ADHD and the Diagnosis Threat

[Trooper Keith]

I'm about to participate in research as a subject on this particular subject, so I thought I'd tell you all about it...I have 45 minutes before my experiment begins.

We'll start with the stereotype threat, since that's the basis for this...

In 1995, a book was published entitled "The Bell Curve" by Hernnstein and Murray. The book stated that there was a significant difference in the IQs of caucasians and africans based on genetics, and not on sociological differences. The book was a hot topic, and understandably raised quite a few issues. However, it was not backed by experimentation, rather, only by life-report data...that is, they looked at demographics, without actually performing an experiment.

While this is a valid form of research, it didn't hold up. The GRE study (Steele, Anderson, 1995) demonstrated that the case was much, much different. They administered copies of the GRE, telling people that they would either be taking the actual GRE and it would be reflective of their abilities, or that the test was only a practice, and they were testing to see if it was reflective. They did this with groups of african americans and caucasians.

The results were incredible. Caucasians showed very little difference in their scores. However, african americans scored much higher on the tests when they did not believe the tests would accurately reflect on them, than when they thought it would be reflective. This apprehension shows something very interesting: a stereotype threat.

African-americans who were stereotyped as being unintelligent performed worse on tests when they were reminded of the stereotype. The results were then tested in multiple subsequent studies. The stereotype threat was established. It is now defined as "the apprehension that ones performance will reflect poorly on themselves and their race by fulfilling cultural stereotypes." The individual then performs worse due to heightened anxiety, role fulfillment, and the self-fulfilling prophecy.

The experiment I will be participating in is researching the diagnosis threat. I will be asked a series of questions, and perform a full battery of neuropsychological evaluations. Which ones, and what tests, and how I will be introduced to the diagnosis threat, I don't know. Fortunately, I made an agreement with the researchers: I will get a copy of my results on all the neuropsychological tests, which is awesome, because those are damn expensive. I will also get a copy of the final report when it is published.

This research is very meaningful in the special education world. Because of the diagnosis threat, it may actually impair students significantly to be diagnosed with a psychiatric condition. The implications are immense: diagnosis of ADHD may be reserved for only the worst of cases in the interest of the student, or may be withheld from the student's knowledge to ensure no issues with the diagnosis threat.

I will not be at liberty to discuss publically any of the proceedings of the experiment, or any results, until the final report is published...however, anyone with any kinds of questions can ask them in private. Things I will be able to answer are: what types of cognitives tests were used, what kind of prelim. questionnaires were used, what kind of equipment was used. I cannot answer what experimental methods, research techniques, or results were used or discussed.

I just thought I'd throw this out here because the whole idea fascinates me...diagnosis threat. The funny part is, I'm actively aiding research that may harm me in the future as a psychiatrist, due to any regulations that may result from this relatively groundbreaking research.

For fairness: I do not know if I've been asked to participate in this research because of ADHD, GAD, OCD, or PD. Likely ADHD, but possibly GAD since it tests apprehension levels.

[RhapsodyInBlue]

Keith, thank you for posting this. I, for one, believe that "diagnosis" threat could be a real danger that they appear to be addressing.

I state this from the point of view of my late diagnosis of my ADHD. It did not make it easier for me to do anything, but it forced my to undergo my own CBT and utilize skills completely unbeknowns to myself.

I had NO idea there was anything wrong with me. Had I known, I do not think I would have succeeded in my chosen field.

I hope you can keep us informed on how you go, and if you find out any relevant data that may interest us all.

Thank you again, and good luck!
Viktoria

[Trooper Keith]

Wow, I myself am going to bump something from the dark age. I found this post while looking to see if I ever posted about my IQ scores, since I've long lost the report that I only managed to obtain from a HIPAA request since I took it when I was 9.

Here is the brief report on this study. Apparently it had to do with mild head injuries, I guess I was recruited as a control or possibly because of a minor concussion I suffered once.

http://www.psych.ohiou.edu/labs/suhr.html

[ginniebean]

Interesting idea and kinda well known in a sense. I mean when you're accused of something you can feel guilty when completely innocent because you start feeling awkward.

[bradd]

This is nice that such questions are being scientifically researched, rather than being left to power struggles within the system between polarized communities of professional opinion; well I hope this is the case, as it appears anyway. (Sorry, I'm cynical due to being impatient over the plodding progress of research to get a more complete and 'higher resolution' picture on sub-types of ADHD; for example their differential responses to stimulant dosages: not merely the "typical" to "low" dosages currently tried, but also "typical" to "high" dosages deserve to be looked at among subtype and/or potential subtypes. Also can an SSRI such as fluvoxamine, known for remote potential to induce a dysexecutive like syndrome? Can these subtly and over a long period be detrimental in in time to those with a strong SCT profile? There are people ADHD-PI people whose symptom profiles seem to fit tightly into academically recognized but not yet practictoner recognized-subtypes, for whom the research community is delighted to discover, but disappointingly very relaxed and silent about the need to develop treatment protocol; not unfairly grouping at least harder to treat or more resistant cases not under some pan-ADHF-PI 'one size fits all' policy.)

Well I'll just go away to bed now and hope I didn't make too much unreadable nonsense here.