Attention-deficit disorder (ADD) and attention-deficit/hyperactivity disorder (ADHD) are among the most frequent diagnoses in child and adolescent psychiatry. Diagnosis for these disorders began around 1980. Before that time, they were called different things, such as hyperkinetic disorder. In 1987, the American Psychiatric Association added ADHD to the Diagnostic and Statistical Manual of Mental Disorders.
A child or adolescent may be diagnosed with ADD or ADHD if he or she exhibits the following behaviors: attention difficulties/short attention span, motor hyper-activity, restless behavior, impulsivity, temper outbursts, and distractibility. Persons with ADHD or ADD often struggle in educational settings. Many are chronically truant as a result of their disorder. Children and youth with ADD/ ADHD often exhibit hostile attributional biases, which refers to the tendency to interpret ambiguous social cues as being hostile. This problem may lead to verbally or physically aggressive behavior, which can then result in suspension or expulsion from school. Because students with ADD/ADHD find it difficult to achieve in a traditional school setting, they may be placed in special education programs.
Many ADD/ADHD-diagnosed children and youth experience comorbidity– that is, the co-occurrence of other disorders. Common comorbid diagnoses or disorders include conduct disorder, learning disabilities, anxiety disorders, Tourette’s syndrome or some other type of tic, affective disorders, and personality disorders. Persons with ADD/ADHD are also more likely to have substance abuse problems. All of these factors place them, according to some studies, at high risk for criminal offending.
Critics contend that ADD/ADHD is over-diagnosed. A 2002 study found that as many as 16% of school-aged children in the United States could have ADD/ ADHD–a far greater percentage than the previous estimate of 3% to 5%. Some contend that this trend toward diagnosing young people with ADD/ADHD is simply a reflection of a culture of short attention spans. Kids face more stressors today, in particular at schools that engage in high-stakes testing, and critics
Actress Kirstie Alley displays a picture of Raymond Perone, a 10-year-old suicide victim, while testifying in front of the Florida House Education Council in favor of a bill to limit the prescribing of psychotropic drugs such as Ritalin in Tallahassee, Florida, on April 19, 2005. According to Marla Filidei of the Citizens Commission on Human Rights, Raymond committed suicide while experiencing withdrawal from Ritalin. (AP/Wide World Photos) contend perhaps it is unfair to expect young people to be attentive in these ways. While some go so far as to question whether ADD and ADHD are really disorders at all, many simply assert that the diagnostic process is far too subjective. There is no independent, valid test for ADD/ADHD. As a consequence, it is easy to diagnose a child or adolescent with ADD/ADHD.
Another concern is that, once a person is diagnosed with ADD/ADHD, the primary intervention is the prescription of some psychoactive drug, such as methyl-phenidate, typically Ritalin or Adderall. These drugs are stimulants much like cocaine, and can have dangerous side effects, including mood swings and loss of appetite. Between 1990 and 1996, prescriptions for methylphenidate increased 500%. The U.S. Drug Enforcement Agency (DEA) noted that, in some locations, 15% to 20% of young people had been prescribed Ritalin, and a Journal of the American Medical Association report found prescriptions for preschool-age children had tripled during the 1990s. Between 1990 and 2000, 569 children were hospitalized and 186 died due to taking Ritalin, according to some scholars. A similar trend of overprescribing Ritalin has been documented in the United Kingdom. Between 1995 and 2000, Britain saw a ninefold increase in the number of children being prescribed this drug.
Several infamous school shooters had been taking prescription drugs at the time of their attacks. T. J. Solomon was taking Ritalin when he went on a shooting spree at his Georgia high school, and some evidence suggests Kip Kinkel had taken Ritalin as well.
- Barkley, R., & Murphy, L. (1998). Attention-deficit hyperactivity disorder: A clinical workbook. New York: Guilford.
- Death from Ritalin. (n.d.). Retrieved from http://www.ritalindeath.com/ADHD-Truths.htm
- Haislip, G. (1996). DEA report: ADD/ADHD statement of Drug Enforcement Administration. Retrieved from http://www.add-adhd.org/ritalin.html
- Smith, L. (2000, April 25). Kids on pills: BBC documentary examines increase in prescription drug use amongst children. World Socialist website. Retrieved from http://www.wsws.org/en/articles/2000/04/rit-a25.html
- Zahn, P. (2002, March 15). The big question: Is ADD overdiagnosed? CNN. Retrieved from http://transcripts.cnn.com/TRANSCRIPTS/0203/15/ltm.01.html