Attention deficit hyperactivity disorder - Essay Example

ADHD: Attention Deficit Hyperactivity Disorder (ADHD) is a syndrome of disordered learning and disruptive behavior that is not caused by any serious underlying physical or mental disorder and that has several subtypes characterized by inattentiveness, hyperactivity and impulsive behavior. According to Hallowell, who previously has been a paid consultant to Eli Lilly, "It is impossible to diagnose attention deficit disorder properly (in minutes)," he said. "Absolutely impossible." He is concerned that general practitioners, who often have just minutes with patients, will misdiagnose ADHD. (Elizabeth Cohen) If the diagnosis of attention deficit disorder were as simple as saying that a child is bored and can not sit still, Einstein, Ted Turner, and Bill Gates could all have been considered to have had attention deficit disorder. One should remember that not every wiggle of a small child is a symptom of ADHD. Not only can other conditions mimic attention deficit disorder, but one could even say that some doctors are trying to medicate away what are essentially normal childhood behaviors. As a result, ADHD is overdiagnosed in children, and harmful medications used to treat the condition are overprescribed. However, there is a big danger in using medications such as methylphenidate, dextroamphetamine, and pemoline when treatment is not necessary. For children who truly have attention deficit disorder, methylphenidate (Ritalin) and other medications have been very effective, but the drug is not at all effective for those who do not have the disorder. In fact, the drug only makes matters worse. Hallowell said many people in today's hurried world may look like they have ADHD when they really don't. "The symptoms of ADHD can look just like the symptoms of modern life," he said. "I would speculate that 55 percent of the population has what I call pseudo-ADD, sort of a severe case of modern life. They're going so fast, they're doing so much, they're so saturated with information overload that they look distracted, impulsive and restless." At this time no laboratory or imaging tests can indicate reliably whether a child does or does not have ADHD. A diagnosis relies only on behavioral symptoms and ruling out other disorders. Many experts believe that the disorder is both over- and under diagnosed, depending on a variety of factors. Diagnosis of attention-deficit hyperactivity disorder is difficult for some of the following reasons: Arguments that ADHD is Over diagnosed in Some Children. The popularity methylphenidate (Ritalin) has encouraged some parents and teachers to pressure physicians into prescribing this standard ADHD drug for children, usually Caucasian boys, who are simply aggressive or who have poor grades. In one study of fifth graders in two different cities, 18% and 20% of Caucasian boys were being treated with medications. In one center, after careful testing, ADHD was the actual diagnosis in only 11% of children referred for ADHD and 18% had no disability. Others were simply poorer learners or had no problems at all. In one study, children more likely to receive medication were young for their grade, indicating they may have been socially and intellectually immature, rather than behaviorally impaired. Being poor and growing up in a single parent household contribute to emotional and behavioral problems. The significant increase in these problems has also paralleled an increase in the diagnosis of ADHD children, who may simply be responding to social and economic problems. Speaking at the 1998 National Institutes of Health Conference on ADHD, William B. Carey of the Philadelphia Children's Hospital, concluded, "What is now most often described as ADHD in the United States appears to be a set of normal behavioral variations. This discrepancy leaves the validity of the construct (of ADHD as a 'disease') in doubt. " "The medical community has elevated Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) to the status of diagnoses, and most people believe that these are real diseases. They aren't- and doctors who label children ADD or ADHD don't have a clue what's really ailing them." (Sydney Walker) In 1998, Florida child psychiatrist, Dennis Donovan said, "ADD is a bogus diagnosis. Parents and teachers are rushing like lemmings to identify a pathology....Our current pathologizing of behavior leads to massive swelling of the ranks of the diseased, the dysfunctional, the disordered and the disabled." How ADHD can be said as over diagnosed: It is not a simple matter to say that the disorder is being accurately diagnosed and treated. The following aspect are taken from diet and health net as the causing reasons for overdiagnosis of ADHD: The diagnosis is subjective, based on observation of behaviors over time. And the behaviors associated with ADHD may only be abnormal in their intensity, frequency or duration. The behaviors, regardless of intensity or frequency, would not necessarily be perceived abnormal in other cultural groups, among children of different social or family circumstances, or in children of another age or sex. But the behaviors could occur as a result of other medical conditions (mental illnesses, allergies, thyroid disease, depression, etc.) There is not yet any standard, generally accepted medical test in place to lend support to the diagnosis. The disorder often occurs-- or is believed to occur-- in conjunction with learning disabilities, which could themselves be the partial or sole cause of the behaviors The behaviors associated with ADD/ADHD seems to end in the teen years or early adulthood for some-- leading some experts to question the validity of the diagnosis, and of the disorder in general (e.g. Is a developmental disorder really a disorder) The medication most commonly used to treat ADHD is increasingly abused by non-sufferers who can experience the same effects sufferers do by taking equivalent doses The emphasis on school achievement places pressure on parents whose children do not succeed at school, increasing the possibility they will seek medical explanation, medical assistance, and special privileges (testing accommodations, etc.) for their children, whether or not the children have a disorder. There is significant and increasing concern at all levels of society about the accuracy and prevalence of the diagnosis and the appropriateness of the treatment. Above all the serious consideration arises from the statistics that shows that the diagnosis is relatively new in the society, yet the number of children diagnosed has exploded in a short time. Lack of Reliability of ADHD Diagnosis: The "reliability" of a diagnosis refers to the degree to which it is dependable; that is, the degree to which we can rely on the fact that the diagnosis will be the same regardless of who is doing the assessment or where the assessment is being done. For example, a broken arm is diagnosed through X-rays and there is a high likelihood that if you visited 100 orthopaedic physicians with the same X-ray, all 100 would make the same diagnosis. "Broken arm" is a highly reliable diagnosis. In contrast, "ADHD" is an almost completely unreliable diagnosis. "There are no objective diagnostic criteria for ADHD-no physical symptoms, no neurological signs, and no blood tests... No physical test can be done to verify that a child has 'ADHD'."( Breggin) Lack of Validity for ADHD Diagnosis: The "validity" of a diagnosis refers to the extent to which it describes something that is real and can be proved. "Despite millions of dollars spent on research over the past twenty years, much of it subsidized by hopeful drug companies, no one has yet been able to identify this 'disease' called ADHD." (Medical Economics) professionals from various fields publicly acknowledge that there is no proof of the existence of ADHD. Following are some of their voices: Associate Professor Robert Reid, PhD, University of Nebraska: "The causes of ADHD are simply not known.". Strengthening the previous argument, Psychology professor Diane McGuinness, PhD says "Methodologically rigorous research indicates that ADHD and hyperactivity as 'syndromes' simply do not exist." Psychiatrist Denis Donovan, MD also expresses that "ADD is a bogus diagnosis. Parents and teachers are rushing like lemmings to identify a pathology. Our current pathologizing of behavior leads to massive swelling of the ranks of the diseased, the dysfunctional, the disordered and the disabled." Neurologist Fred A. Baughman, MD says "We are not misdiagnosing or over-diagnosing, mistreating or over-treating ADHD. It has been a total, 100% fraud throughout its 35-year history." Psychologist John Breeding, PhD: "The diagnosis of ADHD is, itself, fraudulent." Physician William B. Carey, MD, of the Children's Hospital of Philadelphia expresses that ADD is a normal behavioral variation - "What is now most often described as ADHD in the United States appears to be a set of normal behavioral variations. This discrepancy leaves the validity of the construct in doubt. Psychologist Richard DeGrandpre, PhD, citing a study in Pediatrics, a US medical journal, showing that 80% of children reported as hyperactive at home or school showed exemplary behaviour and no signs of hyperactivity in the physician's office: "This finding is consistent with numerous studies showing, and dozens of newspaper articles reporting, considerable disagreement among parents, teachers, and clinicians about who qualifies for a diagnosis. This can only raise questions about the existence of ADD as a real medical phenomenon since it is these symptoms alone that are the basis of the diagnosis." Author Beverly Eakman says "These drugs make children more manageable, not necessarily better. ADHD is a phenomenon, not a 'brain disease'. Because the diagnosis of ADHD is fraudulent, it doesn't matter whether a drug 'works'. Children are being forced to take a drug that is stronger than cocaine for a disease that is yet to be proven." Educator and researcher Brenton Prosser, PhD notifies that "The dominant definition of the condition argues that it is physiologically based and is best treated with amphetamines, while there remains no biological basis for these claims." Over diagnosis and over prescription of Ritalin: Dennis Donovan states that although there is no accepted medical test for ADD/ADHD, and although theories about genetic causes of brain dysfunctions or abnormalities have not been proven, these unproven theories on ADD/ADHD are being used to justify the present regimen of drugs and environmental accommodations in schools. However since it is known that certain physical or biochemical brain abnormalities change behavior in predictable ways, a reliable medical test for ADD/ADHD must be possible. A study conducted by a team of psychiatrists led by Dr. Martin Teicher administered an attention test to 17 boys between 6 and 12 years old. "Eleven of the boys were previously diagnosed ADHD, and the remaining 6 were normal. The attention test identified only six of the 11 ADHD-diagnosed participants as correctly diagnosed. Later, MRI technology was used to image the brains of the 11 ADHD-diagnosed participants. When given Ritalin, the 6 ADHD-diagnosed boys whose diagnosis had been confirmed by the attention test had this in common: once given Ritalin, their brains showed increased activity in the putamen, and they performed better on the attention test. After receiving Ritalin, the 5 ADHD-diagnosed boys eliminated by the attention test showed even less putamen activity than before, and they showed no improvement in test performance." (Diet & Health net). This alarms the over diagnosis of ADHD even in the small group, which eventually leads to the statistics that 75% of ADD/ADHD diagnoses result in prescribed medicines. The Drug Enforcement Administration (DEA) has become alarmed by the tremendous increase in the prescribing of these drugs in recent years. Since 1990, prescriptions for methylphenidate have increased by 500 percent. DEA, expresses that Ritalin is pumped into market than the actual need. It is found that in nearly 15 to 20 percent of the children have been put on as it is a "quick-fix." This far exceeds any professional estimates of actual need. (DEA) The drugs have been over-promoted, over-marketed and over-sold, resulting in profits of some $450 million annually. This constitutes a potential health threat to many children and has also created a new source of drug abuse and illicit traffic. The data shows that there has been a 1,000 percent increase in drug abuse injury reports involving methylphenidate for children in the 10 to 14 age group. This now equals or exceeds reports for the same age group involving cocaine. The reported numbers are still small but experts feel that this is only the "tip of the iceberg. (DEA) According to Health Canada, all drugs for attention deficit disorder may cause psychotic reactions, including rare cases of hallucinations and agitation in children. Conclusion: Basing on the above facts and literature review the study concludes that ADHD is being over diagnosed and over promoted for prescriptions by the drug promoters which is not good the for the children and shows a great impact on the coming generations. Also the study found that most of the symptoms are related to general growth and behavioral patterns that can be normalized with good relation, which doesn't involve any medication. --- References: 1. Breggin, Talking Back to Ritalin, ibid., pp. 141-142. 2. Diagnostic & Statistical Manual of Mental Disorders (DSM-III-R), (American Psychiatric Association, Washington, D.C., 1987), p. 136. 3. Elizabeth Cohen and Debra Goldschmidt, "Adult ADD: Common disorder or marketing ploy." add-adhd.org 21, July , 2003. 20 March, 2007 4. Sharon Kirkey, CanWest News Service, 'New warning over ADHD drugs' canada.com 5. 22 September, 2006. 20 March, 2007 6. 7. Jacobs, Bob, "Australian Children at Risk", Law and Policy Journal of the National Children's and Youth Law Centre 6, September 2002, Article 13, p. 7. 8. McGuinness, Diane, "Attention deficit disorder: The emperor's new clothes, animal 'pharm', and other fiction", in S. Fisher and R.P. Greenberg (eds.), The Limits of Biological Treatments for Psychological Distress, Lawrence Erlbaum Associates, Hillsdale, NJ, 1989, pp. 151-188. 9. Gil Anaf, Oral Testimony to the South Australia Parliamentary Committee Inquiry into Attention Deficit Hyperactivity Disorder, Hansard, August 24, 2001, p. 61. 10. Denis Donovan, quoted in "ADHD" Facts, fightforkids.com 20 March, 2007 11. Carey, William B., National Institutes of Health Consensus Conference on ADHD, November 16-18, 1998. 12. Varadarajan, Tunku, "Shrinking to Excess: I'll be damned if I let a psychiatrist near my son'", The Wall Street Journal, August 21, 2001. 13. Eakman, Beverly, quoted in "ADHD" Facts fightforkids.com 20 March, 2007 14. DeGrandpre, Richard, from Ritalin Nation (Norton, 2000), quoted in "ADHD" Facts, fightforkids.com 20 March, 2007 15. Breggin, Peter R., Testimony before Subcommittee on Oversight and Investigations, Committee on Education and the Workforce, US House of Representatives, September 29, 2000. 16. Rodham Clinton, Hillary, in USA Today Magazine, March, 2001. 17. Raul R. Gainetdinov; William C. Wetsel; Edward D. Sara R. Levin Jones; Mohamed Jaber, "Role of Serotonin in the Paradoxical Calming Effect of Psycho stimulants on Hyperactivity," Marc G. Caron, Science, Jan. 15, 1999. Read More