This is a frustrating article the author presents numerous case studies but hasn't put together any long term and wide ranging data to address the disease. The only thing he seems to be saying concretely is that few patients that he saw in his practice presented the disorder. This doesnt really add anything new to the adhd discussion.
Yes, all true, but because ADHD has never been characterized, meaning no causative agent has been located, and because there's no conception of a cure as is true for real diseases, the scientific burden of evidence rests with those who would like to say ADHD is real. And they aren't rising to the challenge.
Fair, but in science there is no such thing as innocent until proven guilty or vice versus. The burden of proof lies with anyone trying to make a hypothesis and the author of the article is hypothesizing and claiming results without method or control. This makes his argument effectively unscientific in the worst way.
> Fair, but in science there is no such thing as innocent until proven guilty or vice versus.
There most certainly is. In everyday life, people assume an idea is true until proven false. This explains the widespread belief in the Loch Ness monster, Bigfoot, UFOs, and God. But to a scientist, the central precept is called the "null hypothesis", which essentially says that an idea is assumed to be false until evidence supports it -- the opposite of the ordinary outlook.
This means:
1. A new idea is assumed to be false, and
2. The burden of evidence rests with those who introduce a new idea.
> The burden of proof lies with anyone trying to make a hypothesis
Yes, but in your next phrase, you get it entirely wrong.
> ... and the author of the article is hypothesizing and claiming results without method or control.
No, the author is placing the burden of evidence where it belongs -- with the originators of the ADHD idea.
To go into this a bit more deeply, the reason for the current system of evidence responsibility is because the originator of an idea must provide positive proof, but if the rules were as you suggest, the idea's critics (like the author of the linked article) would have to prove a negative, which in most cases is an impossible evidentiary burden.
The impossibility of proving a negative explains why so may ignorant people believe in ideas in the Bigfoot class -- things that cannot possibly be proven not to exist. This is why science has the rules that it does. And this is why psychology is not a science.
I'm sure many mental related illnesses can be described this way though. We know a lot about the brain but not nearly enough to form a clear categorization.
Anyway, when it comes to health issues, the burden of proof rests on ethical issues. It's better to explore all these problems people seem to have. Years ago in biopsych we were shown that early age treatment was important for preventing much worse symptoms later in life. Unreversable but treateable.
If that IS the case, then there is a _great_ problem with people that make a big fuss over children not being treated.
But I'm not a neuroscientist or a doctor. The claims of "over-diagnosing" seem unfounded if there are treatable symptoms that we just happen to currently call ADHD. Comparing diagnostic rates to an earlier time is just silly.
Yes, but only as a description. Science requires testable, falsifiable explanations. If I claim that I can cure the common cold by shaking a dried gourd over the sufferer (which actually works), I have only described my miracle cure, I haven't explained it or considered alternative explanations for the result.
There is a huge literature in psychology that stops at description and increasingly offers drugs as treatment -- drugs that in most cases were created for some other purpose but are now being prescribed off-label, to treat ailments of questionable origin, with questionable results, to an unquestioning public.
> Anyway, when it comes to health issues, the burden of proof rests on ethical issues.
No, ethical issues are orthogonal to the scientific issues. If there is no scientific explanation for various mental illnesses, then there's no scientific substance to the field, at which point an ethical debate may begin about the consequences of treating illnesses we don't understand and that may not even exist in an objective sense.
> Years ago in biopsych we were shown that early age treatment was important for preventing much worse symptoms later in life.
This sort of thing is meaningless until we know what we're treating, otherwise we'll have any number of dried-gourd treatments masquerading as medicine. But wait, that's already true -- Asperger's was brought into existence, and then abandoned, based on votes, not evidence. So was homosexuality, which remained an official, listed mental illness until public opinion shifted away from this outlook.
> The claims of "over-diagnosing" seem unfounded if there are treatable symptoms that we just happen to currently call ADHD.
Not at all -- this won't be the first time psychology has created a new illness out of thin air, and then "treated" it -- see above. Depression is another example -- some argue that it's an illness that can be treated, others have found that "depressed" people are better at reality-testing and accurately assessing their circumstances than those not so diagnosed. This calls into question the very meaning of "mental illness".
Alert the media! Someone writes an article stating the obvious, revealing Big Pharma's effect on psychiatry and clinical psychology and asserting the uncontroversial idea that ADHD is an invention meant to promote drug sales.
With one difference -- the author isn't a science journalist, he's a doctor with direct experience trying to treat ADHD over a period of decades.
A quote: " ... after 50 years of practising medicine and seeing thousands of patients demonstrating symptoms of ADHD, I have reached the conclusion there is no such thing as ADHD."
One of my best friends struggled through college and ended up failing out of grad school because she couldn't focus and couldn't get her work done. It turned out that her teachers had tried to get her tested for ADHD as a child, but her mother refused, not wanting her daughter to have the stigma of a mental disorder. After totaling her car in an entirely preventable accident that stemmed from how exhausted she was as a result of sleeping three hours a night all semester trying (and failing) to get her work done, failing all her classes, and getting kicked out of her school, she got diagnosed, went on medication, and is currently one semester away from finishing her Master's degree.
I'd like to see you explain to her that the medication is doing more harm than good, and that she could have succeeded in school earlier if only she had tried harder.
I absolutely agree that ADHD is likely massively misdiagnosed as a result of symptoms like "being a five year old child", but to say that nobody has it seems as ill advised as to say that everybody has it.
9 comments
[ 2.7 ms ] story [ 33.1 ms ] threadThere most certainly is. In everyday life, people assume an idea is true until proven false. This explains the widespread belief in the Loch Ness monster, Bigfoot, UFOs, and God. But to a scientist, the central precept is called the "null hypothesis", which essentially says that an idea is assumed to be false until evidence supports it -- the opposite of the ordinary outlook.
This means:
1. A new idea is assumed to be false, and
2. The burden of evidence rests with those who introduce a new idea.
More here: http://en.wikipedia.org/wiki/Russell's_teapot
> The burden of proof lies with anyone trying to make a hypothesis
Yes, but in your next phrase, you get it entirely wrong.
> ... and the author of the article is hypothesizing and claiming results without method or control.
No, the author is placing the burden of evidence where it belongs -- with the originators of the ADHD idea.
To go into this a bit more deeply, the reason for the current system of evidence responsibility is because the originator of an idea must provide positive proof, but if the rules were as you suggest, the idea's critics (like the author of the linked article) would have to prove a negative, which in most cases is an impossible evidentiary burden.
The impossibility of proving a negative explains why so may ignorant people believe in ideas in the Bigfoot class -- things that cannot possibly be proven not to exist. This is why science has the rules that it does. And this is why psychology is not a science.
http://xkcd.com/435/
Does something like [this](http://www.ncbi.nlm.nih.gov/pubmed/22983386) characterize the described differences symptoms report?
Anyway, when it comes to health issues, the burden of proof rests on ethical issues. It's better to explore all these problems people seem to have. Years ago in biopsych we were shown that early age treatment was important for preventing much worse symptoms later in life. Unreversable but treateable.
If that IS the case, then there is a _great_ problem with people that make a big fuss over children not being treated.
But I'm not a neuroscientist or a doctor. The claims of "over-diagnosing" seem unfounded if there are treatable symptoms that we just happen to currently call ADHD. Comparing diagnostic rates to an earlier time is just silly.
Yes, but only as a description. Science requires testable, falsifiable explanations. If I claim that I can cure the common cold by shaking a dried gourd over the sufferer (which actually works), I have only described my miracle cure, I haven't explained it or considered alternative explanations for the result.
There is a huge literature in psychology that stops at description and increasingly offers drugs as treatment -- drugs that in most cases were created for some other purpose but are now being prescribed off-label, to treat ailments of questionable origin, with questionable results, to an unquestioning public.
> Anyway, when it comes to health issues, the burden of proof rests on ethical issues.
No, ethical issues are orthogonal to the scientific issues. If there is no scientific explanation for various mental illnesses, then there's no scientific substance to the field, at which point an ethical debate may begin about the consequences of treating illnesses we don't understand and that may not even exist in an objective sense.
> Years ago in biopsych we were shown that early age treatment was important for preventing much worse symptoms later in life.
This sort of thing is meaningless until we know what we're treating, otherwise we'll have any number of dried-gourd treatments masquerading as medicine. But wait, that's already true -- Asperger's was brought into existence, and then abandoned, based on votes, not evidence. So was homosexuality, which remained an official, listed mental illness until public opinion shifted away from this outlook.
> The claims of "over-diagnosing" seem unfounded if there are treatable symptoms that we just happen to currently call ADHD.
Not at all -- this won't be the first time psychology has created a new illness out of thin air, and then "treated" it -- see above. Depression is another example -- some argue that it's an illness that can be treated, others have found that "depressed" people are better at reality-testing and accurately assessing their circumstances than those not so diagnosed. This calls into question the very meaning of "mental illness".
With one difference -- the author isn't a science journalist, he's a doctor with direct experience trying to treat ADHD over a period of decades.
A quote: " ... after 50 years of practising medicine and seeing thousands of patients demonstrating symptoms of ADHD, I have reached the conclusion there is no such thing as ADHD."
Couldn't have said it better myself.
I'd like to see you explain to her that the medication is doing more harm than good, and that she could have succeeded in school earlier if only she had tried harder.