Are we using the ADHD diagnosis too indiscriminately?

The ADHD diagnosis is still more widely defined and more widely applied. The group of people who are diagnosed with ADHD is very diverse and patients may need many different forms of treatment and help, which does not necessarily have to be medical.

2014.03.31 | Tine Bagger Christiansen

Are we using the ADHD diagnosis too indiscriminately? Photo: Colourbox

The ADHD diagnosis is applied very widely to a large group of people who show very diverse symptoms and whose needs differ widely.  According to Carsten René Jørgensen, who is professor of psychology at Aarhus University, it is extremely problematic that we are taking this one-sided approach to ADHD:

“Because the ADHD diagnosis is so widely defined, there is a risk that we are simply overlooking the numerous psychological processes that may be in play in children and young people who are showing what we assume are ADHD symptoms,” explains Carsten René Jørgensen.

Increase in ADHD diagnoses
In recent years, the number of ADHD diagnoses and patients undergoing treatment for ADHD have exploded; first among boys, and more recently the number has generally increased, even among adults, which is problematic because our knowledge about treatment effects on adults is severely limited.

ADHD is now among the most frequent diagnoses among children and young people. But Carsten René Jørgensen is especially concerned about the significant increase in the number of adults who receive medical treatment for ADHD. “The research on adult ADHD is very limited, and in many ways the symptoms resemble other psychological disorders as well, which may make it hard to determine the right diagnosis,” he explains.

Medication is not always the solution
Treatment professionals in the ADHD field predominately take a biomedical approach to treating patients, and psychological perspectives have not gained much ground.

“Psychological illness is increasingly perceived as a ‘brain disorder’ that should be treated medically, and the more complex psychological approaches and treatment models are shoved into the background,” says Carsten René Jørgensen.

He believes that in the healthcare sector we need to take care that we do not indiscriminately use the ADHD diagnosis to diagnose children and young people, who are in fact suffering from more complex or temporary problems, and treat them medically where instead we should have taken a psychosocial approach to their treatment.

 

ADHD resembles several other diagnoses

The problem is that the ADHD diagnosis is hard to distinguish from other ailments resulting from failure of socialisation or ’bad parenting’, natural variation among humans, anxiety, inner turmoil or specific personality disorders and not least conduct disorders.

“Quite often, the medical treatment of ADHD is effective in the short run. But more long-term and fundamental effects are harder to achieve with this approach. It can be tempting to make a diagnosis for which you believe there is effective treatment. But instead we should aim at making the right diagnosis,” says Carsten René Jørgensen and proceeds:

“Traditionally, the ADHD field is based on social scientific research focusing on the effects of medical treatment and short-term behavioural training. We know remarkably little about each child’s own experience and understanding of the difficulties he or she is experiencing. That is why we need to give greater priority to research grounded in the human sciences; research that is aimed at achieving a deeper understanding of the individual and considers ADHD symptoms in correlation with psychological processes, relations, trouble in the family and in school, the child’s social background and so on.”

According to Carsten René Jørgensen it is a perfectly common misconception that all patients with the same diagnosis ‘have the same problem’ and should basically receive the same form of treatment. “But the problem with the conception is that you are rarely able to fully understand a person just by making a diagnosis - and similar symptoms, for instance inner turmoil, can be caused by many different things. If we take a more psychologically grounded approach we will be able to see each patient’s symptoms and problems in a much more comprehensive context,” he concludes.

Carsten René Jørgensen recently published the book  ADHD – Bidrag til en kritisk psykologisk forståelse (ADHD - Contributions to a critical psychological understanding) with the publishing house Hans Reitzels Forlag.

 

Facts

ADHD is an abbreviation of the diagnosis Attention Deficit/Hyperactivity Disorder. Patients suffering from ADHD display problems of attention, hyperactivity or acting impulsively and have trouble perceiving and interpreting, remembering, organising and orientating themselves.  

 

In the past, the diagnosis DAMP was applied here in Denmark. DAMP (Deficits in Attention, Motor control and Perception) is a diagnosis used primarily in the Nordic countries. The DAMP diagnosis has been “replaced” by ADHD, which is an internationally acknowledged diagnosis designation. 

 

Further information

Carsten René Jørgensen

Carsten René Jørgensen

Aarhus University, School of Business and Social Sciences

Mail: carsten@psy.au.dk

Tel.: +45 87165804

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