In Part 1, I gave some suggestions on how to deal with those people who claim that ADD doesn’t exist, it’s not a real condition, you know the people who pretend that they can make prouncements of the validity of a medical condition without a medical degree or background. Can you imagine saying to someone
“Well Bob, I know your background as a carpet installer makes you an expert on the human body and mind, so tell me, is diabetes a real condition, or just a drug company conspiracy?”
I also gave a list of medical, psychological and governmental organizations that say ADD does exist and is a real conditon. In this section I’ll give links to online articles giving clinical evidence of ADD as a real condition. Warning scientific jargon ahead.
Clinical Evidence of the Existence of ADD as a Real Condition.
Brain Imaging Data of ADHD
Psychiatric Times August 2004 Vol. XXI Issue 9. Amir Raz, Ph.D. Assistant professor of clinical neuroscience in the department of psychiatry, at the Columbia University College of Physicians and Surgeons. Documents how advances in the functional imaging of the living brain are shedding new light on our understanding of the pathogenesis, pathophysiology and treatment of ADHD.
Two anterior regions of the corpus callosum were significantly smaller in ADHD boys.
following text was from http://www.btinternet.com/%7Eblack.ice/addnet/cosgrove.html now sadly deleted. But study still online at pubmed. matched controls. They found that two anterior regions of the corpus callosum (the rostrum and the rostral body) were significantly smaller and concluded that this was evidence for frontal lobe dysfunction and abnormal development. The callosal fibres in the rostral body relate to the premotor cortex which is critical for “the suppression of relatively automatic responses to certain sensory stimuli”. This is consistent with a defect in the person’s ability to inhibit responses, which is considered by Barkley to be the fundamental deficit in ADHD.
The genetics of attention deficit hyperactivity disorder.
Waldman ID, Gizer IR. Emory University, United States. Over the past 15 years, considerable progress has been made in understanding the etiology of childhood Attention Deficit Hyperactivity Disorder (ADHD), largely due to the publication of numerous twin studies which are consistent in suggesting substantial genetic influences (i.e., heritabilities ranging from 60% to 90%)….Following from these quantitative genetic findings, numerous molecular genetic studies of association and linkage between ADHD and a variety of candidate genes have been conducted during the past 10 years. The majority of the candidate genes studied underlie various facets of the dopamine, norepinephrine, and serotonin neurotransmitter systems…In this paper, we review recent findings from candidate gene studies of childhood ADHD and highlight those candidate genes for which associations are most replicable and which thus appear most promising.
Cerebral glucose metabolism in adults with ADHD
The New England Journal of Medicine
Researchers measured adults with ADHD with a PET scan. None of the adults had ever been treated with stimulant medication. RESULTS. Global cerebral glucose metabolism was 8.1 percent lower in the adults with hyperactivity than in the normal controls. The largest reductions were in the premotor cortex and the superior prefrontal cortex–areas earlier shown to be involved in the control of attention and motor activity. The largest reductions were in the premotor cortex and the superior prefrontal cortex–areas earlier shown to be involved in the control of attention and motor activity.
The genetics of attention deficit hyperactivity disorder.
Over the past 15 years, considerable progress has been made in understanding the etiology of childhood Attention Deficit Hyperactivity Disorder (ADHD), largely due to the publication of numerous twin studies which are consistent in suggesting substantial genetic influences (i.e., heritabilities ranging from 60% to 90%)….Following from these quantitative genetic findings, numerous molecular genetic studies of association and linkage between ADHD and a variety of candidate genes have been conducted during the past 10 years. The majority of the candidate genes studied underlie various facets of the dopamine, norepinephrine, and serotonin neurotransmitter systems…In this paper, we review recent findings from candidate gene studies of childhood ADHD and highlight those candidate genes for which associations are most replicable and which thus appear most promising.
Australian and New Zealand Journal of Psychiatry.
The dopamine theory of ADHD is supported by neuroimaging, genetic and stimulant medication studies, which confirm an inhibitory dopaminergic effect at striatal/prefrontal level. Anterior and posterior attention systems are involved in inhibition, working memory and orientation. Attention deficit hyperactivity disorder symptoms and subtypes are likely to reflect deficits in both inhibition and working memory, and may be heterogenous.
Normal asymmetry between the volumes of right and left caudate nuclei was absent in ADHD children
Because the caudate nuclei receive inputs from cortical regions implicated in executive functioning and attentional tasks, caudate and total brain volumes were examined in boys with attention deficit hyperactivity disorder (ADHD) and normal comparison subjects with MRI scans.
Results: The normal pattern of slight but significantly greater right caudate volume across all ages was not seen in ADHD. Mean right caudatevolume was slightly but significantly smaller in the ADHD patients than in the comparison subjects, while there was no significant difference for the left. Together these facts accounted for the highly significant lack of normal asymmetry in caudate volume in the ADHD boys. Total brain volume was 5% smaller in the ADHD boys, and this was not accounted for by age, height, weight, or IQ. Smaller brain volume in ADHD did not account for thecaudate volume or symmetry differences. For the normal boys, caudate volume decreased substantially (13%) and significantly with age, while in ADHD there was no age-related change.
CONCLUSIONS: Along with previous MRI findings of low volumes in corpus callosum regions, these results support developmental abnormalities of frontal-striatal circuits in ADHD.
Right fronto-striatal abnormalities in hyperactive adolescents
during motor response inhibition in functional magnetic resonance imaging (fMRI). Department of Child & Adolescent Psychiatry, Institute of Psychiatry, London UK.
Hyperactive adolescents showed 63 percent less brain activation than controls while performing the difficult motor response inhibition paradigm. The functional underactivation affected right-hemispheric mesial and inferior frontal regions. Left-sided caudate and right and left insula, however, showed a stronger signal increase in hyperactives compared to controls. The results suggest that ADHD is associated with an abnormal functioning of right-hemispheric brain areas, particularly of inferior frontal and striatal regions during motor response inhibition. The decrease of brain activity in frontal regions and the increase of brain activity in subcortical regions suggest a dynamic imbalance in interconnections between right frontal cortex and basal ganglia, which may be the underlying cause for the disinhibitory pathology in ADHD.
Volumetric MRI analysis comparing subjects having ADHD with normal controls
OBJECTIVE: To test by MRI-based morphometry the a priori hypotheses that developmental anomalies exist in attention-deficit hyperactivity disorder (ADHD) in left caudate and right prefrontal/frontal/ and/or posterior parietal hemispheric regions, in accord with neurochemical, neuronal circuitry and attentional network hypotheses, and prior imaging studies.
MAIN OUTCOME MEASURES: Global and hemispheric regional volumes (in cm3) of cerebral hemispheres, cortex, white matter, ventricles, caudate, lenticulate, central gray nuclei, insula, amygdala, and hippocampus.
PARTICIPANTS: Fifteen male subjects with ADHD without comorbid diagnoses (aged 12.4 +/- 3.4 years) and 15 male normal controls (aged 14.4 +/- 3.4), group-matched for age, IQ, and handedness.
RESULTS: Despite similar hemispheric volumes, ADHD subjects had smaller volumes of (1) left total caudate and caudate head (p < 0.04), withreversed asymmetry (p < 0.03); (2) right anterior-superior (frontal) region en bloc (p < 0.03) and white matter (p < 0.01); (3) bilateral anterior-inferior region en bloc (p < 0.04); and (4) bilateral retrocallosal (parietal-occipital) region white matter (p < 0.03). Possible structural correlates of ADHD response to stimulants were noted in an exploratory analysis, with the smallest and symmetric caudate, and smallest left anterior-superior cortex volumes found in the responders, but reversed caudate asymmetry and the smallest retrocallosal white matter volumes noted in the nonresponders.
CONCLUSIONS: This study is the first to report localized hemispheric structural anomalies in ADHD, which are concordant with theoretical models of abnormal frontal-striatal and parietal function, and with possible differing morphologic substrates of response to stimulant medication
International Consensus Statement on ADHD
From Dr Russell Barkley’s website. 75 international scientists were deeply concerned about the periodic inaccurate portrayal of ADHD in media reports. So they “created this consensus statement on ADHD as a reference on the status of the scientific findings concerning this disorder, its validity, and its adverse impact on the lives of those diagnosed with the disorder as of this writing (January 2002)”
Here’s one particular quote I like
To publish stories that ADHD is a fictitious disorder or merely a conflict between today’s Huckleberry Finns and their caregivers is tantamount to declaring the earth flat, the laws of gravity debatable, and the periodic table in chemistry a fraud.
From the National Resource Center on ADHD
Myth # 1: ADHD is Not a Real Disorder
Myth # 2: ADHD is a Disorder of Childhood
Myth # 3: ADHD is Over-Diagnosed
Myth # 4: Children with ADHD are Over-medicated
Myth # 5: Poor Parenting Causes ADHD
Myth # 6: Minority Children are Over-Diagnosed with ADHD and are Over-Medicated
Myth # 7: Girls Have Lower Rates and Less Severe ADHD than Boys
Real Science Defines AD/HD as Real Disorder
From the National Resource Center on ADHD. Some of the most prestigious scientific-based organizations in the world conclude that AD/HD is a real disorder with potentially devastating consequences when not properly identified, diagnosed, and treated. Excerpts from the following organizations.
American Medical Association (AMA), Surgeon General of the United States, National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), American Academy of Child and Adolescent Psychiatry (AACAP)
Excellent article. Lot’s of great resources.
I worry that it’s all for naught, though. As my brother has wisely counseled me, “Never argue with idiots.” I don’t know anybody who felt AD/HD didn’t exist that could be swayed from their opinion with argument, informed or otherwise. Some of these people seem to want an excuse to hate and thinking that AD/HD is a figment of somebody’s imagination gives them the excuse they were looking for. Then they can superiorly think anybody who believes differently than them is a simpleton duped by psychologists. Mostly, they just don’t want to give us a break for something they believe is a character flaw. I go into that a bit in my latest column, “Dealing with Distractibility”. I’d love your input on it if you had the time.
In the meantime, I’m bookmarking this blog entry. Not everyone I bump into is an idiot. 😀 Sometimes they just need a bit of information to help them see more clearly.
The Biggest Scam which creates harm to the Individuals that HAVE ADHD, Including the ADULTS – (not only children have it) is that people ignore the fact that Today the ADHD is considered one of the best researched disorders in American History and the overall data on its validity are far more compelling than for most mental disorders and even many medical conditions,” according to the American Medical Association Council on Scientific Affairs.
Please let us not forget that Dr. Baughman one of the most influential naysayers RETIRED in 1993, he was a CHILD Neurologist – so many advances have occurred not only in Science but technology, that allows us to be able to learn more about it.
Now, correct me if I am wrong, but has Dr Baughman been PERSONALLY involved in ANY randomized controlled scientific meta studies, clinical trials or research, based upon ADHD? In Any studies that have been acknowledged by the Medical boards? Especially in the past 10 Years, with the advancements of science and technology? And especially with Adults who have the disorder.. ADULTS who can articulate, and express their experiences better than children! Adults who can express their considerable frustrations and pain dealing with Untreated ADHD?
Noted Quote –
Although he is frequently cited by CCHR and has written articles in support of Applied Scholastics, Dr. Baughman is generally regarded as an unrepresentative and ill-informed voice on learning disabilities. The National Alliance for the Mentally Ill (NAMI) told the Congressional Committee on Education and the Workforce in a letter of September 29, 2000 that Dr. Baughman “represent[s] fringe opinions about the disorder and about psychiatry.” His position is certainly at odds with mainstream research and ignores the findings of a huge amount of research from around the world.
Yes, indeed, the biggest fraud are articles and the individuals who really haven’t invested the time researching the disorder with individuals (ADULT) individuals who suffer from it day to day. and whom can share their Life Experience.
That indeed is a disservice to the public
He has been noted to say that scientific research has yet to prove him wrong.. i say that the Complete OPPOSITE is true. P.S, has anyone noticed also or is it just me, but it is very difficult to respond to many if not most of the sites that present these uninformed, personal prejudices? and if you do get to post, very rarely would you see your responses as they are being censored?
Especially noted by many of the “peers” and friends of Baughman? It does make one wonder.
from Living Proof
Hi, I have been looking for a way to convince my brother that he needs to get help for his nephew – this is the best blog that I’ve ever seen on the subject – way ahead of anything else I’ve seen. It’s easy to understand, well set out and with excellent references. Plus: the humour every now and again is just perfect! Congratulations.
Oops – his son, my nephew
Thanks Jacoba, I appreciate it. Also let your brother know ADHD is 80% genetic so unless he’s adopted, he and his wife should be screened for adhd
I am an adult (38) that has many (if not all to some extent) of the symptoms of ADD. I have above average intelligence, I have completed a degree in engineering and am working toward a graduate degree (mind you very slowly mainly because of the “symptoms” that I have make it difficult for me to get organized and stay focussed long enough to complete the work). I have so many unfinished projects I can’t even count them. My grandmother used to say ” you’d forget your head if it wasn’t attached to your body”, and I’m pretty sure she’s right.
Even though I exhibit the symptoms of ADD, I have always had a really hard time believing that could be the case. I’ve always just considered myself too lazy to get organized. Although now that my marriage is “on the rocks” (we’re separated and have 2 young boys) and I’m really starting to analyze where I’m at in my life, I’m starting to change my tune a little bit. I am still very skeptical, as I still see myself as lacking the skills that I need to get organized.
I’ve always been taught that organization is a learned skill and when we grow up the people that teach us organizational skills are our parents. My parents had no organizational skills whatsoever (other than my mothers grocery lists). Hence, I have always assumed that my lack of organization came from not having learned these skills as a child.
So aren’t almost all of the symptoms of ADD a result of not being taught the proper life skills as a child?
Btw, I have made an appointment to see my family doctor to see if she’ll give me referral for a medical assessment of my issues.
So, I’m not arguing with the mountains of medical research on the topic, I’m just trying to figure out if this actually applies to me. Any comments??
“So aren’t almost all of the symptoms of ADD a result of not being taught the proper life skills as a child?”
Absolutely not. See the book You Mean I’m Not Lazy, Stupid or Crazy?! A Self-Help Book for Adults with Attention Deficit Disorder
+ ADHD is 80% genetic
You Mean I’m Not Lazy, Stupid or Crazy?! A Self-Help Book for Adults with Attention Deficit Disorder http://www.amazon.com/Stupid-Self-Help-Attention-Deficit-Disorder/dp/0684815311/httpwwwadulta-20
MENSA ADHD special interest group with 600+ members
I’m an adult ADHD coach, not a medical doctor so I don’t diagnose ADHD. The only way to find it out is to find someone who actually knows enough about ADHD to diagnose it, not every does.
Whether Adult ADD can be proven to exist or not, I will leave totally up to the professionals.
All I can say is that I am prescribed 60mg af pure Methamphetamine per day, and all it does to me is calm me down, and help me focus.
Just to clarify, 2mg is enough to make the average “normal” person stoned out of their mind. So my tolerance should be at a rate of more than 30x that of a normal person, if I did not indeed have ADD. How likely is that?
I guess that it proves that I, as a 40 year old male, do not react to this stimulant, in any normal way, and therefore I conclude that Adult ADD does indeed exist. Of course there is also all the symptoms and traits, that I have as well, to underpin the reality of Adult ADD.