“a crucial factor was ‘the amount of chaos in the environment'” – Stolen Focus, Chapter 13 Notes

Posted on: June 17, 2022

Last Updated on: June 18th, 2022

Post Category: Book Notes

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About #onepageonepoint

#onepageonepoint aims to summarise new ideas from books on personal and professional development – with (approximately) one point for each page. Read more about this project here.

Today for #onepageonepoint, we have summary notes for Stolen Focus – for chapter 13: ‘Cause Eleven: The Rise of ADHD and How We Are Responding to It’.

If you are interested in getting yourself a copy or learn more about the book, click here.

Chapter 13: ‘Cause Eleven: The Rise of ADHD and How We Are Responding to It’

• ‘Between 2003 and 2011, diagnoses of ADHD soared in the US by 43 percent overall, and by 55 percent among girls… 13 percent of adolescents in the US have been given this diagnosis, and of them, a majority are given powerful stimulant drugs as a result’ (Hari 2022, p. 209).

• Note that there is a lot of disagreement surrounding this topic in the scientific field – disagreement on how ADHD is defined and the contribution/significance of different factors.

• In many parts of the US, 30 percent of boys are now diagnosed with ADHD by the time they turn eighteen, and a huge number of adults are being told they have ADHD, with 3 million adults having prescribed stimulants (such as Ritalin).

• In the US, it is common belief that ADHD is caused by the person’s genes and brain, and that stimulants are necessary. In other places like Finland, it is common belief that it is harmful to consider ADHD a biological disorder and that alternative treatment (to stimulants) should be used.

• For the side that believes that ADHD is a biological disorder, Stephen Hinshaw, professor of psychology at Stanford University, states that genetics account for 75 to 80 percent of ADHD – based on many scientific studies.

• Another theory is that ADHD occurs when instinctive biological behaviours are suppressed i.e. when animals are ‘suffering’ from ‘frustrated biological objectives’. For example, a wild horse will graze 60 percent of the time, while a domesticated horse will crib (fake graze).

• This theory of suppressed biological objectives is consistent with higher rates of diagnosis of ADHD in children: kids do not run as much, they spend most of their time inside, they are fed a diet lacking nutrients for brain development, and they are put in a school environment that emphasises high-stress testing, and this has coincided with rising ADHD diagnosis in children. However, some scientists disagree with this.

• Sami Timimi, leading child psychiatrist in Britain, intervened by taking on a different approach than just offering stimulant drugs for children with ADHD. His approach involved understanding the environment and life experiences of the child and creating a better environment for them, before prescribing drugs (which was the last resort). This has been historically successful: ‘He said that with the vast majority of cases of kids with attention problems that come into his office, if he listens carefully and offers practical support to change the child’s environment, it almost always reduces or ends the problem they have’ (Hari 2022, p. 219).

• During an extensive long-term study of 200 people, which started in Minneapolis, 1973, scientists went to determine/understand life factors that contributed to attention problems. Alan Sroufe, a professor of child psychology at the time, had the hypotheses that ADHD was a biological disorder and so the development of attention problems depended on people’s neurological status at birth.

• However, this was found to be insignificant, and what was more significant was the amount of chaos/stress in the environment i.e. children growing in a stressful environment were more likely to develop attention problems:
  • When you are young, you need an adult soothing you until you can learn to soothe yourself. Parents who are stressed have it harder to soothe their children, and so their children don’t calm and centre themselves as effectively. This leads to more amped-up feelings in difficult situations, causing lower focus.
  • It was also found that parents who had social support (through a friend, family member, etc) reduced the likelihood of their child developing ADHD – ‘Parents experiencing less stress can be more responsive to their infants; then infants can be more secure’ (Hari 2022, p. 222).

• Giving a child or adult a stimulant like Adderall or Ritalin will significantly improve attention, but only in the short-term.

• Prescribing these drugs for ADHD is relatively easy in America – as there is little caution.

• During 2015, Australia experienced a spike in Meth use and there was a study undertaken by the Australian government to investigate replacing the addiction with ADHD drug dextroamphetamine. The results showed that the drug gave relief to meth addicts – much like how nicotine patches gives relief to smokers. This is because Meth and the drug are chemically similar and work on similar neurotransmitters ‘but [Hari] felt unsettled to learn the drugs we give kids turn out to be a reasonable proxy for meth’ (Hari 2022, p. 224).

• There is scientific evidence that there are several risk factors with these drugs – for children, it stunts growth, increases the risk of having heart problem and dying as a result, and there are unknown long-term (neurological) effects (due to lack of research).

• In a study performed on rats, adolescent rats that were given Ritalin for three weeks (equivalent for a few years for humans) experienced significant shrinking in the part of the brain that is responsible for experiencing rewards.

• The positive effects of these drugs are also limited – research shows they improve performance on repetitive tasks but not on learning, and kids who were given stimulants improved as much as students who were given behavioural guidance (on academic tests).

• Other negative effects of taking stimulants include sleeping less, and this raises concerns for brain development in young people. Hari (2022, p. 227) quotes Charles Czeisler, sleep expert at Harvard Medical School: ‘The pushing of all these amphetamines for these kids reminds me of the opioid crisis, except nobody’s talking about it’.

• It is believed that 75 to 80 percent of ADHD is explained by genetics, however the experiment behind these statistics does not include direct analysis of the human genome – it involved a twin study. For the twin study, they take a pair of identical twins, and the logic was that if many twins were both diagnosed with ADHD, this would be evidence that ADHD is explained by genetics.

• However, one flaw is that identical twins grow up in a much more similar behaviour-shaping environment than non-identical twins, so the study can not distinguish between influences by genetics versus the environment.

• From later studies, SNP heritability, a test comparing actual genetic makeup, was used, and it showed that 20-30 percent of attention problems relate to genes.

• Hari (2022, p. 230) quotes Alan Sroufe and Professor Joel Nigg: ‘Genes don’t operate in a vacuum. That’s the main thing we’ve learned from gene studies… Genes are turned on and off in response to environmental input… our experience literally gets under our skin and change how our genes are expressed… your genes might make you more vulnerable to a trigger in the environment – but there still has to be a trigger in the environment.’

If you are interested in getting yourself a copy or learn more about the book, click here.

Interested in reading more? See my notes for Chapter 14.