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	Attention deficit hyperactivity disorder was one of the good articles, but it has been removed from the list. There are suggestions below for improving the article to meet the good article criteria. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
Article milestones Date Process Result September 16, 2006 Good article nominee Listed October 8, 2006 Featured article candidate Not promoted March 13, 2007 Good article reassessment Delisted
Current status: Delisted good article

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We could use some images

Here is a nice image of prevalence in the US. Wondering how to add it or something like it to this page?

http://www.cdc.gov/ncbddd/ADHD/adhdmedicated.htm

Here is a paper that given the prevalence in different area of the world.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1525089

--Doc James (talk) 10:59, 25 November 2008 (UTC)

The first link is broken. The second looks great; have we used it? - Hordaland (talk) 13:52, 3 May 2009 (UTC)

Is ADHD controversial

The question "Is ADHD controversial?" has come up a number of times over the last couple of years. I have added a number of references about this topic and we have a complete page dedicated to it. The controversy has however been referred to as FRINGE. Wondering what others think? To get some balance it would be great if everyone comments once before further comments are made.--Doc James (talk) 04:09, 30 November 2008 (UTC)

Many things have been called controversial with regards to ADHD. No one claims that every controversial issue is fringe. Some issues are definitely fringe.--scuro (talk) 04:17, 30 November 2008 (UTC)

I have ADHD myself and I do think the issue is controverisal. If we could have some sort of ADHD portals that showed famous people speculated to have ADHD or that have ADHD such as michael phelps. One problem I have is these conditions are presented as undesirable disorders and often linked to Deviance_(sociology) (see medicalization) when it is really society that could be the problem. If the diagnostic material can be pointed out as being from the medical research community (see medical literature, scientism and APA controversies) and not representing a "worldwide" view of ADHD that may lower conflict. I think the conflcit is common even on ADHD cites and there many disability rights movments as well so those issues might just be reenacting themselves on wikipedia. I may be able to find some information from disability studies to explain the social view as well as the resources people can have to make it in society. Psychiatry initself I think is going through a crisis and does not have the greatest reputation as well, which I think adds to the ocnlfict.Matsuiny2004 (talk) 01:02, 10 December 2008 (UTC)

• added

I do like that neurodiversity, and alternative views are respected and think this article is very close to representing both views. It does seem that the social aspects are covered fairly well too. Matsuiny2004 (talk) 01:02, 10 December 2008 (UTC)

• added

looking though this article again I would say it is a very scholarly article. What exactly are the problems with it? I will say the medical part could be given its own section as ADHD is its own category and requires years of research to understand in the first place. There should be a wikiportal as well. That would allow there to be much more discussion, if star wars can have its own portal I think ADHD can.Matsuiny2004 (talk) 01:12, 10 December 2008 (UTC)

• added

I think where I can see some problems is the views on ritalin. These days it seems that the discussion of using medication, behavioral therapy, etc are controversial in themselves. If there is a way of discussing that it may help resolve some conflict. The ritalin debate for example could be linked to the debat over should stimulant medication also known as Methylphenidate be used. This can link to the debate of human enhancement, as well as cognitive liberty. There beggining to be people that do not have ADHD or a certain condition that use it for performance enhancement. Behavioral thereapy could be linked to the debate of behacvioral modifcation which I think is a very senstive topic to certain people. Stigma can be inlcuded as well.Matsuiny2004 (talk) 01:12, 10 December 2008 (UTC)

I agree about the importance of looking at the controversy in an academic way. Mental illness issues are controversial as they deal with the philosophical question of what is normal human experience.

The causes are also extensive discussed as the cause often determines the treatment. If the problem is a chemical imbalance then the treatment would be drugs. If the cause is ones society then one has to work on changing society. And just posing this question makes many uncomfortable. If the cause is psychological then cognitive behavior therapy or talk therapy might help.

There is evidence however supporting all three of these points of view. Changing rates of diagnosis and differing rates in different countries support a social / psychological cause. Some of the brain imaging and genetic studies support a chemical cause. The effectiveness of drugs support a chemical cause but the fact that drugs work in all people not those classified as having ADHD casts doubt on this assertion. The fact that the classification is just a subjective list of human actions also causes concern with the bio psychiatric model. None of this data is conclusive and trying to exclude any one of these is POV pushing.

The pharmaceutical industry often tries to frame the cause in such a way that it promotes the use of the treatments they offer. And they of course fund those who share their point of view. This of course is just common business sense.

The cause of all mental illnesses of course is unknown... This makes it different then all other area of medicine and thus so controversial...Doc James (talk) 14:43, 10 December 2008 (UTC)

Doc James, I do not disagree with your viewpoint that if a condition is created or caused by a society, then it is the society that needs to change but unfortunately, that is not always plausible. If one does not fit within a given societal framework and cannot change the society, then the psychological discomfort that accompanies that can be so distressing that it is damaging over the long term. An important remedy in such cases, particularly with ADHD, may be treatment with medication. In other words, treatment with medication can apply to both of your stated causes.

In terms of regarding all psychological disorders as controversial, rather than simply ADHD, that needs to be stated in the article. Referring to ADHD as controversial, when it is meant to encompass all disorders, may be misleading. --Snailgoop (talk) 03:11, 18 February 2009 (UTC)

The cause is however independent of the effectiveness of the treatment. And I would agree changing society is very difficult. I read some interesting stats from the second world war when psychiatry was popularized. They found that about 50% of soldiers went crazy after a 60 days in the trenches and nearly all when mad after half a year. ( This is from a book called Loss of Sadness ).

I have found many refs that ADHD is controversial and some even say it is the most controversial pediatric mental illness. Have come across some refs that say all psychiatry is controversial but they are not a good as the ones for ADHD.

No one can deny the existence of hyperactive children and adults. Activity however is a continuum and were you draw the line between normal and abnormal is subjective. This is not hard science. And even though ADHD is the best studied pediatric mental illness this says more about how poorly mental illnesses in kids have been studied rather than how good the evidence base is. Even Barkleys says that this is so.

Now when it comes to treatments just beccause the condition causes all sort of problems ( which no one denies ) this doesn't mean that treatment gets ride of all these problems. The MTA study illustrate how effective / ineffective stimulants were at treating ADHD. They are not a cure but make a small difference at best. And this has only been shown to be true over the short term.

Those who make these medications have tried to make it sound like they work so well that we should no longer study them as it is unethical not to treat everyone. A previous editor Scuro tried to make this point. Yet we have literature the gives a frequency of ADHD from 1 % to 17% with the average at 5%.--Doc James (talk · contribs · email) 04:43, 18 February 2009 (UTC)

"when it is really society that could be the problem"

society is not the problem...it is how our children are being raised...no guidance and dicipline...its all wrong. I have a suggestion about changing society in this connection. I'd really like to see it tried somewhere, as I'll bet the prevalence of ADHD would be reduced considerably, perhaps to just the genuine cases. Let boys start school at age 6 or 12 months older than their female classmates. School just does require sitting still and paying attention. On average, girls are much more able to do that than boys of the same age at least through elementary school. Has this been tried anywhere? If not, why not; it seems so obvious to me. - Hordaland (talk) 12:59, 18 February 2009 (UTC)

Excellent suggestion. An MD, PHD has actually written two very good books on the subject. http://www.boysadrift.com/ And that was his recommendation. He makes a number of other points such as gender segregation in school. Research shows that girls do equally well in coed and girl only schools but boys do much better in male only school than in coed school. Some people are following his advice. Doc James (talk · contribs · email) 13:31, 18 February 2009 (UTC)

Thanks for the link. I read his chapter one and would certainly read the book if it dropped in my lap. He is very clearly talking about North America, but you'll find the same things happening in Europe, at least here in Norway. I wonder about East and Southeast Asia. - Hordaland (talk) 16:32, 18 February 2009 (UTC)

Boys more often than girls

Lead says: ADHD occurs twice as commonly in boys as in girls.

Epidemiology says: male children (10%) and female children (4%) in the United States..

Society and Culture says: and ADHD is diagnosed approximately three times more often in boys than in girls.

The article should perhaps agree with itself? - Hordaland (talk) 09:12, 3 December 2008 (UTC)

Uptodate.com says the ratio is between 2 andd 4 "ADHD occurs two to four times more commonly among boys than girls (male to female ratio 4:1 for the predominantly hyperactive type and 2:1 for the predominantly inattentive type) ."http://www.uptodate.com/online/content/topic.do?topicKey=behavior/8293&linkTitle=EPIDEMIOLOGY&source=preview&selectedTitle=4~150&anchor=2#2 I agree internal consistencey would be a good idea. Doc James (talk) 14:16, 3 December 2008 (UTC)

ADHD is diagnosed more often in males than in females, but the incidence of ADHD is nearly the same for males and females. Some aspects of the condition have however been suggested to occur with gender dependent incidence. Agalmic (talk) 15:20, 5 January 2009 (UTC)

Do you have a reference for that? It is a debated issue. Is it that males have more hyperactivity and are therefore diagnosed more well more females are undiagnosed as they have more attention problems. Or is there a true difference. Doc James (talk) 15:50, 5 January 2009 (UTC)

I've seen the claim stated by Agalmic written somewhere as well. As I understand it, girls with inattentive ADHD are more likely to go unnoticed and undiagnosed whereas boys with the combined subtype are hard to ignore, which is in line with your above commentary Doc James. It certainly makes sense. "The squeaky wheel gets the oil." --Snailgoop (talk) 03:16, 18 February 2009 (UTC)

Yes, I have read the same and this point definitely deserves better coverage. We need to find a ref and add this.--Doc James (talk · contribs · email) 04:21, 18 February 2009 (UTC)

I added something today, just a small preliminary entry with a reference. It definitely deserves more.--Snailgoop (talk) 07:20, 18 February 2009 (UTC)

NPV

I think this article has reached a NPOV. Should we now remove the tags?--Doc James (talk) 13:02, 9 December 2008 (UTC)

Nope, the editing process and consensus building are dysfunctional. That needs to be fixed first.--scuro (talk) 05:51, 10 December 2008 (UTC)

Just a passing observation from a college student mired in research on ADHD, but this article strikes me as entirely PoV, from CHADD's perspective, CHADD being the 'Grassroots Organization' recieving near a million dollars from Ciba-Geigy. (this taken from http://www.pbs.org/merrow/tv/transcripts/add.pdf , specifically in the middle of page 15. the text is quoted at http://adhd-report.com/adhd/9_ritalin_CHADD.html , which is where i encountered it. i should note that http://adhd-report.com/ is, aside from the biting sarcasam, a fairly good counter-source to what's currently on the page, as well as having links to numerous other counter-ADD arguments.) sidebar aside, even as a mildly informed passing observer, this seems highly spun in favor of CHADD and (perhaps incidentally, perhaps otherwise) Ciba-Geigy. i'm doing a five-page research paper on the whole thing, and i'm allowed to show bias on it; i'm going for anti-ADHD. if you all want, i'll PDF it up and get a link up here for use. otherwise, my two measly cents. Masterofmymind (talk) 06:57, 19 December 2008 (UTC)

There is an entire page on the ADHD controversy. The financial conflicts of interest is mentioned. Theses pages still need alot of work. Feel free to join in.--Doc James (talk) 15:13, 19 December 2008 (UTC)

CHADD does not fail to represent the majority of scientific research on ADHD, regardless of the source of its funding (Shire pharmaceuticals). The problem, in my view, is that organizations who have essentially sold out to pharmaceutical influence largely dismiss alternative theories. Certainly it can be said that funding for alternative approaches is almost non-existent compared with funding research to further treatment with medication. A personal pet peeve of mine is that organizations like CHADD are littered with pharmaceutical advertisements, which in my opinion tends to tip the scales into the realm of biased information.--Snailgoop (talk) 03:22, 18 February 2009 (UTC)

Fake

people who have this are faking it and it is basically caused by bad parenting (Unsigned edit as of 18:18, 17 January 2009 by user:Aquafina09 with edit summary: "addendum to the cervacle reference theorem")

That's a common myth of ADHD perpetuated by ignorant people.--Snailgoop (talk) 03:32, 18 February 2009 (UTC)

Agree.--Doc James (talk · contribs · email) 04:18, 18 February 2009 (UTC)

no its not i have ADD and i can tell you it has nothing to do with parenting my dad was a drill sergent and a very strict parent but i constantly struggled with number and letter reversals forgetfullness attentiveness and emotional issues associated with negative thought loops it is very real trust me and its much tougher to deal with then people think —Preceding unsigned comment added by 71.208.113.39 (talk) 23:52, 2 May 2009 (UTC)

Agree. This is why this is listed as controversial. You think I like having ADHD?--Unionhawk 21:43, 5 May 2009 (UTC)

Geographical bias/vagueness

- cross posted to Misplaced Pages talk:WikiProject Countering systemic bias -

Article contains a number of statements like "It affects about 3 - 5% of children with symptoms starting before seven years of age." "ADHD is generally a chronic disorder with 10 to 40% of individuals diagnosed in childhood continuing to meet diagnostic criteria in adulthood."
In the USA?? In the UK?? In the western cultures?? Worldwide??
The sources cited presumably make the geographic areas clear, but we really need to specify these in the article text itself.
We need to try to eliminate USA-centrism (or other-country-centrism) in this article, and make country-specific facts and cites plain when we include them. -- 201.37.230.43 (talk) 16:45, 24 January 2009 (UTC)

Yes feel free to make changes. --Doc James (talk · contribs · email) 22:15, 24 January 2009 (UTC)

NPOV tag

Well I think we have reached NPOV. Should we now remove the tags. --Doc James (talk · contribs · email) 14:30, 29 January 2009 (UTC)

Yes, it's neutral but I think this article still needs more work (and would edit it if I could!), especially as it as a hot topic!

The initial summary is inaccurate: ADHD is defined primarily by a constellation of symptoms relating to inattention and distractibility with or without a component of hyperactivity and impulsivity. These symptoms must have been present in some form in early childhood (usually < 7 years of age) and impair functioning in school/education, work, and social interactions.

The whole pathophysiology section needs to be reworked. It's confusing and unclear.

Some of the references are confusing and refer to outdated/obsolete info and detract overall from the article (like that whole discussion over PET scans from the 90s) - I'd get rid of it entirely and replace it with data from this decade.

Imaging data is not necessarily cause and effect - if you have a small prefrontal cortex doesn't necessarily mean you have a functional impairment! Besides PET technology is much better now than 10 years ago and lots of studies are in progress to try and make that link between structure and function

More recent studies suggest that ADHD is based in a neurobiological problem where dopamine and norepinephrine transporters on inhibitory neurons in the prefrontal cortex are too efficient resulting in less of these neurotransmitters available in the synapse. The stimulants counteract that effect by blocking these transporters and/or increasing the release of neurotransmitters, thereby slowing down the clearance of these neurotransmitters. In essence, "strengthening the signal". Their absence means loss of inhibition of excitatory neurons, which leads to the constellation of ADHD symptoms.

I would also include a paragraph about how the childhood constellation of symptoms manifests in adulthood (ie how hyperactivity leads to impulsive speech and thinking, tactlessness, etc.)

A statement that clarifies the role of stimulants (and how they don't work for ~20% of people) - they only compensate as far as allowing you to maintain focus and controlling impulses, but they don't make up for not learning certain skills (ie. if you can now focus and listen better, you should be able to learn). Stimulants alone are not a "cure" - they need to be complemented by other interventions.

ADHD is also associated with learning disorders, especially dyslexia.

That statement on hypokalemic disorder confuses the issue. What does that mean? People who are truly hypokalemic may have neurologic symptoms (usually shortly before they die, if untreated) but that has nothing to do with ADHD...

It is estimated in North America that 4% of the total adult population have ADHD, but only 10% are diagnosed formally and have some form of treatment. Quite the impact on productivity!

Most articles regarding ADHD come from the US and Canada. If readers can find references to European models/points of view, please include it.

--CVZ (talk) 21:50, 30 January 2009

I couldn't agree more. Tried a while back to make many of these changes. With your support hopefully we can bring them about.--Doc James (talk · contribs · email) 22:10, 30 January 2009 (UTC)

List

Since last time I saw the article it seems to have improved a lot. However the list of associations should be removed (Maybe to a secondary article similar to List of multiple sclerosis organizations): Lists should be avoided per WP:MOS, wikipedia is not a directory (See WP:NOT) and they only name north america organizations (See WP:BIAS). Best regards.--Garrondo (talk) 14:50, 9 February 2009 (UTC)

Many thanks. And I agree they should be a list.--Doc James (talk · contribs · email) 15:06, 9 February 2009 (UTC)

Consider linking to clinical scales publicly available online

Perhaps after the phrase where the text mentions getting detailed histories from teachers and parents you would consider adding that the following scales are publicly available at psychiatrictimes.com:

Vanderbilt ADHD Diagnostic Parent Rating Scale Vanderbilt ADHD Diagnostic Teacher Rating Scale

http://www.psychiatrictimes.com/clinical-scales/adhd/vadrs/

and where the text discusses adult ADHD you might offer a link to:

Adult ADHD Self-rating Scale

http://www.psychiatrictimes.com/clinical-scales/adhd/

Loiswingerson (talk) 22:38, 12 February 2009 (UTC)Lois Wingerson, CMP Medica

Is this an OK source?

http://www.russellbarkley.org/adhd-facts.htm

It looks all very scholarly, but it is a personal site, not peer-reviewed. It would be preferable to use journal articles/reviews (or newer textbooks) as sources. In this case the prognosis info was changed & the above ref replaced a dead link and an NEJM article from 1999. The article was probably improved, but I question whether the source cited is acceptable in WP. - Hordaland (talk) 10:41, 17 February 2009 (UTC)

Thanks for bringing this up Hordland. Quoting someones personally opinion is completely inappropriate. I have found a 2008 review which says only 30-50% of adult still have symptoms by the time they reach adulthood which I think means even less would still have a formal diagnosis of ADHD. Therefore I have removed the above reference. Still looking for this info.

One may quote Barkleys peer reviewed publications. But his personal site and personal opinion are meanless, as are his power point presenations.--Doc James (talk · contribs · email) 20:55, 17 February 2009 (UTC)

I disagree, Doc James. Based on his considerable authority and the amount of literature that he has contributed to the field, his personal estimate is far from "meanless." Those people coming to Misplaced Pages to learn about ADHD may easily access his website from the reference and learn more, which is quite useful considering most people do not have access to a research library.—Preceding unsigned comment added by Snailgoop (talk • contribs) 01:57, 18 February 2009 (UTC)

Please use APA style references, when possible. It is the most appropriate citation style given the topic.

Not sure who wrote the last bit but having your refs link to a copy of the PMID at pubmed or the journal article is helpful. This tool will do it for you and puts it in the style agreed upon by the WP:MED portal http://diberri.dyndns.org/cgi-bin/templatefiller/index.cgi?ddb=&type=url&id=http%3A%2F%2Fwww.etymonline.com%2Findex.php%3Fsearch%3DObesity%26searchmode%3Dnone --Doc James (talk · contribs · email) 02:12, 18 February 2009 (UTC)

ADD

I'm sorry but what happened to ADD?? Have i been liveing under a rock since i was diagnosed or did it just dissapear?? Theres no such mention of ADD that i can find on wiki (although i just skimmed around\0 There is only one metion of ADD at all on wiki and that is one sentence. Shouldnt there be an ADD section of this page at least or a page of its on? can anyone enlighten me on this subject? 130.123.128.114 (talk) 02:58, 10 March 2009 (UTC)

You may have been living under a rock! The diagnosis of ADD was actually removed from the DSM in 1987; it became the "predominantly inattentive" subtype of ADHD. People still use the terminology because it makes sense, but it's technically not correct. Tim D (talk) 05:16, 10 March 2009 (UTC)

Well thats lame. Is there an article around explaining why ADHD is prevalent over ADD? And maybe it should be in here in a section of history of terminology or something like that. 130.123.128.114 (talk) 20:45, 10 March 2009 (UTC)

I think that would be good. Feel free to add a section under history about the changing terminology used to describe hyperactivity in children. This condition has been refered to be many different name over time and is refered to by different names in different areas of the world.--Doc James (talk · contribs · email) 22:01, 10 March 2009 (UTC)

FYI, there already is a section that addresses the history of terminology and such. But anyway, there are some researchers who argue that the predominantly inattentive subtype of ADHD is a completely different disorder from the combined subtype; it essentially comes down to how they're defined neurologically. I personally wouldn't be too upset if the DSM-V ended up redefining them separately... Tim D (talk) 23:58, 10 March 2009 (UTC)

Yes the classification is debated. The ICD10 uses different terminology and criteria all together. All I was saying is that if the above user find the discussion inadequate then he should feel free to clarify issues.--Doc James (talk · contribs · email) 01:16, 11 March 2009 (UTC)

ADD and ADHD are the same thing. It's just the difference between there being a "Hyperactivity" part there or not. The symptoms (possibly excepting hyperactivity), treatment, and diagnosis are the same. If you want to be technical, ADD is "ADHD predominantly inattentive"--Unionhawk 18:19, 30 April 2009 (UTC)

Really ADD is the same thing as ADHD withouth the Hyperactivity. I think alot more people have ADD then ADHD. So really ADD is just not being able to pay attention and not remembering things. So it actualy covers alot of people. lol--Blake (talk) 21:57, 5 May 2009 (UTC)

other treatment options

The idea that Attention-deficit hyperactivity disorder is only treatable by medication and seeing a psychologist is false. Many people have found that sometimes something as simple as a diet change or social change can essentially cure this "condition". This may not always be the answer for treating it however it does provide an alternative to try instead of spending the money on medicines and therapyGlopus14 (talk) 21:59, 25 March 2009 (UTC)

All we need is a study to back up those claims.--Doc James (talk · contribs · email) 23:18, 25 March 2009 (UTC)

But that should lead to a question of whether those who were "cured" with diet change or social change actually had the disorder in the first place. In these cases, it seems like it would be a disorder of the environment, not of the brain. Too bad we don't really have a sure-fire way of differentiating these things during diagnosis. Tim D (talk) 00:37, 26 March 2009 (UTC)

No one knows if this is a condition of the brain or the environment or both. The PET scan studies or old, seriously questioned, and no one has been able to repeat them. I read an interesting book about mental illness and war. During the first world war it was found that the average kid in the army would love his mind after about 6 to 12 weeks in the trenches. Are culture now says what to this condition as a chemical imbalance.

NO mental illness has a PROVEN chemical cause. Some want us to believe that this question has been settled but it hasn't. Psychiatrists do not diagnosis anything with imaging or labs they still send all their patients to be medically cleared. Glopus may have a valid point he just needs evidence to back it up. Mental illness also may be caused by a chemical balance BUT once again we need evidence. Both of these are still conjectures as far as I know. Cheers --Doc James (talk · contribs · email) 01:19, 26 March 2009 (UTC)

in cases where diet and lifestyle change "cure the disease" it may not have been ADD —Preceding unsigned comment added by 71.208.113.39 (talk) 23:55, 2 May 2009 (UTC)

Documentation of patient experience on stimulant drugs?

I would like to see reporting or reviews which categorize and quantify the different outcomes of people on these stimulant meds. A good report or review would probably include side effects, patient experience as they would describe it, and include some follow up with those who participated in the data collection.

We have reported on the experience of unmedicated people who are labaled ADHD, but not the experience of those who are medicated, which seems like an imbalance.

I would be skeptical of any reports which do not include negative experiences associated with the early high dosages of Ritalin that many were put on back when stim drugs were introduced into treatment. I would also be skeptical of reports which bias toward a placebo effect, however this is based purely on my experience, which includes an increase in memory, memory accuracy, awareness of surroundings and the option to choose what I attend to. Also the non-stop talking has decreased.  :)

These are personal observations, and so I read that this means I can't include them in the content of the article, however I thought an article or study probably exists which might include some more rigorous scientific collection and presentation of this info.

Thanks to everyone who wiki's, this is a great place to learn! ~anonymous user —Preceding unsigned comment added by 151.151.98.234 (talk) 16:25, 30 March 2009 (UTC)

ADHD even though it is "the best studied" pediatric psychiatric disorder is still very poorly studies. Only one study of 18 month of treatment with an extension to 30 months of observation of about 500 people with lots of issues to it. Long term side effects and benefits are thus unknown. One needs to compare a blinded group who received treatment to a group who did not. About 60 % of people who do not get any treatment resolve on there own.--Doc James (talk · contribs · email) 17:10, 30 March 2009 (UTC)

Look at the pharmocological treatments section. I saw a news article on a long-term study today. II | (t - c) 19:08, 30 March 2009 (UTC)

Yes this is the MTA study that I am referring to above. It did not show a great success with stimulants. But people believe in drugs thus regardless of the effectiveness of them they take them / prescribe them / force them on those under their care. Another great example is the use of antipsycotics in dementia. They have been shown to be ineffective and increase mortality, but my colleagues still use them extensively. I see people dieing from there use daily makes me hold my head in shame for my profession.--Doc James (talk · contribs · email) 00:03, 31 March 2009 (UTC)

I need help

I am currently working on a Junior Thesis on ADD/ADHD and how it affects people in life and I was wondering if anyone could help me out in any way. Thank you.Jaj6 (talk) 22:47, 7 April 2009 (UTC)

There are lots of great sources. It is a big topic and very controversial. How ADHD affects ones life of course depends on were you live, how tolerant your society is, and how you define ADHD. It is a very American dominated condition as the ICD 10 does not contain this diagnosis but uses hyperactivity instead with more stringent criteria. ADHD is not a single condition but a spectrum. Being hyper vigilant to your surrounding and easily distracted wrt what you are doing would be a good trait to keep you alive for example if you lived in the jungles of the congo were roving bands of militia go around killing people.

By all means feel free to research and edit this page. Would probably be good to narrow down your topic.

The problem with trying to figure out how ADHD affects ones life is not easy. For example does a child get the diagnosis of ADHD because he or she uses drug and is deficult to deal with or does ADHD cause the use of drug.--Doc James (talk · contribs · email) 23:48, 7 April 2009 (UTC)

I specifically am taking on this big challenge originally because I have ADHD and I am taking the majority of my info from Driven to Distraction Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood by Hallowell, Edward M., M.D., and John J Ratey, M.D. and ADD: Attention Deficit Disorder a Common but Often Overlooked Disorder of Children by Hunsucker, Glenn, M.A. so I know I have good cretible sources. mainly what I'm looking for are ways to treat it and then the points that are against it. of which I have zero treatments as of yet and I only have one point on the negative and that would be that there's no real evicence that proves it exists as a real disorder of the brain. then for one of the points I have proving it it says "'Half of all medical disorders are diagnosed without benefit of a lab procedure," notes Dr. Russell Barkley, professor of psychology at the College of Health Professionals at the Medical University of South Carolina. "Where are the lab tests for headaches and multiple sclerosis and Alzheimer's?" he asks. "Such a standard would virtually eliminate all mental disorders.'" (as a basic link).Jaj6 (talk) 00:19, 8 April 2009 (UTC)

I would give a word of warning to Barkley. He is the most pro drug treatment MD alive. Alzheimers can be diagnosed with a brain biopsy. A headache is a symptom not a diagnoisis ( the brain tumor is diagnosed by CT, menigitis is diagnosed by LP as is a subarachnoid HA ) Primary headaches are diagnosed by a discription from the patinet and you can tell they are in destress whe they have a migraine. Multiple sclerosis is diagnosed by MRI and LP. ADHD however is usually diagnosed by your teacher. It is the label someone gives you when they do not think you are listening to what they are saying. It is not the child who complains. This is a diagnoisis given to someone without their input. And thereare not many other conditions like this. See the page about ADHD controversies. Cheers

P.S. It does not suprise me that Barkley said the above quote. It only confirms my conviction that he is a quake. --Doc James (talk · contribs · email) 00:39, 8 April 2009 (UTC)

You're welcome to think that both Barkley and the condition are quacks, of course. I was first diagnosed long before he was practicing, and before the use of stimulants was known. I was referred to Psychology Department of the Student Health Service at the University I was attending because of falling grades. The testing (then, early 1960s) was doing a bunch of boring clerical chores, moving little pegs around on a big board, adding up columns of numbers, sorting 3x5 cards into alphabetical order, ... tasks which made no sense to me then (and I now understand that the distractions and interruptions by the psychiatrist were intentional on his part; the test was not the task correctness or completion, which I did well on, but the speed at which I returned to the test after the interruption, which I did poorly at.) Their conclusion was that under normal circumstances, they would say that I had Minimal Brain Dysfunction, but since I was a sophomore in the Honors Engineering program, a Merit Scholar, had nearly perfect SAT scores ... I just could not have MBD, and I should apply myself to my studies. Bzzzt. Ah well, I learned, slowly, but it seems some new to the scene haven't. Strattera has, according to my wife and friends, changed me, for the better. Mostly I think it's made me more aware of my failings. But that's a good thing, in many ways. It may be that the current understandings about ADD are wrong. Ulcers were like that for many years, too, and the diets, although ineffective, were not quackery. htom (talk) 03:22, 8 April 2009 (UTC)

A quack? Seriously? Regardless of one's views on the use of medication with ADHD, it's pretty hard to argue that Barkley's research and theory development haven't been invaluable to the field. Tim D (talk) 06:43, 8 April 2009 (UTC)

One word about that though is that I was not diagnosed by any teacher, but my parents suspected and then my doctor diagnosed it. And that quote I got from Barkley was a quote someone quoted him with in an essay titled ADHD Is Not a Myth or Hoax. which I got from the reference I gave earlier.Jaj6 (talk) 00:47, 8 April 2009 (UTC)

It is more his comments that following the MTA study that further research on ADHD would be unethical as all should be treated. The MTA study did not in anyway show fabulous results with treatment and was only of 14 month of duration with an extension to 30 months no blinded.

An extension of this trial to 8 years was published last week. It found no benfit in any variable from prior treatment with stimulants. Further more only 436 people were in this study and this is the best evidence available.Molina BS, Hinshaw SP, Swanson JM; et al. (2009). "MTA at 8 Years: Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study". J Am Acad Child Adolesc Psychiatry. doi:10.1097/CHI.0b013e31819c23d0. PMID 19318991. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

What this study found is that treatment makes no meaningful difference in outcomes.

Barkley also published a position paper saying ADHD is not controversial. It made me laugh when I read it.

So to summarize. Hyperactive/ADHD people exist. Hyperactivity can cause problems in our culture for some people. Stimulants leads minor short term improvements. There are no meaningful long term improvements. There are side effects to stimulants ( addiction, short stature, psychosis to name a few). Stimulants are far from a panacia.--Doc James (talk · contribs · email) 07:24, 8 April 2009 (UTC)

I think the key is that the most effective treatments are those that involve psychosocial components as well. The way I look at it (and I'm sure many others do as well) is that medications can ameliorate the neurological deficiencies enough to open doors, but without the right knowledge and development of adaptive behaviors/habits, they won't do much good in the long term. Tim D (talk) 03:31, 9 April 2009 (UTC)

(out)

CONCLUSIONS:: Type or intensity of 14 months of treatment for ADHD in childhood (at age 7.0-9.9 years) does not predict functioning 6 to 8 years later. Rather, early ADHD symptom trajectory regardless of treatment type is prognostic. This finding implies that children with behavioral and sociodemographic advantage, with the best response to any treatment, will have the best long-term prognosis. As a group, however, despite initial symptom improvement during treatment that is largely maintained after treatment, children with combined-type ADHD exhibit significant impairment in adolescence. Innovative treatment approaches targeting specific areas of adolescent impairment are needed.Clinical trial registration information-Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder. URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00000388.

It seems to me that you confuse the symptom of hyperactivity for the problem being successfully treated, even though there is still a long-term change in ability to master intentional goal pursuit. htom (talk) 15:47, 8 April 2009 (UTC)

Extension of MTA published

Molina BS, Hinshaw SP, Swanson JM; et al. (2009). "MTA at 8 Years: Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study". J Am Acad Child Adolesc Psychiatry. doi:10.1097/CHI.0b013e31819c23d0. PMID 19318991. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)--Doc James (talk · contribs · email) 07:24, 8 April 2009 (UTC)

Disorder

I am sorry to say it, but it is this page that has a serious development disorder.

When I look it over, I try to image what kind of user may want the information in these pages. Is it children, adolescents, doctors, people with ADHD, their families or just some "average" user? Who are we writing for?

I see obsolete facts and bad structure, e.g at the very start: Having an opening statement like "It affects about 3 to 5% of children" is close to 50% truth - ahem. This is not a childhood only disorder. Sure, that fact has a reference, but sorry, wrong context. I suspect the author at that point had no concept of adult ADHD. When someone had, a separate article was created - huh??. I guess it's merge time. Or maybe some of you, here, still believe that this is a childhood only disorder? What are we gonna do - throw references at each other?

Another example is the scattered classification information: A standard infobox with classfication, a classification section that contains generic ADHD info (except the rather surprising information that ADHD appear to be associated with antisocial disorder). This section manages within a few lines to call ADHD a 'developmental disorder', a 'behavior disorder', a 'disruptive behaviour disorder' and then the infamous association with psychopaths. All this without in any sense relating to the reader what the similarities or differences may be. Further classification information appear in various other sections below this. Now, really, is this just lack of structure or is it just really bad qualty?

Comments, anyone? —Preceding unsigned comment added by Sportsmandda (talk • contribs) 17:54, 19 April 2009 (UTC)

Adult ADHD is not in the DSM 4R and is an even more controversial diagnosis. I am sure it will be in the DSM5. It states 3-5% than says 50% resolves leaving use with 1.5 - 2.5 %.--Doc James (talk · contribs · email) 20:07, 19 April 2009 (UTC)

The article needs a re-writing, but this is very difficult to do with topics that have controversy attached. I suspect (but I'm only a patient) that the DSM5 will abandon both ADD and ADHD as being labels that are not useful, and instead have a Hyperactivity Disorder, an Executive Function Disorder, and a Slow C Process Disorder (where in C might be Cognitive or Communication). There's also the possibility of some reference to dopamine receptors and dopamine transport, but that will probably not be until DSM6. htom (talk) 23:59, 19 April 2009 (UTC)

Here we go with the "controversy" thing again, but I'll refrain from discussing that until later. Using the DSM as any kind of reason for not the merging child and adult ADHD articles is misleading, IMO. To illustrate, one recent source concluded that current DSM-4 criteria for children makes ADHD "unlikely to exist as an identifiable disease" PubMed. Where does that leave adult ADHD? That aside, I have read you comment above concerning Ritalin side-effects. You mention "addiction, short stature, psychosis to name a few". The current figures I have concerning this is "stature - less than 0.1%, "psychosis - less than 0.01%". Do you agree with these figures? The "addiction" claim is totally unsubstantiated afaik. None of these side effect are mentioned in the Ritalin article - shouldn't they be if they are that important? Your emphasis on these side-effects makes me suspect you hold distinct anti-Ritalin bias. Your comments above on Russell Barkley ("..confirms my conviction that he is a quake") convinces me that you hold considerable bias to the topic as such. --Sportsmand (talk) 09:19, 20 April 2009 (UTC)

I assume you're addressing Doc James' comment? htom (talk) 13:49, 20 April 2009 (UTC)

Since I have added this article to my watch list after a recent edit I made I will share my views on this debate. This study, suggests more than 0.1% have slowed growth but depends how severe the measurement is, infact they suggest smaller height is typical. If the measurement is just one that reaches "statistical significance" then shortened height is fairly typical from long term use of amphetamine or related drugs in growing children. If the measurement is like they are one foot or half a foot shorter than normal then yeah probably 0.1%. The other side effects really depend on the methodology of how they were calculated and also there is little or no data on long term outcomes of stimulants eg long term randomised placebo controlled trials. Tolerance and dependence is listed in the British National Formulary as a side effect of methylphenidate as well as for dexamphetamine. It is also a schedule 2 controlled drug so obviously there is a strong potential for it to be misused addictively. That is not to say that most people misuse their medication, clearly they don't but clearly some do and it is quite well known that addictive drugs prescribed get diverted to the black market or misused by a subgroup of patients. I have know of people in real life who have abused methylphenidate specifically and doctor shopped for it and become addicted to it. Your above comments regarding antisocial behaviour disorder and classification of ADHD. That argument would need to be taken up with medical journals who publish such studies finding an association and also with the various psychiatric panels who decided to class ADHD in the way that they did. Misplaced Pages just reports the facts, we can't get into reclassifying disorders regardless of the unpopularity by some readers of official classifications. If you lobby lets say The American Psychiatric Association to change the definition of ADHD as a desruptive behavioural disorder then we can change it here but until then unfortunately we just report the encyclopedic facts about ADHD. Adult ADHD is mentioned in the lead and throughout the article so I confused as to your complaint.--Literaturegeek | T@1k? 14:23, 20 April 2009 (UTC)

Sportsman: If you provide some references to support your assertions would be happy to look at them. It looks like about 1 million people in the US abuse prescription stimulants. http://www.nida.nih.gov/ResearchReports/Prescription/Prescription4.html Psychosis is rare but when it occurs is a big deal. I would not be surprised at the rate you give and if you find a ref to back it up I recommend you add it. The growth issues are complicated and I have not added info on this.

The common side effects per uptodate are: Anorexia or appetite disturbance (80 percent) Sleep disturbances (3 to 85 percent) Weight loss (10 to 15 percent), tics(Approximately 15 to 30 percent of children) The common side effects are usually mild well the severe side effects are rare.

The group from McMaster did a good job summing up why ADHD is controversial. Russell Barkley than goes ahead and writes a position paper denying the exsistance of anyones opionion other than his own. I respect his research just not his personal oppinions when it comes to ADHD . Cheers--Doc James (talk · contribs · email) 17:31, 20 April 2009 (UTC)

You refer to a statistic that has nothing to do with ritalin side-effects. It is well-known that Ritalin is being abused, it is well-known that ADHD has comorbidity with drug abuse, but your implication was that Ritalin leads to "addiction". I can't believe a real doc would make a mistake like that. --Sportsmand (talk) 21:26, 20 April 2009 (UTC)

As it turns out, ritalin is abused a lot less than many other drugs with 2% of teens reporting that they have used it in the past 12 months, but 12% reporting non-prescription use of pain medications. The trade off is that kids with ADHD who are prescribed stimulants are less likely to abuse street drugs in general than kids with ADHD who do not. Plus there are the risks of car accidents etc if they are not taking stimulants. Everything is a cost-benefit analysis, and those who do not work with unmedicated patients with ADHD do not realise what the costs are of not taking the medications. But, it is probably not worth it to fight this one, Sportsmand, unless you can cope with a lot of aggro from the anti-med side. --Vannin (talk) 21:54, 20 April 2009 (UTC)

Thanks, but I'm very tenacious :-) It is indeed worth fighting. The Google page ranking makes this article a premier source of ADHD information. Biased information may be a great disservice to a great number of people. --Sportsmand (talk) 22:40, 20 April 2009 (UTC)

Eh, Sportsmand, I don't see Doc James making any implication like that at all. Let's focus on the article. Should side effects of stimulant medications should be mentioned in the pharmacological treatments section? II | (t - c) 22:00, 20 April 2009 (UTC)

"Doc" James asserted above "There are side effects to stimulants ( addiction, short stature, psychosis to name a few)." Side effects of medication should obviously be described in Misplaced Pages IMO. --Sportsmand (talk) 22:30, 20 April 2009 (UTC)

You honestly think people children can't get addicted to their stimulant medications? II | (t - c) 22:57, 20 April 2009 (UTC)

How do you define "addiction" in terms of chronic patients taking prescribed medication? I can't. --Sportsmand (talk) 23:38, 20 April 2009 (UTC)

Actually I read a paper a couple of years ago where they followed up stimulant treated kids to a longer followup date and found an increased risk of cocaine abuse versus those with ADHD who never took stimulant medications. It is true there are studies showing no increased risk of substance abuse but they did not followup beyond I think age 18. If remembering correctly the study I am talking about followed them up to age 23. So the reduction in drug use is controversial, infact I am not sure there have been any studies which showed such a reduction? If there are I would like to read them and why not cite them? The issue with me is not a matter of trying to delete the view point of "the meds have benefits". It is a matter of citing peer reviewed facts from reliable sources and not having significant view points in the literature removed. Sportsmand says there is no controversy, delete everything that says ADHD or its treatment is controversial etc. That is ridiculous and bias. Your claims need to be backed up with reliable sources. If you have a reliable source which states that ADHD meds cause a reduction in car accidents then please do cite it. Misplaced Pages works via reliable sources.--Literaturegeek | T@1k? 22:02, 20 April 2009 (UTC)

I suggest you read what I wrote about Dispute resolution below in stead of putting the words into my mouth. --Sportsmand (talk) 22:30, 20 April 2009 (UTC)

Sportsmand I find your comments insulting. "I can't believe a real doc would make a mistake like that." But then again I have been called a nazi during my time here so no worries I have thick skin. I have asked your to provide evidence for the numbers you quote. I have agreed with you that 0.01 percent is not unreasonable for a rate of psychosis seen with stimulant use. I think it is a good idea to add this to the page to put the side effects in context. There are lots of reliable sources documenting the controversial nature of ADHD. Stimulants are NOT the most abused drugs. I agree with that part of Vannin's statement. The ref I provided above list them as third. That they decrease car crashes and addiction to other drugs with use in ADHD I would love to see the paper that supports that. Other papers do not support that assertion.--Doc James (talk · contribs · email) 13:42, 21 April 2009 (UTC)

If you move this to the proper context, I would be happy to reply. By placing it here like this, I consider it trying to conceal the fact that you were mistaken. --Sportsmand (talk) 09:31, 22 April 2009 (UTC)

BTW I have never said "Ritalin leads to "addiction"" I have said addiction is one of the concerns wrt stimulants, but that as far as I am aware there is no evidence to show stimulant used to treat ADHD either increase or decrease addictions rates among the people diagnosed. This concern of course is why they are schedule 2 drugs in the USA and some parents are concerned about their children having schedule 2 drugs.

--Doc James (talk · contribs · email) 14:21, 21 April 2009 (UTC)

All: Is it possible that the increase in cocaine use by those formerly on prescribed stimulants as a treatment for ADHD is because they are no longer allowed access to those prescription stimulants, and cocaine is easier or cheaper on the illegal market? In other words, having been deprived of what they consider to be useful treatment, they have switched to an illegal substitute in an attempt to return to their former medication? htom (talk) 14:33, 21 April 2009 (UTC)

I have not seen this paper that you mention saying cocaine use is greater in those with previous stimulant use. I would not be suprised if this association were true however it still does not mean that stimulants lead to increase cocain use. The affects of stimulants on addiction is a difficult question to address. People who are prescribed stimulants are likely to have ADHD and thus have borderline personality disorder / conduct disorder (40% association). Those with conduct disorder are more likely to be addicts. Some evidence show stimlants decrease long term drug use, some shows it increases long term drug use. All the evidence is unfortantely of poor quality as is most ADHD research. Part of the reason why it is controversial is that the evidence is not great.

I do know that addicts often use any stimulant they can get their hands on be it cocaine, crystal meth, or amphetamines. We see the same thing with benzos and etoh. People often become addicted to both.--Doc James (talk · contribs · email) 15:32, 21 April 2009 (UTC)

It was 0.1% for psychosis not 0.01% but it was a review of short term clinical trials. However, the limited amount of research into long term use of stimulants suggests a much higher rate of psychosis of more than 6%. Stimulant related psychosis usually only occurs from either chronic use or in overdose. Be careful not to apply short term effects statistics to long term effects statistics, that is original research and almost certainly inaccurate in the case of stimulants.--Literaturegeek | T@1k? 15:31, 21 April 2009 (UTC)

Otter what you just said is a theory so is irrelevant unless you can find a reliable source which demonstrates that theory.--Literaturegeek | T@1k? 15:34, 21 April 2009 (UTC)

Literature sounds like these numbers would be useful to add. Would put the side effects into context.--Doc James (talk · contribs · email) 15:35, 21 April 2009 (UTC)

stimulant therapy associated with reduction in risk for subsequent drug and alcohol use disorders in a meta-analysis --Vannin (talk) 02:47, 22 April 2009 (UTC)

there is a much greater risk of accidents in drivers with ADHD. That risk is reduced by stimulant therapy and . I do actually know what I'm talking about --Vannin (talk) 02:56, 22 April 2009 (UTC)

Vannin never implied you didn't. If you have time you should add these conclusions to the article.--Doc James (talk · contribs · email) 04:56, 22 April 2009 (UTC)

Ref does not say reduced accident rate, (unless I missed it when reading refs). The meta analysis was of mostly short term studies showing improved driving performances after short term acute intake of methylphenidate. There was one study on long term users which was not very strong, basically it asked a relative of the ADHD person, "Do you think he/she drives better on methylpheidate?". Best that you can say is ADHD is associated with worse driving performance and an increased risk of motor vehicle accidents. Treatment with methylphenidate enhances driving performance. I would like to see a source, even a primary source which assesses motor vehicle accident rates in long term users of methylphenidate versus unmedicated ADHD drivers. What happens after chronic use of stimulants? No robust strong studies on driving performance after long term therapy and no evidence at all of reduced accident rate.

Thanks for the meta analysis on methylphenidate and lower drug abuse rates. I have seen criticism of those studies, methodology but nevertheless it is a reliable secondary source as is the one on accident rates and enhanced driving performance after methylphenidate, so please do cite them in the article.--Literaturegeek | T@1k? 17:06, 22 April 2009 (UTC)

Uptodate indicates that the improvement in driving skills is independent of weather a person has ADHD or not. I guess this might be part of the reason why the US uses methyphenadate in its airforce pilots. "The cognitive functions influenced by stimulants impact a number of daily living skills. As an example, methylphenidate ingestion has been found to reduce driving errors in adults . Stimulants may also produce these effects in patients without ADHD, and not all patients with ADHD improve with such therapy. Thus, the patient's response cannot be used to confirm or exclude the diagnosis of ADHD ."--Doc James (talk · contribs · email) 17:43, 22 April 2009 (UTC)

Dispute resolution

I guess we may as well start dispute resolution at this point. I assert that there is no significant "controversy" for the ADHD diagnosis, that the articles Attention-deficit hyperactivity disorder,Adult attention-deficit disorder and Attention-deficit hyperactivity disorder controversies be flagged as "disputed" and I offer the classic "International Consensus Statement on ADHD, January 2002" as reference PubMed, Full text. According to Misplaced Pages policies Misplaced Pages:Neutral point of view "Neutrality requires that the article should fairly represent all significant viewpoints that have been published by a reliable source, and should do so in proportion to the prominence of each. Now an important qualification: In general, articles should not give minority views as much or as detailed a description as more popular views, and will generally not include tiny-minority views at all.". --Sportsmand (talk) 21:03, 20 April 2009 (UTC)

We're off to a good start then, all significant viewpoints should be represented for neutrality. I agree with that. You seem to be of the opinion that the controversy should be deleted and removed as it doesn't exist. Google scholar comes back with 7,180 for adhd and controversy and adhd controversial brings back almost 125 peer reviewed papers including 40 reviews in pubmed. Your citation is not very good. First of all they are only saying the existence of ADHD is not controversial. Most people accept that some people are hyperactive and have poor attention spans. That is only a small part of the controversy. Much of the controversy surrounds the use of amphetamines in young children, drug misuse, side effects, long term effects of medications, overdiagnosis etc etc. Also the paper is just a group of experts from around the world getting together and signing their name saying this condition exists and is not a myth etc. It is just an opinion piece essentially. It is not an opinion of a respected or influential body such as the world health org or some other big national or international health bureaucracy.--Literaturegeek | T@1k? 21:19, 20 April 2009 (UTC)

I might ask, do you also agree with the rest of the policy? But please read what I write: ADHD diagnosis - not treatment. I take your statement "..they are only saying the existence of ADHD is not controversial.. as being in favor of that distinction. Your use of Google scholar as a reference is considered "original research" according to policies and thus not a valid source. So, you have not given any counter to my claim. As for the treatment, I certainly do agree that it is controversial, but that's not the point. --Sportsmand (talk) 07:42, 21 April 2009 (UTC)

I see the reference you cited compares denial of ADHD to denial of whether smoking causes cancer or HIV causes aids LOL. It is just an opinion piece and I bet if I looked into the signators their would be a conflict of interest.--Literaturegeek | T@1k? 21:31, 20 April 2009 (UTC)

This "Opinion piece" still represents contemporary scientific understanding of ADHD. After 7 years, it has not really been countered, and I dare you to do it. What kind of science do you suggest we use as basis, if not like this? ADHD is an officially recognised disorder (usually under other names), we have it in the category infobox so why is there any doubt? This is a PubMed article and a very valid source. Furthermore, you have not any sources, so you have not countered my claim. --Sportsmand (talk) 07:42, 21 April 2009 (UTC)

I see this article actually already covers the fact barkley has finacial conflicts of interest. Interestingly Barkley himself published a paper on the controversies surrounding diagnosing ADHD!--Literaturegeek | T@1k? 21:40, 20 April 2009 (UTC)

How do you suggest we rate the risk, that financial interests may somehow influence the correctness of science? But why bother? There is capitalism and there is science. Money can't influence the results of real science - only the directions. I'm sure Barkley may have used the talk of controversies to sell another book. Does he state in the book, that ADHD is not a valid diagnosis? As you put it here, it is not a valid source and no counter to my claim. --Sportsmand (talk) 07:42, 21 April 2009 (UTC)

Sadly, there is considerable public dispute about both the existence of the disorder and the diagnosis and treatment. (I say sadly because most of the noisiest participants are usually among the least informed about the disorder.) We should cover this, somehow, and provide our users with the best available reliable information: what's true, what's false, what's disputed. htom (talk) 00:31, 21 April 2009 (UTC)

I agree, that the public may dispute ADHD - how could they not?. However, as we have seen right in this very page, the concepts of diagnosis vs. treatment may sometimes not be understood. News-papers, in search of headlines, may write dramatic stories like "ADHD - the disease where doctors give speed to children, hyperactives and addicts" (I have no quote for that one). Honestly, public opinion doesn't matter for us here. Reliable information is the goal - absolutely. --Sportsmand (talk) 07:42, 21 April 2009 (UTC)

The usual RS for Misplaced Pages in matters of controversy tend to the popular rather than the scientific. As medicine is as much art as science, there's lots of room for opinion to be touted as "reliable". htom (talk) 13:06, 21 April 2009 (UTC)

I am well read on the subject of ADHD. I have read a number of books and research papers on ADHD and know someone who took ritalin who wishes that they had never heard of the word ritalin. I also know of a consultant psychiatrist who is the head of a major psychiatric hospital who has noticed a pattern in that many of his patients who present with a diagnosis of borderline psychosis or schizoeffective disorder have a long history of using amphetamine based stimulants, methylphenidate and dextroamphetamine and he believes that his colleagues in child psychiatry and pediatrics are brain damaging children. He also finds that the symptoms do not typically go away after discontinuation of stimulants. He says the problem is how do you tell if it is comorbid or caused by the drug and that it is difficult to prove cause and effect. He is clearly not fringe being the head of a major psychiatric hospital, he is also works in addictions and is a psychopharmacologist. I also know of people who became addicted to ritalin and doctor shopped for it and who would become violently psychotic if they ran out of ritalin and I know of people who abused ritalin. On the other side of the coin I know of people who took stimulants who lead normal lives now and no longer take stimulants. Oh and the books that I have read, one of them was written by CHADD, a group funded by the drug companies who promote stimulants heavily. They actually put forth the hunter versus gatherer theory which suggests that ADHD is only a "problem" due to the environment of current society which actually backs up the point of view that ADHD is not a brain abnormality or neurological disorder but rather a problem for some people in the modern society environment eg school, work environment. The controversy is worse due to the very limited research into the long term effects of stimulants so no one can prove either side of the controversy correct or wrong. Infact many of the controversies can't even be cited on wikipedia as they have never even been raised in the peer reviewed literature.--Literaturegeek | T@1k? 00:50, 21 April 2009 (UTC) .

What you tell sounds horrible, and I don't doubt that it may be true. But as I see it, we as humans accept certain "life-risks", traffic accidents, lifestyle, consuming food, salt or alcohol. The risk of medication should be determined in relation to that. For the individual, it may help to see life and death as raw darwinian statistics. ;-). But finally, the ADHD diagnosis is not connected to stimulants as such, so I wont record what you write as any counter to my claim. --Sportsmand (talk) 07:42, 21 April 2009 (UTC)

Expecting symptoms relieved by drugs (although it's emphasized that the drugs do not cure) to remain relieved when the drugs are removed, shows a magical belief in something, or perhaps a hearing or reading deficiency in the believer. Take my eyeglasses away, I'm still near-sighted, even though I've worn them for a half-century. I don't know that any knowledgeable medical professional has ever claimed that stimulants "cure" ADD, in any of its forms, just as anti-convulsents don't cure epilepsy. Stop taking them, the seizures return. Take them for twenty years, maybe, if you're lucky, they don't. (Well, they haven't yet.) htom (talk) 01:06, 21 April 2009 (UTC)

Let me elaborate on my summary comment, which I mis-somethinged. It should be hunter-gatherer vs farmer; the latter requires a much larger mastery of time and delay of gratification. Indeed, it's almost the step from super-great-ape to mankind. htom (talk) 03:31, 21 April 2009 (UTC)

Epilepsy is a serious neurological disorder which failure to treat can lead to brain damage or even death. The benefits of treatment outweigh by far the risks of treatment. The reality still remains that very young children are at an early age being told they have a defect of the brain, a mental health disorder, they are different and normal like their friends and they are told they need amphetamines in their developing brains in order to "become normal". The long term effects have not been investigated so it is not possible to do a risk benefit ratio calculation. The limited amount of research into the long term effects actually backs up the controversy side rather than "the drugs are as safe" POV. Hence ADHD and amphetamines are controversial. I think the debate should be settled now with citing both sides of the controversy using reliable sources.--Literaturegeek | T@1k? 15:39, 21 April 2009 (UTC)

I understand the risks of epilepsy (which is why I kept taking the drugs even though I hated the fog they put my mind in, and why the VA had such a hard time getting me to slowly withdraw, which has turned out well.) When I think back to my childhood ... in any case, that sounds like a very poor way to explain to either parents or a child what has, is, and will be happening, and what can happen. I would hope that the debate would not "settle", but inspire research into a number of treatments (and lack of treatments) in an attempt to discover what the better treatments are. I don't think there ever will be a "best" treatment; one of my nephews intentionally goes off his meds before playing gigs as a jazz trumpet player, and he does, indeed, play jazz better that way. His grades, though, suffer when he doesn't, and he knows that, too. Adjusting mental performance like that is almost a neat hack. What are the long-term consequences? We don't know, and no one seems interested in doing the study (I can understand why, it would be very difficult and probably have results that could be read either way, adult lives are too variable.) htom (talk) 17:11, 21 April 2009 (UTC)

Here is the critique of the paper that sportsmand was asking about http://www.critpsynet.freeuk.com/Acritiqueofconsensus.htm signed by many exports who hold a different point of view. It two parties disagree one of the parties is not honestly able to deny the existence of the dispute.

And wrt to OR that only applies to the main page OR is allowed on the talk pages.--Doc James (talk · contribs · email) 13:34, 21 April 2009 (UTC)

Above you wrote on Russel Barkley: "I respect his research..". Here you present a minority report. To what proportion do you think the two views should have merit? --Sportsmand (talk) 14:23, 21 April 2009 (UTC)

Barkley published the MTA one of the best research studies available on ADHD. This is the research. The position statement of his is an opinion piece rather than a research study. The critique is also an opionion peice. The McMaster paper from 1999 hold more weight than both in my opinion.

The position statement and the critique are more of a social discussion of ADHD. Both should be mentioned on the ADHD controversies page. Part of what these two peices represent is different views of ADHD in different places. Barkley and most of those who signed his statemement are American the critique is mostly British.--Doc James (talk · contribs · email) 15:22, 21 April 2009 (UTC)

I agree, that this is a valid source. The consensus statement and the critique is most likely the best metrics we can find to assess the matter. We may include other sources. Would you agree to that? Please remember our policies NPOV and please mind, that our job is not to interpret science, but to find the best material that indicates the state of the matter. --Sportsmand (talk) 09:31, 22 April 2009 (UTC)

There is also Dr Vernon Coleman for a polar opposite POV of Barkley.--Literaturegeek | T@1k? 15:45, 21 April 2009 (UTC)

This is not a valid source and no counter to my claim. The article is called "Ritalin: Child Abuse On Prescription?" and relates to ADHD treatment, not diagnosis. I am surprised that people still doesn't comprehend that distinction. --Sportsmand (talk) 11:28, 22 April 2009 (UTC)

Here is another critique of Barkleys statement. This one from Australia. PMID 12557837 Let me know if you cannot get access. I have added a passage on the controversies page to address Barkley's statement and the two critiques.--Doc James (talk · contribs · email) 17:59, 21 April 2009 (UTC)

I am in doubt with this one. It appears a genuine source, but how can we include closed content for future verification? --Sportsmand (talk) 11:28, 22 April 2009 (UTC)

Or see PMID 18658077 from 2008, which concludes that "ADHD is unlikely to exist as an identifiable disease. Inattention, hyperactivity, and impulsivity are symptoms of many underlying treatable medical, emotional, and psychosocial conditions affecting children". II | (t - c) 18:34, 21 April 2009 (UTC)

Lol, I used that source to show the exact opposite above. The true context of your statement is current DSM-4 criteria. They are not good enough to show ADHD in children. This shows problems with current DSM-4 diagnostic criteria, not the diagnosis. This is not a valid counter to my claim. --Sportsmand (talk) 11:28, 22 April 2009 (UTC)

(unindent)There are two basic kinds of disputes, it seems that this one is a content dispute. I have not followed it in detail. I would suggest using a content RfC, and follow RfC practice: avoid threaded comments, but encourage each side of the dispute to clearly state their position(s). Do this before actually putting up the RfC for outside comment, i.e., make the issue to be resolved very clear, otherwise you will simply get drive-by comments, not well-informed. (Content disputes are best resolved on the Talk page of an affected article, behavioral disputes, except for mention on an affected article Talk, are better handled, initially, on editor Talk pages.) I'm happy to try to mediate this, though I'm also involved: I have ADHD, it's not marginal, but I have no fixed opinion on whether it's genetic, originates in trauma or other personal experience, or, for that matter, is merely a moral defect. I'd like to know the truth! And, here, to see that the article is based on reliable source, all of it, not some segment selected for how the text might look in supporting a POV. There is, if I'm correct, still a Controversies article, where most detailed examination of controversy can be stuffed, but mention here seems appropriate where failure to mention could misrepresent, as settled, something where there is still notable controversy. --Abd (talk) 18:53, 21 April 2009 (UTC)

We used lots of closed content and anyone with access to a University library can get access to this paper quoted above.--Doc James (talk · contribs · email) 13:23, 22 April 2009 (UTC)

This is the third time you place a comment out of proper context. I urge you to stop the disruptive editing practices. I will admit the reference on the basis of the author and title and weigh it as such. The burden is on you to provide additional information, possibly information that is usable under Misplaced Pages licensing. --Sportsmand (talk) 16:23, 22 April 2009 (UTC)

I am not sure what you are referring to? Usually one places the comments at the bottom as not everyone looks thru each section for new editions. I have offered to provide complete copies of this reference for those who are interested. I have no idea what you are talking about with respect to licensing. Cheers.--Doc James (talk · contribs · email) 17:23, 22 April 2009 (UTC)

Lets cut through all the bull. As I sum it up, we have the following facts on the ADHD medical diagnosis:

• Fact: It is an officially recognized diagnosis, WHO F90, wikipedia
• Fact: It may utilise schedule 2 drugs
• Fact: It is supported by a large group of international scientist (consensus)
• Fact: Valid minor scientific opposition to consensus, apart from presentation form (Doc James)
• Fact: The consensus statement was seen as "why stop asking question?" (Doc James)

To me, that doesn't look like a controversial medical diagnosis. But I call for additional sources/facts. When we can agree on the facts, we kan move on to resolve the case.--Sportsmand (talk) 21:17, 22 April 2009 (UTC)

We are still in bull at the moment. I will cut through the bull, yes it is officially recognised as a disorder, but it is OFFICIALLY recognised as a controversial disorder with controversial treatments. The National Institute of Clinical Excellence summarised some of the controversies in its National guidance for doctors on ADHD. There are literally 10,s of thousands of reliable sources regarding the controversies. The controversy article is JAM PACKED with sources. How many do you want? Tell ya what if you can persuade wikipedia to change its article size rules from 100 kb up to 100,000 kb then we can add ALL of the controversy citations and actually write an online wikipedia book.--Literaturegeek | T@1k? 22:46, 22 April 2009 (UTC)

I suppose you refer to this: CG72 Attention deficit hyperactivity disorder (ADHD): full guideline? This is a very valid source, an interesting read and I thank you for bringing it to my attention. I don't think it may be characterized as a strictly scientific work, but that doesn't mean it is irrelevant in assesing the validity of the ADHD diagnosis or whether it is controversial or not. But please mind, that merely because a source may state diagnostic controversy, does not mean that we on this basis alone can conclude whether a significant controversy exists or not. In that sense,you have not "cut through the bull" if that is how I am supposed to understand your opening statement. Neither does is constitute an "official" recognition of controversy, if such a condition exists at all. I will gladly accept it to our list of references. If we do, we will have the following interesting situation: We have on the list a scientific source (from Doc james Consensus Critique), the author of which (Sami Timimi) severely denounces the authors (GDG) and work of another source (this). Sami Timimis statements are in your own source. --Sportsmand (talk) 12:32, 23 April 2009 (UTC)

Ya know who I reckon you are, Mwalla on one of your socks again Misplaced Pages:Sockpuppet investigations/Mwalla/Archive. You do the same thing, start nonsensical arguments, use sockpuppets and stalk myself and other users. Infact you are Mwalla because ya using a similar name to one of Mwalla's socks, Xports or something.--Literaturegeek | T@1k? 22:53, 22 April 2009 (UTC)

As I understand it, you are trying to associate me with a known vandalist. Is that correct? If you look carefully, you may find my static, public IP in the page history. If you care to check this, you will see that this IP originates in Denmark. When I check the IP's in the reference you mention, they are all in the US. How do you explain that? That said 'Mwalla' suddenly beamed himself to Denmark in order of being able to continue disrupting editing? (da: Det er simpelthen hinsides min fatteevne til hvilke længder nogen vil gå i denne debat) For your convinience, I will put my public IP right here. Sportsmand. --217.157.164.21 (talk) 06:32, 23 April 2009 (UTC)

Definitely agree with Literaturegeek Sportsmand has done way more editing than his edit count shows and he know much more about wiki policy and editing tricks than I. He also does not seem particularly interested in discussing the research only in pushing his POV.--Doc James (talk · contribs · email) 23:21, 22 April 2009 (UTC)

I have commented on all the sources and most entries in this section. How can you see that as being "not interested in discussing the research?". On the contrary, many of the comments and questions I posted was never replied to. Including a number I posted in response to you. I started editing at Danish Misplaced Pages a few weeks ago. When I turned to English Misplaced Pages for references and material, I saw how skewed it looked to me. Thus, I decided to do something about it. Yes, I know the policies, and so should all other editors as well. The NPOV is not that difficult to understand. Do you hold it against me that I do? Btw, my understanding may be augmented by the fact, that I have worked with free software for many years and pretty well understand GFDL and associated licensing. Yes, I have the POV that the understanding of ADHD is severely lacking in this article. Yes, I have the POV that some editors here have extreme bias (right down to not understanding fundamental medical concepts). And yes, I assert my free right to edit here with exactly that POV. Finally, to witness, I have another user here called "sportsmandda", created before I understood that I could use my danish account here as well. --Sportsmand (talk) 06:59, 23 April 2009 (UTC)

I feel prompted to do a side-note to so-called "anti-pharm" or "anti-med" editors (if any such are present): I just wish your justified concerns about medication wouldn't spill all the way over to medical diagnosis. --Sportsmand (talk) 12:32, 23 April 2009 (UTC)

Thanks sportsmand for verifying your identity. Sorry about the false accusations. Still not sure what in particular you are having problems with? The McMaster study comments on why the diagnosis is controversial PMID 10637682 What exactly do you wish to change within the article?--Doc James (talk · contribs · email) 22:25, 23 April 2009 (UTC)

A valid source, but allow me paraphrase directly from the synopsis: "CONTEXT: The Agency charged McMaster with conducting a review of the literature on the treatment of ADHD.. OBJECTIVE: To identify and appraise on the treatment of ADHD.. CONCLUSIONS: Most on the treatment of ADHD have limited value for guiding clinical, policy, and research decisions..." What McMaster say is that we can't say much about treatment, because the material we got (1982-98) were of limited value. Sorry, this is about treatment, not diagnosis. --Sportsmand (talk) 02:52, 24 April 2009 (UTC)

Thanks, I accept that. False identities are a pest. The very quick one on my conclusion is this: A controversy implies opposing views. That is not the case here. Consensus says ADHD exists, opposition say we dont know for sure. That is not a controversy. Besides that, different views in science are usally not called controversies. The controversy was the position of "why stop asking questions" vs the unlucky absolutes of the consensus statement. It has been 5-7 years since that, so for how long does a controversy linger? In any case that has no bearing on the diagnosis. I can put a lot more behind this if you choose to challenge it ;-)

I agree that I have not been very clear with regard to my intentions, what I propose is along these lines:

• Obviously, I think that the main portion of the articles should reflect the majority view concerning the diagnosis. The minorty view should be included as well, but in a less prominent position. As a quick version of this, it seems to be only the statements "ADHD and its diagnosis and treatment have been considered controversial since the 1970s" we need to fix somehow.
• Secondly the articles should not distinguish between adhd in children and adult adhd. I hope we do not have to dispute that, because there is no evidence either way afaik, only that ADHD is generally recognised to be a permanent condition. We get one less article to maintain. It is probably a major change so it will obviously take some time to get done
• Thirdly, I think there is some need for cleaning the structure, in particular concerning the categorization section. I don't see it as a big deal.
• As to the basic statement on treatment, as you mentioned yourself, we have not much science. I suggest that we mainly adobt the conclusions of the MTA and MTA 8-year follow-up. Sadly, this is the strongest evidence we have on the long-term effects.

Cheers --Sportsmand (talk) 00:42, 24 April 2009 (UTC)

A group of PhDs/MDs writing up a little article and putting "consensus" in the title does necessarily mean there is a consensus, no matter what the title of the article says. The opposition article had a comparable number of qualified individuals, and recent publications have not reasserted the so-called consensus. II | (t - c) 01:02, 24 April 2009 (UTC)

• Saying that the diagnosis is controversial does not mean that we have a group which says it does not exist and one that says it does. There is a lot of discussion about were the cut off between being normal and being abnormal stand. You also have different diagnostic criteria between the ICD10 and the DSM4.
• Uptodate.com divides ADHD in peads and adult. Medicine is also devided into peads and adults. Concerns about cardiac side effects are much greater in adults. Obesity on wikipedia is divided into peads and adults with a subsection on the adult page pertaining to kids.
• What changes are you suggesting for the catergories? It currently mostly follow Misplaced Pages:Manual_of_Style_(medicine-related_articles)
• The conclusions of MTA and it followup are already there and I agree they could be clarified. --Doc James (talk · contribs · email) 01:33, 24 April 2009 (UTC)

Ok, several points made here by Sportsmand. Having an opinion on a few drugs that the risks outweigh the benefits or that long term effects are not well or properly studied does not make someone anti-pharm or antimed as there are THOUSANDS of drug classes prescribed by physicians, so one would need to be opposed to all or most drugs to be anti-pharm or anti-med. Your explaination as to your identity seems plausable. I was aware that your ip address was Danish as I was active on wikipedia when you signed your ip and I looked it up and saw it was Danish but thought that it was a proxy. Mwalla was banned and is on a static ip but he was able to evade his ban and come back before on a different username so I assume he is using proxys. Anyway he has a habit of following me around creating new socks for targeting me on different pages so assumed you were him. Sorry for accusing you. Anyway today I had the opportunity to speak with a pediatrician (which isn't very difficult as I can fone them up or sometimes walk down the stairs and speak to them) and asked them about ADHD. I asked them if ADHD was "highly controversial diagnosis" and they said yes of course it is. I said why? They said there are lots of reasons but the main one is the diagnostic criteria. I see peer reviewed articles using the term controversial ALL the time in a clinical context. We seem to be having pointless debates again which was why I initially thought that you were Mwalla. You speak very good english I do wonder as to your intentions in triggering debates over what is used by English speaking doctors and not. Your stances really are not going to go anywhere because they are nonsensicle arguments like "doctors don't use the word controversy in a clinical context" so therefore there is no controversy..--Literaturegeek | T@1k? 22:06, 24 April 2009 (UTC)

Part of the problem (at least as I understand it, having relatives who are pediatricians and who are elementary teachers) is that some parents are so competitive and try to get every possible advantage (or what they see as an advantage) for their child; the teachers fear that if they don't report Robin's daydreaming or Terry's horseplay that the school will be sued for depriving the child of needed extra care. We all know (hopefully) that every child (and for that matter, every adult) has an "ADD moment" every once in a while; the treatable problem is when they have "ADD hours" and "ADD days", rarely having a moment or two of developmentally appropriate behavior. htom (talk) 23:47, 24 April 2009 (UTC)

Yes. I think that is another controversial aspect. The problem is not a matter of "doctors and drug companies" but also parents wanting their children on stimulants to increase their "competative edge" or for other reasons that you have raised.--Literaturegeek | T@1k? 01:39, 25 April 2009 (UTC)

Another notable point Sportsmand but worth bringing up. Take a look around the various medical, psychiatric and pharm pages and read their talk pages and you will soon notice that the ADHD pages are the MOST controversial pages on wikipedia. I have never edited an article with so much controversy archived and active. There are already 8 archived full talk pages of mostly controversy for this article alone!--Literaturegeek | T@1k? 01:53, 25 April 2009 (UTC)

(You have not looked at Waterboarding and its many talk pages, I suspect.) htom (talk) 05:29, 25 April 2009 (UTC)

Dispute2

Sportsman has stated that there is "no significant "controversy" for the ADHD diagnosis". He has put forth one reference to support his conclusion. Four peer reviewed references have been provided to counter this statement and many more on available on the ADHD pages. I hope we can all now say that the majority of evidence supports that ADHD is a controversial diagnosis both within the medical community and within the public at large. We have commented on Barkley's position statement on the controversies page.--Doc James (talk · contribs · email) 19:51, 21 April 2009 (UTC)

This is the second time you place comments out of context, and I will consider editing all such to maintain overview of the argumentation. --Sportsmand (talk) 09:31, 22 April 2009 (UTC)

Sorry I am not sure what you are referring to under dispute resolution and what changes you are proposing.--Doc James (talk · contribs · email) 13:26, 22 April 2009 (UTC)

Sportsman, judging by your contributions I think that you are a sock of someone, what was your previous username?--Literaturegeek | T@1k? 16:55, 22 April 2009 (UTC)

Let's keep a cool head here everyone. It doesn't matter whether Sportsmand is a sock or not. People have legit reasons for using socks. Regardless, we seem to have reached a consensus that it is appropriate to characterize certain aspects of ADHD as controversial, including the diagnosis. At this point, pressing the issue of whether or not the diagnosis is controversial much further might be considered disruptive editing. Sifaka 03:20, 23 April 2009 (UTC)

We have not reached such a consensus. We have not even agreed what material the dispute resolution should be based on. If you consider what I write 'disruptive editing', by all means: Charge me. --Sportsmand (talk) 07:11, 23 April 2009 (UTC)

That is because all you have done here is start pointless arguments and filled the talk page up with them with very little talk of specific refs or detail on the article. See above.--Literaturegeek | T@1k? 22:09, 24 April 2009 (UTC)

How the article currently stands it represents primarily the mainstream consensus of ADHD. It describes the diagnostic criteria of the DSM and says that stimulants are the most effective treatment. There is a brief bit in the lead saying that ADHD is controversial which is than backed up with very good references. There is a small section in the bottom of the main article with most of the discussion about the controversy split off into its own page.

I do not know if I am right sportsman but I get the feeling that you think all discussion of the controversies should be removed from wikipedia. This will not happen as that would be eliminating the opinions of a substancial minority with well referenced ideas. A previous editor tried to remove all discuss of ideas that were contrary to those of Barkleys.--Doc James (talk · contribs · email) 06:28, 25 April 2009 (UTC)

I think I may briefly suspend commenting in the previous section, to address a pattern in the dialogue above, that may be at the root of our disagreement.

• First, I see our roles here as being encyclopaedic editors. In principle, we cannot use any knowledge that we may have or may not have, to conclude anything in any matter that relates to Encyclopaedic content. What we have are sources. We may refer to facts, but essentially, we cannot conclude new facts. That would be original research. We are obviously allowed to read material and on the basis of those, write our encyclopaedic entries, but that is not the same. When we try to access facts, we use the best sources we can get. To me, that is scientific research. Secondary source are usable, myth, stories, legend, talk, count the least.
• Secondly, an Encyclopedia is very much about how we use words. If we state "controversy", it better live up to our own definitions.
• Finally, this is a topic in medicine, which is also a scientific discipline. When we access facts, this must absolutely be the proper viewpoint/aspect/context.

So I guess this is it: You are talking about "controversy" in the public. I am talking about "controversy" from the aspect of medical science. That may be why some may think that my arguments are "non-sensical" or such..

If we are to assume that the view of the public - in stead of medical science - would be the correct context of this, the following would be true as well: Misplaced Pages is in the public. Misplaced Pages states "controversy". Ergo, there is "controversy" in the public. Due to the size and importance of Misplaced Pages, the moment we state "controversy", it may definately amplify the impression of "controversy". The whole thing becomes a self reference, an endless recursion, an oxymoron. That is not a place I want to be.

To say it one more time: I have no intention of removing all signs of "controversy" in relation to ADHD. Because that would be untrue. Again, I am talking about the medical diagnosis from the aspect of medical science. ADHD "is", it is a real thing, it is a valid diagnose. There is no real scientific opposition to that, let alone "controversy". --Sportsmand (talk) 10:25, 28 April 2009 (UTC)

It seems to me that the areas/subjects of controversy haven't been well-enough defined for the purposes of discussion. Here's an attempt. Even if useful, it no doubt will require revision.

1) Is ADHD a valid diagnosis?

a) Few scientists and/or medical professions claim that the diagnosis should not exist.

b) Many members of the public believe that ADHD as a diagnosis, is nonsense.

2) Should young children be treated with stimulants? Addition: age 5 and under? age 6 and over?

a) A substantial proportion, probably not a majority, of scientific/medical professionals says no.

b) A substantial proportion of the public says no.

3) Is ADHD an over-used diagnosis in many countries; that is, should other causes of symptoms be more actively sought?

a) Many, perhaps most, professionals: yes.

b) Many, perhaps most, members of the public: yes.

4) ............

Feel free to add to the above and/or argue with it. - Hordaland (talk) 13:00, 28 April 2009 (UTC)

This is a very useful structure as it separates the question of "controversy" into public and scientific/professional aspects. What I have been asserting is probably adequately described under 1a). I would personally put it a bit stronger as "Few or no scientists..", as I actually do not know of any relevant source that states that the diagnosis should not exist. In general, I find it a bit hard to see how we can "meter" the opinion of the public (no,few,some,many,most,all..?) but nevertheless, I am not inclined to disagree with 1b), 2b) and 3b) at all. As to 2a) I have no real knowledge, but I would absolute tend to agree. I am a bit unsure of how to interpret your question in 3), but I suppose it means something like "should a doctor rule out other explanations of the symptoms before diagnosing ADHD?". To that I most definately agree, and I guess that a huge majority of doctors thinks so as well. Finally, I have somewhere read sources, that describes ADHD as simultaneously being the most over-diagnosed disorder and the most under-diagnosed disorder. As I remember it, this relates primarily to over-diagnosis in children and under-diagnosis in adults. Thus we may consider having that in the structure as well. --Sportsmand (talk) 10:54, 29 April 2009 (UTC)

To add to the section on children. NICE guidelines recommend children under 6 not be treated. I would say the majority of physicians would not agree with treating children under six with stimulants. Just as many do not agree with the treatment of adults due to concerns of CV side effects.--Doc James (talk · contribs · email) 13:13, 28 April 2009 (UTC)

That sounds to me to be a very good summary of the main aspects of the controversy Hordaland. Agree with Doc James as well. What bothers me as well is the repeated essentially original research of using short term clinical trials to determine safety and effectiveness of long term use. This is not just a problem with ADHD medications but essentially almost all drug classes.:)--Literaturegeek | T@1k? 21:37, 28 April 2009 (UTC)

I am not sure what you mean by "..repeated essentially original research..". Do you by this mean "original research" in terms of Misplaced Pages policies or what? --Sportsmand (talk) 10:54, 29 April 2009 (UTC)

Would agree. We have good long term data with the cardiovascular drugs but not much on psychiatric meds and these are drugs people are expected to be one for the rest of their lives all based on trial of on average 4 weeks. Hopefully the new US administration will require and fund these studies. We have little idea on how these meds affect long term morbidity and mortality and much of the data for antipsychotics anyway show that they increase mortality.

This is partly why psychiatry is so controversial among professionals. The quality of research in psychiatry sucks.--Doc James (talk · contribs · email) 21:54, 28 April 2009 (UTC)

I must take clear exception to your last statements. Are you really now trying to say, that the field of psychiatry is controversial in medical science? These statements begs an explanation. --Sportsmand (talk) 10:54, 29 April 2009 (UTC)

Hi Sportsmand. Your position on secondary sources is not how wikipedia views them. They are considered the best sources to use actually. Please see WP:MEDRS. There is significant controversy amongst doctors as to the diagnostic criteria and "false positives" or labeling someone with mild to moderate attentional or hyperactive symptoms as being mentally ill under the DSM or other diagnostic guides for determining whether someone is mentally ill or disordered. Of course there is controversy over labeling 5 - 10% of children mentally disordered in the scientific community. There are plenty of scientific peer reviewed publications which acknowledge this. I really don;t know how much evidence you need.--Literaturegeek | T@1k? 02:48, 29 April 2009 (UTC)

To start with: I have been asking all the way in this debate for sources that shows a "controversy" as to the diagnosis. Where are the "..plenty of scientific peer reviewed publications.." you refer to?? If they are easy to find - do please bring them to our attention. The reason I ask for evidence is simple. I can't find it - and neither has anyone else up to this point. When you state "Of course there is controversy over labeling 5 - 10% of children mentally disordered..", you are absolutely conducting original research. We can't use that.

Secondly, the Misplaced Pages policy you mention is very relevant and I wasn't aware of its existense. I don't see my statements/opinion as being counter to policies, but I appreciate the qualification.

Finally, please consider this: In the previous section, you 2 times refer to the source "Consensus Statement" as an "opinion piece". Now you are saying that secondary sources "..are considered the best sources to use..". In the policy you just referred to, secondary sources are explicitly examplified by the words "..position statements..". Would you please care to explain to me how I am to interpret that? --Sportsmand (talk) 10:54, 29 April 2009 (UTC)

Agreed Doc. I believe sometimes and in certain aspects of psychiatry or perhaps often certain drug trials these trials are intentionally designed that way to produce certain results.--Literaturegeek | T@1k? 02:52, 29 April 2009 (UTC)

Here is a review article stating that 5-10% of children are mentally ill with the mental health disorder called ADHD diagnosable under the Diagnostic and Statistical Manual of Mental Disorders criteria for psychiatric disorders. I assumed that you were aware that the official rate of ADHD was 5-10% in children so didn't cite a source. Here are refs disputing diagnosis or else talking about overdiagnosis., , . Here is a good quote, "The idea that children who don’t attend or who don’t sit still in school have a mental disorder is not entertained by most British clinicians." from the British Psychological Society. , see full text. Consensus statement is a primary source and an opinion piece. You are free to cite it in the article if you like. Your argument is with wikipedia policy of reliable sources. I suggest if you have a problem with the wording or criteria on the reliable sources page that you take it up on the talk page over there. If you don't understand something then please ask for help on the relevant talk page. I would rather keep discussion here on ADHD.--Literaturegeek | T@1k? 13:09, 29 April 2009 (UTC)

Allow me to address the last part of your statement first. No, my argument is not with Misplaced Pages policies, quite the contrary actually. But I agree, that there was something that I did not understand. Now however, it is becoming increasingly evident to me.

• The first source you mention clearly states: "Converging evidence from epidemiologic, neuropsychology, neuroimaging, genetic and treatment studies shows that ADHD is a valid medical disorder.". The source, as you say, states a prevalence of 5-10% in children which is somewhat higher than the figues I am familiar with. You have been an editor here for several years as I understand it. Yet you did apparently not put that prevalence figure in the article - it states 3-5%. So, as I see it, it appears to be only a point in arguing with me.
• The source you mention, appears to be about treatment only and I don't see it as relevant in this context.
• The source , was discussed briefly in the sections above. It proves that current DSM-4 diagnostic criteria are insufficient, so how is that in any sense relevant to this debate?
• The source - the "consensus critique", was introduced as a source previously - see the section above. Yes, some scientists are less sure of the data, etc. Do they say, that ADHD is not a valid diagnosis? Answer: No, they are not even close to saying that. Do you read it differently?
• The source is from 1999, and is a highly abridged version of a report from 1996. Besides the fact that it is old, I can't see anything to support any notion of "controversy". Do you?
• You state "Consensus statement is a primary source and an opinion piece". I simply can't understand that grouping, and I would ask you to please clarify it. --Sportsmand (talk) 15:39, 29 April 2009 (UTC)

Here is another one saying about its diagnosis being one of the most controversial mental illnesses.--Literaturegeek | T@1k? 13:35, 29 April 2009 (UTC)

That source is in the article reference list and is well known to me. It is actually used as a source for the "controversy" claim in the first section of the article. Excuse me for saying so, but do you actually read the sources you refer? The synopsis of this source clearly states (my emphasis) "The enduring controversy over ADHD in the public arena..". How on Earth can you interpret that as anything that counters my assertion? As a matter of fact, I count that as a source that supports my assertion. --Sportsmand (talk) 15:39, 29 April 2009 (UTC)

Several of the editors on this thread have MAJOR page ownership issues. I've been debating on the controversies talk page for what seems like forever about a single citation. They don't address that citation but throw up a pile of new citations or call me names. I'm not allowed to edit that page without it being reverted. I'm not even allowed to put a POV tag up without it being removed. One contributor has been through two mediation processes, the last one was specifically about page ownership and supported by an administrator. In both cases he withdrew from mediation. A link to his RFC is on the other talk page. Also look at the archived history of this talk page.

Sportsmand, let me first say that what you are stating makes perfect sense to me. To the others who know better and choose to be silent, well your strategy really hasn't worked. I left Misplaced Pages for over two months and the same issues are here when I left. For administrators watching this page, it's about time something was done. Why must a lawlessnes environment be endured for months on end when a contributor has shown virtually no personal growth? Doesn't such a policy drive away many excellent people from wikipedia?--scuro (talk) 16:07, 29 April 2009 (UTC)

Thanks, Scuro for bringing this to my attention. See below. --Sportsmand (talk) 21:33, 29 April 2009 (UTC)

I see now, that Doc James has created an Rfc in the ADHD controversies talk page with the following content:

This is a distinct misrepresentation of what I claim and what I intend. I take extreme exception to that, and to the fact that this Rfc was created in "ADHD controversies" talk page, but clearly aimed at my position in the ADHD talk page. Neither was I notified by Doc James that the Rfc was created. As is evident, I have never contributed to the "ADHD controversies" talk page, so I obviously cannot be expected to have read this without being informed. If this is how the formal process of dispute resolution is supposed to work, we have very serious problems. --Sportsmand (talk) 21:33, 29 April 2009 (UTC)

Would like to state first of all that the RfC was not started because of you. I know that you are not saying no controversy exists. To tell you the truth though I am still not sure what exactly you want to see changed. And what you want this to be changed too? I think if you say I want to changed such and such a line to such and such based on these references than we could move forwards. --Doc James (talk · contribs · email) 01:05, 30 April 2009 (UTC)

As long as you state that the mentioned Rfc is not directed towards my position in this talk page, it is perfectly fine with me and I rest my objection. Yes, it is time to move forward with some concrete changes and I will present my first suggestion "shortly". I did mention some pretty concrete things in the section above and I will resume commenting there as well.--Sportsmand (talk) 17:31, 30 April 2009 (UTC)

Would like to add to 1 a) above. Peter Breggins does not believe the diagnosis exists and has published extensively on this in respected journals. But there are not many others. So I would agree few clinicians agree it does not exists. There is however dispute about the diagnositic criteria.--Doc James (talk · contribs · email) 01:08, 30 April 2009 (UTC)

A ref "a minority ( 12.5% )of clinicians (British adult psychiatrists in the year 2000) expressed the view that ADHD did not exist in adults" PMID 10757256

And another "ADD and ADHD are politically manufactured concepts, created by committees of the American Psychiatric Association. ADD was created in 1980, ADHD in 1987. The plain truth is that they are not real diseases in any legitimate scientific meaning of the term disease. To declare otherwise is not medicine; it is fraud. " http://jhp.sagepub.com/cgi/content/abstract/43/2/50

And this says it is unlikely to exist. PMID 18658077 --Doc James (talk · contribs · email) 01:42, 30 April 2009 (UTC)

I reply here to Doc James' comments in last four paragraphs above.

Diagnostic criteria first: First I must stress, that I use the word "diagnosis" to separate this aspect of ADHD from etiology and treatment. I do not claim that any sources state that "ADHD has fully validated diagnostic criteria" or anything like that. At least none I know of. So in that sense, I concur that some disagreement may exist. However, I don't know of any actual dispute as such; my impression is that "everybody" agrees that current diagnostic criteria must be improved.

The source you mention as "this says it is unlikely to exist", is related to this. It actually has the title "ADHD: does new research support old concepts?" and the full conclusion sentence sounds "ADHD is unlikely to exist as an identifiable disease" (my emphasis). The context of this statement is explicitly current DSM-4 criteria.

Concerning Peter Breggin. This is an intersting source, even though it appears to be mainly a portal for his book sales. I couldn't find any source of his in PubMed that relates to the ADHD diagnosis. Indeed, most of his books seems more related to countering treatment that is being used (very) irresponsibly. One can only wish him good luck with advancing that.

The "fraud" paragraph seems to not be connected to the source you refer to. It is called "Informed Consent And The Psychiatric Drugging Of Children". But I would love to read the proper article.

Finally, concerning the british psychiatrists: The article is called "..Trent Adult Psychiatry Psychostimulant Survey.." (2000), but I think you mixed your quotations. The source states "only a minority of 11 (12.5%) used psychostimulants in their usual practice" and "..a minority of clinicians expressed the view that it did not exist in adults."--Sportsmand (talk) 20:09, 30 April 2009 (UTC)

What about the same set of problems under the old names? Minimal Brain Dysfunction, etc? http://www.ncbi.nlm.nih.gov/pubmed/4581984 http://www.britannica.com/EBchecked/topic/384045/minimal-brain-dysfunction The description of the behavior set goes back to the 1800's. htom (talk) 05:27, 30 April 2009 (UTC)

Breggin has failed both the Daubert standard and the Frye Standard in court and has been criticized harshly by several judges for poor credibility, including the Colombine case where apparently Breggin never looked at any of the physical evidence including 100's of hours of video by the killers before he went to court. As far as I know, he almost exclusively publishes in journals which he created, or journals created by organizations he has founded. As far as I know, he has also done no independent research. No one in the field takes him seriously. This is not the sort of "scholar" one would want to hang your hat on.--scuro (talk) 11:16, 1 May 2009 (UTC)

I see, that Doc James misspelled Peter Breggins. Scuro didn't refer me to the fact, that WE have an article on and including the controvertial nature of Peter Breggin. So, both of you, didn't get your sources straight in response to me. We seem to have issues communicating clearly and putting the proper context into things for all to understand. I say, look forward now and work together with all. New disputes will be handled according to policy. --Sportsmand (talk) 10:42, 4 May 2009 (UTC)

Low arousal approach-

Low arousal approach in the links section should be changed to low arousal theory, as the former is about handling patients who are sexually aroused... Nina124.171.248.88 (talk) 13:51, 27 April 2009 (UTC)

Done. And 'twas about time! - Hordaland (talk) 20:02, 30 April 2009 (UTC)

MCOTW

ADHD is the current medical collaboration of the week. This page has improved significantly since it was nominated but hopefully we can make further improvements.--Doc James (talk · contribs · email) 17:22, 30 April 2009 (UTC)

ADHD was briefly labeled collaboration of the week (MCOTW), but "by popular demand" MCOTW has been changed to Swine flu. This must mean that ADHD is very near the top of the list and will be MCOTW soon. It might be wise for the regulars here to clean up the reflist and to try to stay on-topic on the talk page -- to better welcome an influx of new eyes on the article. Just sayin'. - Hordaland (talk) 19:57, 30 April 2009 (UTC)

There are contributors with HUGE ownership issues on this page and the sister page ADHD controversies. This has been documented by an administrator and nothing has changed. Until the process of consensus building is respected, it is a waste of time to nominate this article.--scuro (talk) 04:23, 1 May 2009 (UTC)

I nominated this article as I think extra eyes from some very smart people who understand both research and science / medicine will improve and solidify the consensus of the article. POV if any will be removed and consensus will be easier to make. I do not understand why you would want to keep more eyes away from this article?--Doc James (talk · contribs · email) 17:23, 4 May 2009 (UTC)

Seeing that I have virtually been blocked from editing the page in over a year by more then one editor, you would think POV issues and page ownership issues should be dealt with first. Why bring others into a process that is not working?--scuro (talk) 19:03, 5 May 2009 (UTC)

Having more people look at and contribute to the article is good. It's the opposite of hogging an article to yourself. If there are OWN problems then take it to dispute resolution rather than griping about it in topics like Medical Collaboration Of The Week where it is irrelevant please. Sifaka 19:30, 5 May 2009 (UTC)

I respectfully disagree with you. Alerting other potential contributors that ownership is a major issue is the right thing to do.--scuro (talk) 03:12, 7 May 2009 (UTC)

Doc James/jmh649's filing of a rfc content dispute

Make no mistake, although the content dispute may be made against a single user, the intention may well be to use a ruling in his favour, more broadly. Also be aware that James had an ownership RFC filed against him in which he requested that content be part of the RFC. That was agreed to but James chose to drop out of the mediation.--scuro (talk) 10:45, 1 May 2009 (UTC)

If that should indeed be proved to be his intention, I am very sure it will not pose any kind of problem to me. The circumstances of the Rfc is on record and clearly visible to everyone. If he chooses to press the Rfc in my direction, I will simply take it from there. In case you should be in doubt, I am very capable of defending myself.

If you want to help, please do it in the form of sources. For example, in relation to what you state about Peter Breggin above, it could be sources to verify what you claim.

It is clear to me that you and Doc James is having a dispute for some reason, based on circumstances at a time before I became an editor. Personally, I refuse to spend hours on end, examining archived talk threads to form a fixed opinion in relation to that. --Sportsmand (talk) 13:26, 1 May 2009 (UTC)

Scuro and Sportsmand the content RFC is NOT an attack on anyone. It is mainly to deal with the issue as I see it that Scuro denies that any group other than Scientology see ADHD as controversial regardless of the evidence provided and provides no references to support his own opinion.--Doc James (talk · contribs · email) 13:49, 1 May 2009 (UTC)

Also by the way I have just learned that the RFC has not been opened properly. An admin is attempting to help with current issues see: http://en.wikipedia.org/Wikipedia:WQA#Scuro_and_editors_generally so I hope we can get thing resolved shortly.--Doc James (talk · contribs · email) 14:22, 1 May 2009 (UTC)

That wasn't a content RFC. It had NOTHING to do with content or the RFC process. Oh,...and it sure felt like an attack. James, you asked specifically for a content RFC? For the record I'm stating that your contention about what I believe to be controversial about ADHD to be false. That is unless what you mean is that I believe that Scientology is the only group that believes EVERYTHING about ADHD is controversial. But I would even disagree about that too since there are a number of anti-psych groups who believe that too....and who knows other religious groups, political groups....it's a big world out there. --scuro (talk) 23:40, 7 May 2009 (UTC)

Emotional effects

i was wondering why this article never mentions the depressive and anxious versions of ADD or as dr Dainel Amen classifies them the eeyore and piglet types—Preceding unsigned comment added by Itshouldbereversed (talk • contribs) 20:05, May 2, 2009

If you found reliable sources they could be cited and the info on depression and anxiety features of ADHD being added.--Literaturegeek | T@1k? 06:05, 4 May 2009 (UTC)

its in DR. Daniel Amens book Healing ADHD:The Breakthrough Program That Allows You to See and Heal the 6 Types of ADD.—Preceding unsigned comment added by Itshouldbereversed (talk • contribs) 19:27, 4 May 2009 (UTC)

If you want to cite the book, here is the cite book template. Template:Cite book--Literaturegeek | T@1k? 07:42, 6 May 2009 (UTC)

Tried to resolve diagreements

I stumbled upon a reference which states that most healthcare professionals accept the validity of ADHD as a genuine disorder but significant controversies exist with regard to how it is diagnosed and its treatments or words to that effect. I have added this to the lead giving it prominant attention for the reader of this article so hopefully this will resolve the issues raised by Sportsmand and others. :)--Literaturegeek | T@1k? 10:42, 4 May 2009 (UTC)

I agree it is a good clarification.--Doc James (talk · contribs · email) 17:09, 4 May 2009 (UTC)

I am sure, the esteemed gentlemen of Western Australia would be pleased by the prominent placement given to the 2004 reprint from 'Australian Family Physician'. I will just introduce to the audience the identities of said gentlemen. My answer to your hope is definately implied.

• Moira G Sim, MBBS, FRACGP, FAChAM, is Associate Professor, Edith Cowan University, Adjunct Staff, School of Psychiatry and Clinical Neurosciences, the University of Western Australia, a general practitioner, Yokine, Western Australia, and Senior Medical Officer, the Drug and Alcohol Office of Western Australia.
• Gary Hulse, BBSc, PhD, is Professor and Head, Unit for Research and Education in Drugs and Alcohol, School of Psychiatry and Clinical Neurosciences, University of Western Australia.
• Eric Khong, MBBS, GradDipPHC, FRACGP, is Medical Officer, Drug and Alcohol Office, Adjunct Senior Lecturer, Edith Cowan University, Adjunct Clinical Lecturer, School of Psychiatry and Clinical Neurosciences, the University of Western Australia, and a general practitioner, Edgewater and Duncraig, Western Australia. --Sportsmand (talk) 20:48, 4 May 2009 (UTC)

I strongly suspect that Moira is not a gentleman, esteemed or otherwise. :-) - Hordaland (talk) 21:20, 4 May 2009 (UTC)

My abject apologies to the esteemed Lady Moira. I think I need a gaelic refresher course ;o)--Sportsmand (talk) 21:33, 5 May 2009 (UTC)

Allow me to explain how I see this source. It is a valid reference in our debate and I suppose it could serve somewhere in our complex of ADHD information. It actually shows the need to keep the proper proportions as to the prominence of our sources.

First point: Your reference is supposed to support the entire new sentence "Most healthcare providers however accept that ADHD is a genuine disorder but significant controversy surrounds how it is diagnosed and also its treatment." You seem to have "translated" this by substituing your own words for what the source really say:

• "Most healthcare providers however accept that ADHD is a genuine disorder but.."

The source states "While the existence of this disorder is generally accepted"

• "significant controversy surrounds how it is diagnosed"

Did this come from "debate continues in relation to aspects of assessment"?

• "and also its treatment"

The source says "as well as the effectiveness and choice of treatment options and their continuation into adult life."

The source states at the beginning: "There is significant controversy surrounding attention deficit hyperactivity disorder (ADHD)". I think we know that now. It also states "the existence of this disorder is generally accepted". So, by logic, the controversy is not about the ADHD diagnosis and the whole thing is moot.

In total, if I may ask: Do you see this as a proper representation of what the source actually says?

Second and more important point. This is a 2004 minor source aimed at the australian public and explicitly in the context of substance abuse. It is written by 3 professionals all working in the context of "Drugs and Alcohol". The source itself declares: "This is the fifth article in a series of case files from general practice that explore treatment issues around substance use and commonly encountered general practice presentations".

Now really, is this the kind of source that goes directly to the main section of the ADHD article? With or without original synthesis, we seem to disagree with some basic tenents of NPOV. I hope we can do better. --Sportsmand (talk) 21:33, 5 May 2009 (UTC)

If I don't get an answer, I will definately revert this. --Sportsmand (talk) 22:28, 5 May 2009 (UTC)

""translated" this by substituing your own words for what the source really say"

This is what editors on wikipedia are meant to do as wikipedia prohibits copying and pasting sentences from sources. If you insist on reverting it then fine. I added it to try and make the article less biased by showing that most doctors accept the diagnosis as a valid disorder which I thought was what you wanted. I don't really see any flaws in how I interpreted the source.--Literaturegeek | T@1k? 07:46, 6 May 2009 (UTC)

Considering the authors and their intended audience, I agree that this is a very weak source, almost laughably so. However I also agree with LG that s/he hasn't misinterpreted the chosen bits.

What I really want to ask Sportsmand is something else, which I have 'felt' further up the page and which seems to be clearly stated here: also states "the existence of this disorder is generally accepted". So, by logic, the controversy is not about the ADHD diagnosis and the whole thing is moot. What whole thing is moot? Does Sportsmand believe that any time we speak of 'ADHD controversy', we're referring only to the question of whether the diagnosis does or should exist? IMO the controversies include at least the questions of over-diagnosing (too many kids!) and use of medication both short- and long-term. Have I misinterpreted something? - Hordaland (talk) 09:08, 6 May 2009 (UTC)

Well, I can see that the statement is not very clear and could be interpreted as you suggest. That is not the case. The aspects you mention could well be examples of where real controversy exists.

The "moot thing" was simply a comment to the uniformly treatment/drugrelated references LG for weeks have tried to use as counters to my basic assertion concerning the ADHD diagnosis. And yet again, s/he uses a drugrelated article as a reference to the controversy "thing". I consider it just as "moot" as all the others in relation to the diagnosis. LG has never stated whether s/he agrees to my basic assertion or not. I hope this clarifies my statement. --Sportsmand (talk) 21:40, 6 May 2009 (UTC)

The main problem can probably best be shown with that you replace the word "debate" with "significant controversy". In this context I consider it original synthesis. The overall meaning of what the source states is not represented faithfully in my opinion. The sentence you created uses the words such as "however" and "but" and these qualifications are not in the original source. How you got from "generally accepted" to "Most healthcare providers however accept" is a mystery to me. Almost generally??

The main point I made is not related to how you represent the source. Could you please comment related to that? --Sportsmand (talk) 21:40, 6 May 2009 (UTC)

<-My main point remains unanswered. At this point however, I do not really intend to revert the sentence, as it seems to illustrate a concern more than one editor is trying to raise. At this place and in view of the ongoing "controversy" debate among the editors, a separate "citation" vs "citation" debate seems pointless. Not that I wouldn't clearly appreciate editor Literaturegeeks' comments here, but in addition and too be clear, I suspect that the present mention of controversy, at this place in this kind of article may in its current form represent undue weight. I do not really want to argue this viewpoint here at the moment. The underlying and clarifying debate concerning validity and placement of sources is underway in this section Talk:Attention-deficit_hyperactivity_disorder_controversies#the_intro_-coatrack.2C_undue_weight_issues. My questions to editor Literaturegeek concerning sources will be proceded in there. --Sportsmand (talk) 10:44, 8 May 2009 (UTC)

Pathopysiology criticism: Concerns about undue weight, beyond scope of sources

This section is rather long and I'm not sure the objections to neuroimaging brought up here are disputed significantly by the mainstream medical community considering the length of this section. I don't have sources to support this since it's an off the cuff observation I've made.
Something else that bothers me more is that the criticism section talks about neuroimaging in general, but in reality the sources for the criticism section only apply to certain types of neuroimaging studies. Specifically those reviews by Leo and Cohen only look at the brain size studies, not the glucose metabolism ones, dopamine and related distribution/reuptake analysis, blood flow, genetic analysis, etc. Therefore they are being used beyond their intended scope because the criticism section wording implies that the results are applicable to all the different types of neuroimaging studies rather than brain size studies only.
There is pretty much one source used in the pathophysiology section which is potentially within the scope of the criticism and that's "Brain Matures a Few Years Late in ADHD, But Follows Normal Pattern," however that source is more recent (2007) than the latest Leo and Cohen review used as a sources (2003 and 2004) and uses different methodology than previous studies Leo and Cohen looked at (new image analysis technique allowed the researchers to pinpoint the thickening and thinning of thousands of cortex sites in hundreds of children and teens, with and without the disorder). That means that none of the criticism of neuroimaging is directly relevant to any of the studies used in the pathophysiology section. I have also noticed that some quotes from the Leo and Cohen papers could be construed as being more general, but that would be taking them out of context.
Currently the criticism section is misleading because it seems to imply that the criticism is applicable to the sources used in the pathophysiology section. This section needs to be put into proper scope: the criticism is about brain size studies only. This section also needs to find some new sources that are directly relevant and preferably cover some of the content or studies/reviews used as sources in the pathophysiology section. If such sources can't be found, I would rather delete the section since it fails to be relevant criticism to any of the content or sources for the content in the pathophysiology section. I tagged the section with an n-NPOV tag mostly because I couldn't find a over-generalizing source scope section-only tag. If there is a more relevant tag, please replace it with the one I put there. Sifaka 15:56, 5 May 2009 (UTC)

I agree that the section is too big and the article itself is actually getting too big. I wonder should a seperate article page be created for the neuroimaging research and then just a short paragraph or two left on this article with a see also or main article link above it? I have reworded a sentence to clarify that the only dispute is with regard to the brain volume size. I think that the criticism section is still relevant though as it is an important fact brain volume size and if studies were flawed then this should be noted in the article. I will try and find newer sources.--Literaturegeek | T@1k? 08:00, 6 May 2009 (UTC)

Another reason it is relevant is because stimulants slow down the rate of growth as well. Maybe we can shorten the criticism paragraph and add it after the brain volume paragraph? I am sure that we will be able to work out a compromise and sort out neutrality.--Literaturegeek | T@1k? 09:44, 6 May 2009 (UTC)

Is brain volume, itself, influenced by stimulants (or other drugs), and is there a correlation between brain volume and ADHD (or other neuro-whatever contitions?) Are short or slim people more likely to be ADHD? htom (talk) 18:24, 6 May 2009 (UTC)

Lots of drugs influence brain volume if used chronically some mildly, some severely. Alcohol is probably the worst drug for shrinking the brain but as we know is not prescribed. I have seen papers on prescription sedative hypnotics, anticonvulsants, antipsychotics being linked to brain shrinkage. Whether amphetamine based stimulants cause brain shrinkage they may very well do. There is controversy in the literature over whether ADHD itself or stimulants cause the brain shrinkage.--Literaturegeek | T@1k? 08:54, 7 May 2009 (UTC)

I deleted the separate section and vacuum packed it into two sentences. Perhaps a bit drastic and bold, but I'm happy because it still gets the main point across without overwhelming the rest of the section and it gets rid of the undue weight, irrelevancy, and scope of the source problem while giving some idea of who is debating the issues. Sifaka 04:50, 9 May 2009 (UTC)

Fair enough but I still think the section is too large especially as the pathophysiology is not conclusive. I think that it still needs shortened or else an article created on the pathophysiology of ADHD or else merge some of it into this article low arousal theory.--Literaturegeek | T@1k? 10:43, 12 May 2009 (UTC)

ADD?

There is no article for Attention Deficit Disorder (Without hyperactivity). It is difficult to sort through the ADHD-specific information. 12.239.57.101 (talk) 20:50, 7 May 2009 (UTC)

ADHD predominantly inattentive is ADD--Unionhawk 21:18, 7 May 2009 (UTC)

You don't need to sort through it; it (almost) all applies. I'm not a doctor, but I suspect that you can ignore any information explicitly and only about uncontrollably running around the classroom; otherwise, every other bit of information about ADHD will apply to those with ADD (or ADD predominately inattentive, or ADD without hyperactivity.) We should have a redirect from Attention Deficit Disorder Without Hyperactivity to here, though. (Unsigned comment by OtterSmith, 7 May 2009)

If you could spare a few minutes to describe what the difficulty was I would really appreciate it. Did you find the information you were looking for? We have an ongoing debate among the regular editors concerning the structure of our ADHD-articles, and your experience could be useful input in this debate. --Sportsmand (talk) 10:50, 8 May 2009 (UTC)

coatrack and undue weight issues

Debate about the whole controversies article also has ramifications here. There is a fair bit of mention of controversies in this article and the same questions are relevant:

1. What is the controversy?
2. What is the majority and minority viewpoint about the controversy?
3. Have both viewpoints been stated clearly with due weight according to wiki standards?

As wiki states( WP:UNDUE )"Undue weight applies to more than just viewpoints. Just as giving undue weight to a viewpoint is not neutral, so is giving undue weight to other verifiable and sourced statements. An article should not give undue weight to any aspects of the subject, but should strive to treat each aspect with a weight appropriate to its significance to the subject. Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, prominence of placement, and juxtaposition of statements."

While this article is of higher quality then the controversies article, I believe there are still coatrack( WP:COATRACK ) issues, with cherry picking of sources ( WP:CHERRY ) Wiki states, "Often the main tool of a coatrack article is fact picking. Instead of finding a balanced set of information about the subject, a coatrack goes out of its way to find facts that support a particular bias....Even though the facts may be true as such, the proportional volume of the hand-picked facts drowns other information, giving a false impression to the reader".

To repeat from what was said on the controversies page, it is not at all clear what the overreaching controversy is, if in fact there is one, and who holds minority and majority viewpoint. What should really be done is that the article should be tagged POV until this sorted out. The action is warranted because of the very slow pace of consensus building.--scuro (talk) 11:51, 8 May 2009 (UTC)

There are a lot of people out there that think ADHD does not exist, and that it's just the result of bad parenting. Besides, you pretty much only cited one official policy. The rest are essays, and are more guidelines than actual rules. (In fact, per WP:IAR, so are the policies)--Unionhawk 12:43, 8 May 2009 (UTC)

Do you believe the ADHD deniers form a majority, minority, or fringe opinion? Can we not at least sort out and identify the different positions as wikipedia asks us to do?--scuro (talk) 16:14, 8 May 2009 (UTC)

I don't know... 50-50-ish? I personally have ADHD, and know that these people are wrong, but that's another issue. That's why this is flagged controversial. Some people don't think it exists, the rest of people either have it or have to live with someone who has it.--Unionhawk 16:20, 8 May 2009 (UTC)

Sorting them out is going to be OR, and extremely difficult OR as well. There are multiple controversies, with multiple shades within each. Those who totally deny the existance of ADHD, claiming that it's only willful misbehavior, I'd label both an extreme minority, and fringe; I'll guess that they are at most 0.1% of those having an opinion. htom (talk) 00:53, 9 May 2009 (UTC)

mmm.... I'm not so sure. (I have ADHD.) I think the idea that ADHD is an excuse for bad behavior is not uncommon. It's actually not necessary to sort out what's fringe, for the way that due weight is determined is through the weight of reliable sources, with particular attention paid to peer-reviewed academic sources. Wherever a view is substantially controversial though, even if it is expressed in reliable source, it should be attributed. --Abd (talk) 02:18, 9 May 2009 (UTC)

I wasn't clear. There are people who claim that ALL instances of ADHD/ADD behavior flaws are really conscious, willful misbehavior. We (I have ADD, too) intend our failures. htom (talk) 15:36, 10 May 2009 (UTC)

Possible new source (here or at controversies)

Press release: Treating Sleep Disorders May Ease ADHD Symptoms : Team suggests screening spares patients lifetime of problems. - Hordaland (talk) 22:10, 9 May 2009 (UTC)

Suspect image

The image to the right, present in this article as of today, is suspect. Why does it show glucose being metabolized outside the brain? It appears to me like some guy turned a knob to turn up the contrast and there are all these artifacts, which in turn makes the in-brain pixels suspect. The link to the source on the image page is to a "Page Not Found" page. Tempshill (talk) 01:36, 11 May 2009 (UTC)

Also issues about copyright. It is published in the NEJM and i am unable to find it one the NIMH site.

Therefore removed

--Doc James (talk · contribs · email) 04:25, 11 May 2009 (UTC)

removing social construct theory of ADHD

This theory denies that ADHD exists. It is fringe opinion and belongs on the controversies page.--scuro (talk) 04:52, 12 May 2009 (UTC)

Disagree. Many people believe this. Cheers.--Doc James (talk · contribs · email) 05:11, 12 May 2009 (UTC)

Many people believe that ADHD doesn't exist? Can you be more specific, say...people outside of the western world? Don't forget WP:UNDUE. If this is a minority opinion there will be "prominent adherents" (eminent; distinguished above others) of this theory. Who do you have in mind?--scuro (talk) 05:29, 12 May 2009 (UTC)

That is cited to a publication by the National Institute for Clinical Excellence, a high quality secondary source. Do you have a secondary source to dispute this scuro?--Literaturegeek | T@1k? 08:50, 12 May 2009 (UTC)

Using your own citation, NICE stated this about ADHD on page 138. "ADHD is a valid clinical condition that can be distinguished from coexisting conditions and the normal spectrum". and this on page 133, "The evidence presented at the consensus conference indicated that there was a high degree of unanimity about there being a group of people who could be seen as having distinct and impairing difficulties and who should trigger the use of this guideline". So NICE believes that the disorder is FAKE but also believes it is a clinical condition for which the guideline expounds on how to treat the disorder is written? Please provide such evidence, I'd like to see that. Also provide prominent adherents of the "denier" viewpoint as requested earlier. Otherwise the section should be immediately removed.--scuro (talk) 11:37, 12 May 2009 (UTC)

Yes NICE conclude that but also acknowledge that the disorder has a number of controversies. Insomnia is a valid disorder but its pharmacological treatment and over-diagnosis is controversial. I have been for the past number of days adding more and more data on the controversies of ADHD as you have requested. I will continue to expand on controversies sections with more citations as you requested. Please be patient.--Literaturegeek | T@1k? 22:13, 12 May 2009 (UTC)

No one is disagreeing that there are no controversies. I was the one who wrote the section on giving toddlers stimulants. There are controversies and there are fringe viewpoints. That all needs to get sorted out. Adding more controversies doesn't prove that the disorder is FAKE. You may simply make the controversy article more of a coatrack then it already is which is a bad thing. Quality is more important then quantity.

Now no one has stated who the "prominent adherents" of the SC theory is. No one has shown where the NICE document sees the SC theory as a viable minority theory that explains ADHD. I'll be posting a POV tag on the section shortly. I do want to consensus on this issue but lets please stay on topic and answer each others questions.--scuro (talk) 01:52, 13 May 2009 (UTC)

The sources used are mostly good quality secondary sources. Please provide sources for your view point.--Literaturegeek | T@1k? 09:07, 13 May 2009 (UTC)

LG, I used your own source and sifted through 500 plus pages to post two quotes to demonstrate that your source didn't state what you said it did. I'm glad that you have found many sources for the article but simply finding lots of sources, doesn't give you a "get out of jail" blanket protection for your VP. Contributors have a right to question if ANY material belongs on a page, and the threshold of it's inclusion often doesn't require super-duper outside counter citations that best the citations on the page. We are trying to determine is something is fringe, not if it is majority/minority viewpoint. The support for my reasoning comes from Wikipolicy which was cited. Besides, if something is fringe opinion/fringe source, it may very well not have any citable good sources discussing that topic.

In consensus building, we seek the middle ground, answer questions, and we consent when our position is very weak. Page ownership is all about never compromising and protecting one version on the page. I've asked two questions and they are still unanswered. User:Scuro|scuro]] (talk) 12:01, 13 May 2009 (UTC)

Firstly it is not my source and not my edit. The reference says that there is considerable controversy surrounding ADHD and devotes a section discussing the controversies. The source also summarises the controversies as saying that some question whether ADHD exists. It is a National Institute for Clinical Excellence national report. Please quit trying to use your POV to trump a NICE national high quality source. Please provide peer reviewed sources for your position.--Literaturegeek | T@1k? 16:40, 13 May 2009 (UTC)

LG...LG...I've taken the trouble to point out specific sections of the guidelines that counters what you state. I've cut and pasted these passages and also provided page numbers. I've also taken the trouble to cut and paste three specific passages on wiki policy and fringe viewpoint. Now granted the guideline does discuss controversy but at no point does it question the existence of ADHD. As a guideline it indicates what the best methods of treatment are. They did research on this so that the guideline would be informed. If they thought ADHD was FAKE why would they do that? Anyways the ball is in Doc James court and he refuses to play ball. These questions have been asked and no one is answering:

1. who are the "prominent adherents" of the SC theory?
2. where in the NICE document does it state that the SC theory is a viable minority theory that explains ADHD?

If you can't answer then the citation means nothing with regards to SC and SC certainly looks to be a clear cut case of a fringe theory.--scuro (talk) 03:18, 14 May 2009 (UTC)

You know, that's actually, if not still now, at the very least in the past the dominant theory. "prominent adherents" include scientologists, and people who don't have ADHD/don't have to live with someone with ADHD. Just look in the talk page/talk archives/past vandalism on this page alone! How many (→Replaced content with "FAKE FAKE FAKE FAKE FAKE FAKE FAKE FAKE FAKE FAKE!!!!! ADHD DOESN"T EXIST!!!") s have we gotten? a lot.--Unionhawk 03:31, 14 May 2009 (UTC)

I have added four references that verify the existence of SC theory. Here is the page in the NICE guidelines: National Institute of Clinical Excellence (2009). Attention deficit hyperactivity disorder: THE NICE GUIDELINE ON DIAGNOSIS AND MANAGEMENT OF ADHD IN CHILDREN,YOUNG PEOPLE AND ADULTS (PDF). NHS. p. 121. Retrieved May 13,2009. {{cite book}}: Check date values in: |accessdate= (help) Ignoring those who have views that are different from that of pro pharma / pro ADHD by the way does not make these people not exist. Thankfully wikipedia does not have a memory hole. Unionhawk's comment is well put. People beleive these alternative views which is exactly why we have people coming here a replacing the entire page with the words FAKE. It makes one think that maybe ADHD is just a bit controversial. :-) --Doc James (talk · contribs · email) 03:42, 14 May 2009 (UTC)

Hence the controversial tag at the top of the talk page.--Unionhawk 03:44, 14 May 2009 (UTC)

external links bloated?

Are there not too many external links? Also, the controversy links, wouldn't they be more appropriate on the controversy article?--scuro (talk) 04:55, 12 May 2009 (UTC)

Feel free to prune this section. I see no objection.--scuro (talk) 11:38, 12 May 2009 (UTC)

I have pruned the section. Thanks for pointing that out.--Literaturegeek | T@1k? 11:43, 12 May 2009 (UTC)

wiki basics, be civil/focus on content/seek consensus - can we follow these guidelines?

Behaviour such as indirectly speaking ill of others, not answering questions, and not focusing on content should be avoided. I've seen this behaviour recently on others talk pages, the talk page, and also in edit summaries. Can we please stop?--scuro (talk) 15:41, 12 May 2009 (UTC)

Divide Article into More Shorter articles? Or move info to the existing side-articles.

The article is (as of 18:38, 12 May 2009 (UTC)) 99KB long (and therefore, should be shortened). I can already see that a lot of side-articles have already branched off of this one. Should we split this into more articles, or move some of the information to the existing articles, and leave just a summary here?--Unionhawk 18:38, 12 May 2009 (UTC)

I think that the first section that should be split off into its own page should be the pathophysiology section. It is too large.--Literaturegeek | T@1k? 09:04, 13 May 2009 (UTC)

I guess we could spit of the history section. Other than that there is not much more that could be split off.--Doc James (talk · contribs · email) 17:35, 13 May 2009 (UTC)

removing material because the section is too "long"

Can we all agree that we shouldn't eliminate material solely on the basis that a section is to "long"? There are many options here and what is desperately needed is a consensus approach. Seek consensus in talk to find solutions. Dividing articles into new articles is one solution like the controversy section.

This section ] has been removed twice because it is too long and is missing a citation. What it needs is a citation tag.--scuro (talk) 02:00, 13 May 2009 (UTC)

Look, the article is 99KB long as it is. We can cut some things out and have them in their own seperate article, leaving a summary with a {{Main|Main Article}} tag. If you want to add more information on sections that already have a {{main}} tag, add it to the main article mentioned. Guidenines at WP:SPLIT say that at 100KB and above, you should probably split it. Although there's not a size limit, but as it is, it may take a few minutes to load for dial up customers. Right now, it is too long, and you're pretty much the only one who disagrees.--Unionhawk 11:29, 13 May 2009 (UTC)

What I disagree about is "poofing" material out of existence. Disappearing material, with lamest of excuses that an article is too long, and also doing this with no discussion in talk is wrong. What I stated is that there are many options BUT seek consensus first before you toss stuff in the trash. Now do you think I am the only one who thinks this?...and even if I am do think that matters a hoot?--scuro (talk) 11:43, 13 May 2009 (UTC)

Calm down. It's still in the history either way. I think I've mentioned WP:BOLD before. If it's unsourced, at this point, it has to go somewhere. Misplaced Pages is not an indiscriminate collective of information, so it's not neccecary to include everything. GA class would be awesome, but that doesn't require that we cover every last detail.--Unionhawk 14:39, 13 May 2009 (UTC)

I am calm, when I use bold it's because a point hasn't sunk in after repeated postings. I'm bringing that point to your immediate attention. Who makes you the singular judge of what information is "everything" and can be eliminated off the page without consensus, and what information is important? Don't just do what you want and justify it in the end. I've reverted the deletion and it's been reverted back. At this point I am stating that this is wrong and there is no consensus on this issue. The information doesn't have to immediately go anywhere. One solution is that the citation tag be placed on it, and then after an acceptable period of time, if no one has responded, it could be removed. Is this not acceptable?--scuro (talk) 16:10, 13 May 2009 (UTC)

Or, we could remove things, and if people legitimately think it should have been included, then they can revert and discuss, instead of you reverting every time an edit is made without "seeking consensus" (asking permission) on the talk page. We don't need to file a RFC every time an edit is made.--Unionhawk 16:16, 13 May 2009 (UTC)

Hi Union, I think that the history section Attention-deficit_hyperactivity_disorder#History and the pathophysiology section Attention-deficit_hyperactivity_disorder#Pathophysiology should be considered for their own seperate articles with a short summary left on this page. They are far too big for this article I think. If they are shortened then we will end up with an article of around 80 kbs or less. Any opinions?--Literaturegeek | T@1k? 18:38, 13 May 2009 (UTC)

all right, I added a {{Split section}} tag to those sections.--Unionhawk 18:49, 13 May 2009 (UTC)

Unionhawk, why...I do think that the multiple sections of information deleted by LG without talk, should be "legitimtely be included". Why else would I revert? Now where did you ever get the notion in your head that I'm "reverting every time and edit is made"?!?? That is really out in left field. And on those very few times that I do revert, that I do so, "without seeking consensus??? By starting this thread I pointed out an obvious problem and sought consensus to rectify it.

Back to the task at hand, I offered a solution on my last point, do you have an opinion? One solution is that the citation tag be placed on it, and then after an acceptable period of time, if no one has responded, it could be removed. Is this not acceptable?--scuro (talk) 19:12, 13 May 2009 (UTC)

I am beginning to wonder Scuro if you are only here to disrupt wikipedia or run down other editors that you don't like. You seem to just want to wear people down. The article was over 100 kb in size. Poorly cited or uncited data should not be in the article. I simply moved the history data of adult ADHD to the main adult adhd article as people seemed to think it was notable albeit uncited.--Literaturegeek | T@1k? 19:25, 13 May 2009 (UTC)

I am in support splitting. I think from above section doc james would also be in favour of splitting the history section.--Literaturegeek | T@1k? 19:40, 13 May 2009 (UTC)

I am against splitting off the pathophysiology section even though it is long because there isn't quite enough content to make a full article unless it is elaborated on. Also, having a lot of separate articles makes it more difficult to navigate the topic and make sure the various articles are in agreement with one another. I might switch sides if it becomes much longer or someone thinks they can elaborate on the information, but I haven't seen anyone besides litgeek (and maybe me) interested in adding new content lately so I don't think that making it a new article will suddenly free up some editor's previously-suppressed-by-length-of-section desire to add new content. I weakly support splitting off the history section, since that is getting up there in length and there is enough info for a decent full article, but again having lots of sub articles makes it harder to navigate and ensure that the content on one page agrees with the content on another. Sifaka 20:51, 13 May 2009 (UTC)

"I am beginning to wonder Scuro if you are only here to disrupt wikipedia or run down other editors that you don't like. You seem to just want to wear people down....--Literaturegeek" Literaturegeek, are you a newbie. It is wrong to take potshots at people in talk. Misplaced Pages asks us to focus on content and not the contributors, and to be civil. Continue with this sort of behaviour and action will be taken. You have been warned several times.--scuro (talk) 03:01, 14 May 2009 (UTC)

As have you. Now will both of you just drop it? Honestly...

However, I do agree with LG here; I think edit summaries are sufficient.--Unionhawk 03:11, 14 May 2009 (UTC)

All right, I'm ending this "must seek consensus on talk" argument once and for all; reading some previous comments that I somehow missed, I have decided to take that up at the village pump. I'm done with this endless battle.--Unionhawk 03:16, 14 May 2009 (UTC)

Unionhawk I would strongly support your move to bring this to the village pump.--Doc James (talk · contribs · email) 03:55, 14 May 2009 (UTC)

It's nuts that we can't seek consensus here but have no objections to it being brought to the village pump.--scuro (talk) 04:01, 14 May 2009 (UTC)

(←)Would you rather I brought it to RFC? I can do that, if you would like.--Unionhawk 13:27, 14 May 2009 (UTC)

NICE

The complete NICE guideline is now out. http://www.nice.org.uk/nicemedia/pdf/ADHDFullGuideline.pdf --Doc James (talk · contribs · email) 21:20, 12 May 2009 (UTC)

From page 518 "The Guideline Development Group (GDG) acknowledged at the outset that the use ofthe diagnosis of ADHD has been the subject of considerable controversy and debate"

Very NICE, are you going to cite it?--Literaturegeek | T@1k? 21:36, 12 May 2009 (UTC)

Fell free. There is lots here for everyone. They even included a section on criticisms at the very end.--Doc James (talk · contribs · email) 22:08, 12 May 2009 (UTC)

What you quote speaks in the past tense. I don't disagree with that statement.--scuro (talk) 02:04, 13 May 2009 (UTC)

Page ownership continues to be alive and well on the ADHD pages

The Social Construct Theory of ADHD believes that ADHD is FAKE. I've pointed out that this is a fringe theory ] and removed the section. No one made the case why this is not a fringe theory yet the section was reverted back. I put a POV tag on the section. The tag was removed. Diff here -> ] That tag specifically states not to remove it till the conflict is resolved. The might is right approach is very uncivil and has been alive and well on this page now for over a year.--scuro (talk) 03:32, 14 May 2009 (UTC)

I removed a POV tag (not the one cited above) because that tag implies that you're going to discuss it, which I did not see an actual discussion at the time. Social construct theory, on Google Scholar, has over 14,000 results, so is by no means a small time theory. It may be wrong, but it is out there in the mainstream. Trust me: about 50% of adults I know w/o children with ADHD think it's just bad parenting. Every sentence in that section has a reference, so, I think fringe is out. Wrong, maybe, but fringe, no.--Unionhawk 03:39, 14 May 2009 (UTC)

I agree with Unionhawk. I did not write any of this info on SC just found references for it. We are not here to determine the truth but to reflect what is out there in the published literature. No one else has come forwards with a definitive cause of ADHD. Therefore until someone does many theories will abound.--Doc James (talk · contribs · email) 03:44, 14 May 2009 (UTC)

The diff above shows that Doc James removed the POV tag but Unionhawk, you are welcome to add it back on. I assume that you mean that you missed the thread called "removing social construct theory of ADHD". If you take a look now you will see that I have made a very good case why the material should be removed. Even if you disagree with my opinion you will notice that I have asked two very important questions that continue to go unanswered. The POV tag states not to remove it until the conflict is resolved. Clearly the ball is in Doc James court so I see absolutely no reason why the tag should be removed. The most important question to determine if a theory is not a fringe theory is to name the "prominent adherents" of the theory.--scuro (talk) 03:52, 14 May 2009 (UTC)

I have previous to these comments added four references to books and the peer reviewed literature to support these passages. I have also added the name of one of the most well known adherents who has extensively published on the topic.--Doc James (talk · contribs · email) 13:57, 14 May 2009 (UTC)

I have 2 cents to add here; take it or leave it. Scuro says "The most important question to determine if a theory is not a fringe theory is to name the "prominent adherents" of the theory." I don't think that that is necessarily so. We've made very plain that the controversies rage not just among "experts", researchers, medical people etc., but also in the media and among the public. Since a fair proportion of the public, and much reporting in the media, claim that ADHD is doubtful or even fake, one doesn't need a prominent adherent to be able to say that an opinion is not fringe. - Hordaland (talk) 15:12, 14 May 2009 (UTC)

Reverted "Learning Disabilities"

I just removed the term "Learning Disabilities" from this page. I will admit upfront that I have both first hand experience with "learning disabilities" AND a strong opinion on this. Therefore, I'm biased. First, I was diagnosed as "learning disabled" and attended a school for the learning disabled for all elementary straight up through 7th grade. As someone who's actually "been there", I'll tell you that "Learning Disabled" or "Learning disability" is a bullshit term. It's a convenient label for teachers to lay on kids that actually learn by doing, not just listening and therefore don't fit the normal classroom mold. Based on my experience (1st hand) the term is bullshit and needs to not be here.
I understand wiki is about consensus, so, I will not pull that phrase out if it gets put back in. Just an explanation — Kosh _{Naluboutes, Nalubotes} 16:40, 14 May 2009 (UTC)

I have reverted your removal. Despite your personal experience with the matter, the information comes straight from the reference. --Onorem♠Dil 17:03, 14 May 2009 (UTC)

Interesting point of view and I can see your reasoning and opposition to the term but unfortunately we can't change how medicine or psychiatry categorises dare I say "impairments" or "differences". So I have to agree with Onorem.--Literaturegeek | T@1k? 17:32, 14 May 2009 (UTC)

1. http://find.galegroup.com/ovrc/
2. Ernst M, Liebenauer LL, King AC, Fitzgerald GA, Cohen RM, Zametkin AJ (1994). "Reduced brain metabolism in hyperactive girls". J Am Acad Child Adolesc Psychiatry. 33 (6): 858–68. doi:10.1097/00004583-199407000-00012. PMID 8083143.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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