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Comment by bloqs | Hacker News Reader

ADHD as a self diagnosis is a plague. As a medical diagnosis it is consistently overdiagnosed, and dangerously underdefined.

It's largely the verbalisation of personality trait arrangement: If on the BIG FIVE you are: - Low in Conscientiousness - Low in Agreeableness - High in Neuroticism - Posses an above average IQ, but a below average working memory due to poor prefrontal cortical development (not entirely causal but partially causal for above personality elements)

You will suffer from the "symptoms" of ADHD. Typically, unstable or volatile childhood environments are seen as a key driver of this.

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> As a medical diagnosis it is consistently overdiagnosed

Not in adults https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195639/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9884156/ https://pubmed.ncbi.nlm.nih.gov/27553219/ https://pubmed.ncbi.nlm.nih.gov/25317367/

Okay when the parent poster is clearly stating a disagreement with the broad medical community, citing journals is a useless retort.

Its possible for thr broad medical community to not be in line with the latest research (diagnostic criteria are somewhat trailing), and evidence of that would be the strongest possible support for a claim that the broad community was wrong (because it had not incorporated the latest relevant research.)

Now, sure, its useless for convincing the speaker (though not others who may be witnessing the debate) to bring out research evidence if the argument is “the medical community is wrong, and my source for that is my own unsupported belief bolstered by a conspiracy theory that the truth is actively suppressed from publication.”

Yep :) my comment was for the people reading the thread, not the person I replied to.

> It's largely the verbalisation of personality trait arrangement: If on the BIG FIVE you are: - Low in Conscientiousness - Low in Agreeableness - High in Neuroticism - Posses an above average IQ, but a below average working memory due to poor prefrontal cortical development (not entirely causal but partially causal for above personality elements).

> You will suffer from the "symptoms" of ADHD.

If one accepts, for the sake of argument, your description is true and supported by evidence, you still haven't supported your claim of overdiagnosis, or even explained the symptoms, just defined an equivalence.

Now, if you could also justifiably claim that a substantial and definable in advance, on other basis than treatment response, subset of those people will not respond to ADHD treatment, you’d have a decent cases that ADHD was overly broadly defined and that its diagnostic criteria swept in at least two distinct subpopulations that can and should be distinguished diagnostically, and one of which should be considered to have something different than ADHD.

Because your comments lack citations, my rebuttal will too…

> As a medical diagnosis it is consistently overdiagnosed, and dangerously underdefined.

Maybe in your population, but it is under-diagnosed in the following populations: adults, women/girls, prison population, gifted/talented students, populations with an exceptional stigma towards mental disorders.

I don’t understand what you mean by ADHD being under-defined.

> You will suffer from the "symptoms" of ADHD.

Suffering the symptoms and having those symptoms significantly interfere with your life is what it means to have ADHD.

> Typically, unstable or volatile childhood environments are seen as a key driver of this.

This is false. Child rearing has little to no effect on having the disorder. However, genetic variation contributes to (i.e. has an effects size of) at least 70% of the disorder.

> Posses an above average IQ

IQ is negatively correlated with ADHD… are you discussing a specific type of person with ADHD with the second paragraph?

It seems you have simply redefined it within a different framework of understanding you are more agreeable to, but I do not see how it is useful. This is in fact one of the rare diagnoses which respond unreasonably well to medication alone, at least (as the author noted) while you are under its effects. Its not clear what treatment your understanding might offer that differs significantly from that of mainstream psychiatry. I have only heard of "the Big Five" mentioned in association with Jordan Peterson and personality tests, neither of which do much to recommend this.

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