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Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Attention deficit hyperactivity disorder.
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On 14 October 2022, it was proposed that this article be moved to ADHD. The result of the discussion was not moved. |
In this on 22 October 2023, Димитрий Улянов Иванов changed the lead sentence of the article from:
"Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappropriate."
to
"Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by executive dysfunction occasioning inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and otherwise age-inappropriate."
The edit summary states: "Revised the initial description to be more accurate concerning the disorder and its symptoms. As noted in the paragraph below (with citations), ADHD symptoms arise from executive dysfunction (the underlying deficit in ADHD is EF) and emotional dysregulation is often considered a core symptom."
While the user is correct that this article does note that the article does state that "ADHD symptoms arise from executive dysfunction", this is not necessarily accurate about ADHD, nor are the statements claiming it well supported. (I do not object to the "emotional dysregulation" aspect being added.)
For example, let's examine that statement in the second paragraph of the article: "ADHD symptoms arise from executive dysfunction..." To support this, three references are given; however, only two actually discuss "executive dysfunction" in ADHD. (The Malenka does not mention “executive dysfunction" in regards to ADHD and would be an WP:OR interpretation). The first is a 2008 article with the single author, Thomas Brown, in which the author acknowledges that his opinion that ADHD is "cognitive disorder, a developmental impairment of executive functions (EFs)" is a departure from the belief of "many clinicians". This article fails WP:MEDRS and also likely fails WP:FRINGE and/or WP:DUE, as the author notes his opinion is in conflict with “many clinicians” and is also in conflict with the WP:MEDRS compliant article below. The second is a single-author manuscript by Diamond from 2012–13, which only mentions ADHD twice, and the references to it appear to be “provided in passing” per WP:CONTEXTMATTERS. In any case, it is also not a WP:MEDRS complaint source.
Other areas of the article also seem to have similar statements: The symptoms of ADHD arise from a deficiency in certain executive functions (e.g., attentional control, inhibitory control, and working memory)." To support this, a single reference is given with the supporting quote, "Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention." The source merely notes that "early results" show that those with ADHD, as a group, may have thinning in areas that impact "working memory and attention." It does not say "symptoms of ADHD arise from a deficiency in certain executive functions". Attempts to say otherwise would be, at best, WP:OR.
The objection I have to the phrase "executive dysfunction" being used in the way it is used in article is that it implies that executive dysfunction is not only required for a diagnosis of ADHD, but is also the cause of ADHD. I do not feel this is accurate, nor is supported by the weight of the evidence, nor do the DSM nor the ICD mention "executive dysfunction" in regards to ADHD. While executive dysfunction is certainly more common in those with ADHD, it is far from required for a diagnosis, much less the cause of the disorder. A
WP:MEDRS complaint source states: "Specifically, estimates for the proportion of pediatric ADHD cases who exhibit any form of executive dysfunction range from 21% to 60% across studies employing a wide range of tasks and impairment criteria (Biederman et al., 2004; Coghill et al., 2014; Fair, Bathula, Nikolas, & Nigg, 2012; Geurts, van der Oord, & Crone, 2006; Nigg et al., 2005; Solanto et al., 2001; Sonuga-Barke, Bitsalou, & Thompson, 2010)." (Kofler MJ, Irwin LN, Soto EF, Groves NB, Harmon SL, Sarver DE (February 2019).
"Executive Functioning Heterogeneity in Pediatric ADHD". Journal of Abnormal Child Psychology. 47 (2): 273–286.
doi:
10.1007/s10802-018-0438-2.
PMC
6204311.
PMID
29705926.) My point is more explicitly stated in a WP:RS (but admittedly not a WP:MEDRS due to age): "Indeed, executive dysfunction is not required for the diagnosis of ADHD, which is defined at the behavioral, rather than neuropsychological, level." (Cortese S, Comencini E, Vincenzi B, Speranza M, Angriman M (November 2013).
"Attention-deficit/hyperactivity disorder and impairment in executive functions: a barrier to weight loss in individuals with obesity?". BMC Psychiatry. 13: 286.
doi:
10.1186/1471-244X-13-286.
PMC
4226281.
PMID
24200119.{{
cite journal}}
: CS1 maint: unflagged free DOI (
link))
In summary, I feel the above statements should be modified to remove "executive dysfunction" as a cause of and/or requirement of ADHD. At the absolute minimum, if WP:RS and WP:MEDRS are found to give the viewpoint WP:DUE, WP:CONFLICTING states both viewpoints should be acknowledged. Wikipedialuva ( talk) 10:15, 9 January 2024 (UTC)
Here I examine the nature of and evidence for a frequently cited benefit of ADHD claimed in this article – that being “hyper-focusing (HF).". Despite its widespread belief, this relationship has not been explored much in the scientific literature, with less than 8 studies being identified. The results are conflicting, depending on whether the study used people who just had elevated symptoms of ADHD, and not the disorder, compared to studies of clinically diagnosed individuals who had the full disorder (symptoms and impairments). In general, there does seem to be a significant relationship between ADHD and HF when ADHD is measured as rated symptoms. But in clinically diagnosed people the results are conflicting, with one study finding the relationship and another not ( Groen et al., 2020; Ozel-Kizil et al., 2016). And while HF is often presented as a benefit or gift of ADHD, some studies show that it also has a very negative side, being related to risk for internet addiction ( Ishii et al., 2023) and certain types of offending behaviour ( Worthington & Wheeler, 2023). From my understanding the roots of hyperfocus are in the EF/poor self-regulation that underlies ADHD. People vary in the degree to which their behaviour is controlled by distant rewards (e.g., if I study a lot, I'll get a good job a few years from now) vs. immediate rewards (e.g., when playing a video game, the environment is providing a great deal of continuous and immediate rewards for engagement; placing little demands on EF) ( Jackson & Mackillop, 2016; Marx et al., 2021). For many people with ADHD, immediate rewards are very potent and can lead to such perseverative responding ( Patros et al., 2016), even to the point of an inability to disengage from such environments likely linked to the same deficits in the disorder (i.e., in inhibition and working memory). So, the claim that ADHD is definitely linked to hyper-focusing and that it is a positive trait is not definitively established at this time. More research is clearly needed but such claims of HF as being widespread among those with ADHD, and entirely a benefit, cannot be taken on face value as an established fact. Assertions in this article regarding HF should therefore be amended. Димитрий Улянов Иванов ( talk) 00:34, 16 January 2024 (UTC)
The article currently looks like an instance of ref- WP:OVERKILL. Just in the top section, there are sentences with:
I think we should consider
trimming some sources, but if the sources are all deemed useful and should be kept, then perhaps we should look at
bundling the references.
Kimen8 (
talk) 21:17, 28 January 2024 (UTC)
sorry, I'm new to this whole Wikipedia editor/talk page poster thing so excuse me if I don't do this right.
I'm reading through, and got to the suicide risk chapter(?) and am wondering where these numbers are from? " the prevalence of suicide attempts in individuals with ADHD was 18.9%, compared to 9.3% in individuals without ADHD."
I'm personally looking for general worldwide attempt percentage, but I cannot find anything else past this.
thank you :> Mteaseil ( talk) 03:27, 11 February 2024 (UTC)
the original paper literally has a single sentence with ZERO fucking citations. ZERO!
Claim is unverified and should be deleted. CDLLBOSS ( talk) 01:08, 13 February 2024 (UTC)
This
edit request has been answered. Set the |answered= or |ans= parameter to no to reactivate your request. |
Regarding te paragraph under "Epidemiology" that reads:
"Due to disparities in the treatment and understanding of ADHD between caucasian and non-caucasian populations, many non-caucasian children go undiagnosed and unmedicated. It was found that within the US that there was often a disparity between caucasian and non-caucasian understandings of ADHD. This led to a difference in the classification of the symptoms of ADHD, and therefore, its misdiagnosis. It was also found that it was common in non-caucasian families and teachers to understand the symptoms of ADHD as behavioural issues, rather than mental illness."
'Caucasian' and 'non-Caucasian' should be edited to the proper capitalizations. Crextorbium ( talk) 22:00, 14 February 2024 (UTC)
Certain nutritional deficiencies are known to be associated with ADHD, yet none of these are mentioned. Drsruli ( talk) 21:06, 23 February 2024 (UTC)
ADHD is a set of symptoms that may be predicated by a nutritional deficiency. (An absence of certain nutrients can certainly make concentration difficult.) This is elsewhere alluded to in the article. Just not in the ‘causes’ section. (And aside from zinc, an associated magnesium deficiency has also been found in some cases, resolving with correction.) There has been much research into the possibility of deficiency of certain nutrients during development. The research should be mentioned. Drsruli ( talk) 07:59, 29 February 2024 (UTC)
Currently the WP:LEAD contains about 10 paragraphs, which is too lengthy ( MOS:LEADLENGTH). The lead should contain the most important information and leave the details/elaborations to the body. Димитрий Улянов Иванов, please do not extend the lead any further. If you want to add something, add it to the body under the respective subheading.
The leads needs to be trimmed to 4-5 paragraphs. -- WikiLinuz ( talk) 02:20, 5 March 2024 (UTC)
“...they may be to maintain an unusually prolonged level of attention...” should probably be: ”...they may be able to maintain an unusually prolonged level of attention...” Viewpoint2927 ( talk) 11:37, 10 March 2024 (UTC)
Not sure where this can be placed, but the first reference to ADHD can now be pushed back in the medical literature to a Latin text in 1753 by Dutch physician Cornelius Kloekhof, describing a condition closely resembling ADHD. The previously first known references were by Adam Weikard (1770-75) and Alexander Crichton (1798) who describes both an ADHD and CDS-like disorders of attention. See: https://journals.sagepub.com/doi/10.1177/10870547241238926 Димитрий Улянов Иванов ( talk) 20:38, 28 March 2024 (UTC)
Please place new discussions at the bottom of the talk page. |
This is the
talk page for discussing improvements to the
Attention deficit hyperactivity disorder article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
Archives: Index, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28Auto-archiving period: 3 months |
Discussions on this page often lead to previous arguments being restated. Please read recent comments and look in the archives before commenting. |
This topic contains controversial issues, some of which have reached a consensus for approach and neutrality, and some of which may be disputed. Before making any potentially controversial changes to the article, please carefully read the discussion-page dialogue to see if the issue has been raised before, and ensure that your edit meets all of Wikipedia's policies and guidelines. Please also ensure you use an accurate and concise edit summary. |
Attention deficit hyperactivity disorder has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it. | |||||||||||||||||||||||||
|
This
level-4 vital article is rated GA-class on Wikipedia's
content assessment scale. It is of interest to multiple WikiProjects. |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Attention deficit hyperactivity disorder.
|
On 14 October 2022, it was proposed that this article be moved to ADHD. The result of the discussion was not moved. |
In this on 22 October 2023, Димитрий Улянов Иванов changed the lead sentence of the article from:
"Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappropriate."
to
"Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by executive dysfunction occasioning inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and otherwise age-inappropriate."
The edit summary states: "Revised the initial description to be more accurate concerning the disorder and its symptoms. As noted in the paragraph below (with citations), ADHD symptoms arise from executive dysfunction (the underlying deficit in ADHD is EF) and emotional dysregulation is often considered a core symptom."
While the user is correct that this article does note that the article does state that "ADHD symptoms arise from executive dysfunction", this is not necessarily accurate about ADHD, nor are the statements claiming it well supported. (I do not object to the "emotional dysregulation" aspect being added.)
For example, let's examine that statement in the second paragraph of the article: "ADHD symptoms arise from executive dysfunction..." To support this, three references are given; however, only two actually discuss "executive dysfunction" in ADHD. (The Malenka does not mention “executive dysfunction" in regards to ADHD and would be an WP:OR interpretation). The first is a 2008 article with the single author, Thomas Brown, in which the author acknowledges that his opinion that ADHD is "cognitive disorder, a developmental impairment of executive functions (EFs)" is a departure from the belief of "many clinicians". This article fails WP:MEDRS and also likely fails WP:FRINGE and/or WP:DUE, as the author notes his opinion is in conflict with “many clinicians” and is also in conflict with the WP:MEDRS compliant article below. The second is a single-author manuscript by Diamond from 2012–13, which only mentions ADHD twice, and the references to it appear to be “provided in passing” per WP:CONTEXTMATTERS. In any case, it is also not a WP:MEDRS complaint source.
Other areas of the article also seem to have similar statements: The symptoms of ADHD arise from a deficiency in certain executive functions (e.g., attentional control, inhibitory control, and working memory)." To support this, a single reference is given with the supporting quote, "Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention." The source merely notes that "early results" show that those with ADHD, as a group, may have thinning in areas that impact "working memory and attention." It does not say "symptoms of ADHD arise from a deficiency in certain executive functions". Attempts to say otherwise would be, at best, WP:OR.
The objection I have to the phrase "executive dysfunction" being used in the way it is used in article is that it implies that executive dysfunction is not only required for a diagnosis of ADHD, but is also the cause of ADHD. I do not feel this is accurate, nor is supported by the weight of the evidence, nor do the DSM nor the ICD mention "executive dysfunction" in regards to ADHD. While executive dysfunction is certainly more common in those with ADHD, it is far from required for a diagnosis, much less the cause of the disorder. A
WP:MEDRS complaint source states: "Specifically, estimates for the proportion of pediatric ADHD cases who exhibit any form of executive dysfunction range from 21% to 60% across studies employing a wide range of tasks and impairment criteria (Biederman et al., 2004; Coghill et al., 2014; Fair, Bathula, Nikolas, & Nigg, 2012; Geurts, van der Oord, & Crone, 2006; Nigg et al., 2005; Solanto et al., 2001; Sonuga-Barke, Bitsalou, & Thompson, 2010)." (Kofler MJ, Irwin LN, Soto EF, Groves NB, Harmon SL, Sarver DE (February 2019).
"Executive Functioning Heterogeneity in Pediatric ADHD". Journal of Abnormal Child Psychology. 47 (2): 273–286.
doi:
10.1007/s10802-018-0438-2.
PMC
6204311.
PMID
29705926.) My point is more explicitly stated in a WP:RS (but admittedly not a WP:MEDRS due to age): "Indeed, executive dysfunction is not required for the diagnosis of ADHD, which is defined at the behavioral, rather than neuropsychological, level." (Cortese S, Comencini E, Vincenzi B, Speranza M, Angriman M (November 2013).
"Attention-deficit/hyperactivity disorder and impairment in executive functions: a barrier to weight loss in individuals with obesity?". BMC Psychiatry. 13: 286.
doi:
10.1186/1471-244X-13-286.
PMC
4226281.
PMID
24200119.{{
cite journal}}
: CS1 maint: unflagged free DOI (
link))
In summary, I feel the above statements should be modified to remove "executive dysfunction" as a cause of and/or requirement of ADHD. At the absolute minimum, if WP:RS and WP:MEDRS are found to give the viewpoint WP:DUE, WP:CONFLICTING states both viewpoints should be acknowledged. Wikipedialuva ( talk) 10:15, 9 January 2024 (UTC)
Here I examine the nature of and evidence for a frequently cited benefit of ADHD claimed in this article – that being “hyper-focusing (HF).". Despite its widespread belief, this relationship has not been explored much in the scientific literature, with less than 8 studies being identified. The results are conflicting, depending on whether the study used people who just had elevated symptoms of ADHD, and not the disorder, compared to studies of clinically diagnosed individuals who had the full disorder (symptoms and impairments). In general, there does seem to be a significant relationship between ADHD and HF when ADHD is measured as rated symptoms. But in clinically diagnosed people the results are conflicting, with one study finding the relationship and another not ( Groen et al., 2020; Ozel-Kizil et al., 2016). And while HF is often presented as a benefit or gift of ADHD, some studies show that it also has a very negative side, being related to risk for internet addiction ( Ishii et al., 2023) and certain types of offending behaviour ( Worthington & Wheeler, 2023). From my understanding the roots of hyperfocus are in the EF/poor self-regulation that underlies ADHD. People vary in the degree to which their behaviour is controlled by distant rewards (e.g., if I study a lot, I'll get a good job a few years from now) vs. immediate rewards (e.g., when playing a video game, the environment is providing a great deal of continuous and immediate rewards for engagement; placing little demands on EF) ( Jackson & Mackillop, 2016; Marx et al., 2021). For many people with ADHD, immediate rewards are very potent and can lead to such perseverative responding ( Patros et al., 2016), even to the point of an inability to disengage from such environments likely linked to the same deficits in the disorder (i.e., in inhibition and working memory). So, the claim that ADHD is definitely linked to hyper-focusing and that it is a positive trait is not definitively established at this time. More research is clearly needed but such claims of HF as being widespread among those with ADHD, and entirely a benefit, cannot be taken on face value as an established fact. Assertions in this article regarding HF should therefore be amended. Димитрий Улянов Иванов ( talk) 00:34, 16 January 2024 (UTC)
The article currently looks like an instance of ref- WP:OVERKILL. Just in the top section, there are sentences with:
I think we should consider
trimming some sources, but if the sources are all deemed useful and should be kept, then perhaps we should look at
bundling the references.
Kimen8 (
talk) 21:17, 28 January 2024 (UTC)
sorry, I'm new to this whole Wikipedia editor/talk page poster thing so excuse me if I don't do this right.
I'm reading through, and got to the suicide risk chapter(?) and am wondering where these numbers are from? " the prevalence of suicide attempts in individuals with ADHD was 18.9%, compared to 9.3% in individuals without ADHD."
I'm personally looking for general worldwide attempt percentage, but I cannot find anything else past this.
thank you :> Mteaseil ( talk) 03:27, 11 February 2024 (UTC)
the original paper literally has a single sentence with ZERO fucking citations. ZERO!
Claim is unverified and should be deleted. CDLLBOSS ( talk) 01:08, 13 February 2024 (UTC)
This
edit request has been answered. Set the |answered= or |ans= parameter to no to reactivate your request. |
Regarding te paragraph under "Epidemiology" that reads:
"Due to disparities in the treatment and understanding of ADHD between caucasian and non-caucasian populations, many non-caucasian children go undiagnosed and unmedicated. It was found that within the US that there was often a disparity between caucasian and non-caucasian understandings of ADHD. This led to a difference in the classification of the symptoms of ADHD, and therefore, its misdiagnosis. It was also found that it was common in non-caucasian families and teachers to understand the symptoms of ADHD as behavioural issues, rather than mental illness."
'Caucasian' and 'non-Caucasian' should be edited to the proper capitalizations. Crextorbium ( talk) 22:00, 14 February 2024 (UTC)
Certain nutritional deficiencies are known to be associated with ADHD, yet none of these are mentioned. Drsruli ( talk) 21:06, 23 February 2024 (UTC)
ADHD is a set of symptoms that may be predicated by a nutritional deficiency. (An absence of certain nutrients can certainly make concentration difficult.) This is elsewhere alluded to in the article. Just not in the ‘causes’ section. (And aside from zinc, an associated magnesium deficiency has also been found in some cases, resolving with correction.) There has been much research into the possibility of deficiency of certain nutrients during development. The research should be mentioned. Drsruli ( talk) 07:59, 29 February 2024 (UTC)
Currently the WP:LEAD contains about 10 paragraphs, which is too lengthy ( MOS:LEADLENGTH). The lead should contain the most important information and leave the details/elaborations to the body. Димитрий Улянов Иванов, please do not extend the lead any further. If you want to add something, add it to the body under the respective subheading.
The leads needs to be trimmed to 4-5 paragraphs. -- WikiLinuz ( talk) 02:20, 5 March 2024 (UTC)
“...they may be to maintain an unusually prolonged level of attention...” should probably be: ”...they may be able to maintain an unusually prolonged level of attention...” Viewpoint2927 ( talk) 11:37, 10 March 2024 (UTC)
Not sure where this can be placed, but the first reference to ADHD can now be pushed back in the medical literature to a Latin text in 1753 by Dutch physician Cornelius Kloekhof, describing a condition closely resembling ADHD. The previously first known references were by Adam Weikard (1770-75) and Alexander Crichton (1798) who describes both an ADHD and CDS-like disorders of attention. See: https://journals.sagepub.com/doi/10.1177/10870547241238926 Димитрий Улянов Иванов ( talk) 20:38, 28 March 2024 (UTC)