After reading the selected critical issue, use the following questions to analyze the issue. 1. What are at least two facts presented by each side of the critical issue? The NIMH cites studies which have shown that 25% of family members of those suffering from ADHD also have ADHD, and that studies concerning identical twins also show that genetic considerations play a large role in the development of ADHD (Halgin, 2009).
Further, the NIMH mentions several clear neurological differences in children that exhibit behavioral signs of ADHD compared with controls: 1) decreased white matter volume; 2) smaller overall brains and; 3) abnormalities in the basal ganglia. These clear observations would seem to necessitate a biological basis for ADHD; however, the results do not conclude causation, only correlation. Therefore, it is not clear whether the biological abnormalities cause the behavioral signs of ADHD or whether the behavior/environmental stimuli itself cause the biological abnormalities.
Wright pulls from a study of 168,113 children/adolescents that exhibited signs of ADHD in 39 states. This study concluded that the number of children on medication could be reduced through the use of the institution of a compassionate male role model in the child’s life and counseling (Halgin, 2009). These results would seem to purport that environmental factors play a larger part in ADHD symptoms than genetic/biological factors. However, Wright is quick to differentiate between emotionally caused ADHD and neurologically caused ADHD.
Moreover, Wright intones that, historically speaking, symptoms of hyperactivity and attention deficits have been treated as secondary symptoms of a larger psychoneurological problem, rather than a cause in and of itself. He explains that in the past medication for ADHD symptoms was only a temporary fix until a solution to the underlying problem could be found. 2. What are at least two opinions presented by each side of the critical issue?
The NIHM does a good job of explaining the bio-genetic precursors of ADHD, but then goes on to discount environmental causes without any experimental backing. They explicitly state, “There is little compelling evidence at this time that ADHD can arise purely from social factors or child-rearing methods” (Halgin, 2009, p. 137). They sideline environmental factors as on causing the degree and severity of the symptom of the disorder, rather than having any direct impact on the cause of the disorder.
Additionally, the NIMH explains that medications for not intended to cure ADHD, but only mediate the symptoms of ADHD on the day the medication is taken. Building upon this admonition the NIHM goes on to explain that taking medication now to prevent symptoms can help children avoid negative experiences that might otherwise scar them for a lifetime. I am not so convinced about the logic behind this: use a temporary solution—that only works on the day taken—in order to mediate the psychological effects of a biologically caused disorder.
Why not try to cure the disorder, which would in turn cause a cessation of the psychological effects of the disorder, rather than trying short-term solutions that do not fix the problem? Wright believes that there is a clear difference between neurologically-caused ADHD and emotionally-caused ADHD (Halgin, 2009). He puts forth the idea that neurologically caused disorders tend to diminish in symptomology shortly after the incident that caused the damage—in cases of physical trauma—but that the symptoms of emotionally-caused ADHD tend to get worse throughout adolescence and adulthood.
He also claims that psychotherapy is a waste of time in cases of true ADHD and that, “…remedial training in visual perception, motor activites, visual-motor integration, spatial relations, numerical skills, and reading and writing may be crucial in alleviating or at least diminishing the impact of symptoms” (Halgin, 2009, p. 146). He seems to want to take a very practical and down-to-earth approach to the treatment of hyperactivity and inattention in children. 3. What are some of the strengths associated with the Pro side of the issue?
The greatest pro of the NIMH position is that they lay a very firm statistical foundation for the genetic/biological basis of ADHD. They cite several studies and clear neurological abnormalities that explain how ADHD can be caused by non-environmental factors. Likewise, they cite biologically-based treatments as one component of the preferred means of mediating the symptoms of ADHD: stimulants. They explain that stimulants can greatly decrease the symptoms of ADHD in children with both hyperactive and impulsive forms of ADHD.
I would say this is their greatest weakness because, even though it is true, it tries to purport that medication is a long-term solution for ADHD. It would have been better if they would have shown more experimental support for medication as an effective long-term treatment for ADHD. 4. What are some of the strengths associated with the Con side of the issue? What are some of the weaknesses? The greatest strength of the con article is its alternative explanations of ADHD besides genetic/biological factors.
Wright explains that fatigue, emotional distress, and clear neurological deficits can cause ADHD—that many of the symptoms of ADHD are only transient and change as the child develops. He even goes so far as to say that the current methodological treatment of ADHD, “… attempts to treat the problem with a single entity, resulting in a one-pill-fits-all response” (Halgin, 2009, p. 145). The greatest weakness of the article is that it makes extensive use of case-studies and does not directly combat the long-term ineffectiveness of medication as a treatment.
Of course this subject is not broaches by either party, but Wright does offer many alternative treatments for people who exhibit signs of hyperactivity and inattention. 5. How credible were the authors of each argument? Explain your answer. Well…I would suppose that the NIMH is quite credible, but on this particular article they only showed part of the story. They show that genetic/biological causes underlie ADHD symptoms, but then they don’t explain that most cases of ADHD must include psychotherapy, behavioral therapy, vocational therapy in order to properly mediate.
So, the article by the NIMH is quite credible on the points that it makes, but there are some gaping logical holes in their arguments (i. e. biological causes and therapeutic treatments). It would seem that the treatment should follow the etiology. The article by Wright is not as credible as the article by the NIMH, simply because he used case studies as examples to make his points. I would have liked to see more statistical backing for the efficacy of environmental interventions—there was only one study cited on this subject.
6. Based on the statements presented in this critical issue, which author do you agree with? Why? I would have to agree with Wright over the NIMH. There is clear evidence that a real disorder called ADHD exists, but that in most cases of diagnosed ADHD there are other intermediary variables that contribute to the disorder. As with many disorders, the genetic/biological foundation must be activated or triggered by environmental variables to bring about dysfunction.
If the environmental triggers are never actualized, then the biologically caused potentiality is never exhibited through behavior. As Wright puts it, “Certainly, there are deficiencies of attention and hyperactivity, but such behavioral aberrancies are most often indicative of a transitory state or condition within the organism” (Halgin, 2009, p. 144). Fatigue and other factors can activate ADHD behaviors, but as soon as the environmental variable has ceased so do the hyperactive/attentional deficits. 7. Which side of this critical issue does contemporary research support?
Please provide specific examples in your response. Muller et al (2011) found several interesting details of symptom estimates between parents, teachers, questionnaires, and interviews. They found that parents estimated the number and severity of symptoms of ADHD as higher than that of teachers, and that interviews were more accurate than questionnaires. This evidence would seem to purport a situational basis for the diagnosis of ADHD—where the place and type of diagnostic instrument can have a large impact on the outcome.
They also did not find a consistent age/gender pattern between the different testing centers, meaning that there was no clear pattern of causation that accompanied gender or age patterns. References Halgin, R. (2009). Taking sides: Clashing views in abnormal psychology (5th ed. ). New York,NY: McGraw-Hill. Muller, U. C. , Asherson, P. , Banaschewski, T. , Buitelaar, J. K. , Ebstein, R. P. , Eisenberg, J. , & … Steinhausen, H. (2011). The impact of study design and diagnostic approach in a large multi-centre ADHD study. Part 1: ADHD symptom patterns. BMC Psychiatry, 11(1), 54-74. doi:10. 1186/1471-244X-11-54.