Archive for the ‘add/adhd’ Category

Ok, probably only partly.

ADHD kids have higher levels of lead in their blood than normal kids – even though their levels are higher than “safe” levels.

It would be great if  ADHD turned out to have an avoidable (or at least reducible) cause.  Seriously great.

Some stuff we still need to know (and the kind of questions you should ask yourself whenever you see a claim about etiology (cause of a disorder) based on a correlational study):

Is it causation: Are kids with ADHD more often from homes with lead-based paint?   (Or lots of toys from China, maybe?) If not, that suggests some other cause for higher levels of lead in their blood.  For example, they may be more likely to lick the walls.  (Not joking – kids with ADHD, at least those who are hyperactive, tend to seek stimulation.  And a major cause of higher lead levels in blood is licking lead paint because it tastes good.)

Are there kids with ADHD who don’t have higher levels of lead in their blood: It could be a cause, but not *the* cause.  It’s entirely possible ADHD has more than one cause.  As a quick analogy, take pneumonia – it’s a condition that can be caused by bacteria, viruses, physical injury…  We only have so many pathways in the body (including in the brain), and pathways can be interrupted by more than one cause.

And, of course, does it replicate?

New idea: Kids with attention deficit disorder are just late bloomers.

This is not being said (at least outright) by some major news outlets like ABC and Time, although the public is jumping on it.

To their (minimal) credit, Time even noted that the study has not been peer reviewed (meaning no one other than the researchers has yet evaluated their work, and it should not yet be being reported as fact), and a number of news outlets are even reporting that the study only found that about half the kids catch up to their peers.

An article in the NY Times even mentioned the fact that the study wasn’t about ADHD. Not the article on the front page, but an article in the opinion section, in which the author reports actually contacting the researcher to verify their findings.

Greg J. Duncan, a professor in the School of Education and Social Policy at Northwestern University and the lead author of the school study, was somewhat mystified that his research – which attempted to understand the links between kindergarteners’ math, reading, attention-paying and “socioemotional” skills and their later academic achievement – was being discussed in the same breath with ADHD at all. The study, he said, wasn’t “about clinical levels of attention problems.”

This was true. Duncan’s research didn’t measure the effect of ADHD on future achievement; in fact, it made no mention of ADHD at all.

As a quick note: Often kids with developmental disabilities have delayed maturation of skills/abilities (and often don’t catch up entirely). This is one of the core impairments in kids with autism or Asperger’s. Delay in maturation doesn’t necessarily mean things will turn out fine if you just wait. What it does mean is that children with delays like this are hitting developmental and social milestones unevenly. As a (possibly more extreme) example, someone who doesn’t learn to speak until they’re nine – even if they catch up to normal levels by the time they’re 18 – is not going to have the same set of educational or social experiences that their normally-developing peers do.

I store interesting things up for when I have time to post, but I’m too jaded today to do anything but criticize them.

Finding a single gene causing schizophrenia? May be being misunderstood by the science writer – people have been looking for years and years for a (meaning one single) gene that causes bipolar disorder, schizophrenia, etc., and it’s much more likely that multiple genes are in play. And the body of the article doesn’t talk about a single gene, just the leader into the article.
ADD is not overdiagnosed. They define “overdiagnosed” as the number of people mistakenly diagnosed with ADD exceeding the number of people who have ADD but no diagnosis. While evidence does suggest it’s underdiagnosed much more often than overdiagnosed, by this definition you could misdiagnose the entire population of several countries with ADD, while failing to diagnose the population of substantially more (let’s say 10) countries with ADD (and failing to diagnose anyone properly at all). I think a lot of people would still be justifiably concerned with overdiagnosis, were that the case. (And I think that’s what a lot of people are thinking of when they mean “overdiagnosis” – how many people don’t have ADD and get diagnosed with it.)

Cardiovascular disease, not suicide, is the #1 killer of the mentally ill. That sounds pretty counterintuitive until you realize that cardiovascular disease is the #1 killer in the U.S. Although I don’t want to minimize the damage caused by cardiovascular disease, the appropriate comparison here is the ratio of mentally ill with cardiovascular disease to the general population with cardiovascular disease, versus the mentally ill/non-mentally ill ratio for suicide.

Losing 25 to 30 years of life (on average) compared to the general population is still pretty scary, though. I’m not jaded about that. I would think it might be better in countries that don’t require you to have a job with benefits to get good medical insurance, rather than the crappy jobs that many people with severe mental illness get, if they’re able to hold one down at all. But I don’t know that.

I enjoyed reading this post and the comments, which are noteworthy for having some actually interesting content (sleep disorders, suggestion that the distinction between ADD-inattentive and other forms of ADD is that the former primarily have attention problems, and the latter primarily have executive function deficits surrounding poor behavioral inhibition).

They do inevitably get hijacked by a troll of the “there’s no physical proof therefore it’s not real” variety, with guest appearances by the “they’re just bored gifted kids” and the “sit down and shut up” variety. There’s also a little bit of the “ADD people save the tribe from predators! Yay ADD people!” self-valorization thing, but it’s pretty minimal.

I feel a bit cheap when I write about how researchers have located a brain area for something or other. It’s unremarkable that every aspect of cognition occurs in the brain; that’s where it all goes on. Except most people still find it really interesting to hear that people perceive faces with a specific part of the brain, or inhibit their behavior with a specific part of the brain. (I heard once that if you’re at a teaching/education conference and really want to drive your point home, you say that your learning technique leads to changes in the brain zomg.) The aspect most relevant here is that convincing people that mental illnesses are brain disorders tends to carry a lot of weight. (Although actually, they tend to involve the body too, and that’s pretty important.)

My guess is a lot of it is due to our having different mental systems for handling people’s thoughts/beliefs/intentions and for handling people as biological bodies, so it’s counterintuitive and mentally catchy to find out that something you’d thought was part of the person is actually part of their body. Reality doesn’t have a boundary between biological and mental, but the distinction we have between the two in our minds tends to influence things in odd ways.

Anyhow, here’s the link that inspired this. I think this is interesting beyond the “omg it’s in the brain” aspect, because it lifts out “remembering visual information in order” as a thing in itself and suggests that it might be impaired in ADD (and my guess would be other mental disorders as well since bipolar also involves the prefrontal cortex, depression involves the prefrontal cortex, autism involves the prefrontal cortex, etcetera). I’d love to see some investigations on whether/how this is an issue in daily life.

In a pilot study (i.e., not a full-fledged study, but a smaller one to be followed up on later that was interesting enough to publish nevertheless), a researcher attempted to obtain empirical evidence supporting/disconfirming the bioethics concern that stimulants may alter children’s authenticity. She looked at children’s moral self-understandings, and found that they perceive themselves as a bad person when they are unmedicated and a bad person when they are on medication (although less bad). For the pilot study she interviewed only children who were currently medicated (she claims that it is difficult to get unmedicated children to participate in interviews, and I believe her), but she has received funding to carry out a bigger study with medicated, unmedicated and normal children.

So this is good, right? Children see their core selves as persisting despite medication, and aren’t viewing it as a magic cure for the fundamentally bad people they believe they are?

From her abstract:

This finding complicates two bioethical assumptions: That the authentic person is inherently good, and that there is inherent value in the experience of having access to a core, authentic dimension of oneself.

And yeah, maybe the kids aren’t accurate about their REALLY REAL TRUE core dimensions of theirselves. If anyone knows how to measure the true core dimensions of one’s self – not just a person’s perception of themself, or others’ perceptions of them, or a score on a test that some other people decided measured core dimensions – you can make a lot of money from self-help junkies, from the legal system, from HR departments, etc.

(I’m inclined to believe that what should be investigated is why we believe in core, authentic dimensions of the self despite loads of evidence for situational determinants of behavior – and luckily there is a lot of interesting research in that domain, which I may write about some other time…)

Stimulant medication helps with acceptance of noise in AD/HD study (pubmed abstract). “Acceptance of noise” appears to basically mean “how much background noise you’re willing to put up with when listening to speech” and was initially coined to refer to how much background noise hearing-impaired people were willing to put up with in a hearing aid before refusing to use it at all.

(anecdote warning) When I first started a stimulant medication, I was floored by how calm I felt, but more surprised by how different sensory input was – it was like a bird passing overhead was a solid, coherent bird object, rather than a set of discoherent pictures. Not on the level of vision, but on the level of attention. The “background noise” was turned down.

This is one of those interesting things that doesn’t get much play in most peoples’ conceptions of mental disorders: ADHD is about being hyperactive and distractible, mood disorders are about mood, schizophrenia is about psychosis, etc. All of those things are true (I mean, we do call them mood disorders etc for a reason), but mental disorders involve multiple systems, often in non-intuitive ways. Depression and heart disease, for example, or schizophrenia and apathy.