ADHD Research Can Lead To Inconsistencies And More

This past week, I had the great opportunity to hear one of the world’s foremost experts on ADHD speak about his latest research findings.  Dr. Russell Barkley is likely one of the world’s most prominent speakers and researchers on the topic, and he has contributed significantly to what we know about ADHD.

Hearing him speak was remarkable – given understanding on the topic and his ability to speak so clearly about what the research says.

I have to admit that while I was thoroughly impressed with his talk, it raised a number of questions for me… Of particular concern was this notion of the underlying negative portrayal of ADHD in the media and our overall society.

Let’s be real.  ADHD has a bad reputation.  After all, the most common symptoms are:

• Hyperactivity
• Inattention
• Impulsiveness

Beyond these hallmark symptoms is the general idea that children with behavioral problems must have ADHD.

But what no one seems to be talking about is the problem with the diagnosis itself, or rather the diagnostic criteria.

From the DSM-IV (manual used to diagnose psychiatric illness), one of the criteria is that symptoms must significantly impair their functioning at home, with peers, and at work or school.

But what about the people who are successful?

Are we to assume that the only people with ADHD are the ones who struggle throughout life?

Unfortunately, in his book, Dr. Barkley more or less refutes personal claims (and clinical anecdotes) that adults with ADHD  possess certain positive traits.  Popular authors (such as Hallowell & Ratey, Nadeau, Solden, and more) have suggested that adults with ADHD tend to be more intelligent, creative, optimistic, and entrepreneurial.  Yet Dr. Barkley asserts that there is no valid empirical evidence to support these findings.

While I am certainly not the researcher that Dr. Barkley is, I have to wonder about the scientific method.  There are always limitations in a study – no matter how well it has been designed and constructed.

If we know that approximately 8 million adults in this country would qualify for an ADHD diagnosis, and only 2 million are diagnosed, where are the rest?

Dr. Barkley said last night that one of the problems is likely due to adults having found successful strategies, resources, partners, and other who are able to support their efforts.

Isn’t that a good thing?  And does that necessarily mean they can’t have ADHD and be undiagnosed?

After all, don’t we want to see people be successful in life?

Perhaps the biggest question I have relates to the scientific method itself.  In the latest studies reviewed in his book, Dr. Barkley shares that participants were all struggling with ADHD (as the primary diagnosis).  So wouldn’t it make sense then that the traits we find from the research are the more negative qualities?  Or at least the results found would be skewed?

While there is no questioning Dr. Barkley’s contributions to the field of ADHD, I do have wonder about this diagnosis and whether or not we are overlooking a tremendous portion of those suspected of having ADHD?  I can’t help but wonder why someone needs to be failing or struggling in life to meet the criteria for diagnosis.

In simple terms, ADHD is a diagnosis of differences in brain wiring and brain functioning.  Given the complexities of the brain, should we be surprised that such differences exist?