Friday, March 7, 2014

The Myth That "ADHD Doesn't Exist"

guest post by Mary V. Solanto, PhD

Recently, there has been much attention paid to an article entitled “ADHD Doesn’t Exist” that appeared in a number of major U.S. publications, based on a book of the same name just published by Richard Saul, MD. Dr. Saul, who describes himself as a behavioral neurologist, makes his point by describing cases of children who came to him exhibiting signs suggestive of ADHD (difficulty concentrating, poor academic work etc), but who turned out upon closer examination to instead have a learning disorder, anxiety, impaired vision, or even bipolar disorder. His implication is that all children who are referred for attention or behavior problems will be found instead to have another condition that accounts for their symptoms. Abundant evidence indicates otherwise.

Any reputable, knowledgeable mental health practitioner will take care to rule out these alternative conditions as the exclusive or primary cause of a child’s attention or behavior problems before diagnosing ADHD. But after other possible disorders are ruled out, a significant number of children meet the formal criteria for ADHD, as described in the Diagnostic and Statistical Manual. These are: (1) symptoms of inattention and/or hyperactivity-impulsivity that are extreme for the child’s age; (2) that occur both at home and at school; (3) with clear evidence that the symptoms reduce the quality of the child’s social, academic, or occupational functioning; (4) that are chronic, starting before age 12 and lasting at least 6 months; and (5) are not explained by another disorder.

Evidence that ADHD is a real disorder—and specifically a brain disorder—comes from several major sources. Neuroimaging has demonstrated that children with ADHD show (a) structural size differences in relevant brain areas and (b) less activation of brain regions that control attention, impulses and motor activity, organization, and planning, and that many of these differences persist to adulthood as well. Finally, family studies indicate that the condition is highly heritable and point to a genetic predisposition in the great majority of cases.

The unfortunate impact of this and other publications that are not fact-based is that they add to the stigma of ADHD and hinder the diagnosis and treatment of thousands of people who do have ADHD, and whose lives would be significantly improved with treatment.


Mary V. Solanto, PhD, is associate professor of psychiatry and director of the ADHD Center in the Division of Child and Adolescent Psychiatry at Mount Sinai School of Medicine. She is a member of the advisory board of the Journal of Child Psychology and Psychiatry and of the editorial boards of the Journal of Attention Disorders and The ADHD Report. Dr. Solanto serves on the professional advisory boards of Children and Adults with ADHD (CHADD) and the American Professional Society of ADHD and Related Disorders (APSARD). She is the author of Cognitive-Behavioral Therapy for Adult ADHD: Targeting Executive Dysfunction (Guilford Press, 2011).

11 comments:

Bridging The Gap said...

Thank You :)

Brian R King said...

Thank You :)

Anonymous said...

Yes, Thank you!

Collin Smith said...

Thank you for posting this article. I think every adult with ADHD who suffered though their pubic education as a child, would agree that ADHD is real.
So, who's money is behind the discrediting of ADHD as a real disorder, especially that of ADHD adults. Their seems to be a systematic effort with large amount of media attention being paid for in the area of legitimizing the use of medication.
My guess is

Collin Smith said...

Thank you very much for this article,
It seems there is quite a lot of money being spent in the media to further this agenda now that it was included as a legitimate disability in the 2008 ADA amendment. I suspect the insurance lobby are investing heavily to increase negative coverage of ADHD medications. What do you think?

Anonymous said...

Thank you! This was my reaction, too, when Dr Saul was interviewed on a local radio talk show. It wouldn't be fair to discount his book since I haven't read it for its entire message. I know first hand, though, the difference a diagnosis, AND the prescription, has made for BOTH me and my daughter. Last summer, my 21 yr old daughter was diagnosed, and I was, too, one month later at age 51. Guess who made the Dean's Honor list Fall 2013? Yes, she did, and will graduate this May with a Psychology degree with a minor in Criminal Justice. :-) So very proud of her achievement. I only wish we both knew years before.

Rebecca M said...

Yes, this. And a behavioral neurologist should know that ADHD is often co-morbid with other conditions - having another disability doesn't always mean you don't have ADHD.

Barbara Pierce Drew said...

Thank you!

Becky said...

Yes, while all of these problems could of course be primary diagnoses, they are often frequently associated with a diagnosis of ADHD. Once the ADHD is diagnosed and treated these associated problems may or may not need to be treated separately. I so often see children and adults who are so relieved to understand the source of their problems that anxiety, mood and behavior problems are much reduced.

Cinda said...

Thank you!

Robin said...

I have been treating ADHD for 12 years in the Family Care setting. My daughter and son have ADHD. People come to me when they have exhausted all other methods and their children are on the verge of failure. ADHD is mimicked by other disorders and can exist co-morbidly with depression, etc... ADHD children have the same right as others do to develop behaviorally, socially and academically. This right is denied them if they are denied treatment.