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When Sroufe suggests the brain disorder known as ADHD may simply be the result of environment without providing a bit of supporting evidence, he ignores mountai

by trotsky 15y ago

When Sroufe suggests the brain disorder known as ADHD may simply be the result of environment without providing a bit of supporting evidence, he ignores mountains of data that show strongly correlated multi-generational symptoms even when there was little or no contact. There is a reason science doesn't get presented on opinion pages. Trying to convince parents that it may not be a real disorder, or may not be developmental, or that drugs are ineffective does a serious disservice to the diagnosed. Stimulant drugs are unlikely to be the end all and be all for ADHD treatment, but they are currently the best we have and they've been shown again and again to provide significant benefit.

chimeracoder 15y ago
The same thing can be said about depression too - we don't really know why SSRIs work, but they generally work enough that we use them as a first-line treatment for depression. Like ADHD, depression is sometimes confused for being a product of the environment, when in both cases the environment is really just an exacerbating factor (clinical depression, unlike PTSD, cannot be caused by environment alone). The problem with studying ADHD like this is that we generally agree that ADHD is over-diagnosed and over-prescribed, but then for evidence that ADHD exists as a medical condition, we look to the existing pool of people who are diagnosed or even taking medication to confirm that there is a difference between those who are diagnosed and those who aren't. 'm not saying that this means ADHD is a hoax - I agree with you that it's more than just the environment. It's just very difficult to construct definitions for mental conditions in particular, because there's usually no way to do a double-blind randomized experiment. The problem is that ADHD and depression are both heterogeneous conditions - they're likely not single conditions themselves, but a bunch of somewhat related conditions that we're currently unable to distinguish between. The various hypotheses for what causes ADHD (and depression) may not be mutually exclusive. That makes studies that much harder to conduct, because you have a mixed population, which makes identifying characteristic traits harder (and sometimes impossible, depending on the mixture). It also means that anecdotal evidence is that much more worthless, because what is true about one member in the population could be completely false for another. And, in some cases, having a mixed distribution can give you the exact opposite results; see Simpson's Paradox: http://en.wikipedia.org/wiki/Simpsons_paradox http://en.wikipedia.org/wiki/Simpsons_paradox

by trotsky 15y ago

chimeracoder 15y ago

The same thing can be said about depression too - we don't really know why SSRIs work, but they generally work enough that we use them as a first-line treatment for depression. Like ADHD, depression is sometimes confused for being a product of the environment, when in both cases the environment is really just an exacerbating factor (clinical depression, unlike PTSD, cannot be caused by environment alone). The problem with studying ADHD like this is that we generally agree that ADHD is over-diagnosed and over-prescribed, but then for evidence that ADHD exists as a medical condition, we look to the existing pool of people who are diagnosed or even taking medication to confirm that there is a difference between those who are diagnosed and those who aren't. 'm not saying that this means ADHD is a hoax - I agree with you that it's more than just the environment. It's just very difficult to construct definitions for mental conditions in particular, because there's usually no way to do a double-blind randomized experiment. The problem is that ADHD and depression are both heterogeneous conditions - they're likely not single conditions themselves, but a bunch of somewhat related conditions that we're currently unable to distinguish between. The various hypotheses for what causes ADHD (and depression) may not be mutually exclusive. That makes studies that much harder to conduct, because you have a mixed population, which makes identifying characteristic traits harder (and sometimes impossible, depending on the mixture). It also means that anecdotal evidence is that much more worthless, because what is true about one member in the population could be completely false for another. And, in some cases, having a mixed distribution can give you the exact opposite results; see Simpson's Paradox: http://en.wikipedia.org/wiki/Simpsons_paradox http://en.wikipedia.org/wiki/Simpsons_paradox