How ADHD really works

Does it make me a bad parent for mentioning my son’s ADHD on my blog?  Hopefully not.  Let’s hope he doesn’t go searching through my archives in a few years and confront me as an angry teenager.  Actually, I don’t have much to say about his particular case here, but it is why I was especially intrigued by this. Anyway, I was going to send a link to this really interesting Jonah Lehrer post to my wife, but I thought like a modern tech-savvy family, we’d communicate through her reading my blog posts.  Anyway, the cool new way of thinking about ADHD is not a deficit of attention, but rather a deficit in how effectively one controls the focus of one’s attention:

What, then, is the problem in people with ADHD? The disorder is really about the allocation of attention, being able to control our mental spotlight. There’s a new Dana Foundation briefing paper that eloquently explains this new understanding:

Martha Bridge Denckla, M.D., a clinician and scientist at the Kennedy Krieger Institute and Johns Hopkins University, says she faces these kinds of questions regularly from parents who bring their children to the ADHD clinic where she practices. “I am constantly having to explain to parents that ADHD is not a deficit in the sense of say, a budget deficit or a thyroid deficiency, where you don’t have enough of something. Rather, it’s the control over attention.”

Denckla, who is a member of the Dana Alliance for Brain Initiatives, has found it useful to speak in terms of the allocation of attention when communicating with parents about ADHD. The question, Denckla says, is: “Where is the child’s attention being allocated? Is it where it needs to be to meet the demands of home, school, and society?”
Allocating one’s attention appropriately for success in school requires a degree of willful control—what might be thought of as will power—to turn away from a preferred activity and focus on an activity that may not be as compelling or immediately rewarding…

[Lots of neuroscience here]

The problem with ADHD is not that there’s no attention. As I mentioned before, kids with ADHD can still immerse themselves in activities that require focus – they just tend to require a higher threshold of interest, which is why they don’t pay attention to a boring arithmetic lesson but can easily spend all day on World of Warcraft. Drugs for ADHD, such as the amphetamine-derivatives Ritalin, Adderall, Concerta, etc. work by increasing the amount of dopamine in the synapse. (Like most psychoactive drugs, the exact mechanisms remain unclear, although many think that the drugs work by blocking dopamine transporters, which remove dopamine after it has been released.) Interestingly, some people get a similar boost naturally: studies have linked small coding difference in the genes that underlie dopamine production, such as the COMT Val/Met polymorphism, to variations in “attentional abilities,” with more neurotransmitter equaling more attention. (Alas, the same mutations that increase dopamine activity in the prefrontal cortex also seem to make us more anxious and sensitive to pain. Needless to say, much more work is needed before this pathway and its implications are fully understood.) In other words, ADHD medications act like a chemical shortcut: Because those dopamine neurons in the midbrain are so excited – they are suffused with the neurotransmitter – the world is suddenly saturated with intensely interesting ideas, which get passed along to the prefrontal cortex. Even arithmetic is now compelling enough to notice; the neural currency of long division has been increased, which makes it easier to allocation our attention to the place in the classroom it’s supposed to be allocated. But here’s my point: The drugs haven’t suddenly turned on the spotlight of attention. The spotlight was always there. Instead, they have made it easier for us to point the spotlight in the right direction. [emphasis mine]

That certainly fits with my experience as an ADHD parent.   It’s also why I don’t feel like I have somehow fundamentally altered my son’s personality by giving him a powerful psychoactive drug– rather I am giving his brain a boost to let the best aspects of his personality take control.

It’s still the economy stupid

Chait highlights a recent poll from PPP showing that voters are currently seem to prefer to vote for Republicans, despite feeling less favorable towards them.  There’s some fairly obvious conclusions to be drawn from this:

I’ve been banging the drum for a long time about how the combination of a midterm election and a terrible economy makes significant out-party gains all but inevitable. Many analysts, especially those with conservative sympathies, want to paint the electorates mood as a straight ideological judgment: they’re voting Republican because they think the Democrats are too liberal. If that was true, you’d see people approving of the Republican Party, at least at higher rates than they approve of the Democratic Party.

That isn’t happening. The facts, rather, fit my story pretty tightly: people are angry about the economy, they don’t agree with the Republican worldview but they’re taking their anger out on the incumbents.

I’d make that, the “incumbent party” rather than incumbents, but– yep.  At least after the election, I’ll have a new metric to be able to assess which pundits are full of crap– all the ones who insist that the election outcome is a result of Obama’s “liberal over-reach.”

Farming and monogamy

An interesting summary in Miller-McCune of new research which suggests that monogamy arose fairly late in human evolution largely in response to agriculture:

Fortunato argues from the historical record that monogamy first arose in Eurasian societies just as true agriculture was taking hold — about 12,000 years ago. Agriculture involves intensive cultivation of large tracts of land, often requiring ploughing, irrigation, fertilization and other soil improvements.

As agriculture spread, arable land became scarcer — and valuable. Land ownership became critical to reproductive success, driving a new form of marriage in which males were assured of investing resources in their heirs, thus improving the odds that their genes would be successfully passed on…

A couple arrives at a shared (if unspoken) understanding: If the man commits to passing on his resources to her children, the woman will commit to mating monogamously — meaning the children are likely his offspring. Fortunato sees in this contract the roots of elaborate social norms regarding female sexual behavior.

Fortunato cites historical examples in support of her argument. In ancient Rome, where monogamous marriage was the norm, men regularly had children with women other than their wives, she says.

“Why did these societies have a norm promoting monogamy when they in fact condoned polygamous mating? The explanation which we give is that marriage strategies have more to do with how property is transferred across generations than they have to do with mating and the production of children.”

Hmmm, now I need to finish this up with some pithy commentary on my own marriage, but I fear I’ve let you down today.  Sorry.  Still, I thought this was some pretty interesting research.

TARP: perception and reality

I think one of the most frustrating things about this current election season is just how divorced voters’ perceptions are from reality.  Of course, a big part of it is the fact that Republicans have been lying so shamelessly and pervasively for the past 18-months.  But still.  Anyway,  great example of this is “the bank bailout” or TARP, which, of course, was not exactly fun to reward the banks for their misbehavior, but truly beats the alternative of another great depresssion.  This action (undertaken under the Bush administration) undoubtedly saved our economy from a catastrophe.  Yet, Republicans have convinced the voters it was some crazy socialist plot and has ruined the economy.   Based on a recent report that TARP will ultimately cost the taxpayers very little, if anything, (pretty good deal for saving the economy), Yglesias has some nice commentary:

At the White House on Thursday, the Treasury secretary, Timothy F. Geithner, briefed President Obama about A.I.G. and about the broader outlook for the expiring rescue program, putting the projected losses at less than $50 billion, at most. Yet neither the White House nor Congressional Democrats are likely to boast much in the month remaining before midterm elections. For most voters, TARP remains a four-letter word.

To go even stronger here, it’s clear that the much-loathed core of TARP—the injection of government funds into insolvent banks—is going to earn a substantial profit. Losses will be attributable to efforts to use money to save the auto companies and to assist homeowners. Main TARP—the bank bailout—isn’t going to cost you anything. For a program that’s attracted such widespread derision, that’s pretty remarkable. Do you think letting the banks fail would have had zero disruptive impact on the economy? None whatsoever? What other programs can you name that garned support from Nancy Pelosi and George W Bush, helped people millions of people, and had a negative cost to the government? And yet people think it’s horrible, in part because the public sphere has utterly failed to defend it.

That’s a problem, in part because the early days of TARP were a huge success for the public sphere. The month before a nationwide general election is not a great time to ask a legislature to approve a bank bailout. And initially the House of Representatives rejected it. But responsible people came together and bludgeoned a critical mass of House rightwingers into doing the right thing. Then Hank Paulson devised a plan for asset purchases that almost certainly would have lost tons of money and possibly not stabilized the system. But in response to vigorous and well-informed criticism from a variety of quarters (with Paul Krugman playing a leading role I would say) he changed directions in favor of the equity injections that are giving us the negative-cost bank bailout we’re enjoying today.

It became a lost opportunity for ideological instruction. Instead it’s become a moment of anti-instruction, which people think has demonstrated the lesson that the government consists of nothing but corrupt giveaways. It makes me sad. When it was first proposed, I didn’t understand this issue correctly. But in the ensuing two years, I’ve learned more about it and improved my understanding. The public as a whole, however, as just gotten itself more confused.

Yes, the public has “gotten itself more confused,” but it is plenty to safe to say they’ve had more than a little help in that matter.

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