This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 10 | ← | Archive 15 | Archive 16 | Archive 17 | Archive 18 | Archive 19 | Archive 20 |
The scientific community lists both the cause as unknown as well as the pathophysiology with the most likely hypothesis being that both are multifactorial ( ie. many causes ). Saying that there are potentially many interacting causes means that we should list many causes. This is what we have done. These causes are not at the exclusion of one another. For genetics to be a cause evolutionary theory much have played a role.
Now some fringe points of view are: ADHD is completely genetic ( no one in the medical community believes this ) that the pathophysiology has been worked out conclusively ( no one believe this either ). Doc James ( talk · contribs · email) 05:26, 14 August 2009 (UTC)
I am getting a little tired of your repeated agression which is almost always entirely unprovoked Hyperion. I also would like to know if you have any connection with scuro? You appear to know him. How do you know him?-- Literaturegeek | T@1k? 12:43, 20 August 2009 (UTC)
In the last paragraph of the Pathophysiology subsection we have this material, "Critics, such as Jonathan Leo and David Cohen, who reject the characterization of ADHD as a disorder, contend that the controls for stimulant medication usage were inadequate in some lobar volumetric studies which makes it impossible to determine whether ADHD itself or psychotropic medication used to treat ADHD is responsible for the decreased thickness observed [1] in certain brain regions. [2] [3] They believe many neuroimaging studies are oversimplified in both popular and scientific discourse and given undue weight despite deficiencies in experimental methodology. [2]".
As Hyperion previously stated about the authors and their book, "..it included a passage on Realist vs. Anti-Realist philosophy and how this related to whether one can ever know whether ADHD really exists. The page that was cited actually attempts claim that Zametkin disagrees with ADHD as a medical diagnosis. I am not making this up...I actually wish it were a joke: [1]". I'm all for minority opinion but fringe opinion has no place on this article and this material should be moved to the controversies article or deleted.-- scuro ( talk) 14:16, 8 August 2009 (UTC)
The sources are peer reviewed and are not given undue weight so they should stay. Do you have any sources which sounter what they say regarding the robustness of the imaging studies? The passage in the book seems to be just the authors covering the range of controversies of ADHD in a large book. Books are large and often cover a large range of territories and anyway is irrelevant as the book is not cited in the article.-- Literaturegeek | T@1k? 16:59, 10 August 2009 (UTC)
as saying that "dopamine is a brain structure". htom ( talk) 17:40, 11 August 2009 (UTC)That medication-naive ADHD patients demonstrate differences in dopamine transmission compared to non-ADHD controls, and that administration of methylphenidate successfully altered these differences.
Perhaps if individuals had chosen to carefully read the studies that I cited, this misunderstanding could be avoided. The research papers that I have referenced here refer to differences in the density of DAT, the dopamine transporter, which is a protein found on the cell membranes of neurons at the axon terminal. This structure plays a role in dopamine uptake, removing dopamine (yes, dopamine is a neurotransmitter) from the synapse. Again, please read these studies carefully, and please ensure that you are familiar with some basic cellular neurology, neuropharmacology, and the basic properties of neurochemical transmission *before* you critique these studies. I was trying to keep my comments brief, rather than turning this into a lecture on neuropharmacology. I did not say that dopamine was a brain structure.
So let me recap here, I was discussing how these researchers used functional neuroimaging to find differences in the expression of proteins on the cell membranes of neurons. Now, can we all agree that neurons are a part of the brain's structure? Can we all agree that proteins on the cell membranes of neurons, that facilitate neurochemical transmissions are a part of the brain's structure? Any objections so far?
Now, I am trying to keep my replies here short. Unfortunately, I may have been too short in my previous reply, as apparently there was confusion as to what I meant. In the interest of keeping this reply short, I will stop here, and if anyone has further questions, I will address them. Also, I would prefer it if individuals would be more polite, please, and ask me to clarify my remarks before dismissing them as irrelevant. I can assure you that these citations are most definitely relevant, and I am sorry if there is some sort of misunderstanding as to why I referenced them, ok? ~ Hyperion35 ( talk) 08:58, 12 August 2009 (UTC)
Hi Hyperion, I did read the studies and they were discussing neurotransmitters, specifically dopamine or their transporters. I am also familar with the basics of neuropharmacology and cellular neurology. The disputed sentence(s) were discussing brain volume size, so your refs on dopamine transporters were not relevant.-- Literaturegeek | T@1k? 10:33, 18 August 2009 (UTC)
I am not sure if you even read the review articles. Cohen never said that there have been no comparison studies, at least in his most recent review. He criticises the methodology. I cannot help it if you do not agree with his criticisms but your criticisms I feel are original research and a misrepresention what the references say. Anyway here are some exerpts.
"Moreover, the few recent studies using unmedicated ADHD subjects have inexplicably avoided making straightforward comparisons of these subjects with controls."
"The most important — and we would say legitimate — comparison was between unmedicated patients and controls. However, compared to the controls, the unmedicated patients were two years younger, shorter and lighter.4 Castellanos et al. state that height and weight did not correlate with brain size in their study. Yet in that study these variables were significantly correlated with the diagnosis of ADHD. Thus, although finding three biological differences between the ADHD children and controls, the researchers only focused on brain size."
"for the most important comparison in the paper the subgroup of unmedicated patients is drawn from this already smaller and lighter group of patients; we are not told the height and weight of this subgroup of unmedicated patients but we are told that they are almost two years younger than the entire patient group; and for this reason the unmedicated patients are probably also significantly shorter and lighter than the control group. We say “probably” because for the most important comparison in the article the subjects’ specific physical characteristics are not provided. The issue of height and weight is especially relevant here because most research on brain size has found brain size to be correlated with body weight."
"this effect was not eliminated in the Castellanos et al. (2002) study."
"In fact, given all these other variables it would be noteworthy if they did not have smaller brains."
"However, this hardly seems the type of study to adequately address this issue, since the authors provided no information whatsoever about medication use (such as doses, durations, or even types of drugs used) except this one sentence: “At the time of the first scan, 103 patients (68%) were being treated with psychostimulants”"
I assume that you did not read the review by Cohen. He raises valid criticisms which you are most likely in good faith misrepresenting. As stated earlier I would respectfully request that you do not reply with original research, I cannot help it if you do not agree with Cohen's review of the evidence base.-- Literaturegeek | T@1k? 17:55, 24 August 2009 (UTC)
From the NIH consensus statement of 2002: [3] We, the undersigned consortium of international scientists, are deeply concerned about the periodic inaccurate portrayal of attention deficit hyperactivity disorder (ADHD) in media reports. This is a disorder with which we are all very familiar and toward which many of us have dedicated scientific studies if not entire careers. We fear that inaccurate stories rendering ADHD as myth, fraud, or benign condition may cause thousands of sufferers not to seek treatment for their disorder. It also leaves the public with a general sense that this disorder is not valid or real or consists of a rather trivial affliction.
We have created this consensus statement on ADHD as a reference on the status of the scientific findings concerning this disorder, its validity, and its adverse impact on the lives of those diagnosed with the disorder as of this writing (January 2002). Occasional coverage of the disorder casts the story in the form of a sporting event with evenly matched competitors. The views of a handful of nonexpert doctors that ADHD does not exist are contrasted against mainstream scientific views that it does, as if both views had equal merit. Such attempts at balance give the public the impression that there is substantial scientific disagreement over whether ADHD is a real medical condition. In fact, there is no such disagreement—at least no more so than there is over whether smoking causes cancer, for example, or whether a virus causes HIV/AIDS. The U.S. Surgeon General, the American Medical Association, the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry, the American Psychological Association, and the American Academy of Pediatrics, among others, all recognize ADHD as a valid disorder. Although some of these organizations have issued guidelines for evaluation and management of the disorder for their membership, this is the first consensus statement issued by an independent consortium of leading scientists concerning the status of the disorder. Among scientists who have devoted years, if not entire careers, to the study of this disorder there is no controversy regarding its existence.
Dr. Silver has also mentioned this divide about what is considered controversial. [4] The scientific and medical community see little controversy in comparison to the media and general public. This material will be added shortly unless there are objections.-- scuro ( talk) 12:07, 13 August 2009 (UTC)
(undent) Please do not be partronizing. -- Doc James ( talk · contribs · email) 14:45, 18 August 2009 (UTC)
The so called cheery picking was me using secondary sources, reviews and meta-analysis. Please focus on content and not the contributer scuro! There is a lot of good, but the remaining stuff that you don't agree with means that it is not neutral? Hmmm, ok.-- Literaturegeek | T@1k? 00:15, 15 September 2009 (UTC)
Wikipedia is here to represent the breadth and depth of human knowledge. What we have here is two camps. One who questions a purely pharmaceutical and genetic approach to ADHD and the other that claims ADHD has a genetic basis and all other view points need to be banished. Wikipedia is not here to take a position only to represent all POV as they are presented by their proponents ( not their opponents as was done previously ) . Doc James ( talk · contribs · email) 15:56, 17 August 2009 (UTC)
And I am confused as to why you are attempting to remove well referenced opinions. Anyway sorry for the short responses will try to address your concerns more fully in latter Sept. as currently busy with real life. Doc James ( talk · contribs · email) 15:04, 18 August 2009 (UTC)
I personally think that due to the huge and valid controversies and drama and debate on this talk page regarding authors with a conflict of interest, be it scientology, clearly identified as antipsychiatrists, employed by drug manufacturers of amphetamine based medications that we should strive to use other sources for these view points OR ELSE if we are citing them we should make clear their conflict of interest in the article text, such as "So and so with ties to CCHR (or ties to the drug manufacturers) found (or stated) that xyz".-- Literaturegeek | T@1k? 12:51, 20 August 2009 (UTC)
Ok, good sounds like we have consensus on this issue regarding drug companies and scientology and attributing association. I would like to see the context in which Timmi made these statements as scientology has a habit of cutting sentences out of context and rewording it to suit an agenda, not just doctors who they agree with but also those they oppose. However, I agree that the statements by Timmi are rather extreme.-- Literaturegeek | T@1k? 18:41, 24 August 2009 (UTC)
The fact that stimulants have been around since the 1930 has no effect on how useful they are. Effectiveness is based on scientific research. The requirement to prove effectiveness has only been around since 1962 in the USA. [5] And evidence based medicine is even younger than that. Doc James ( talk · contribs · email) 07:02, 15 September 2009 (UTC)
(undent) Not at all true. The largest and longest study involving ADHD was 2 years in duration and involved 579 children. The Women's Health Initiative involved 93,000 women and lasted 11 years. Doc James ( talk · contribs · email) 23:30, 17 September 2009 (UTC)
{{ Deadlocked}} Many issues are still unresolved, see archives 12-16. Contributors have had plenty of time to respond to these unresolved issues but they have been ignored.-- scuro ( talk) 00:06, 15 September 2009 (UTC)
Scuro I want you to retract and apologise for the character slur you have made against editors. You have no right to behave like this and label people as this. You have no right to publicly denigrate editors here as anti-psychiatry/scientology like. Retract this attack immediately and acknowledge that it is not true. You know that this is lies as I stated that I wanted to avoid use of anti-psychiatrists etc in this article as much as possible.-- Literaturegeek | T@1k? 01:24, 16 September 2009 (UTC)
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This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 10 | ← | Archive 15 | Archive 16 | Archive 17 | Archive 18 | Archive 19 | Archive 20 |
The scientific community lists both the cause as unknown as well as the pathophysiology with the most likely hypothesis being that both are multifactorial ( ie. many causes ). Saying that there are potentially many interacting causes means that we should list many causes. This is what we have done. These causes are not at the exclusion of one another. For genetics to be a cause evolutionary theory much have played a role.
Now some fringe points of view are: ADHD is completely genetic ( no one in the medical community believes this ) that the pathophysiology has been worked out conclusively ( no one believe this either ). Doc James ( talk · contribs · email) 05:26, 14 August 2009 (UTC)
I am getting a little tired of your repeated agression which is almost always entirely unprovoked Hyperion. I also would like to know if you have any connection with scuro? You appear to know him. How do you know him?-- Literaturegeek | T@1k? 12:43, 20 August 2009 (UTC)
In the last paragraph of the Pathophysiology subsection we have this material, "Critics, such as Jonathan Leo and David Cohen, who reject the characterization of ADHD as a disorder, contend that the controls for stimulant medication usage were inadequate in some lobar volumetric studies which makes it impossible to determine whether ADHD itself or psychotropic medication used to treat ADHD is responsible for the decreased thickness observed [1] in certain brain regions. [2] [3] They believe many neuroimaging studies are oversimplified in both popular and scientific discourse and given undue weight despite deficiencies in experimental methodology. [2]".
As Hyperion previously stated about the authors and their book, "..it included a passage on Realist vs. Anti-Realist philosophy and how this related to whether one can ever know whether ADHD really exists. The page that was cited actually attempts claim that Zametkin disagrees with ADHD as a medical diagnosis. I am not making this up...I actually wish it were a joke: [1]". I'm all for minority opinion but fringe opinion has no place on this article and this material should be moved to the controversies article or deleted.-- scuro ( talk) 14:16, 8 August 2009 (UTC)
The sources are peer reviewed and are not given undue weight so they should stay. Do you have any sources which sounter what they say regarding the robustness of the imaging studies? The passage in the book seems to be just the authors covering the range of controversies of ADHD in a large book. Books are large and often cover a large range of territories and anyway is irrelevant as the book is not cited in the article.-- Literaturegeek | T@1k? 16:59, 10 August 2009 (UTC)
as saying that "dopamine is a brain structure". htom ( talk) 17:40, 11 August 2009 (UTC)That medication-naive ADHD patients demonstrate differences in dopamine transmission compared to non-ADHD controls, and that administration of methylphenidate successfully altered these differences.
Perhaps if individuals had chosen to carefully read the studies that I cited, this misunderstanding could be avoided. The research papers that I have referenced here refer to differences in the density of DAT, the dopamine transporter, which is a protein found on the cell membranes of neurons at the axon terminal. This structure plays a role in dopamine uptake, removing dopamine (yes, dopamine is a neurotransmitter) from the synapse. Again, please read these studies carefully, and please ensure that you are familiar with some basic cellular neurology, neuropharmacology, and the basic properties of neurochemical transmission *before* you critique these studies. I was trying to keep my comments brief, rather than turning this into a lecture on neuropharmacology. I did not say that dopamine was a brain structure.
So let me recap here, I was discussing how these researchers used functional neuroimaging to find differences in the expression of proteins on the cell membranes of neurons. Now, can we all agree that neurons are a part of the brain's structure? Can we all agree that proteins on the cell membranes of neurons, that facilitate neurochemical transmissions are a part of the brain's structure? Any objections so far?
Now, I am trying to keep my replies here short. Unfortunately, I may have been too short in my previous reply, as apparently there was confusion as to what I meant. In the interest of keeping this reply short, I will stop here, and if anyone has further questions, I will address them. Also, I would prefer it if individuals would be more polite, please, and ask me to clarify my remarks before dismissing them as irrelevant. I can assure you that these citations are most definitely relevant, and I am sorry if there is some sort of misunderstanding as to why I referenced them, ok? ~ Hyperion35 ( talk) 08:58, 12 August 2009 (UTC)
Hi Hyperion, I did read the studies and they were discussing neurotransmitters, specifically dopamine or their transporters. I am also familar with the basics of neuropharmacology and cellular neurology. The disputed sentence(s) were discussing brain volume size, so your refs on dopamine transporters were not relevant.-- Literaturegeek | T@1k? 10:33, 18 August 2009 (UTC)
I am not sure if you even read the review articles. Cohen never said that there have been no comparison studies, at least in his most recent review. He criticises the methodology. I cannot help it if you do not agree with his criticisms but your criticisms I feel are original research and a misrepresention what the references say. Anyway here are some exerpts.
"Moreover, the few recent studies using unmedicated ADHD subjects have inexplicably avoided making straightforward comparisons of these subjects with controls."
"The most important — and we would say legitimate — comparison was between unmedicated patients and controls. However, compared to the controls, the unmedicated patients were two years younger, shorter and lighter.4 Castellanos et al. state that height and weight did not correlate with brain size in their study. Yet in that study these variables were significantly correlated with the diagnosis of ADHD. Thus, although finding three biological differences between the ADHD children and controls, the researchers only focused on brain size."
"for the most important comparison in the paper the subgroup of unmedicated patients is drawn from this already smaller and lighter group of patients; we are not told the height and weight of this subgroup of unmedicated patients but we are told that they are almost two years younger than the entire patient group; and for this reason the unmedicated patients are probably also significantly shorter and lighter than the control group. We say “probably” because for the most important comparison in the article the subjects’ specific physical characteristics are not provided. The issue of height and weight is especially relevant here because most research on brain size has found brain size to be correlated with body weight."
"this effect was not eliminated in the Castellanos et al. (2002) study."
"In fact, given all these other variables it would be noteworthy if they did not have smaller brains."
"However, this hardly seems the type of study to adequately address this issue, since the authors provided no information whatsoever about medication use (such as doses, durations, or even types of drugs used) except this one sentence: “At the time of the first scan, 103 patients (68%) were being treated with psychostimulants”"
I assume that you did not read the review by Cohen. He raises valid criticisms which you are most likely in good faith misrepresenting. As stated earlier I would respectfully request that you do not reply with original research, I cannot help it if you do not agree with Cohen's review of the evidence base.-- Literaturegeek | T@1k? 17:55, 24 August 2009 (UTC)
From the NIH consensus statement of 2002: [3] We, the undersigned consortium of international scientists, are deeply concerned about the periodic inaccurate portrayal of attention deficit hyperactivity disorder (ADHD) in media reports. This is a disorder with which we are all very familiar and toward which many of us have dedicated scientific studies if not entire careers. We fear that inaccurate stories rendering ADHD as myth, fraud, or benign condition may cause thousands of sufferers not to seek treatment for their disorder. It also leaves the public with a general sense that this disorder is not valid or real or consists of a rather trivial affliction.
We have created this consensus statement on ADHD as a reference on the status of the scientific findings concerning this disorder, its validity, and its adverse impact on the lives of those diagnosed with the disorder as of this writing (January 2002). Occasional coverage of the disorder casts the story in the form of a sporting event with evenly matched competitors. The views of a handful of nonexpert doctors that ADHD does not exist are contrasted against mainstream scientific views that it does, as if both views had equal merit. Such attempts at balance give the public the impression that there is substantial scientific disagreement over whether ADHD is a real medical condition. In fact, there is no such disagreement—at least no more so than there is over whether smoking causes cancer, for example, or whether a virus causes HIV/AIDS. The U.S. Surgeon General, the American Medical Association, the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry, the American Psychological Association, and the American Academy of Pediatrics, among others, all recognize ADHD as a valid disorder. Although some of these organizations have issued guidelines for evaluation and management of the disorder for their membership, this is the first consensus statement issued by an independent consortium of leading scientists concerning the status of the disorder. Among scientists who have devoted years, if not entire careers, to the study of this disorder there is no controversy regarding its existence.
Dr. Silver has also mentioned this divide about what is considered controversial. [4] The scientific and medical community see little controversy in comparison to the media and general public. This material will be added shortly unless there are objections.-- scuro ( talk) 12:07, 13 August 2009 (UTC)
(undent) Please do not be partronizing. -- Doc James ( talk · contribs · email) 14:45, 18 August 2009 (UTC)
The so called cheery picking was me using secondary sources, reviews and meta-analysis. Please focus on content and not the contributer scuro! There is a lot of good, but the remaining stuff that you don't agree with means that it is not neutral? Hmmm, ok.-- Literaturegeek | T@1k? 00:15, 15 September 2009 (UTC)
Wikipedia is here to represent the breadth and depth of human knowledge. What we have here is two camps. One who questions a purely pharmaceutical and genetic approach to ADHD and the other that claims ADHD has a genetic basis and all other view points need to be banished. Wikipedia is not here to take a position only to represent all POV as they are presented by their proponents ( not their opponents as was done previously ) . Doc James ( talk · contribs · email) 15:56, 17 August 2009 (UTC)
And I am confused as to why you are attempting to remove well referenced opinions. Anyway sorry for the short responses will try to address your concerns more fully in latter Sept. as currently busy with real life. Doc James ( talk · contribs · email) 15:04, 18 August 2009 (UTC)
I personally think that due to the huge and valid controversies and drama and debate on this talk page regarding authors with a conflict of interest, be it scientology, clearly identified as antipsychiatrists, employed by drug manufacturers of amphetamine based medications that we should strive to use other sources for these view points OR ELSE if we are citing them we should make clear their conflict of interest in the article text, such as "So and so with ties to CCHR (or ties to the drug manufacturers) found (or stated) that xyz".-- Literaturegeek | T@1k? 12:51, 20 August 2009 (UTC)
Ok, good sounds like we have consensus on this issue regarding drug companies and scientology and attributing association. I would like to see the context in which Timmi made these statements as scientology has a habit of cutting sentences out of context and rewording it to suit an agenda, not just doctors who they agree with but also those they oppose. However, I agree that the statements by Timmi are rather extreme.-- Literaturegeek | T@1k? 18:41, 24 August 2009 (UTC)
The fact that stimulants have been around since the 1930 has no effect on how useful they are. Effectiveness is based on scientific research. The requirement to prove effectiveness has only been around since 1962 in the USA. [5] And evidence based medicine is even younger than that. Doc James ( talk · contribs · email) 07:02, 15 September 2009 (UTC)
(undent) Not at all true. The largest and longest study involving ADHD was 2 years in duration and involved 579 children. The Women's Health Initiative involved 93,000 women and lasted 11 years. Doc James ( talk · contribs · email) 23:30, 17 September 2009 (UTC)
{{ Deadlocked}} Many issues are still unresolved, see archives 12-16. Contributors have had plenty of time to respond to these unresolved issues but they have been ignored.-- scuro ( talk) 00:06, 15 September 2009 (UTC)
Scuro I want you to retract and apologise for the character slur you have made against editors. You have no right to behave like this and label people as this. You have no right to publicly denigrate editors here as anti-psychiatry/scientology like. Retract this attack immediately and acknowledge that it is not true. You know that this is lies as I stated that I wanted to avoid use of anti-psychiatrists etc in this article as much as possible.-- Literaturegeek | T@1k? 01:24, 16 September 2009 (UTC)
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)
{{
cite journal}}
: Check |issn=
value (
help); Unknown parameter |coauthors=
ignored (|author=
suggested) (
help)
{{
cite journal}}
: Unknown parameter |coauthors=
ignored (|author=
suggested) (
help)