6 ms·

ADHD and monotropism (2023)

114 points by wonger_ 11mo ago

starlight1980 11mo ago
I understand thatnyou tjink ADHD is a type of autism ?
- wonger_ 11mo ago
  Not quite, but I think there's a lot of overlap between ADHD and autism, and that the labels are becoming increasingly blurry. The final paragraph touched on it: > It is, I think, too early to say with any confidence that autism and ADHD (or KCS) share a common root in monotropism, but the overlapping traits of the people receiving each label clearly demand some kind of explanation, and preliminary results do suggest that each is strongly correlated with monotropism – especially in combination. Also, a definition of monotropism from their homepage (not my writing): > I believe that the best way to understand autistic minds is in terms of a thinking style which tends to concentrate resources in a few interests and concerns at any time, rather than distributing them widely. This style of processing, monotropism, explains many features of autistic experience that may initially seem puzzling, and shows how they are connected.
  - theshackleford 11mo ago
    Diagnosed with both (as a child, then again as an adult after ignoring said diagnosis for a long time) I’ve been continually told there is a close link between the two, in that it’s not uncommon if you have one, to be diagnosed with the other. I’ll say I’ve found “treatments” from both schools helpful. Even though I resisted stuff on the autism side for a long time because I felt “insulted” by it and was convinced it was a diagnosis made in error.
- TexanFeller 11mo ago
  I think of ADHD and autism as brothers, or at least cousins. Lots of overlap, but not quite the same. With the older concept and diagnosic criteria for autism there was less overlap. ADHD and autism used to be considered mutually exclusive diagnoses. Autism used to imply delays in speech and most people diagnosed also had significant intellectual disability. Autism is now a dramatically larger umbrella than it used to be with the last couple of DSM editions merging Aspergers and other conditions with it and making it not be mutually exclusive with ADHD. The shift in definitions makes autism extremely difficult to discuss in public because people have wildly different concepts of it depending on when they learned. Side comment, merging Asperger's into autism was motivated in part by awareness of Hans Asperger's evil deeds and not wanting that association. It was also championed based on enabling help/protections given to autistics to folks with Aspergers as well, and maybe because being part of a larger and harder to ignore pool would help autistics with intellectual disabilities get more attention as well. So far I haven't seen a clear explanation of why it made sense in terms of better understanding the condition/difference, everyone that discusses it focuses on perceived potential social good.
  - 0olong 11mo ago
    A big factor was the defining feature of Asperger's being a lack of language delay, which turned out to be poorly correlated with life outcomes. The categories were also used very inconsistently - a lot of people, and some clinics, thought the Asperger's distinction implied far more than it did on paper, but not everyone went along with that.
nynx 11mo ago
I find this type of science is infuriating. Monotropism as a theory of autism or adhd is equivalent to saying that “tendency to focus on a few things” is a theory of autism or adhd. You’re describing the symptoms, which explains almost nothing. A theory of autism would explain the underlying physical causes of the behavior.
- grosswait 11mo ago
  I read the whole article and I agree that the first sentence was a very poor choice as an introduction to the rest of the content. However, it is an interesting article if you ignore that bit of bluster. The amount of overlap and traits commonly associated with ADHD and autism.
- lazide 11mo ago
  Eh, newtons theory of universal gravitation is still a theory, even if he had no access to particle physics, and even if later the Theory of General Relativity (among others) largely supplanted it. It’s also still useful (and used!) in most real life engineering situations. It’s rare where time dilation applies in say civil engineering. That folks with Autism and ADHD may have large portions of their symptoms occur because they focus too much on some specific things, to the detriment of others - like emotional well being/regulation - can still be falsifiable (better than most psychiatric theories for sure!) and useful clinically. Personally, it lines up with what I’ve seen and experienced. That there is another (perhaps chemical, or brain structure) theory too doesn’t necessarily change that!
  - nynx 11mo ago
    I don’t think it’s falsifiable until there are autism diagnostics that aren’t behavioral. Right now, they’re 100% behavioral, which that any theory that tries to cluster autism symptoms is hopelessly tainted by a recursive definition -> diagnosis -> definition cycle.
    - lazide 11mo ago
      If intervention x results in y behavior changing in z% of the population (or not), would that count? I think it would. Just because it doesn’t describe 100% of situations or work 100% of the time doesn’t mean it couldn’t be shown to produce useful predictions and work or not. And yes, that isn’t particle physics type falsifiable, but it is medical treatment falsifiable. Kinda. Newtons theory never predicted Mercury’s behavior, but was still super useful eh?
cjonas 11mo ago
I was diagnosed with ADD as a kid (before it was ADHD). People always describe the disorder as "lack of focus" but that's a really poor description for what I have. I would say I have "hyper focus", to the point where if I'm working on something interesting, I will lose track of time and am unable to redirect my attention to anything else. This makes me incredibly "spacey" as often my mind is still fixated on the task even long after I've stopped working on it. It also makes it very hard for me to accomplish any task I don't think are interesting... And often a new idea will strike me like an epiphany that immediately takes the top spot of my attention. The result is I have hundreds of half finished projects in flight across countless areas of interest.
- ddtaylor 11mo ago
  This used to upset me, but as time goes on I'm more excited about it. Sometimes I run into someone else that only does that one or two things. They are happy they finished them, etc., but they seem envious of being able to do lots of things even if they don't end up mattering.
  - cjonas 11mo ago
    Ya sometimes it feels like a missed opportunity, but I think it's mostly just ego and not anything of real value. On the flip side, I feel like I've gained an incredible amount of diverse experience.
    - R_D_Olivaw 11mo ago
      This right here. The shear breadth of experience is sometimes staggering. The difficulty for me is translating that into sustainable income. Job and experience hopping is great when your young, but then you get older and your resume portrays you as a total flake. (And admittedly, of the project is slow and boring, I might just dip. Life is short, I have things to do. And sitting still in an office for 8+hrs a day isn't one of them)
- CoastalCoder 11mo ago
  Same for me. I think this experience is pretty common amongst people diagnosed with AD[H]D.
aeonik 11mo ago
Definitely resonates with my experience. Not diagnosed autistic, but ADHD.
daoboy 11mo ago
We've refined and relabeled the art of naming the demon that possess a person based on the characteristics of their symptoms. Then put a scientific sheen on the proscribed exorcisms and potions, without understanding the underlying issue. Modern day shamanism. That is a bit hyperbolic (we clearly have real knowledge of the underlying neurological mechanisms), but closer to the truth than most people like to acknowledge. The DSM was never meant to carry the burden we've placed upon it. https://asteriskmag.com/issues/12-books/you-arent-in-the-dsm https://asteriskmag.com/issues/12-books/you-arent-in-the-dsm
- zbentley 11mo ago
  I think this is partly right, partly misguided. Misguided: there's now a focus on causality and precise identification based on symptoms and negative impact caused that wasn't present in the days of exorcisms and shamanism. Those eras were primarily characterized by people in positions of (often corrupt or unqualified) authority declaring diagnoses for others, largely without the consent of the diagnosed. Now, the default mode of mental health treatment is now focused on identifying symptoms according to specific rubrics, and diagnosing (or not) based on the presence of those rather than the agenda, religious feelings, or whims of people in positions of authority. Partly right: what I described above is the default or desired diagnostic approach. We have a long way to go before it's actually performed for everyone. Coercive diagnoses are not uncommon even under modern medical/diagnostic practices: parents seek out spectrum or ADHD diagnoses for kids who aren't suffering, just not meeting parental expectations; psychotic people are handled by modern mental health systems with extremely low autonomy, etc. Conversations here are also often confused: diagnoses for many mental health conditions are qualitative and measured not only by symptoms but by harms. The DSM and friends aren't like the diagnostic instruments for cancer or heart disease: physiological indicators are much rarer in mental health, so mental health diagnoses combine enumerations of behavioral symptoms and negative impacts caused to one's life. That implies a subtlety that's hard to come by among non-medical-professionals: you don't "have" ADHD (or OCD, Autism, etc.) in the same way you "have" an ulcer; you have those conditions if you present with a certain subset of the symptoms for the diagnosis, many of which are behavioral. Whether a particular treatment is merited has to do with both symptoms and the harms posed by those symptoms to your quality of life. So saying "I have ADHD" is a less meaningful statement than "I have some symptoms of ADHD and they seriously damage my quality of life, therefore I seek treatment". Add to that our limited (but growing, and better than it was in past decades) understanding of pharmaceutical treatments for mental health disorders--many of the drugs we use to treat, say, depression or ADHD behave with all the subtlety of driving a bulldozer through a convenience store because you wanted to get a gallon of milk--and you have a complex area discussed using outdated binary pathological terminology. That's a recipe for suspicion and confusion. In short, it is, as you say, hyperbolic to characterize modern mental health treatment as shamanism. But lingering corrupt medical practice and the complexity of the field for laypeople make it hard to see how, specifically, things are improving in this area.
jtrn 11mo ago
If anybody has a question for a clinical psychiatrist from Norway who has worked with both adults, children, and at an inpatient unit, over many years, feel free to ask. Maybe I can contribute something compared to many of the computer-related discussions here that are beyond my expertise. On the article I would somewhat agree but it’s too limited a view. It ignores too much of the at current assumed underlying causes that we know are relevant. For instance, it’s more correct to say that autism is associated with an increased attentions to “details”, not small things, and challenges with associations and broad concepts, maybe grounded all the way down to increased dendritic connectivity due to less aggressive pruning. of Also, the effect of motivation to focus over a period of time on unrewarding activities is not well incorporated into this theory of (monotropism). I thing there are some valid obersvation but it’s way to simplistic a model when working with real life ADHD. For instance, on interesting commonality seems to be inability to filter out information. But ADHD are unable to filter out Salient content (like a conversation) and autism are usually unable to filter out details or granular sensory stimuli. Anyways. Ask and I can attest give my perspective
- styluss 11mo ago
  What kind of work accomodations have you seen that work/help for people with autism or ADHD?
  - jtrn 11mo ago
    There are two levels to this. The Standard Environmental Fixes This is about finding the right level of stimulation vs. distraction. Many people with ADHD work better with external stimulation, like music. Small habits help, too—like taking photos of tasks to remember them. (e.g., snap a photo of the empty printer paper so you remember to order more when you scroll through your camera roll later). The Job Fit (The more interesting intervention). Sometimes we need to figure out if the problem is the job, not the person. Some people with ADHD simply cannot tolerate meaningless or monotonous tasks. An active person, for example, probably shouldn't work as a data entry clerk. for instance a 50-year-old builder who becomes a manager because his body is too beat up for hard labor. He is suited for leadership but can't stand the administrative work. Even if he wants the job, the boredom of the paperwork makes him miserable. These are the people who often present as depressed and benefit most from medication, as it gives them the stability to tolerate boring but necessary tasks. So basically spanning everything from small techniques, to existential and professional evaluation of best fit, to medication. Everyone is different.
g4zj 11mo ago
> There is a shattering sound at around 2:50. Oof. I'm glad I turned down the volume in response to this warning. Why not just remove this awful sound?
polotics 11mo ago
This is all well meaning and nice... Still between Dr Russel Barkley's excellent lectures and papers' reviews, and Dr Rege's very clear explanations, both on Youtube, your time may well be better spent there instead of here if you have an interest on the subject.
darthvaden 11mo ago
It is sad to see that mental health awareness is leading to over diagnosis and leading people down a rabbit hole. Especially these genz's obsession of using psychological jargon to express their inadequacies when in reality soome adjustments could have helped most people

114 points by wonger_ 11mo ago

starlight1980 11mo ago

I understand thatnyou tjink ADHD is a type of autism ?

wonger_ 11mo ago
Not quite, but I think there's a lot of overlap between ADHD and autism, and that the labels are becoming increasingly blurry. The final paragraph touched on it: > It is, I think, too early to say with any confidence that autism and ADHD (or KCS) share a common root in monotropism, but the overlapping traits of the people receiving each label clearly demand some kind of explanation, and preliminary results do suggest that each is strongly correlated with monotropism – especially in combination. Also, a definition of monotropism from their homepage (not my writing): > I believe that the best way to understand autistic minds is in terms of a thinking style which tends to concentrate resources in a few interests and concerns at any time, rather than distributing them widely. This style of processing, monotropism, explains many features of autistic experience that may initially seem puzzling, and shows how they are connected.
- theshackleford 11mo ago
  Diagnosed with both (as a child, then again as an adult after ignoring said diagnosis for a long time) I’ve been continually told there is a close link between the two, in that it’s not uncommon if you have one, to be diagnosed with the other. I’ll say I’ve found “treatments” from both schools helpful. Even though I resisted stuff on the autism side for a long time because I felt “insulted” by it and was convinced it was a diagnosis made in error.
TexanFeller 11mo ago
I think of ADHD and autism as brothers, or at least cousins. Lots of overlap, but not quite the same. With the older concept and diagnosic criteria for autism there was less overlap. ADHD and autism used to be considered mutually exclusive diagnoses. Autism used to imply delays in speech and most people diagnosed also had significant intellectual disability. Autism is now a dramatically larger umbrella than it used to be with the last couple of DSM editions merging Aspergers and other conditions with it and making it not be mutually exclusive with ADHD. The shift in definitions makes autism extremely difficult to discuss in public because people have wildly different concepts of it depending on when they learned. Side comment, merging Asperger's into autism was motivated in part by awareness of Hans Asperger's evil deeds and not wanting that association. It was also championed based on enabling help/protections given to autistics to folks with Aspergers as well, and maybe because being part of a larger and harder to ignore pool would help autistics with intellectual disabilities get more attention as well. So far I haven't seen a clear explanation of why it made sense in terms of better understanding the condition/difference, everyone that discusses it focuses on perceived potential social good.
- 0olong 11mo ago
  A big factor was the defining feature of Asperger's being a lack of language delay, which turned out to be poorly correlated with life outcomes. The categories were also used very inconsistently - a lot of people, and some clinics, thought the Asperger's distinction implied far more than it did on paper, but not everyone went along with that.

nynx 11mo ago

I find this type of science is infuriating. Monotropism as a theory of autism or adhd is equivalent to saying that “tendency to focus on a few things” is a theory of autism or adhd. You’re describing the symptoms, which explains almost nothing. A theory of autism would explain the underlying physical causes of the behavior.

grosswait 11mo ago
I read the whole article and I agree that the first sentence was a very poor choice as an introduction to the rest of the content. However, it is an interesting article if you ignore that bit of bluster. The amount of overlap and traits commonly associated with ADHD and autism.
lazide 11mo ago
Eh, newtons theory of universal gravitation is still a theory, even if he had no access to particle physics, and even if later the Theory of General Relativity (among others) largely supplanted it. It’s also still useful (and used!) in most real life engineering situations. It’s rare where time dilation applies in say civil engineering. That folks with Autism and ADHD may have large portions of their symptoms occur because they focus too much on some specific things, to the detriment of others - like emotional well being/regulation - can still be falsifiable (better than most psychiatric theories for sure!) and useful clinically. Personally, it lines up with what I’ve seen and experienced. That there is another (perhaps chemical, or brain structure) theory too doesn’t necessarily change that!
- nynx 11mo ago
  I don’t think it’s falsifiable until there are autism diagnostics that aren’t behavioral. Right now, they’re 100% behavioral, which that any theory that tries to cluster autism symptoms is hopelessly tainted by a recursive definition -> diagnosis -> definition cycle.
  - lazide 11mo ago
    If intervention x results in y behavior changing in z% of the population (or not), would that count? I think it would. Just because it doesn’t describe 100% of situations or work 100% of the time doesn’t mean it couldn’t be shown to produce useful predictions and work or not. And yes, that isn’t particle physics type falsifiable, but it is medical treatment falsifiable. Kinda. Newtons theory never predicted Mercury’s behavior, but was still super useful eh?

cjonas 11mo ago

I was diagnosed with ADD as a kid (before it was ADHD). People always describe the disorder as "lack of focus" but that's a really poor description for what I have. I would say I have "hyper focus", to the point where if I'm working on something interesting, I will lose track of time and am unable to redirect my attention to anything else. This makes me incredibly "spacey" as often my mind is still fixated on the task even long after I've stopped working on it. It also makes it very hard for me to accomplish any task I don't think are interesting... And often a new idea will strike me like an epiphany that immediately takes the top spot of my attention. The result is I have hundreds of half finished projects in flight across countless areas of interest.

ddtaylor 11mo ago
This used to upset me, but as time goes on I'm more excited about it. Sometimes I run into someone else that only does that one or two things. They are happy they finished them, etc., but they seem envious of being able to do lots of things even if they don't end up mattering.
- cjonas 11mo ago
  Ya sometimes it feels like a missed opportunity, but I think it's mostly just ego and not anything of real value. On the flip side, I feel like I've gained an incredible amount of diverse experience.
  - R_D_Olivaw 11mo ago
    This right here. The shear breadth of experience is sometimes staggering. The difficulty for me is translating that into sustainable income. Job and experience hopping is great when your young, but then you get older and your resume portrays you as a total flake. (And admittedly, of the project is slow and boring, I might just dip. Life is short, I have things to do. And sitting still in an office for 8+hrs a day isn't one of them)
CoastalCoder 11mo ago
Same for me. I think this experience is pretty common amongst people diagnosed with AD[H]D.

aeonik 11mo ago

Definitely resonates with my experience. Not diagnosed autistic, but ADHD.

daoboy 11mo ago

We've refined and relabeled the art of naming the demon that possess a person based on the characteristics of their symptoms. Then put a scientific sheen on the proscribed exorcisms and potions, without understanding the underlying issue. Modern day shamanism. That is a bit hyperbolic (we clearly have real knowledge of the underlying neurological mechanisms), but closer to the truth than most people like to acknowledge. The DSM was never meant to carry the burden we've placed upon it. https://asteriskmag.com/issues/12-books/you-arent-in-the-dsm https://asteriskmag.com/issues/12-books/you-arent-in-the-dsm

zbentley 11mo ago
I think this is partly right, partly misguided. Misguided: there's now a focus on causality and precise identification based on symptoms and negative impact caused that wasn't present in the days of exorcisms and shamanism. Those eras were primarily characterized by people in positions of (often corrupt or unqualified) authority declaring diagnoses for others, largely without the consent of the diagnosed. Now, the default mode of mental health treatment is now focused on identifying symptoms according to specific rubrics, and diagnosing (or not) based on the presence of those rather than the agenda, religious feelings, or whims of people in positions of authority. Partly right: what I described above is the default or desired diagnostic approach. We have a long way to go before it's actually performed for everyone. Coercive diagnoses are not uncommon even under modern medical/diagnostic practices: parents seek out spectrum or ADHD diagnoses for kids who aren't suffering, just not meeting parental expectations; psychotic people are handled by modern mental health systems with extremely low autonomy, etc. Conversations here are also often confused: diagnoses for many mental health conditions are qualitative and measured not only by symptoms but by harms. The DSM and friends aren't like the diagnostic instruments for cancer or heart disease: physiological indicators are much rarer in mental health, so mental health diagnoses combine enumerations of behavioral symptoms and negative impacts caused to one's life. That implies a subtlety that's hard to come by among non-medical-professionals: you don't "have" ADHD (or OCD, Autism, etc.) in the same way you "have" an ulcer; you have those conditions if you present with a certain subset of the symptoms for the diagnosis, many of which are behavioral. Whether a particular treatment is merited has to do with both symptoms and the harms posed by those symptoms to your quality of life. So saying "I have ADHD" is a less meaningful statement than "I have some symptoms of ADHD and they seriously damage my quality of life, therefore I seek treatment". Add to that our limited (but growing, and better than it was in past decades) understanding of pharmaceutical treatments for mental health disorders--many of the drugs we use to treat, say, depression or ADHD behave with all the subtlety of driving a bulldozer through a convenience store because you wanted to get a gallon of milk--and you have a complex area discussed using outdated binary pathological terminology. That's a recipe for suspicion and confusion. In short, it is, as you say, hyperbolic to characterize modern mental health treatment as shamanism. But lingering corrupt medical practice and the complexity of the field for laypeople make it hard to see how, specifically, things are improving in this area.

jtrn 11mo ago

If anybody has a question for a clinical psychiatrist from Norway who has worked with both adults, children, and at an inpatient unit, over many years, feel free to ask. Maybe I can contribute something compared to many of the computer-related discussions here that are beyond my expertise. On the article I would somewhat agree but it’s too limited a view. It ignores too much of the at current assumed underlying causes that we know are relevant. For instance, it’s more correct to say that autism is associated with an increased attentions to “details”, not small things, and challenges with associations and broad concepts, maybe grounded all the way down to increased dendritic connectivity due to less aggressive pruning. of Also, the effect of motivation to focus over a period of time on unrewarding activities is not well incorporated into this theory of (monotropism). I thing there are some valid obersvation but it’s way to simplistic a model when working with real life ADHD. For instance, on interesting commonality seems to be inability to filter out information. But ADHD are unable to filter out Salient content (like a conversation) and autism are usually unable to filter out details or granular sensory stimuli. Anyways. Ask and I can attest give my perspective

styluss 11mo ago
What kind of work accomodations have you seen that work/help for people with autism or ADHD?
- jtrn 11mo ago
  There are two levels to this. The Standard Environmental Fixes This is about finding the right level of stimulation vs. distraction. Many people with ADHD work better with external stimulation, like music. Small habits help, too—like taking photos of tasks to remember them. (e.g., snap a photo of the empty printer paper so you remember to order more when you scroll through your camera roll later). The Job Fit (The more interesting intervention). Sometimes we need to figure out if the problem is the job, not the person. Some people with ADHD simply cannot tolerate meaningless or monotonous tasks. An active person, for example, probably shouldn't work as a data entry clerk. for instance a 50-year-old builder who becomes a manager because his body is too beat up for hard labor. He is suited for leadership but can't stand the administrative work. Even if he wants the job, the boredom of the paperwork makes him miserable. These are the people who often present as depressed and benefit most from medication, as it gives them the stability to tolerate boring but necessary tasks. So basically spanning everything from small techniques, to existential and professional evaluation of best fit, to medication. Everyone is different.

g4zj 11mo ago

> There is a shattering sound at around 2:50. Oof. I'm glad I turned down the volume in response to this warning. Why not just remove this awful sound?

polotics 11mo ago

This is all well meaning and nice... Still between Dr Russel Barkley's excellent lectures and papers' reviews, and Dr Rege's very clear explanations, both on Youtube, your time may well be better spent there instead of here if you have an interest on the subject.

darthvaden 11mo ago

It is sad to see that mental health awareness is leading to over diagnosis and leading people down a rabbit hole. Especially these genz's obsession of using psychological jargon to express their inadequacies when in reality soome adjustments could have helped most people