A plea for the abolition of ADHD

A plea for the abolition of ADHD.

(20.09.2010) A representative survey, which the social research institute Forsa carried out on behalf of the magazine "Eltern", gave a frightening result: When asked: "Which health disorders do you fear most that your child could get?" by far most parents - namely 44 percent - the attention deficit (hyperactivity) syndrome AD (H) S (Eltern 2009). So far it has come with the completely unfounded insecurity, even fear of parents regarding the fashion disease ADHD! Unsettled, frightened parents are of course worse educators, so one has to fear that the increased fear of ADHD leads to educational errors, which in turn can lead to “ADHD”. The cat bites its own tail, so to speak, a classic self-fulfilling prophecy. What should I do?

The psychotherapist Hans Reinhard Schmidt is now subjecting the construct of ADHD to radical criticism in a book that has recently been published by Centaurus. He comes to the conclusion that the construction of this disease brings more disaster than blessing and should be abolished or overcome.

Parents do well to doubt an ADHD diagnosis. This advice, which Hüther and Bonney give in their bestseller “News from Zappelphilipp” (Hüther 2008), is by no means meant to be provocative, the author emphasizes. Rather, it makes a lot of sense if you hear, experience and read again and again that parents are dissatisfied if their child is NOT diagnosed despite this, despite thorough examination. The current popular "specialist literature", the advice in relevant Internet self-help groups and the "helpful" Ritalin effect experienced by many people lead many concerned parents to premature self-diagnosis and to the pseudo-security that their child has this "illness" too. Almost everything that children, adolescents and adults show in behavioral difficulties fits into the "ADHD" collection pot.

When parents describe their problems in the relevant Internet forums, it has rarely been read that someone tells them that their problems can mean anything, more likely the expression of relationship difficulties than an alleged brain dysfunction, emphasizes Schmidt. Instead, they are advised almost consistently to have "ADHD" checked by a doctor, the address of a suitable doctor will be provided immediately. It is then mostly a doctor who has gotten around that he likes to diagnose ADHD frequently. Parents are often even warned to go to another professional who may be critical of ADHD. Such a doctor or psychologist would then simply be incompetent for ADHD, is popular.

Schmidt knows, however, that diagnoses are not always valid and reliable, but rather strongly dependent on the diagnostician, especially in the case of such unclear "clinical pictures" as ADHD. Whether I go to a psychoanalyst, a critical or non-critical psychologist or a doctor who is convinced of ADHD decides on the diagnosis. And parents choose the expected or desired diagnosis through their conscious choice of diagnostician. In the sense of "self-fulfilling prophecies" the circle closes and everyone seems satisfied.

The diagnosis of “ADHD” is extremely unreliable. There is no clear biological or morphopathological marker for the alleged disease ADHD, otherwise one would not have the problems with the unreliable and ambiguous, purely clinical behavioral diagnosis. There is still no specific ADHD test, neither psychological nor medical.

In view of the large number of misdiagnoses, the inadequacy of the diagnostic tools for ADHD, the serious stigmatizing psychosocial long-term consequences of the diagnosis, especially for children (supposedly genetic, inheritable brain metabolism disorder) and the uncertain long-term effects of the psychotropic drugs administered to young children in reality, the lack of scientific clarity of the ADHD syndrome would initially give parents every reason to doubt this diagnosis.

Quite apart from the fact that there is no scientifically objective, valid and undisputed diagnosis of ADHD anyway, most diagnoses do not even meet the minimum standard of the medical diagnosis guidelines. A work by Angold shows that 75% of children treated with stimulants did not meet the diagnostic criteria for ADHD required by DSM-IV at all. Almost 60% of the diagnoses were simply wrong (Angold 2000; Lehmkuhl 2002). If you consider the abundance of possible differential diagnoses, it quickly becomes clear why so often inaccurate diagnoses are mentioned: in the diagnostic manuals, profound developmental disorders, disruption of social behavior, seizure disorders, adaptation reactions to extraordinarily stressful family relationships or excessive demands on school, emotional disorders such as anxiety disorder are mentioned as exclusion criteria, agitated depression, mood disorders. If these clinical pictures were always carefully sorted out, a number of 1-2% of "ADHD" diagnoses would probably remain.

Nobody knows what is reliably and validly measured in this diagnosis. Is a medical illness measured, or only more or less normal behavioral variations or well-known psychoreactive behavioral disorders of various causes? When three professionals talk about ADHD, each of them probably means something different. In view of such incredible diagnostic and therapeutic grievances, under which many children are often treated with psychostimulants for years, there is no need to question the meaningfulness of many ADHD studies based on such arbitrary diagnostics.

Dipl.-Psych. Hans-Reinhard Schmidt is a psychological psychotherapist and works among other things in the family and Educational advice in Brühl u. Wesseling. (PM conference ADHD)

Also read:
- Schmidt, Hans-Reinhard: I study like a zombie. Advocate for the abolition of ADHD. Centaurus 2010, 320 pages.
- ADHD: prescribing Ritalin is restricted
- Cannabis effective for ADHD?
- Environmental factors in ADHD hardly examined

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