7 thoughts on “ADHD Diagnostic Criteria Rewritten by People Who Don’t “Believe” in ADHD

  • December 21, 2018 at 9:24 am

    Nicely done, Neil, thank you! I’m going to share this article with clients and family!

    Reply
  • December 21, 2018 at 11:13 am

    Neil,
    Read Adult ADHD: What the Science Says by Dr. Russell Barkley. Throughout this book, he emphasized how the direct interview with the person asking about ADHD is by far the best way to make the diagnosis. Opinions of others, like teachers and parents do have an innate bias.

    Dr. Mike Ruggiero
    Aggieland ADHD Center

    Reply
    • December 22, 2018 at 5:02 pm

      Hi Mike,

      Thanks for commenting! I think there are different schools of thought on this. True, teachers and parents can be biased, but patients themselves can also lack insight into their symptoms. Getting multiple perspectives isn’t necessary for a diagnosis, nor is it practical in some cases, but it can be helpful. The research seems to indicate that multiple informants provide reports that are moderately correlated, but not so highly correlated as to be redundant — here‘s a recent example, but there’s a whole body of literature on this.

      Reply
      • December 23, 2018 at 11:38 am

        I may be a little biased, Neil.
        The most satisfying words after slowly teasing things out as the interviewer are, “geez, Doc, nobody’s ever gotten the way my brain works before!” The toughest part is finding the line between getting openness or coercing with suggestions. The key? Letting them know not only that I get I, but it’s “OK to be like that!” In my opinion, unless, as an interviewer, you understand the nuance to what seems to be chaos, you aren’t going to understand the patient and the trust is gone.

        I’ve taught and practiced Family Medicine for 35 years, the last fifteen or so on diagnosing and trying to help ADHD folks. To isolate characteristics is restraining and counterproductive. ADHD is,in my opinion, as much a Spectrum Disorder as Autism. When the DSM V narrows it to three distinctions that continually overlap in presence and vary in intensity, We’d still have at minimum six categories.
        Anyone familiar when the daily goings on for ADHD folks knows this an intuitive diagnosis which can be reinforced by noting general and specific improvements. Working in a college town, I have an almost objective metric – GPA! If I could just gather data and chart grade improvements, but anecdotally I’m amazed every day.
        We go about this all wrong because the miracle treatment is a cousin of Crystal Meth and in my state the cause of the Opioid crisis, but I digress.
        Sitting with reps of big pharma they ask how to market to patients. The experts all agree, teach the doctors how to diagnose and see how many get real life-changing benefits!

        Reply
      • December 24, 2018 at 4:17 pm

        Thanks for sharing your experiences with this, Mike. As you’ve probably heard before, that feeling of “now it makes sense” that an ADHD diagnosis can provide is so gratifying. It’s interesting to hear what that “aha” moment is like for someone on the other end of the diagnostic process. My impression is that diagnosis is currently both an art and a science, although my hope is that as research continues to be done, it will become more and more of a science.

        Reply
      • December 26, 2018 at 11:46 am

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903601/

        This is an article on some preliminary, yet really exciting, findings using “Functional” MRI to predict Autism and ADHD. Of everything I’ve seen over the years, this may be the most promising area of study to finally get something close to objective findings.

        We’ll have to wait and see. Hopefully it will come to fruition in my lifetime!

        Reply
      • December 26, 2018 at 3:32 pm

        I agree that this is a really interesting area of research. In fact, I wrote a post on this topic this summer that you might be interested in: One Step Closer to a Brain Scan for ADHD

        Reply
 

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