© Martin WhitelySpeed Up and Sit Still: The Controversies of ADHD Diagnosis and Treatment
The American Psychiatric Association (APA) has published its draft changes for the fifth edition of its internationally influential Diagnostic and Statistical Manual of Mental Disorders (DSM5), due for final release in May 2013. Along with other worrying changes the APA seems determined to further loosen its already absurdly broad diagnostic criteria for ADHD.
Four more ways to display ADHDThe most obvious of the changes is the inclusion of four extra ways of exhibiting ADHD. For a diagnosis of the primarily hyperactive subtype instead of children having to display 6 of 9 (67%) impulsive/hyperactive diagnostic criteria, 6 of 13 (47%) would be sufficient. The four additional criteria are;
1- Tends to
act without thinking, such as
starting tasks without adequate preparation or avoiding reading or listening to instructions. May speak out without considering consequences or make important decisions on the spur of the moment, such as impulsively buying items, suddenly quitting a job, or breaking up with a friend.
2- Is often
impatient, as shown by feeling restless when waiting for others and wanting to move faster than others, wanting people to get to the point, speeding while driving, and cutting into traffic to go faster than others.
3- Is
uncomfortable doing things slowly and systematically and often rushes through activities or tasks.
4- Finds it
difficult to resist temptations or opportunities, even if it means taking risks (A child may grab toys off a store shelf or play with dangerous objects; adults may commit to a relationship after only a brief acquaintance or take a job or enter into a business arrangement without doing due diligence).
1(The full list of the proposed DSM5 behavioural criteria are listed at the end of this blog or from
dsm5.org)
All of the new DSM5 criteria are normal human behaviours. I for one never read instructions, am often impatient, frequently give into temptation, sometimes speed (and occasionally get angry with those who don't and sit in the passing lane). I do these things because like the other 7 billion odd people on the planet I am far from perfect.
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