Attention-Deficit/Hyperactivity Disorder Analysis - Essay Example

3 March Attention-Deficit/Hyperactivity Disorder (ADHD A Real Disorder For the past few decades, the mental health professions have identified attention-deficit/hyperactivity disorder (ADHD) as a condition that involves 3 to 8% (Steinhausen 393) or 8 to 12 % (Faraone 1) of children around the world. The ICD-10 and the DSM-IV stress that the fundamental features of ADHD are “inattentiveness, hyperactivity and impulsiveness” (Steinhausen 393). Although health professionals have recognized the veracity of ADHD and its prevalence, other scholars have criticized the validity of ADHD as a real disorder (Steinhausen; Tait). This paper argues that Attention-Deficit/Hyperactivity Disorder (ADHD) is a real disorder, because scientific device demonstrates its genetic and neurobiological causes; differences between children with ADHD and no ADHD are observable in their social interactions; a set of criteria and characteristics of the disorder is listed in the DSM-IV-TR to guide the identification of ADHD; ADHD medication shows changes in brain matter; and professionals are present to diagnose this condition. Scientists are finding more and more evidence that ADHD is a diagnosable condition in that stems from biological causes. Studies indicate that ADHD is strongly influenced by genetics, and that children with ADHD demonstrate brain differences compared with children who do not have ADHD. Several researches had examined the genetics of ADHD through family studies, adoption studies, and twin studies and findings showed that “ADHD clusters in families and that the disorder is highly heritable” (Steinhausen 393). Twin studies have been used to approximate heritability, which measures the extent to which genes shape disorders (Faraone 5). Heritability varies from zero to one with elevated levels showing a larger impact of genes on having ADHD (Faraone 5). In Faraone’s review of literature, fifteen twin studies of ADHD demonstrated that genetic factors can produce around 75% of the ADHD-related behavioral difference (Faraone 5). Even though these studies come from around the world, specifically United States, Australia, United Kingdom, Sweden, and employ a diversity of methods of determining ADHD, they emphasized high rates of heritability for this disorder (Faraone 5). Furthermore, behavioral genetic studies provided evidence that individual (non-shared) environmental factors affect behavioral variance, while familial (shared) environmental factors may have a small role in developing ADHD (Steinhausen 393). Brain scans also demonstrate that people with ADHD have a different brain than those who do not have this disorder. Anatomical MRI studies have given proof that children with ADHD, compared with normally developing children, show a slight drop in total brain volume (Steinhausen 395). Aside from this global decrease in volume, individuals with ADHD demonstrate “smaller prefrontal volumes, smaller volumes of the caudate nucleus and differences in the cerebellum, in particular, a smaller vermis” (Steinhausen 395). Thus, neurobiological differences assert the existence of ADHD as a disorder. Although all children can experience hyperactivity, distractibility, poor concentration, or impulsivity, for children with ADHD, such behaviors often affect their performance in school, social relationships, or their life at home. Many children with ADHD suffer from serious problems in cognitive and social functioning (Steinhausen 395). ADHD includes attention deficits which can affect school performance and may impair intelligence (Steinhausen 395). Intelligence may be affected by either poor attention span or due to “shared genetic causes” (Steinhausen 395). Furthermore, ADHD can also seriously impair education, employment, and social functioning (Steinhausen 395). When compared with controls, adolescents with ADHD have been demonstrated to have higher tendencies for attempted suicide, intentional injury, incarceration and substance abuse, while adults with ADHD experience higher rates of unemployment or lower job status, relationship/marital problems, disorganized household organization, risk taking behavior, accidents and legal contraventions (Steinhausen 395). ADHD impacts social and academic functioning in severe ways, thereby making it a valid disorder. To assess whether someone has ADHD, specialists compare the person’s pattern of behavior against a set of criteria and characteristics of the disorder as listed in the DSM-IV-TR. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) defines ADHD as a “persistent pattern of inattention or hyperactivity- impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development” (American Psychiatric Association [APA] 85 qtd. in Stolzer 5). Its symptoms must be observable in two or more environments, such as school and home and there must be evidence that the ADHD symptoms negatively affect social and academic performance (Stolzer 5). Symptoms of ADHD consist of: sloppy mistakes in schoolwork, disorganized or unfinished assignments, poor attention span, difficulty in following instructions, poor organizational skills, lost or messy materials, and easily diverted attention (APA qtd. in Stolzer 5). Research shows that medication, ideally in combination with behavioral treatment, is the most effective remedy for ADHD. While the brains of non-medicated ADHD children have abnormally small volumes of white matter, once medicated, the white matter brain volume of these children does not differ from that in non-ADHD children. Medications have a mainly noradrenergic effect that alleviates the symptoms of the disorder (Faraone 6). Several studies demonstrate that tricyclic antidepressants have either a modest or strong response rate for treating ADHD symptoms in both children and adults (Spencer and Biederman qtd. in Faraone 6). These drugs are shown to improve the white matter brain volume of children with ADHD. Behavioral strategies are also important, because they help condition new sets of behaviors and attitudes (Faraone 6). People who believe that they may have ADHD should consult with a professional with expertise in the diagnosis of this situation. From a clinical point of view, it is critical that a large group of patients with ADHD get permanent professional counseling and treatment by highly quali?ed specialists (Steinhausen 398). Only professionals with expertise in diagnosing ADHD can be a reliable source of diagnosis (Steinhausen 398) and this does not include philosophers and observers who claim that ADHD is not a real disorder. This paper proceeds to the criticisms of ADHD as a disorder and one of them is that ADHD cannot be objectively measured, so it cannot be described as a disorder. Stolzer stresses that there are “no neurological, metabolic, or attentional tests to confirm the existence of ADHD” (13). Instead, formal diagnoses rely on the outcomes of standardized assessment questionnaire, and it has been noted that the questionnaire is “highly subjective and lacks scientific validity and reliability” (Stolzer 13). Common childhood restlessness or activity can be easily assessed as ADHD symptoms. In response to this criticism of ADHD, it must be underscored that the DSM–IV–TR provides distinct behavioral measures of ADHD. For instance, hyperactivity is substantiated by restlessness, wriggling in one’s seat, or not remaining inactive when asked to do so (Stolzer 5). Symptoms of hyperactivity are running, climbing, or refusing to play with less noise (Stolzer 5). Children who are said to have ADHD frequently emerge to be “on the go” or behave as if they are “driven by a motor” (APA 86 qtd. in Stolzer 5). The DSM–IV–TR adds that twitching objects, tapping hands or feet, talking markedly, and acting edgy are also legitimate indicators of ADHD (APA qtd. in Stolzer 5). These behaviors should also be present in two or more settings. Thus, it is clear that children’s ordinary high-energy manifestations are not instantly diagnosed as ADHD symptoms. Critics of the ADHD diagnosis also argue against the psychopharmacologic treatment of the disorder and maintain that stimulants, the most frequent psychopharmacologic therapy for ADHD, are” overprescribed and unnecessary” (Carey and Diller 2001; McCubbin and Cohen 1997 qtd. in Faraone 2). They believe that ADHD is a normal childhood behavior that can be handled through behavior management strategies alone. This paper asserts that medicine can reduce ADHD. Meta-analyses, such as those done by Faraone and Biederman and Schachter et al. of treatment for ADHD evidently show that methylphenidate and amphetamine decrease the “overactivity, impulsivity, and inattentiveness of ADHD children, adolescents and adults” (Faraone 5-6). Aside from reducing ADHD symptoms, literature reviews provide evidence that these medications are also efficient in decreasing ADHD-associated impairments (Faraone 6). Medications are shown to enhance on-task behavior, academic performance, and social functioning (Faraone 6). Adults with ADHD also benefit from being able to handle their jobs and marriages after medication (Faraone 6). Better social skills are also evident at home and school environments (Faraone 6). Studies showed that stimulants improve maternal-child interactions and sibling relations (Faraone 6). Several studies also show enhancements in “vigilance, cognitive impulsivity, reaction time, short-term memory, and learning of verbal and non-verbal material in children with ADHD” (Faraone 6). Hence, these drugs are not overprescribed and unnecessary. They help lessen the effects and symptoms of ADHD and help people with ADHD live “normal” lives (Faraone 6). ADHD is a real disorder, because overwhelming scientific evidence proves its existence; ADHD is observable in social interactions; the DSM-IV-TR clearly guides the identification of ADHD; ADHD medication improves brain matter; and professionals can validly diagnose this condition. Critics will argue that ADHD lacks objective diagnostic tools, even when the DSM-IV-TR provides specific symptoms. Critics will also say that medication is unnecessary, although empirical evidence shows improvement in brain matter, as well as enhancements in academic and social functioning. ADHD is a real disorder which can be identified and treated. To say that children with ADHD symptoms are merely over-active will do disservice to them, because they require professional help to ascertain and to treat their ADHD. Works Cited Faraone, Stephen V. “The Scientific Foundation for Understanding Attention-Deficit/Hyperactivity Disorder as a Valid Psychiatric Disorder.” European Child & Adolescent Psychiatry 14.1 (2005): 1-10. Print. Steinhausen, H-C. “The Heterogeneity of Causes and Courses of Attention-Deficit/Hyperactivity Disorder.” Acta Psychiatrica Scandinavica 120.5 (2009): 392-399. Print. Stolzer, J. M. “Attention Deficit Hyperactivity Disorder: Valid Medical Condition or Culturally Constructed Myth?” Ethical Human Psychology & Psychiatry 11.1 (2009): 5-15. Print. Tait, Gordon. “The Logic of ADHD: A Brief Review of Fallacious Reasoning.” Studies in Philosophy & Education 28.3 (2009): 239-254. Print. Read More