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Beyond polemics: science and ethics of ADHD

An Erratum to this article was published on 26 November 2008

Abstract

What is attention-deficit hyperactivity disorder (ADHD)? Why are so many children being diagnosed with ADHD and prescribed medication? Are stimulant drugs an effective and safe treatment strategy? This article explores the current state of scientific research into ADHD and the key social and ethical concerns that are emerging from the sharp rise in the number of diagnoses and the use of stimulant drug treatments in children. Collaborations among scientists, social scientists and ethicists are likely to be the most promising route to understanding what ADHD is and what stimulant drugs do.

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Figure 1: Co-occurring disorders in the Multi-modal Treatment Study of children with ADHD.
Figure 2: Worldwide consumption of methylphenidate.

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Acknowledgements

Many thanks to J. McClellan, N. Rose and B. Vitiello for their comments on earlier versions of this manuscript. Thanks to K. Kelleher for discussions on interventions and outcomes that informed this article. Special gratitude to E. Taylor, for insightful criticism and generous support. The author is funded by a Wellcome Trust University Award in Biomedical Ethics.

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FURTHER INFORMATION

Ilina Singh's homepage

NIMH Multimodal Treatment Study

NIMH webpage on ADHD

US National Children's Study

Voices Study (Voices On Identity, Childhood, Ethics and Stimulants)

Glossary

Conduct disorder

A childhood behaviour disorder characterized by persistent aggressive or anti-social behaviour that disrupts the child's environment and impairs his or her functioning.

Connors Parent/Teacher Rating Scales

Rating scales that are used to check for symptoms of ADHD. Ideally they are filled out by both teachers and parents to assist in measuring a child's behaviour and comparing it with that of other children of the same age.

Masculinity stereotypes

Sets of rigid beliefs about social roles, behaviours, activities and styles of self-presentation that are associated with being male.

Mothering ideology

A pervasive, often unconscious, set of cultural beliefs and prescriptions about what constitutes good mothering and a good mother.

Oppositional defiant disorder

A childhood behaviour disorder characterized by a persistent pattern of negative, hostile or defiant behaviour that impairs the child's social and academic functioning.

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Singh, I. Beyond polemics: science and ethics of ADHD. Nat Rev Neurosci 9, 957–964 (2008). https://doi.org/10.1038/nrn2514

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