieves (in my opinion there aren´t any better and more successful thieves than people with ADHD ), be it as a medic in emergency situations, be it as a Nescar-driver or be it, as it used to be in paleolithic ages, as a hunter hunting mammoths, deer and else.
Thom Hartmann issues the advantages of low- to middle-grade ADHD in nomadic hunting soscieties and I am linking this here: https://books.google.de/books?id=wmA...20adhd&f=false
In this context I also get thinking of Ninja and their Guerilla-warfare tactics as the ideal model of ADHD in medieval Japan versus their opponents without ADHD , the Samurai

Not sure who said this, or what he had been smoking, but the Navajo (who live in the AZ/NM desert where hunting is notoriously poor!) have been agrarian herders since their recent arrival in the American SW some 300 years before the arrival of the Spanish. They do hunt deer seasonally in the fall (and collect pinon nuts), and I'm sure the odd rabbit or javelina ends up in the pot, but traditionally they lived mostly on mutton and vegetables that they raised. They are also matrilineal, which would be very unusual amongst hunter societies. Surely there is no credible ethnologist who would describe the Navajo as hunters.

Although I briefly lived on the Navajo Reservation in AZ, and attended school with both Navajo and Hopi classmates, I had never heard of ADHD at that time, and nothing ADHD-ish jumps out at me in hindsight. I do recall no one wanted to stand out academically, but nothing unusual about risk-taking. Of course the current residents are in a state of transition to modern living, but I would be very interested in seeing any research on the incidence of ADHD among the Navajo.

[Kunga Dorji]

Originally Posted by Overthesky1119

Hey, I thought of opening this thread and starting with a BBC-documentary about ADHD in Egypt

I was told before (by well-renownend ADHD experts in Germany) that actually in Japan there is a higher prevalence of ADHD which is associated to the Hikikomori phenomenen in Japanese society and so on... additionally I asked if the Sinti and Roma can be considered an ethnic hotspot of ADHD which was answered with the same view ("...the Sinti and Roma, the Aborigines and the Apaches...")... of course this is all direction Thom Hartmann and Hunter Farmer Theory... I apoligize for my at some points perhaps insufficient English as I am not a native speaker and have also never written in English-speaking adhd forums (although much in German language ADHD forums)... what do you think about ethnic and geographic hotspots of ADHD?

Hartmann invented the "Hunter Farmer theory" as a narrative to tell his young son so that he could think positively of himself despite the ental health diagnosis.

It is an interesting fable, but it has never been tested, nor indeed has it ever been formatted in a manner suitable for any scientific study.
For the tie being it looks "unfalsifiable"- a big problem for any would be theory.

Furthermore given the very high rate of clumsiness in ADHD kids (50% have developmental coordination disorder) it seems to me that ADHD would be unhelpful and probably dangerous for hunter gatherers.

If you think about the logic of this it would suggest that the genetic hypothesis is wrong- which I have been saying for the last 10 years.

(btw Hartnann is a skilled NLP practitioner though and he has many great take home messages on supporting mental positivity, which, naturally, will improve symptoms).

I have seen a study a few years ago which showed significantly higher ADHD rates in the Eastern US (highly urbanised areas) and also the Appalachian coal mining states, but significantly lower rates in the MidWest.
Brazil has high rates and France has much lower rates.

[Overthesky1119]

Originally Posted by 20thcenturyfox

e.g.
" The regions represented were Africa (four studies), Asia (15), Europe (32), the Middle East (four), North America (32), Oceania (six), and South America (nine). The main finding was that the variation in prevalence associated with the samples’ geographic origin did not fit a pattern consistent with the notion that ADHD is a byproduct of American culture. The North American rate (6.2%) only slightly exceeded the European rate (4.6%). The highest rates emerged from Africa (8.5%) and South America (11.8%). Corroboration comes from a dimensional ADHD scale used in 21 countries. Japanese and Finnish children scored lowest, Jamaican and Thai children scored highest, and American children scored about average (7) ."

from comment on: The worldwide prevalence of ADHD: a systematic review and metaregression analysis.
Polanczyk G1, de Lima MS, Horta BL, Biederman J, Rohde LA.
https://ajp.psychiatryonline.org/doi...2007.164.6.856

Conclusion BTW was that prevalence is roughly uniform, as apparent differences tend to disappear when differences in methods, sampling, definitions, etc are taken into account.

Further to your idea of hotspots, though, I would agree that grouping results by large regions would tend to obscure any really interesting differences arising from, say, fish consumption, pesticide exposure, refugee migrations, etc.

I don´t think that the prevalences of ADHD are everywhere on the world roughly the same... the scientific data regarding varying ADHD prevalences over geography and ethnic groups is inconclusive



https://www.ncbi.nlm.nih.gov/pubmed/26002410



"...Our results confirmed a substantially higher ADHD prevalence rate (more than double) than the suggested pooled worldwide prevalence, although similar to the one recently detected in a representative populational sample of children in the US (11 %). These findings, consistent with previous developmental epidemiology studies from Turkey, confirm that ADHD is highly prevalent in Turkish elementary school children." ...anyway, I don´t think it is a coincidence that there is nowadays so much research on ADHD being done in Turkey, that may have to do as well with the population of Turkey having moved to urban areas in the last 20 years and counting but also with a significantly higher ("more than double than the pooled worldwide prevalence") prevalence of ADHD in Turkey...



also: http://english.alarabiya.net/en/life...ave-ADHD-.html

[20thcenturyfox]

Originally Posted by Overthesky1119

I don´t think that the prevalences of ADHD are everywhere on the world roughly the same... the scientific data regarding varying ADHD prevalences over geography and ethnic groups is inconclusive
....

I don't have a strong opinion on how this will come out, but I do think it's likely there are differences in ethnic/geographic prevalence. Even more so there are likely to be geographic and genetic clusters, and studying the clusters would probably tell us a lot more about the causes and aggravating factors of ADHD than smoothing out the statistics over large areas.

Details matter. If John Snow had only looked at the incidence of cholera in London (or England) as a whole during the outbreak of 1854, not only the germ theory but also the science of epidemiology would have had to wait. At that time people believed cholera was transmitted through the air. But instead he took the trouble to map the addresses of the fatalities and noticed that they were clustered around 1 particular public water pump (out of dozens). Even though it was just his theory, his observation was compelling; the City listened and closed the pump, more or less ending that particular outbreak. Of course it was later discovered the water source for the pump was contaminated by sewage including the nappies of the first cholera victim, a baby. The germ theory was validated, the cholera germ was identified, and the rest is history. So, although the solution in the end called for public health measures, the idea for the solution came from the details.

I have previously posted that I think ADHD (like MDD) is a label of convenience which obscures several distinct disorders, and this lumping together of disparate conditions is making it harder to learn what specifically will help whom specifically.

In the same way I think lumping together ADHD prevalence statistics over a wide area gives more comfort to the public health authorities that they are doing "nothing wrong" than to patients and their doctors suffering as they try one thing after another, not knowing even exactly what is not working in their case, let alone what is working for others with the same underlying variant of ADHD.

[Overthesky1119]

I don´t think that ADHD is the summary of various versions of neurodiverity or mental abnormalities... actually there are predictions that ADHD will one day come ot to be a core topic in all of psychiatry... roughly 50% of patients in psychiatric hospitals are according to this acutally having adhd, not only ADHD many of them, but also ADHD, Kurt Cobain had Bipolar Disorder, but had ADHD as well, Michael Phelps has endogen Depression, but has also ADHD, Jackie Chan has OCD, but has also ADHD https://www.jaynestars.com/news/jayc...-ocd-and-adhd/ ,



https://sg.style.yahoo.com/blogs/sin...9hR1wCgTJTxJth




, a friend of mine has a diagnosis of ADHD but also is diagnosed with schizophrenia and so on...


that ADHD is overlapping with these other neurodevelopmental disorders, see here: https://www.ncbi.nlm.nih.gov/pubmed/29930110


...why is ADHD the quantitative core of these neurodevelopmental disorders? Because of the evolutionary advantages of ADHD-genes and ADHD boosts these other neurodevolpmental disorders as comorbidities evolutionarily (roughly 50% of Aspergers-patients have ADHD as well), to evolution of ADHD also this: https://www.cambridge.org/core/journ...88/core-reader


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903618/

[Greyhound1]

I think the inherent problem with determining ethnic and geo hotspots is with the diagnosis of ADHD, cultural awareness and societal biases. Since there’s no definitive test or mandatory format for diagnosis methods for ADHD different Dr’s, cultures and societies view and treat it differently.

Without any consistency in diagnosis, Dr. awareness and a cultural value of acknowledgement and treatment makes determining this seem impossible to me on a world wide level with so many variables.

[Lunacie]

Originally Posted by Greyhound1

I think the inherent problem with determining ethnic and geo hotspots is with the diagnosis of ADHD, cultural awareness and societal biases. Since there’s no definitive test or mandatory format for diagnosis methods for ADHD different Dr’s, cultures and societies view and treat it differently.

Without any consistency in diagnosis, Dr. awareness and a cultural value of acknowledgement and treatment makes determining this seem impossible to me on a world wide level with so many variables.

That is what I wanted to say earlier but could not find the right way to express.
Thanks Hound!

[Kunga Dorji]

Originally Posted by Overthesky1119

I don´t think that ADHD is the summary of various versions of neurodiverity or mental abnormalities... actually there are predictions that ADHD will one day come ot to be a core topic in all of psychiatry... roughly 50% of patients in psychiatric hospitals are according to this acutally having adhd, not only ADHD many of them, but also ADHD, Kurt Cobain had Bipolar Disorder, but had ADHD as well, Michael Phelps has endogen Depression, but has also ADHD, Jackie Chan has OCD, but has also ADHD https://www.jaynestars.com/news/jayc...-ocd-and-adhd/ ,



https://sg.style.yahoo.com/blogs/sin...9hR1wCgTJTxJth




, a friend of mine has a diagnosis of ADHD but also is diagnosed with schizophrenia and so on...


that ADHD is overlapping with these other neurodevelopmental disorders, see here: https://www.ncbi.nlm.nih.gov/pubmed/29930110


...why is ADHD the quantitative core of these neurodevelopmental disorders? Because of the evolutionary advantages of ADHD-genes and ADHD boosts these other neurodevolpmental disorders as comorbidities evolutionarily (roughly 50% of Aspergers-patients have ADHD as well), to evolution of ADHD also this: https://www.cambridge.org/core/journ...88/core-reader


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903618/

The real question is whether or not DSM has gone too far in subdividing these disorders.

ie There are a series of conditions described as "comorbids of ADHD" namely Developmental Coordination Disorder, Dyslexia, dysarthria, ocular convergence insuffriciency.

But why are these conditions listed separately?
They all use the same neurology in the cerebellum and basal ganglia:

ADHD as a Model of Brain-Behavior Relationships (SpringerBriefs in Neuroscience) 2013th Edition
by Leonard F. F. Koziol (Author), Deborah Ely Budding (Contributor), Dana Chidekel (Contributor)

Subcortical Structures and Cognition: Implications for Neuropsychological Assessment 2009th Edition
by Leonard F. Koziol (Author), Deborah Ely Budding (Author)


In Sweden they are not listed separately, he usual term there is "DAMP":_ Deficits of Attention, Motor control, and Perception.

The term attention deficit disorder is based on the intellectual prejudices of the elite of US psychiatrists.

One real difficulty is that those contributing to DSM do not even have an agreed definition of Mind. Additionally there is little recognition that cognition is an internalisation of planned motor activity.

I became more fully aware of these physical aspects to ADHD in the last few years of my career.

However in the last 2 years I was able to observe physical signs of all the above conditions in patients, and document them consistently- both on questionnaire and on physical examination.

So the point that I am making is that the definition ADHD is incomplete- a rough estimate of the real condition, but because it focusses purely on the behavioural aspects of the problem it misses important elements which are helpful to management.

I'm sure there will always be a class of patients for whom stimulants are helpful, but it might end up with a different name and additional treatments.
Neurorehabilitation of these other aspects of the problem is quite simple, and is already available.