Testing someone in a completely artificial environment (sitting in an office during a diagnosis playing some tasks clicking on a computer screen) is hard for me to believe is exactly an accurate metric for revealing any of these things. Most especially, when a lot of people are actively seeking this diagnosis, and are motivated to alter their behavior to get the result they are looking for.
Im really curious how this company decided these tests are accurate at all. I assume they did some studies to find some variability in the test results and those who were already diagnosed and then determined those variability were indicative of ADHD. So what test is really doing IMO is just reinforcing the standard diagnostic criteria.
You are right that attention is a complex phenomenon, but keep in mind that people who evaluate ADHD are aware of the limitations -- that is why TOVA isn't typically the only mechanism used for diagnosis. ADHD evaluation often involves multiple sessions in which other possible explanations are ruled out or explored, along with questionnaires from friends and family who know the person -- incidentally some of the questions on the ones I collected from my friends/family were about my driving!
Even with this, there are still limitations, but there's no need to throw the baby out with the bathwater -- the goal is to produce an actionable explanation that we can use to reduce suffering, and for many people this explanation does exactly that.
So did shamens, tarot readers, and psychics. The "actionable" part of all this is prescribing stimulants. Why can't we just focus on prescribing stimulants to those who would benefit from stimulants? Is the "ADHD" part of it really necessary?
I don't understand your question about whether or not the "ADHD" part is necessary. Yes, we should have words for complex ideas.
The comparison to shamans and tarot readers comes off as dismissive and uninformed, and generally in poor taste. Ultimately you are questioning a diagnostic framework that you don't understand very well given your other comments. There are critiques to be made and even aspects of your position that I agree with but you really need to understand the framework you intend to tear down before tearing it down
Does this mean that you identified a definite cause, or does this mean as part of an ADHD diagnosis, you managed to capture a group of individuals with specific traits like being more impulsive, taking higher risks, etc?
I can for example, make up 9 seemingly related symptoms, and given a large enough population millions of people will fit it. Then I assure you I can do a wide range of studies that will find that my group of people will deviate from the norm in X,Y,Z.
Also weirdly enough, I noticed I make a lot more mistakes while driving while on adderall.
In any case, I still think of ADHD and a lot of psychiatric diagnoses as models. We try to make these models useful to relieve suffering. They are far from perfect, but it doesn't make sense to throw the baby out with the bathwater and discount the many people who have been helped
What am I missing?
>In any case, I still think of ADHD and a lot of psychiatric diagnoses as models. We try to make these models useful to relieve suffering. They are far from perfect, but it doesn't make sense to throw the baby out with the bathwater and discount the many people who have been helped
This is what it keeps getting down to every time I have this discussion. But I really feel like the discourse is hindering having an deeper understanding of the topic. The mental model and the resulting language, like people saying "I HAVE X,Y,Z" seems to be somewhat philosophically askew. Everything I read seems to point more to "X is a real objective thing, and were trying to find better ways of diagnosing it", rather than "X is what we call these assortment of symptoms alot of patients seem to exhibit which is helped by Y"
From a patient standpoint I think its a monumental difference with people saying things like "I am like Y because I HAVE X", as if X, what was the observed collection of (possibly unrelated) symptoms, now being a cause in itself.
There has been lots and lots of writing on the phenomenology of mental illness and modern mental health culture. There is lots to not like: for instance it tends to encourage excessive rumination and negative feedback loops and over-identification with these designations, as you say. This is why I prefer to think of my diagnoses as models -- they are approximate descriptions of my behavior, and the treatments prescribed are also approximations, and it's up to me to use these as tools to improve my life. But you might enjoy reading some prior art on the topic
But in any case, if the tools aren't useful, then discard them -- I was diagnosed with PTSD in my early 20s, and at the time it was a tremendously helpful and eye-opening -- it hadn't occurred to me that the violence I experienced was impacting me so many years later, but when someone pointed it out to me, I was able to adjust the ways I related to myself and other people, and for the most part, my symptoms are in remission today. I no longer think of myself as "someone with PTSD" -- it's no longer a helpful lens through which I can understand myself
