Researcher Published by CQ Press, an Imprint of SAGE Publications, Inc. CQ www.cqresearcher.com Treating ADHD Are attention disorders overdiagnosed? nce viewed chiefly as affecting grade school-age children — chiefly hyperactive boys — attention deficit hyperactivity disorder (ADHD), which makes it difficult to focus attention and control Oimpulses, today is widely seen as a lifelong condition affecting both genders equally. As more and more children, adolescents and adults are diagnosed with ADHD, prescriptions for stimulants such as Ritalin and Adderall to fight the disorder are soaring. Yet many experts say that while stimulants temporarily ease symptoms, they do nothing to improve academic or work performance or social Blake Taylor, a student at the University of California, Berkeley, began taking medication for ADHD at age 5. skills, and some worry the condition is being overdiagnosed. At ADHD is widely seen today as a lifelong condition affecting both genders equally. the same time, non-drug treatments remain under-used. The in- creased availability of stimulants, which are addictive, is fueling I N prescription-drug abuse among students and others who do not THISREPORT S have ADHD but use the drugs as study aids or to get high. THE ISSUES ....................671 I BACKGROUND ................678 D CHRONOLOGY ................679 E AT ISSUE........................685 CQ Researcher • Aug. 3, 2012 • www.cqresearcher.com CURRENT SITUATION ........686 Volume 22, Number 28 • Pages 669-692 OUTLOOK ......................687 RECIPIENT OF SOCIETY OF PROFESSIONAL JOURNALISTS AWARD FOR BIBLIOGRAPHY ................690 EXCELLENCE N AMERICAN BAR ASSOCIATION SILVER GAVEL AWARD THE NEXT STEP ..............691 TREATING ADHD CQRe search er Aug. 3, 2012 THE ISSUES SIDEBARS AND GRAPHICS Volume 22, Number 28 • Is ADHD being over- One in 10 Children MANAGING EDITOR: Thomas J. Billitteri 671 diagnosed? 672 Diagnosed With ADHD [email protected] • Are too many stimulants Diagnosis rates exceed ASSISTANT MANAGING EDITOR: Kathy Koch being prescribed? 14 percent in four states. [email protected] • Are ADHD therapies ef- CONTRIBUTING EDITOR: Thomas J. Colin Childhood ADHD, Drug [email protected] fective over the long term? 673 Treatment on Rise BACKGROUND Nine percent of children ASSOCIATE EDITOR: Kenneth Jost received ADHD diagnoses STAFF WRITER: Marcia Clemmitt between 2008 and 2010. Disorder Defined CONTRIBUTING WRITERS: Peter Katel, 678 Psychiatrists crafted the first Cultural Expectations Fuel Barbara Mantel, Jennifer Weeks definition of ADHD in 1968. 674 ADHD Diagnosis DESIGN/PRODUCTION EDITOR: Olu B. Davis School pressures help define Widening Spectrum normal behavior. ASSISTANT EDITOR: Darrell Dela Rosa 680 Most researchers agree FACT CHECKER: Michelle Harris ADHD traits lie on a con- More High School Seniors 676 Turning to Adderall INTERN: Kate Irby tinuum from normal to Nearly twice as many used damaging. the drug without a prescrip- tion in 2011 as in 2007. 681 Drug Abuse By the 1930s amphetamine 679 Chronology decongestants were used Key events since 1937. An Imprint of SAGE Publications, Inc. to enhance performance. Non-drug Therapies May VICE PRESIDENT AND EDITORIAL DIRECTOR, 680 Help With ADHD HIGHER EDUCATION GROUP: Under the Influence? Michele Sordi 683 In the 1960s fears grew A change in breathing can have rapid effects on the DIRECTOR, ONLINE PUBLISHING: that Ritalin and other stim- brain. ulants could be dangerous. Todd Baldwin Students Abuse ADHD Copyright © 2012 CQ Press, an Imprint of SAGE Pub- 682 Drugs as Study Aids lications, Inc. SAGE reserves all copyright and other CURRENT SITUATION Experts warn of potentially rights herein, unless pre vi ous ly spec i fied in writing. dangerous consequences. No part of this publication may be reproduced Numbers Rise electronically or otherwise, without prior written 686 ADHD prescriptions rose At Issue permission. Un au tho rized re pro duc tion or trans mis - 46 percent from 2002 to 685 Are ADHD and artificial food sion of SAGE copy right ed material is a violation of 2010. dyes linked? federal law car ry ing civil fines of up to $100,000. CQ Press is a registered trademark of Congressional Changing Policies Quarterly Inc. 686 ADHD diagnosis guidelines FOR FURTHER RESEARCH now cover children from CQ Researcher (ISSN 1056-2036) is printed on acid- For More Information free paper. Pub lished weekly, except: (March wk. 5) ages 4 to 18. 689 Organizations to contact. (May wk. 4) (July wk. 1) (Aug. wks. 3, 4) (Nov. wk. 4) and (Dec. wks. 3, 4). Published by SAGE Publica- Bibliography tions, Inc., 2455 Teller Rd., Thousand Oaks, CA 91320. OUTLOOK 690 Selected sources used. Annual full-service subscriptions start at $1,054. For Debate Continues pricing, call 1-800-834-9020. To purchase a CQ Re- 687 The Next Step searcher report in print or electronic format (PDF), Brain imaging and genetic 691 Additional articles. visit www.cqpress.com or call 866-427-7737. Single profiles eventually may reports start at $15. Bulk purchase discounts and Citing CQ Researcher help in diagnosing ADHD. 691 electronic-rights licensing are also available. Periodicals Sample bibliography formats. postage paid at Thousand Oaks, California, and at additional mailing offices. POST MASTER: Send ad dress chang es to CQ Re search er, 2300 N St., N.W., Suite 800, Wash ing ton, DC 20037. Cover: AP Photo/Jeff Chiu 670 CQ Researcher Treating ADHD BY MARCIA CLEMMITT children to succeed in school, many scholars say. THE ISSUES Prescriptions for Ritalin, Con- atricia Quinn, a pedi- certa, Adderall and other stim- atrician in Washington, ulant drugs — long the first- P D.C., specializes in at- line treatment for ADHD — tention deficit hyperactivity dis- also are increasing. For some order (ADHD), and she has medical experts as well as par- lots of personal experience to ents, that stirs fears that the back up her medical training. amphetamine-like drugs could Quinn is a self-described clas- cause unforeseen health prob- sic example of an adult ADHD lems, if taken long term. And sufferer who struggles with some worry about an epidemic organization, focus and time of stimulant abuse as people management. She’s also the without an ADHD diagnosis mother of four children, three use the drugs to help them of whom also have ADHD. concentrate or to get high. “I’ve forgotten to pick up Over the past three decades, my kids from soccer practice,” the number of children diag- she says. “I interrupt a con- nosed with ADHD has soared, versation to finish a conversa- /CaitlinTeal Price rising nearly eightfold between tion we were having three days 1980 and 2007. 1 The per- ago.” And without her busi- centage of children ages 4 to ness partner’s help, she says, 17 diagnosed with ADHD in- she’d often commit them to creased at an average rate of more clients and projects than 5.5 percent a year from 2003 they could reasonably handle. The WashingtonPost to 2007. 2 In the mid- to late- Quinn didn’t fully realize 1990s, the nationwide preva- how hard it was for her to lence of ADHD among Amer- focus her attention until she ican children was estimated at 3 was in medical school in the Getty Images/ between 4 and 5 percent. 1960s. Despite being a high Michelle Suppers, a mother of two in Manassas, Va., gets By 2007 — the most recent her eldest son, Anthony, started on his homework as achiever, “I had to reread soon as he comes home from school so he doesn’t get year for which the Centers for and reread and reread” to get distracted. When she learned he had ADHD, Suppers Disease Control and Preven- the full meaning of texts, she also underwent testing and found she too has the tion (CDC) has analyzed data recalls. She didn’t identify condition. Nearly 10 percent of children ages 4-17 — 9.5 percent of children, or her problem as ADHD until have been diagnosed with ADHD 5.4 million, had been diag- at some point in their lives. much later, however. nosed. 4 That wasn’t unusual. In the ’60s, sidered: a developmental problem that Because young boys are most like- doctors were only beginning to iden- children outgrew in their teens. ly to exhibit hyperactivity, adults and tify the mental traits of hyperactivity, Like most mental disorders, ADHD girls with ADHD often have gone un- impulsiveness and attention-focusing is diagnosed by observations of be- diagnosed in the past, says Quinn. About problems as a psychiatric disorder. They havior, not physical abnormalities. Brain 13.2 percent of boys have had an ADHD called the condition “minimal brain imaging and genetic studies have turned diagnosis, compared to 5.6 percent dysfunction” and diagnosed it only in up clues about brain regions and func- of girls. 5 children, primarily below the age of tions that may be involved in ADHD, But many specialists now say ADHD puberty. Today, psychiatry holds a dif- but no consensus exists about its cause. is probably about equally prevalent in ferent view. Adults are increasingly di- As more and more adults are diag- both genders. They give more weight agnosed with ADHD, which many nosed with ADHD, so too are increasing to attention problems as the hallmark specialists view as a lifelong condition numbers of children and teens. Driving of the condition than in the past, which rather than what it used to be con- the increase is growing pressure on helps to extend the diagnosis to adults www.cqresearcher.com Aug. 3, 2012 671 TREATING ADHD them, Milich says. “The other kids hate One in 10 Children Diagnosed With ADHD them,” perhaps because they have poor Nearly 10 percent of children ages 4 to 17 have been diagnosed with impulse control. “They act like ADHD. Diagnosis rates exceed 14 percent in Alabama, Delaware, younger kids.