Imza wrote:I agree that he is confusing disease and disorder but I don't think he is completely wrong. ADHD is a "real" thing in the sense that we categories people on a normal curve and those who are sufficiently abnormal can be classified as being in the disorder range. I don't think this method is necessarily wrong but it is different from certain medical conditions where we can identify specific physiological markers/causes that least to the disease/disorder.
Yes. Glad to see you recognise the difference as people in psychology often don't seem to.
For me, the problem is the degree of subjectivity and circularity in how we choose to categorise things in the first place. Yes, you can categorise a particular set of symptoms together and define a position on one end of the bell curve of thaat categorisation as being ADHD. Does this mean ADHD is "real"?
Well, obviously people vary in the symptoms being studied, so they total variance in their symptoms taken together, that qualifies some for a diagnosis, is "real". But then if I wanted to, I could invent a disorder called "Wee Wee Wanna Shag Hangover Disorder", based on (a) how well someone is able to suppress the need to urinate, (b) how often they fantasize about sex, and (c) how prone they are to hangovers. Since all these things tend to affect concentration and task application, it would be likely that those at one end of the bell curve for my disorder would suffer some impairment from it. Does that make it "real"?
I suppose there are a few different meanings of real here. The problem with psychological disorders is that we can't actually see the thing causing the disorder in operation, like we can see cancer cells or a broken bone. The the decision about what we bring under the umbrella of the disorder is much more open, and open to dispute. (Eg the fact that Aspergers has now, according to the DSM, ceased to exist as a discrete thing and become one with autism spectrum disorder). It can be hard in these situations to take the phenomenon as the objective reality that it's something claimed to be.
However, what neither of these address is whether or not there actually are functional impairments to the person who meets classification criteria. For me, unless there actually are functional impairment, as perceived by the person or society, we shouldn't classify ADHD as a disorder.
The diagnostic criteria are pretty clear on that point, as they are for most disorders. From the DSM-V:
Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7.
Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
And that's the point at the end of the day. The point of these things is to help people who are suffering.
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