Training the Brain: Cognitive Therapy As An Alternative To ADHD Drugs

Posted by on July 25th, 2005 | No Comments

I have written for years that only by redefining ADHD can we address the problem through education and training. Finally, the movement is approaching mainstream as indicated in the article from Scientific American entitled, Training the Brain, Cognitive Therapy As An Alternative To ADHD Drugs.

It is interesting to note that the techniques mentioned in the article have been incorporated in the Play Attention cognitive tools for about ten years.

“Recent studies support the notion that many children with ADHD have cognitive deficits, specifically in working memory–the ability to hold in mind information that guides behavior. The cognitive problem manifests behaviorally as inattention and contributes to poor academic performance. Such research not only questions the value of medicating ADHD children, it also is redefining the disorder and leading to more meaningful treatment that includes cognitive training.”

Salient issues raised by the author include:

1. The difficult decision by parents “To medicate or not? Millions of parents must decide when their child is diagnosed with attention-deficit hyperactivity disorder (ADHD)–a decision made tougher by controversy.”
2. While medication may calm a student’s outward behavior, research shows that it does not increase cognitive ability manifesting in improved academic performance, social relationships, or defiant behavior over the long-term.
3. This has led scientists to research effective means of cognitive training as a substitute.

This is really a shift in our understanding of this disorder from behavioral to biological,” states Rosemary Tannock, professor of psychiatry at the University of Toronto. Tannock has shown that although stimulant medication improves working memory, the effect is small, she says, “suggesting that medication isn’t going to be sufficient.” So she and others, such as Susan Gathercole of the University of Durham in England, now work with schools to introduce teaching methods that train working memory. In fact, working-memory deficits may underlie several disabilities, not just ADHD, highlighting the heterogeneity of the disorder.”

The article focuses on Dr. Torkel Klingberg of the Karolinska Institute in Sweden who trained around 40 kids with ADHD with a software program that addressed “working memory.” After more than 20 days of training parents reported that their children had greatly improved attention and lessened hyperactivity.

Klingberg essentially proved that cognitive retraining improved neurobiological function. This work has been underway with Play Attention since 1994. It’s good to see the paradigm shift beginning to happen.

Children: Adderall and Safety

Posted by on July 25th, 2005 | No Comments

Medical News Today reports that ADDERALL XR® from Shire Pharmaceuticals Group plc has been indicated for use among adolescents aged 13 to 17 with attention deficit hyperactivity disorder (ADHD) by the US Food and Drug Administration. (ADHD – FDA expands indication for ADDERALL XR® (CII) confirming safety and efficacy in adolescents)

The drug was originally approved for treatment in ADHD children aged 6 to 12 years in October of 2001 and since August 2004 in adults 18 years and older. ADDERALL XR is currently the most commonly prescribed brand of ADHD medication in the United States.

“There has long been an unmet need for ADHD research and treatment among the adolescent population despite an increasing awareness of ADHD’s potential impact on quality of life. Therefore, approval of an ADHD treatment for this underidentified age group is an important milestone,” explained Dr. Timothy Wilens of Massachusetts General Hospital. “The symptoms of ADHD often continue past childhood into adolescence and adulthood, where they can have a significant impact on an individual’s family, academic performance, and overall quality of life. Stimulant therapies are effective and generally well tolerated, and have been used medically in patients for more than 60 years.”

This directly contrasts with Health Canada’s decision to remove ADDERALL from the Canadian market (Health Canada Suspends ADHD drug Adderall XR) due to 20 or so deaths associated with the drug’s use. According to Shire Pharmaceuticals, “ADDERALL XR may not be right for everyone. ADDERALL XR was generally well tolerated in clinical studies. The most common adverse events in pediatric trials included loss of appetite, insomnia, abdominal pain, and emotional lability. The most common side effects in the adolescent trial included loss of appetite, insomnia, abdominal pain, and weight loss. The most common adverse events in the adult trial included dry mouth, loss of appetite, insomnia, headache, and weight loss.

The effectiveness of ADDERALL XR for long-term use has not been systematically evaluated in controlled trials. As with other psychostimulants indicated for ADHD, there is a potential for exacerbating motor and phonic tics and Tourette’s syndrome. A side effect seen with the amphetamine class is psychosis. Caution also should be exercised in patients with a history of psychosis.”

One must wonder whether the side effects are worth using a drug whose efficacy has not been evaluated for long-term use. Terms like ‘emotional lability’ appear as an attempt to obfuscate. It is much clearer to say, ‘emotional change or breakdown.’

Mental Processing is Continuous, Not Like a Computer

Posted by on July 25th, 2005 | No Comments

The following research, New Cornell study suggests that mental processing is continuous, not like a computer appeared recently in a number of major publications.

Through computerized testing, the researchers essentially confirmed AND disputed work theorized by computer scientist, Marvin Minsky, in his book, The Society of Mind. Minsky theorized that the brain processes information through a variety of separate, distinct agents that work together in various capacities. Thus, according to Minsky, information processing is somewhat linear as in our working computers. The researchers seem to confirm the linear biological processing (input) of information, yet claim their findings demonstrate that the “neural activation patterns flow back and forth to produce nonlinear, self-organized, emergent properties – like a biological organism,” when processing (outputting) information.

There are many similarities between Minsky and Cornell’s group, however, they seem different possibly only by semantics. Once again, the mind seems to have a difficult time describing its own activities.

June 27, 2005

New Cornell study suggests that mental processing is continuous, not like a computer

By Susan S. Lang ITHACA, N.Y. – The theory that the mind works like a computer, in a series of distinct stages, was an important steppingstone in cognitive science, but it has outlived its usefulness, concludes a new Cornell University study. Instead, the mind should be thought of more as working the way biological organisms do: as a dynamic continuum, cascading through shades of grey.

Kevin Stearns/University Photography Cornell psycholinguist Michael Spivey asks Florencia Reali to listen for a word and then click on its picture. By studying the curvature of the trajectory of the mouse, he can analyze language comprehension processes. Copyright © Cornell University

In a new study published online this week in Proceedings of the National Academy of Sciences (June 27-July 1), Michael Spivey, a psycholinguist and associate professor of psychology at Cornell, tracked the mouse movements of undergraduate students while working at a computer. The findings provide compelling evidence that language comprehension is a continuous process.

“For decades, the cognitive and neural sciences have treated mental processes as though they involved passing discrete packets of information in a strictly feed-forward fashion from one cognitive module to the next or in a string of individuated binary symbols – like a digital computer,” said Spivey. “More recently, however, a growing number of studies, such as ours, support dynamical-systems approaches to the mind. In this model, perception and cognition are mathematically described as a continuous trajectory through a high-dimensional mental space; the neural activation patterns flow back and forth to produce nonlinear, self-organized, emergent properties – like a biological organism.”

In his study, 42 students listened to instructions to click on pictures of different objects on a computer screen. When the students heard a word, such as “candle,” and were presented with two pictures whose names did not sound alike, such as a candle and a jacket, the trajectories of their mouse movements were quite straight and directly to the candle. But when the students heard “candle” and were presented with two pictures with similar sounding names, such as candle and candy, they were slower to click on the correct object, and their mouse trajectories were much more curved. Spivey said that the listeners started processing what they heard even before the entire word was spoken.

“When there was ambiguity, the participants briefly didn’t know which picture was correct and so for several dozen milliseconds, they were in multiple states at once. They didn’t move all the way to one picture and then correct their movement if they realized they were wrong, but instead they traveled through an intermediate gray area,” explained Spivey. “The degree of curvature of the trajectory shows how much the other object is competing for their interpretation; the curve shows continuous competition. They sort of partially heard the word both ways, and their resolution of the ambiguity was gradual rather than discrete; it’s a dynamical system.”

The computer metaphor describes cognition as being in a particular discrete state, for example, “on or off” or in values of either zero or one, and in a static state until moving on. If there was ambiguity, the model assumed that the mind jumps the gun to one state or the other, and if it realizes it is wrong, it then makes a correction.

“In thinking of cognition as working as a biological organism does, on the other hand, you do not have to be in one state or another like a computer, but can have values in between – you can be partially in one state and another, and then eventually gravitate to a unique interpretation, as in finally recognizing a spoken word,” Spivey said.

Whereas the older models of language processing theorized that neural systems process words in a series of discrete stages, the alternative model suggests that sensory input is processed continuously so that even partial linguistic input can start “the dynamic competition between simultaneously active representations.”

Spivey’s co-authors are Marc Grosjean of the University of Dortmund, Germany, and Günther

A Probe into the Side Effects of ADHD Drugs

Posted by on July 22nd, 2005 | No Comments

The FDA probes side effects of ADHD drugs Government plans to strengthen label warnings.

From CNN.com

Thursday, June 30, 2005; Posted: 11:27 a.m. EDT (15:27 GMT)

WASHINGTON (AP) – The government is planning to strengthen warnings about possible psychiatric side effects from Concerta and related treatments for attention deficit hyperactivity, and is probing whether other ADHD drugs need updating, too.

Concerta is a long-acting form of methylphenidate, sold generically and under the brand name Ritalin. For years, those drugs’ labels have listed possible psychiatric side effects, such as agitation, psychosis or transient depression.

But a routine Food and Drug Administration review of Concerta’s use in children turned up more reports of psychiatric reactions than anticipated, including some that aren’t explicitly labeled, such as suicidal thoughts, hallucinations and violent behavior. A subsequent review of all methylphenidate products found similar reports.

The FDA can’t say if the drugs actually causes those side effects – the reports are from a database of reactions reported by medication users that make such determinations very difficult.

But, in a statement posted on its Web site, the agency said it does intend to strengthen the labeled warnings for all methylphenidate products.

Currently, the drugs’ labels may downplay the seriousness of psychiatric side effects, and suggest they’re only a risk in people who’ve already experienced psychiatric disorders, wrote FDA drug safety evaluator Kathleen Phelan.

Indeed, stimulant drugs “may exacerbate symptoms and reveal them for the first time” in children with previously unrecognized psychiatric illnesses, she wrote.

But, among 36 cases of psychiatric side effects in child Concerta users, six report histories of psychiatric illness, three deny such histories and there’s no information on the rest, Phelan wrote. Further investigation is needed to determine if such side effects may also occur in people without underlying illness, she added.

FDA said it doesn’t intend to change the drugs’ labels right away. It is investigating whether similar behaviors are seen with additional ADHD treatments, such as Adderall and Strattera – to avoid people switching drugs over the concern “based on incomplete safety assessments,” said an FDA document prepared for a meeting of the agency’s scientific advisers on Thursday.

That probe should be finished early next year.

ADHD Drug Treatment

Posted by on July 21st, 2005 | No Comments

Wouldn’t you know it, but research says the people who use medicines the most to treat ADHD are wealthier and have better medical plans from their HMOs. It would be equally interesting to see just how poorer families cope and if their children perform accordingly.

FSU researcher puts attention on ADHD drug treatment

by Jill Elish

The use of drugs to treat attention deficit hyperactivity disorder has grown in the last decade, but it’s those who live in the most affluent areas of the United States who are most likely to get medication for the disorder. Dr. Farasat Bokhari

Florida State University Economics Professor Farasat Bokhari was the co-author of a study published in the journal Pharmacoepidemiology and Drug Safety that found wide variations in the distribution of pyschostimulant drugs to treat ADHD. The study raised a number of questions for which the author and his colleagues received a $900,000 grant from the National Institute of Mental Health to further research the economic issues and policy decisions surrounding the use of ADHD medications.

ADHD is the most commonly diagnosed behavioral disorder in children and is considered a major public health concern, according to Bokhari. Between 3 percent and 5 percent of U.S. school-age children are estimated to have ADHD, and these children often have problems that take a toll on schools, social service agencies and health care and criminal justice systems.

“People are really polarized on this thing,” Bokhari said. “States are passing laws about whether teachers can talk to parents about psychostimulant drug treatments, and there’s a lot of disagreement about both the diagnosis and the treatment of ADHD.”

Some states, such as Michigan, Georgia and Virginia, have a tradition of using ADHD drugs more than others, such as California and New York. Bokhari and colleagues Rick Mayes at the University of Richmond and Richard Scheffler at the University of California at Berkeley wanted to find out why. Using data from the Drug Enforcement Administration, the researchers looked at the distribution of ADHD drugs to each county in the United States.

The researchers found that the counties where ADHD drug use was the highest had higher per capita income, lower unemployment rates, greater population density and more access to health care, meaning more HMOs and a higher percentage of people enrolled in them. Given the cost-saving objectives of HMOs, the researchers theorized that HMOs could be authorizing ADHD drug therapy because it is cheaper than counseling.

These high-use counties also had a higher ratio of younger-to-older doctors, prompting the researchers to question whether younger doctors just happen to locate in more affluent areas or whether younger doctors are more likely than their older counterparts to prescribe ADHD medication.

They also found that areas with high use have a higher student-to-teacher ratio. The researchers suggested that the greater burden on teachers may cause them to send more children to the school psychologist for screening, resulting in higher detection rates of ADHD and use of medication to treat the disorder.

In addition, the researchers found that high-use counties have, on average, slightly fewer children as a proportion of the population—a finding that seems counterintuitive given that ADHD is primarily diagnosed among children. However, Bokhari cited previous research that has shown that children of smaller families are more likely to use ADHD medication.

The findings are significant because nobody has really looked at the variation in the use of these drugs across the country, Bokhari said. He and his colleagues will next conduct a market analysis of the factors influencing the supply and demand for ADHD drugs.

“Some people who need medication aren’t getting it and some who don’t need it are,” he said. “You could be playing the lottery whether your child gets the drug or not. It often seems to depend as much on where you live as on medical science.”

Multitasking vs Task Switching Research

Posted by on July 21st, 2005 | 1 Comment

I recently debated multitasking to task switching. Multitasking denotes attention to a variety of extraneous and internal stimuli. All research that I can find concludes that the human mind performs much less efficiently under multitasking environments–this includes the following article from Johns Hopkins University and published in The Journal of Neuroscience.

Task switching denotes shifting full attention from one activity to the next. It seems to parallel our current understanding of brain function in a high stimuli environment.

Multitasking: You can’t pay full attention to both sights and sounds Lab findings suggest reason cell phones and driving don’t mix The reason talking on a cell phone makes drivers less safe may be that the brain can’t simultaneously give full attention to both the visual task of driving and the auditory task of listening, a study by a Johns Hopkins University psychologist suggests. The study, published in a recent issue of “The Journal of Neuroscience,” reinforces earlier behavioral research on the danger of mixing mobile phones and motoring.

“Our research helps explain why talking on a cell phone can impair driving performance, even when the driver is using a hands-free device,” said Steven Yantis, a professor in the Department of Psychological and Brain Sciences in the university’s Zanvyl Krieger School of Arts and Sciences.

“The reason?” he said. “Directing attention to listening effectively ‘turns down the volume’ on input to the visual parts of the brain. The evidence we have right now strongly suggests that attention is strictly limited – a zero-sum game. When attention is deployed to one modality – say, in this case, talking on a cell phone – it necessarily extracts a cost on another modality – in this case, the visual task of driving.”

Yantis’s chief collaborator on this research project was Sarah Shomstein, who was a doctoral candidate at Johns Hopkins. Shomstein is now a post-doctoral fellow at Carnegie-Mellon University.

Though the results of Yantis’ research can be applied to the real world problem of drivers and their cell phones, that was not directly what the professor and his team studied. Instead, healthy young adults ages 19 to 35 were brought into a neuroimaging lab and asked to view a computer display while listening to voices over headphones. They watched a rapidly changing display of multiple letters and digits, while listening to three voices speaking letters and digits at the same time. The purpose was to simulate the cluttered visual and auditory input people deal with every day.

Using functional magnetic resonance imaging (fMRI), Yantis and his team recorded brain activity during each of these tasks. They found that when the subjects directed their attention to visual tasks, the auditory parts of their brain recorded decreased activity, and vice versa.

Yantis’ team also examined the parts of the brain that control shifts of attention. They discovered that when a person was instructed to move his attention from vision to hearing, for instance, the brain’s parietal cortex and the prefrontal cortex produced a burst of activity that the researchers interpreted as a signal to initiate the shift of attention. This surprised them, because it has previously been thought that those parts of the brain were involved only in visual functions.

“Ultimately, we want to understand the connection between voluntary acts of the will (for instance, a choice to shift attention from vision to hearing), changes in brain activity (reflecting both the initiation of cognitive control and the effects of that control), and resultant changes in the performance of a task, such as driving,” Yantis said. “By advancing our understanding of the connection between mind, brain and behavior, this research may help in the design of complex devices – such as airliner cockpits – and may help in the diagnosis and treatment of neurological disorders such as ADHD or schizophrenia.”

Pharmaceutical Makers : Follow the Money

Posted by on July 20th, 2005 | No Comments

Ever wonder why so much hoopla surrounds ADHD? The media know it’s a top of mind issue for parents. However, pharmaceutical makers also know where their bread is buttered. The following article reflects the vast sums of money involved in the business of ADHD medications.

Press Release Source: Research and Markets Ltd.

Research and Markets: Current Global ADHD Market Is Worth $2.7Bn and is Expected to Reach $3.4Bn by 2015
Tuesday June 14, 10:15 am ET

DUBLIN, Ireland–(BUSINESS WIRE)–June 14, 2005–Research and Markets (http://www.researchandmarkets.com/reports/c19199) has announced the addition of Pipeline Insight: ADHD – Shire Driving Diversity in ADHD to their offering.
The current ADHD market has long been saturated with traditional methylphenidate and amphetamine based drugs, with the only innovations being the development of extended release versions. However, the recent launch of Strattera (atomoxetine) has already shattered the traditional approach to drug therapy, opening the door for the uptake of new novel drug therapies.

This report provides an overview of the epidemiology, diagnosis and management of ADHD across the seven major pharmaceutical markets. In includes an examination of the ADHD pipeline with in-depth clinical and commercial profiles of late-stage candidates. Seven market sales forecasts, commercial potential and research/clinical/commercial assessment of late-stage products to 2015 are provided together with insight and commentary from qualitative interviews with ADHD opinion leaders in the US and Europe.

The current global ADHD market is worth $2.7bn and is expected to reach $3.4bn by 2015, driven primarily by the launch of pipeline drugs and the continued growth of Strattera.

Innovation is key – manufacturers can no longer expect significant returns on standard extended release formulations. The current pipeline offers drugs with novel delivery mechanisms; improved durations of action and anti-abuse profiles, which will help differentiate these pipeline drugs from the current established ADHD therapies.

Although ADHD drugs have demonstrated significant efficacy in improving the three main symptoms of ADHD – inattention, hyperactivity and impulsivity – none have shown efficacy in treating the cognitive deficits of ADHD.

This report will give you an understanding of the unmet needs in the ADHD market based on opinion leader comments regarding both currently marketed and pipeline products. It can help you benchmark key late-stage ADHD compounds against current market leaders and assess the global sales forecasts of late-stage pipeline drugs for ADHD and examine their clinical and commercial potential.

Ritalin and Cancer

Posted by on July 19th, 2005 | No Comments

The FDA has taken an interest in the University of Texas’ preliminary research regarding Ritalin and cancer. While the research is alarming, it is far too premature to be conclusive.

From HealthCentral.com:

Researchers Urge Caution on Ritalin-Cancer Link Finding Despite FDA concerns, Texas scientists say their study was only preliminary.

By Amanda Gardner HealthDay Reporter

FRIDAY, July 1 (HealthDay News) – As the U.S. Food and Drug Administration moved to examine a potential link between Ritalin and cancer, the scientists who first unearthed the connection stressed Friday that the finding was preliminary and should not be cause for panic.

The concerns about the drug, a stimulant that has been used to treat attention-deficit hyperactivity disorder (ADHD) for decades, surfaced during a FDA pediatrics advisory committee meeting Thursday. The findings, by researchers from the M.D. Anderson Cancer Center at the University of Texas, showed damage to the chromosomes of 12 children who had taken Ritalin for three months.

The advisory committee had been called to discuss yet another health issue surrounding the class of ADHD medications known as methylphenidates, to which Ritalin belongs: Some psychiatric side effects have been reported among children using Concerta, Ritalin and other versions of these drugs.

But the Texas scientists said their Ritalin study was far too small to prompt the parents of ADHD patients to abandon the drug.

“We’re not telling people to all go off their medication because you don’t know what this means,” said Melissa L. Bondy, co-author of the study, which first appeared in the Feb. 16 online issue Cancer Letters. “You can’t base changing practice on 12 patients. Look how many millions of kids are on this. Do you want to tell all the mothers and fathers to take their kids off of the drugs?”

Bondy said she and her colleagues have submitted a grant proposal to the National Institutes of Health for a larger study looking at more patients and more ADHD drugs.

“We definitely need a larger study,” said lead researcher Dr. Randa A. El-Zein. If approved, the study would not even be funded until March 2006.

The government interest is there, however.

Scientists from the FDA, the NIH and the Environmental Protection Agency traveled to Texas on May 23 to examine the study methods used by the researchers. “They thought, ‘Yes, we do have a public concern,’ and that a larger study should be performed,” El-Zein said.

“We’re hoping that they’ll see this as a major public health issue, and as something that needs to be done,” Bondy added.

Meanwhile, the question of labeling changes because of possible psychiatric effects of Ritalin and other methylphenidates have been put on hold after the advisory committee told FDA officials that it was hesitant to recommend such changes.

According to an FDA release, committee members suggested waiting until more safety data have been collected on two other types of drugs used to treat ADHD – methamphetamines such as Adderall and the non-stimulant Strattera, something that won’t happen before early 2006.

The FDA should “delay the labeling change until they have a good sense of class effect,” Acting Committee Chairman Robert Nelson, of The Children’s Hospital of Philadelphia, told FDA officials according to the release.

“We heard there is no terrible signal,” Office of Pediatric Therapeutics Director Dianne Murphy added.

The FDA had been considering labeling changes to all methylphenidates with regard to psychiatric events and potential cardiovascular side effects. A review had found 36 psychiatric events for Concerta, compared to 16 for Ritalin and other methylphenidates. These side effects included hallucinations and suicide ideation. Concerta had 20 cardiovascular event reports, while the other methylphenidates had four such reports.

Despite the committee’s advice, Murphy said the agency still may change labeling about psychiatric side effects to “try to make it clearer what the situation is with regard to certain adverse events.”

The FDA’s decision to take a closer look at the psychiatric side effects of medications for ADHD did not surprise some experts.

“These types of issues theoretically were possible with the medication because of the way it works. It’s not surprising that they’ve had some reports that relate to psychiatric side effects… ” said Dr. Lenard Adler, director of the Adult ADHD Program at New York University Medical Center.

The drugs have been around for 40 years, Adler added, and have a “wide margin of safety.”

“Any medicine that has therapeutic effect can have some side effects,” Adler continued. “This is appropriate scrutiny by the FDA, but the benefits are also very clear and clearly outweigh the risks.”

Another expert believes labeling changes may not be the answer.

“Labeling is an oversimplification of the problem,” said Dr. Eugenio M. Rothe, director of the child and adolescent psychiatry clinic at Jackson Memorial Hospital and an associate professor of psychiatry at the University of Miami School of Medicine. “It scares people, and it doesn’t address the other problems that are affecting the outcome. The problem is much more complex than that, and has to do primarily with the stigma associated with mental health conditions.”

This is just the latest chapter in the ongoing debate over the safety of ADHD medications.

In February, Health Canada ordered Adderall XR off the market, after reports of sudden cardiac death in 20 patients. The FDA, however, elected at the time only to require the company to update Adderall’s label to warn that it should not be used in anyone with structural cardiac abnormalities.

Almost 2 million children in the United States have been diagnosed with ADHD, according to the National Institute of Mental Health.

Too much TV Lowers Tests Scores

Posted by on July 18th, 2005 | No Comments

This story is from HealthCentral.com. It is important to realize these data are from three recent studies all indicating the same thing: too much TV results in poorer educational performance.

Kids Who Watch Too Much TV Have Lower Test Scores

Reading, math scores and college education suffer, studies find.

By Steven Reinberg HealthDay Reporter

MONDAY, July 4 (HealthDay News) – The effect of television on children has been debated ever since the first sets were turned on.

Now three new studies find that too much tube time can lower test scores, retard learning and even predict college performance.

The reports appear in the July issue of the Archives of Pediatrics & Adolescent Medicine.

In the first report, researchers studied the effect that having a TV in a child’s bedroom can have on third graders. “We looked at the household media environment in relation to academic achievement on mathematics, reading and language arts tests,” said study author Dina L.G. Borzekowski, an assistant professor at Johns Hopkins Bloomberg School of Public Health.

Borzekowski and her colleague, Dr. Thomas Robinson of Stanford University, collected data on 386 third graders and their parents about how much TV the children watched, the number of TV sets, computers and video game consoles in the household and where they were. They also collected data on how much time the children spent using the different media, as well as the time spent doing homework and reading.

The researchers found that the media in the household, where it is and how it is used can have a profound effect on learning. “We found that the household media environment has a very close association with performance on the different test scores,” Borzekowski said.

“A child who has a TV in his or her bedroom is likely to have a score that is eight points lower on a mathematics test compared to a child who doesn’t have a TV in the bedroom,” she noted. These children also scored lower on the reading and language arts tests.

However, children who have access to a home computer are likely to have higher scores on each of the tests compared with children who don’t have access to a home computer, Borzekowski noted.

The reasons why TV has this negative effect are not clear, Borzekowski said. “When there’s TV in the bedroom, parents are less likely to have control over the content and the amount watched,” Borzekowski said. “They are also unable to know how early or how late the set is on. This seems to be associated with kids’ performance on academic tests.”

Borzekowski believes that content and the time the TV is on may be the primary reasons for its negative effect. “If the TV is in the family room, then parents can see the content of what children are watching,” she said. “Parents can choose to sit alongside and watch, or turn the set off. A simple and straightforward, positive parenting strategy is to keep the TV out of the child’s bedroom, or remove it if it’s already there.”

In the second report, Dr. Robert J. Hancox from the University of Otago in Dunedin, New Zealand, and colleagues found, regardless of your intelligence or social background, if you watch a lot of TV during childhood, you are a lot less likely to have a college degree by your mid-20s.

In their study, the researchers followed 1,037 people born in 1972 and 1973. Every two years, between the ages of 5 and 15, they were asked how much television they watched. The researchers found that those who watched the most television during these years had earned fewer degrees by the time they were 26.

“We found that the more television the child had watched, the more likely they were to leave school without any qualifications,” Hancox said in a prepared statement. “Those who watched little television had the best chance of going on to university and earning a degree.”

Hancox’s team found that watching TV at an early age had the most effect on graduating from college. “An interesting finding was that although teenage viewing was strongly linked to leaving school without any qualifications, it was earlier childhood viewing that had the greatest impact on getting a degree,” he said. “This suggests that excessive television in younger children has a long-lasting adverse effect on educational performance.”

In the third paper, Frederick J. Zimmerman and Dr. Dimitri A. Christakis from the University of Washington report that, for very young children, watching TV can result in lower test scores in mathematics, reading recognition and reading comprehension.

“We looked at how much television children watched before age 3 and then at ages 3 to 5,” Zimmerman said. “We found that for children who watched a small amount of TV in the earlier years, there was considerable beneficial effect compared to children who watched a lot of TV.”

For children aged 3 to 5, the effect was not as clear, Zimmerman said. “There were some beneficial effects of watching TV on reading, but no beneficial effects for math or vocabulary,” he noted. “The worst pattern was to watch more than three hours of TV before age 3. Those kids had a significant disadvantage compared to the other kids.”

Parents should follow the American Academy of Pediatrics recommendation, which is no TV for children under 2, Zimmerman said. “Personally, I feel the cutoff should be children under 3, because there is just not any good content for children under 3.”

One expert believes that TV can have both positive and negative effects, but it all depends on what children are watching.

“Content matters,” said Deborah L. Linebarger, an assistant professor at the University of Pennsylvania, who co-authored an accompanying editorial. “Educational content has been found to be related to performance on school readiness tests, higher grades when they are teenagers, whereas, non-educational content tends to be associated with lower academic performance.”

Another expert agrees. “TV watching takes up space that could be used by more useful things,” said Dr. Christopher P. Lucas, a clinical coordinator at the Early Childhood Evaluation and Treatment Program at the New York University Child Study Center. “TV is not necessarily toxic, but is something that has to be done in moderation; something that balances the other needs of the child for healthy development.”

Lucas puts the responsibility for how much TV kids watch and what they watch squarely on parents. “The amount of TV watching certainly has a link with the reduced amount of time reading or doing homework,” he said. “The key is the amount of control parents have in limiting the amount of access. Get the TV out of the bedroom; be aware of what is being watched; limit the amount of TV watching.”

Dubious Disorders

Posted by on July 17th, 2005 | No Comments

Gartner is the latest in a gushing stream of authors and spokespeople who identify themselves as having a disorder or rare group of personality traits that one day might have landed them on medication or in an asylum, but that today are considered unique and eclectic, and even in some cases essential to success. It’s a controversial idea that some say makes light of serious disorders. Others condemn it as a useless way of talking about personality and say that it may suggest that some disorders are worth hanging onto.

As I wrote about previously, Robert Jergen, an ADHD adult, wrote a book about his ability to regulate his ADHD. It seems that there is a trend to identify oneself with a particular ailment or disorder to sell books.

In the following article from the Pittsburgh Post-Gazette, Dr. John Gartner identifies himself as having “hypomania,” a disorder that he identifies with the likes of Apple founder Steve Jobs, Chris Columbus, etc. Critically, one must wonder what benefit these books have other than to produce income for the authors.

Let us now praise … hypomania?

Wednesday, July 06, 2005

By Alana Semuels, Pittsburgh Post-Gazette

You probably wouldn’t think that this guy you know – the one who talks incessantly, interrupts constantly, and has grandiose ideas about his own potential in life and love – would have anything in common with Christopher Columbus, William Penn or Andrew Carnegie.

But psychiatrist John Gartner thinks that your friend is one of a rare breed that has built America, and further, that such people – who can be defined as hypomanics – are essential to the future of this country.

In his recent book, “The Hypomanic Edge: The Link Between (a little) Craziness and (a lot of) Success in America,” Gartner argues that some of history’s most influential figures were successful because they were hypomanics.

Gartner is the latest in a gushing stream of authors and spokespeople who identify themselves as having a disorder or rare group of personality traits that one day might have landed them on medication or in an asylum, but that today are considered unique and eclectic, and even in some cases essential to success. It’s a controversial idea that some say makes light of serious disorders. Others condemn it as a useless way of talking about personality and say that it may suggest that some disorders are worth hanging onto.

A hypomanic edge?

Hypomania is tough to define – medically it might be called a mild form of extreme excitement or passion, a mania that is often free of deep depression. Gartner is a hypomanic, and compares others like him – such as Apple founder Steve Jobs and Revolutionary War era statesman Alexander Hamilton – to Babe Ruth in that, metaphorically speaking, they hit lots of home runs but also strike out a lot. He claims that every single religious prophet was or is bipolar, and to some extent, hypomanic.

Gartner estimates that about 3.5 percent of the U.S. population is hypomanic.

“We’re irritating, arrogant, impulsive and frustrated that things aren’t far enough along,” he said. “We’re people who are generating ideas, some of which will work.”

Central to his argument is that America, as a nation of immigrants, has a greater population of hypomanics than countries with a low rate of immigration. Immigrants, after all, took bold risks when they decided to come to America.

Gartner first got the idea for his book during the dot.com boom, when he interviewed a bunch of CEOs from tech companies. All seemed to have the same hypomanic traits, from their innovative ideas to their abrasive personalities.

For the book, he picks notable figures from history and diagnoses them as hypomanic on the basis of the documents they left behind.

Integral to their success was their hypomania, he says, but it also was integral to their failure, because they generate and invest in hundreds of different ideas, some that work, some that are flops.

But this way of thinking also could trivialize a debilitating mental health state that is dangerous if not treated.

Alexander Hamilton, for example, was killed in a duel. David Selznick, a Hollywood writer mentioned in Gartner’s book, had deep fits of depression and sadness and gambled his money away. Craig Venter, the decoder of the human genome, tried to kill himself in Vietnam.

Claiming that hypomania breeds success is like embracing depression in artists because it makes them more creative, or hiring executives with ADHD because it allows them to think outside the box.

“Is the suffering of the illness necessary in order to motivate or inspire great art?” asked Dr. Michael Thase, a professor of psychiatry at UPMC’s Western Psychiatric Institute and Clinic. “It is fair to say that if people have illnesses that are placing their lives in danger, they should be treated.”

When conditions are treated properly, patients won’t necessarily lose the aspects of their personality that make them unique, such as creativity.

Peter Kramer, the Brown University psychiatrist, put forth a similar argument in his recent book “Against Depression,” which explains depression as a disease rather than a means to creativity.

Gartner argues that hypomania certainly has its down sides, and that mild medications can take the edge off the intense emotions. But, “It’s easy to overmedicate hypomanics,” he says. “To take away their creativity, their edge.”

He worries that future genetic testing for a bipolar gene could genetically engineer genius, hypomanics among them, out of the human race.

A club with no real members

It’s that mentality – that hypomanics are an elite bunch who hold the future of America in the palms of their always-moving hands – that has caused Gartner the most trouble, by giving an excuse to people with strange and often irritating habits to hold onto them as part of their genius.

By definition, most hypomanics will think that they’re geniuses out to change the world, whether or not they’ve got a shot. Those who do proudly wear the label of hypomania are more likely to be people with more serious disorders who would rather think of themselves as geniuses than as mentally ill, said Laurence McKinney, founder of hypomanics.com.

McKinney, a Harvard grad, entrepreneur and self-proclaimed inventor of the guitar reverb, says that most hypomanics who have contacted him would rather not be typecast as having any type of a mania. In this way, founding an association of hypomanics is a bit like herding cats.

But like Gartner, McKinney thinks that true hypomanics are more successful than the average slow-moving human. In his eyes, they’re part of a club that just moves faster and does more, and has more capacity for doing something really great.

Or, as he puts it, in a typically hypomanic way:

I am fast. I have to be careful, because if I don’t watch myself, people will think I’m manic. Well I can be. But I’ve always been that way. So most people seem to me to be sort of slow. I have to watch it though. For this reason, I’d rather – and for the gentlemen or women I talked to who are true hypomanics – they’d rather have people know them for their accomplishments.

« Previous Entries