My letter to the APA Monitor on females and AHD - 2003
Women and ADHD
REGARDING NICOLE Crawford's excellent article, "ADHD: a women's issue," (February Monitor ), attention-deficit hyperactivity disorder (ADHD) is a well-known disorder that is not known well. What is not known well is that gender stereotypes contribute to missed opportunities for identification and effective medication and psychological treatments for female adults with ADHD. For example, many females do not present with the classic "Dennis the Menace" triad of ADHD symptoms--restlessness, distractibility and [lack of] self-control. Rather, they suffer severe chronic and pervasive difficulties with distractibility--a difficulty filtering out external distractions that is often misdiagnosed and sometimes associated with disorders such as anxieties, substance abuse and depression.
A core problem in the diagnosis and treatment of ADHD is that scientists know much about how brains and minds work but have no knowledge about how brains produce minds. This wide brain-mind gap is often filled by political ideologues--both liberal and conservative--claiming they do not "believe" that ADHD exists, or at least know it is vastly over-diagnosed. Liberal ideologues tell us we mask the problems with medication. Conservative ideologues say ADHD is another myth of mental illness.
Until we have a medical test to identify ADHD, no amount of scientific knowledge, clinical experience or testimonies from those with the disorder will convince some citizens of the validity of neurophysiology disorders such as ADHD in adult females or anybody else. Your article does much to clarify the influence of stereotypes and myths about adult females with ADHD.
December 2012, Vol 43, No. 11
Print version: page 4
Jerome Kagan: Reminding us not to get complacent
In response to your insightful interview with Professor Jerome Kagan ("The ghost in the lab," October Monitor), anybody who can constructively criticize the many misadventures of psychological research ("Psychology's Ghosts") and tell us how genes, culture, time and luck make us who we are ("The Temperamental Thread") gets my attention, especially when the author is one of the world's most distinguished psychologists with a resilient nature and more than 50 years of experience.
In these recent books, Dr. Kagan elaborates on the pioneering work of Drs. Paul McHugh and Phillip Slavney in "The Perspectives of Psychiatry."
Dr. Kagan outlines four "families" of psychological disorders, which have their origins in brain disease (e.g., autism, schizophrenia); temperamental biases for anxiety and depression (e.g., phobias, depression, obsessive-compulsive disorder); temperamental biases that make it difficult to regulate impulsive behavior (e.g., ADHD, conduct disorder); or distressful life encounters (e.g., grief, adjustment disorders).
One single "family" or method cannot explain all mental distress.
Lest we get too complacent about what we know about the secrets of human nature, Dr. Kagan reminds us that the DSM-IV and the V to follow soon consist of a list of ingredients for many psychological disorders with no recipes for the causes or etiology of any of the increasing number of mental maladies — our answers to what mental illness is often sound muddle-headed or simple-minded.