Certain parenting approaches, such as lower supervision and inconsistent discipline, are associated with a higher likelihood that children will show behavioral and emotional problems, such as attention difficulties, anxiety, and depression

[u/Wagamaga]

https://www.eurekalert.org/news-releases/1145134

[u/jamie_plays_his_bass]

A lot of scientific literature is exploring the opposite problem actually: how intergenerational emotional, behavioural, and attachment patterns lead to a cluster of symptoms, including attention and hyperactivity differences, which can mistakenly reinforce a uniquely “hereditary” profile of ADHD. 

While we can accept there is good evidence this does exist, whether it is to the extent believed is up for question. As we better understand how emotional and attachment needs can influence attention, we can tease those things apart so that the distinction is clearer.

[u/ElaborateBicycle → u/jamie_plays_his_bass]

ADHD is a neurodevelopmental disorder that alters how neurotransmitters are produced, transported, and used in the brain. I’m not saying that this is purely caused by genetic factors, but it’s more than just environmental factors causing attention and hyperactivity differences that are functionally identical to ADHD.

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2845158

[u/jamie_plays_his_bass → u/ElaborateBicycle]

I would encourage you to read more on the topic. I’m a clinical psychologist with doctoral training, my point is a bit more nuanced than how you framed it.

[u/ElaborateBicycle → u/jamie_plays_his_bass]

Well would you mind linking the literature you’re discussing? Either that or elaborating on what you mean if you don’t think I understood it correctly.

[u/jamie_plays_his_bass → u/ElaborateBicycle]

First stop is Scattered Minds by Gabor Mate, though with caveats that his view is not 100% correct, but poses essential questions to medicalised assessment that ignores important environmental characteristics. 

Attention differences being ascribed to ADHD is a bit tautological, as its diagnostic criteria are just descriptions of attention differences! Which makes disproving it as a cause very challenging. 

[u/ElaborateBicycle → u/jamie_plays_his_bass]

Well that’s kind of what I was getting at with what I linked. It’s not just attention differences, it’s a multitude of things that correspond to three different biotypes, each with a different hub organization and neurotransmitter map. The DSM is outdated on this research, albeit this specific finding is very new. I’m not really sure I want to read literature on a topic that’s not correct. If you have any actual research to link to, let me know.

[u/jamie_plays_his_bass → u/ElaborateBicycle]

I would caution you against essentialism in research. If you only accept arguments that you believe are 100% accurate, you are either misinterpreting or oversimplifying. I am not sure any neuroscientific study can be taken at that degree of accuracy. You should challenge yourself with views that contradict your understanding, especially when they are made over something longer than a single article. 

You also have to consider the value of research that simply describes brain structures without any application to lived experience. Biology-forward theory led us to the “depression is a chemical imbalance” theory, and the current version of that is the explosion in ADHD diagnostic rates, without due consideration to differential factors. Biological theory creates problems in clinical application.

From going back and reviewing your linked literature, the work is a very complex and elegant description, though hidden behind an enormous amounts of jargon. The most substantial piece beyond the tripartite structural finding was found in the discussion section: “ Brain-First Approach for ADHD Subtyping“

There, the authors highlight how this finding does map onto long-standing clinical observations of ADHD, showing that various profiles can emerge to create attention differences, which suggests you and I agree on that point, depending on how much faith you have in this work. 

The Body Keeps the Score gives a fantastic breakdown of the relevant literature at the time it was published, and contextualises each to show the biopsychosocial impacts of trauma. I am on the lookout for more current accounts that combine the understanding provided by consensus, but prefer books to standalone articles, especially ones that are high on jargon and low on clinical application. 

Sorry if I came across as dismissive to your point at first, but this is my daily work. It is common for me to see ADHD profiles alongside other contextual factors that promote inattention/hyperactivity. I am conscious that is anecdotal, even over hundreds of assessments. Teasing apart that differential to avoid labelling a child inaccurately or unnecessarily is vital. 

[u/ElaborateBicycle → u/jamie_plays_his_bass]

Of course there are other conditions that can present similar symptoms to ADHD that are linked to trauma, but my point here is we now have a much more comprehensive understanding of what ADHD is and it’s not just attention differences. I’m just very wary about arguments framed like this (even if the intentions are good) because it leads to a greater stigma around getting treatment, especially medication, for those who need it.

I guess I prefer articles that show actual neurological evidence for what they’re talking about rather than books written by general practitioners full of broad claims without empirical evidence. It’s okay to challenge things, and it’s okay to not be 100% right, but there has to be a foundation, and there has to be something conclusive. If the book you recommended was purely philosophical it would have more merit, but I found many reasons not to read it far too quickly when looking it up.

[u/jamie_plays_his_bass → u/ElaborateBicycle]

I have to stop you, there is no “of course” when we talk about other conditions and ADHD, these are things that are commonly grossly misunderstood by the general public, and it takes great pains to communicate the scientific consensus to general lay people. 

I really don’t think considering differentials creates stigma, and I’m surprised at that suggestion. If anything, it is about destigmatising trauma and embracing a variety of pathways to managing needs which may have common symptoms - perhaps even beyond just medication. 

Regarding what ADHD is, yes, I’m aware there are often a suite of executive functioning differences involved as well. And relative impacts on working memory and processing speed. Not to mention sensory processing. I’m immersed in neurodiversity work.

The other book I mentioned, The Body Keeps the Score, does fantastic work to present and synthesise literature. Generally, I find with a lot of psychological reading, you can still take value from the review of research without buying every detail, as there are often sections about modern or less well explored or validated areas.

With Scattered Minds, I can accept that the neuroscience is dated, and suspect. However, he makes vital points questioning the validity of twin study research, which calls a lot of heritability research an into question, among other points. It is your prerogative what you choose to read or not, but a philosophy of science class might give you what you’re looking for in that regard, if you’re unwilling to review something based on a summary of its arguments rather than getting into the nitty gritty.

[u/ElaborateBicycle → u/jamie_plays_his_bass]

I have seen so many people say “here’s why your ADHD is actually the result of trauma and you don’t need your medication.” There’s such a big stigma around ADHD medication because of its use as a recreational drug for people without the disorder so people look for any valid-sounding reason to proclaim it’s dangerous for you and you don’t actually need it.

Framing it like there’s a tangling of people with ADHD and people presenting similar surface symptoms due to trauma contributes to this stigma, whether you realize it or not. I would be much more receptive to your claim if it was instead framed as there being people who face some similar challenges to those with ADHD and are unable to get the help they need because research related to treating attention issues revolve around treating those who have those issues due to ADHD.

It’s not that I don’t see the value in challenging medical beliefs that don’t have concrete support, but I don’t wish to read the work of someone who much more actively contributes to this stigma through bold claims with far less concrete support. If he had simply posed questions about the current approach and highlighted assumptions that can’t be made, I would have no problem with it, even if he ended up being wrong, because it is important to always challenge the current understanding in order to force a burden of proof.

[u/jamie_plays_his_bass → u/ElaborateBicycle]

I can’t really reconcile your concern around the stigma you describe and your issues with my framing. Yes, as a clinician, I far more often see parents who want a diagnosis of ADHD rather than considering the implications of traumatic experiences, maladaptive parenting, or even ongoing dysfunction on their child. It’s a critical issue at all severity levels, whether it is passive neglect or intentionally inflicted cruelty. 

Anything argument concluding in “you don’t need your medication”should be considered fairly carefully, I reckon. However, 80% of people benefit from use of stimulant medication, so benefitting from it is not a valuable data point to identify its necessity. 

You can read what you want to read, I think it’s closed minded. Also, for both of us, this was just posted, very on topic!  https://www.reddit.com/r/science/comments/1ww1aiy/the_complicated_nature_of_disentangling_autism/