Attention Deficit (Hyperactivity) Disorder

2022-09-25 – 2023-10-07
Maybe related 🤷:

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Mental health

This page has merch on my redbubble store.

Another style of cognitive way-of-being that I am interested in. Also interesting: depression, addiction, personality disorders, autism, gender dysphoria, and generally, having feelings etc.

My expertise here is minimal, but I would like it to be better because ADHD is probably the most salient in my personal life.

Medicating

Curious about the psychopharmacology of stimulants in particular, e.g. Handelman and Sumiya (2022). Why do they work?

Also curious about the political economy of stimulants in the medicalisation economy.

Involvement in modern attention economy

In a political economy that is dominated by the war for salience, what niche does ADHD fill? Is ADHD a risk factor? An adaptive response? A side-effect?

What even is mindfulness?

I don’t know. See meditation for now.

Implications for learning

We tend to think about attention, in part, as a learning mechanism now. What does ADHD say about the human learning mechanism?

Pollak (2023):

Indeed, children with ADHD needed more trials to reach the criterion, suggesting poor learning. However, they needed more trials under both the constant and the partial reinforcement conditions. On the extinction phase, children with ADHD made fewer previously-rewarded choices, suggesting faster extinction, as predicted by the DTD.

The combination of slow learning and fast extinction might seem surprising, as participants must learn the new rewards regimen in the extinction phase. Conversely, this combination is understandable; forgetting something one did not learn well is easier. Therefore, the results suggest that children with ADHD have a fundamental learning deficit, which is independent of whether the reinforcement is constant or partial.

See also (Addicott et al. 2021; Hulsbosch et al. n.d.; Nissan et al. 2023; Smith et al. 2022).

Incoming

Thanks Oglaf

References

Addicott, Merideth A., John M. Pearson, Julia C. Schechter, Jeffrey J. Sapyta, Margaret D. Weiss, and Scott H. Kollins. 2021. “Attention-Deficit/Hyperactivity Disorder and the Explore/Exploit Trade-Off.” Neuropsychopharmacology 46 (3): 614–21.
Berman, S. M., R. Kuczenski, J. T. McCracken, and E. D. London. 2009. “Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review.” Molecular Psychiatry 14 (2): 123–42.
Blum, Kenneth, Peter K. Thanos, Marlene Oscar-Berman, Marcelo Febo, David Baron, Rajendra D. Badgaiyan, Eliot Gardner, et al. 2015. “Dopamine in the Brain: Hypothesizing Surfeit or Deficit Links to Reward and Addiction.” Journal of Reward Deficiency Syndrome 1 (3): 95–104.
Cassidy, John. 2015. “The Attention-Deficit-Disorder Economy.” The New Yorker, February 21, 2015.
Caye, Arthur, James M. Swanson, David Coghill, and Luis Augusto Rohde. 2019. “Treatment Strategies for ADHD: An Evidence-Based Guide to Select Optimal Treatment.” Molecular Psychiatry 24 (3): 390–408.
Dodson, William W. 2005. “Pharmacotherapy of Adult ADHD.” Journal of Clinical Psychology 61 (5): 589–606.
Doran, Peter. 2017. A Political Economy of Attention, Mindfulness and Consumerism: Reclaiming the Mindful Commons. Routledge Studies in Sustainability. Abingdon, Oxon ; New York, NY: Routledge.
Handelman, Kenneth, and Fernando Sumiya. 2022. “Tolerance to Stimulant Medication for Attention Deficit Hyperactivity Disorder: Literature Review and Case Report.” Brain Sciences 12 (8): 959.
Hulsbosch, An-Katrien, Tom Beckers, Hasse De Meyer, Marina Danckaerts, Dagmar Van Liefferinge, Gail Tripp, and Saskia Van der Oord. n.d. “Instrumental Learning and Behavioral Persistence in Children with Attention-Deficit/Hyperactivity-Disorder: Does Reinforcement Frequency Matter?” Journal of Child Psychology and Psychiatry n/a (n/a).
Ls, Woon, Hazli Z, and Gan Lly. 2018. “Pharmacotherapy for Comorbid Adult Attention-Deficit Hyperactivity Disorder and Stimulant Dependence: A Systematic Review.” IIUM Medical Journal Malaysia 17 (2).
Maté, Gabor. 2011. Scattered Minds: The Origins and Healing of Attention Deficit Disorder. Knopf Canada.
Nissan, Noyli, Uri Hertz, Nitzan Shahar, and Yafit Gabay. 2023. “Distinct Reinforcement Learning Profiles Distinguish Between Language and Attentional Neurodevelopmental Disorders.” Behavioral and Brain Functions 19 (1): 6.
Pedersen, Morten Axel, Kristoffer Albris, and Nick Seaver. 2021. “The Political Economy of Attention,” October.
Pollak, Yehuda. 2023. “Poor Learning or Hyper‐exploration?: A Commentary on Hulsbosch Et Al. (2023).” Journal of Child Psychology and Psychiatry, August, jcpp.13875.
Sciberras, Emma, Jared Streatfeild, Tristan Ceccato, Lynne Pezzullo, James G. Scott, Christel M. Middeldorp, Paul Hutchins, Roger Paterson, Mark A. Bellgrove, and David Coghill. 2022. “Social and Economic Costs of Attention-Deficit/Hyperactivity Disorder Across the Lifespan.” Journal of Attention Disorders 26 (1): 72–87.
Smith, Ryan, Samuel Taylor, Robert C. Wilson, Anne E. Chuning, Michelle R. Persich, Siyu Wang, and William D. S. Killgore. 2022. “Lower Levels of Directed Exploration and Reflective Thinking Are Associated With Greater Anxiety and Depression.” Frontiers in Psychiatry 12.
Stoops, William W., and Craig R. Rush. 2013. “Agonist replacement for stimulant dependence: a review of clinical research.” Current Pharmaceutical Design 19 (40): 7026–35.
Volkow, Nora D. 2006. “Stimulant Medications: How to Minimize Their Reinforcing Effects?” American Journal of Psychiatry 163 (3): 359–61.
Yanofski, Jason. 2011. “The Dopamine Dilemma—Part II: Could Stimulants Cause Tolerance, Dependence, and Paradoxical Decompensation?” Innovations in Clinical Neuroscience 8 (1): 47–53.

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1 comment

Sam

Thanks for linking me - though I would like to point out that my coaching project focuses on quite different things to what you have been focussing on so far in this notebook.

Let me write a skipping stoney/rabbit holey argument and then let's have a long and involved discussion when it's not a comment box -

Coaches don't give advice when they are in a session with a client, but since this is a website comment, I think it would be great if you left the medication / psychiatry journal pathway for a little while and explored some of the reasons medications and other practical supports for ADHD exist, and some of the barriers, including bureaucracy, misunderstanding and misdiagnosis in therapeutics, and stigma against medication that ADHDers face.

Practical resources, such as the Australian ADHD Professionals Association Australian Evidence-Based Clinical Practice Guideline For ADHD (https://adhdguideline.aadpa.com.au/) are a good start.

More importantly, I would really love you to do a deep read of the ramifications of undiagnosed, untreated, and misunderstood outcomes for ADHDers, and their requirement to jump through clinical and governmental hoops to access support and treatment, which is currently subject to a Senate Committee (enquiry?) (https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/ADHD)

Reading through the hundreds of senate submissions (mine is in there, deidentified, see if you can find it) that reflect people's lived experience can give a really different, and in my opinion, more relevant perspective on the way this topic is approached.

I know it's hearing stories such as these that have made me want to focus more on improving ADHDers' quality of life, happiness and connection. This can include medication if the person chooses (I know I did).

After reading the (as of writing) 600-odd submissions to to the committee, then try and find some psych papers that seek to match, understand or find a way forward for the struggles outlined here. I know I have tried (for example, try and search for studies related to ADHD meds and fertility... and have the results be about people with uteruses...) and have been disappointed so far.

But who am I to tell you what to include in your lovely notebooks that I love to rabbit hole down?

Reply to Sam

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