Is ADHD a Valid Disorder?
Robert Furey and Colleen Furey, reviewers of The ADHD Explosion: Myths, Medication, Money, and Today’s Push for Performance by Stephen P. Hinshaw and Richard M. Scheffler, describe the “ADHD explosion” in stark and alarming terms: in 2011, there were 2 million more children aged 4 to 17 in the United States with an ADHD diagnosis compared with 2003; an estimated one in nine youths (6.4 million) currently has an ADHD diagnosis; 19 percent of adolescent males in the United States have received the diagnosis at some point in their lives; an estimated 9 million U.S. adults have an ADHD diagnosis. The financial costs of ADHD can be measured in the hundreds of billions of dollars, including both cost of treatment services (direct costs) as well as “hidden” costs such as unemployment, underemployment, loss of productivity in the workplace, and costs incurred in the criminal justice system through higher rates of criminal behavior.
The diagnosis of ADHD, and its medication treatments, has not been without controversy—some say that ADHD doesn’t exist at all, that the symptoms can be better explained by other syndromes. Others maintain that ADHD exists, but it is overdiagnosed due to cursory assessments and failure to adequately distinguish it from other syndromes. There is also controversy about the medications used to treat ADHD—children are commonly treated with central nervous system stimulants, like Ritalin, that work on the neurotransmitter dopamine and carry potential for abuse.
What is your view of the ADHD explosion—is it “an epidemic of ADHD misdiagnosis” as recently characterized by neurologist Richard Saul (2014) (cited in the review, para. 7)? Is it a valid disorder? Is there need for concern about the safety and long-term impact of the stimulant medications used for treatment?
By Robert Furey and Colleen Furey
PsycCRITIQUES, 2014 Vol 59(40)