ADHD not just a product of our culture

Ever since becoming a household term across Canada and the US, attention deficit/hyperactivity disorder (ADHD) has inspired controversy.

Many people have questioned its validity as a true disorder as well as the rates at which it is diagnosed. Some skeptics say symptoms are just normal childhood behaviour; others say inattentive, hyper kids are the result of poor parenting; and still others think a greedy pharmaceutical industry is making up a disorder to sell us all drugs.

Studies have largely dismissed these criticisms.

ADHD is only diagnosed when a person exhibits a persistent set of symptoms including poor attention, hyperactivity and impulsive behaviour. These traits must start before the age of seven and impair functioning both at school and at home.

Research to date suggests that contrary to some assumptions, ADHD is under-diagnosed in our country and prevalence rates are the same regardless of parenting.

A recent analysis of data gathered from 102 studies around the world is shedding light on yet another argument against the validity of ADHD as a medical disorder.

This argument claims ADHD is nothing more than a cultural construct - the creation of our permissive culture and is rarely seen outside of North America.

After a decade of debate on this issue, a Brazilian research team has published the most comprehensive study to date examining geographic rates and disparities in ADHD. According to this analysis, ADHD affects roughly five percent of children worldwide and North America is not the geographic area with the highest prevalence of the disorder.

Regions from around the world including Africa, Asia, Europe, the Middle East, North America, Oceania and South America were examined for this study and results showed variations in prevalence did not support a notion that ADHD is a product of North American culture.

Rates did vary in different geographic areas - North American rates were average at just over six percent with Europe slightly lower at four and a half percent. The highest rates of the disorder were found in Africa (eight and a half percent) and South America (11.8 percent). Japanese and Finnish children scored the lowest.

Scientists hoped the varying rates might shed light on causal factors for ADHD. If one country or region had much higher rates while another had very low rates, it may be possible to determine what makes one place susceptible or protects another place.

However, differences in methodology must first be ruled out. In this case, different diagnostic criteria used in Europe than in North America explained the different rates in these regions. Diagnostic criteria used in Europe are slightly stricter than those used in North America. As a result, fewer children are diagnosed.

In support of this conclusion, a multi-site study using the same diagnostic criteria at all sites found similar rates across clinics in Africa, Australia, Europe and North America.

Because of this, these researchers say the worldwide prevalence rate for ADHD is just over five percent.

Research continues into this condition to find better treatments as well as to learn what causes it and exact biological markers to be able to identify it in brain scans.

Until then, scientists are confident that ADHD is indeed a true medical condition affecting some children and adults around the world and not the result of poor parenting, or greedy drug companies.

If you think your child may have ADHD, speak with your doctor and get a referral to a mental health professional for an appropriate diagnosis.

 

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