How many people have ADHD, and why is it becoming so common?
Another area of ongoing debate surrounds the question, "How many people have ADHD?" The frequency of a disease or disorder is called a prevalence rate. Prevalence rates for ADHD appear to be sharply rising. In the United States, from 1997 to 2006, the rate of ADHD diagnoses went up an average of 3% per year. The percentage of children diagnosed with ADHD continued to increase from 7.8% in 2003; to 9.5% in 2007; to 11.0% in 2011. That's a 44% increase in 4 years! The number is even higher according to parental reports: In the USA, 6.4 million children (ages 4-17), or 11%, have had an ADHD diagnosis. Of this group, 69% are taking medications for the condition (National Survey of Children's Health, 2011).
Although there can be error in statistical analysis, error alone cannot account for this increase. The likelihood of error is offset by improvements in data collection methods. As causes for possible error have been identified, methods to correct these errors have been developed. Therefore, by numbers, there really isn't any debate that the numbers are increasing. What experts continue to debate are the causes for such increases.
Moreover, despite drastic increases, many experts believe the statistics actually underestimate the accurate number people with ADHD (prevalence). These professionals think there are many people with ADHD who have not yet been evaluated or diagnosed.
Another factor affecting prevalence rates involves the use of diagnostic labels in children. Some people are reluctant to label children as mentally ill. This is particularly true if it leads to giving them medication. This understandable type of stigma-avoidance could cause a decrease the number of children referred for evaluation. This reluctance to refer children for evaluation would lead to an underestimation of ADHD prevalence.
Alternatively, another group of professionals believe the current prevalence rates of ADHD diagnoses are overestimated. They cite errors in diagnosis and assessment of symptoms as one plausible cause. The diagnostic criteria for ADHD are fairly general. Therefore, it is possible that various types of disruptive behavior, and/or learning disabilities, are mislabeled as ADHD. In addition, there is no objective, standardized ADHD assessment tool that measures all of the symptoms listed in the DSM-5. Instead, the primary methods used to assess ADHD are self-report; parent and teacher questionnaires; or clinician-rated behavioral observations. These types of assessment tools are somewhat subjective. As a result, they can be influenced by feelings, values, cultural norms, and opinions.
In some cases, people who provide self-reports or behavioral observations may be unduly influenced by the idea that ADHD is increasingly common. They may be more willing to endorse symptoms that reflect this diagnosis. This suggests a reduced stigma associated with the disorder. From this perspective, the net effect would be to overestimate ADHD. Of course, an alternative explanation is also valid. The vague and general diagnostic description of symptoms, and the subjectivity of the assessment tools, could just as easily lead to an underestimate of ADHD. This would occur if people are misdiagnosed with other disorders that have shared symptoms; or, while trying to avoid the perceived stigma of this label. For the reasons cited above, the Center for Disease Control (CDC) emphasizes that statements about rates of the disorder are premature (Center for Disease Control, 2009).
Other researchers speculate that the increase in prevalence does not reflect a true increase. This argument proposes that the demands of the modern world simply make ADHD symptoms more obvious. From this perspective the prevalence itself is not increasing: We are just better able to detect it. To illustrate, our world is filled with electronic gadgets. This includes computers and cell phones that require more focused attention and concentration than was needed in the past. Thus, the change in the environment upped the demand for heightened attention. This in turn led to more people becoming dysfunctional in our modern environment. This interesting speculation recognizes that the survival skills needed in ancient civilizations (e.g., hunter-gatherer societies) are quite different than skills needed in today's world. In fact, ADHD characteristics could be desirable qualities that enhanced the chance of survival in pre-historic times. Viewed from this perspective, ADHD is just as prevalent as it was in the past. What has changed are the environmental demands. Therefore, what was once a beneficial skill is now a harmful symptom, leading to daily difficulties with everyday functioning.
In a related manner, cultures evolve and change; sometimes not for the best. Some researchers argue the ADHD increase is in response to contemporary lifestyle changes. These modern lifestyle changes include decreased physical activity; unstructured play time; and time spent in a natural environment. This approach suggests that as we move further away from our natural environment, and become detached from the nature's rhythm, we develop impulsivity, restlessness, and hyperactivity. This theory is similar to the ancient survival skill set argument described above. Both arguments suggest ADHD is on the rise because the symptoms became problematic when modern societies became disconnected from nature.
Whatever the reason, rates of newly diagnosed cases of ADHD are on the rise. The reason for this increase remains unresolved. While the cause and accuracy of these increases remains under debate, the increasing rates are still a reason for concern.
Not Erroneous - Allan N. Schwartz, PhD - Jul 29th 2010
Thank you for your interest in this very important topic. However, the information presented is not erroneous. If you read more carefully, the authors state that ADHD drugs have a very high potential for abuse and are abused by people who want to get high. However, and at the same time, it is not true that having ADHD and being prescribed this class of stimulants will cause the patient to turn to drug abuse. Yes, anyone can abuse drugs but it does not mean that someone who is precribed a drug will ipso facto become a drug abuser.
And, yes, there are behavioral training methods that can help people control their ADHD symptoms. The problem is that there are many times where the medications are needed because children are too impulsive to settle down to learning those methods.
Erroneous info - Kylie - Jul 29th 2010
While I do agree with some of what you said, it's hard to respect what you are trying to say because you are clearly not educated in what you are talking about... 1. Adderall and dexedrine ARE speed, they are amphetamines (Which is speed) and actually ritalin is by far, a more euphoric drug than dexedrine/adderall. I have done both many times. Ritalin is VERY much like cocaine, almost identifcal in effects. You get an intense euphoria for about 45 minutes - sometimes comparable to even ecstasy, and definitely the same effect, even more powerful then cocaine sometimes. Adderall and dexedrine are not quite as rushingly euphoric as ritalin. But the high/peak lasts longer and the comedown is much smoother. Make no mistake - ritalin is an intensely euphoric drug and actually, most ppl who abuse adhd meds prefer ritalin, it isn't a last resort. For me, I couldn't handle the short intense highs followed by intense crashes, so even tho I prefer ritalin over dexedrine, dexedrine is more smooth and easier on me.
I use these drugs recreationally and as you said above, like most ppl who are adhd med addicts or abusers, am NOT being treated for adhd. I think its a complicated issue, yes putting children on drugs (and lets face it, thats what they are...amphetamine (speed!) and something nearly identical in effect and pharmacologically to cocaine (can even show up as cocaine on a drug test sometimes!) we are getting children high to change their behaviour) and that can totally easily make way to drug abuse and what not, but also, NOT medicating adhd kids can lead them on the path of drug abuse too. A lot, if not majority of meth addicts are ADHD and I think many of them start using it bc it makes them feel and behave normally, and they think its their only choice to better themselves because theyve gone their lives dealing with their ADHD. I think best thing would be to work harder on other approaches that dont involve drugs right off the bat, these meds are highly over prescribed. I think a lot of ADHD kids just need to learn in a different environment, a more hands on approach.
Lack of citation - - Oct 23rd 2008
I agree with the abobe/bellow reader. No citations and this article, while it sounds more like and Ad created to clean up the image of ADHD medications. It would be interesting to see a study, statstics or some -factual- information about the thruth of addiction and dependency.
Cite Sources - Matthew - Oct 20th 2008
I am a freshman in college with ADHD. I have always wondered to myself if it was the right decision to use Adderall XR to treat my ADHD. So mow i get to my point, could you please give me a little citation, because without it it make me question your creditability. Thanks.
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