background The field of diagnosing and treating adhd is fraught with controversies and inconsistent research findings. Some examples are: is ADHD a brain disorder or a behavioral variation? Where are the boundaries of adhd? Is there under- or overdiagnosis? Does ADHD persist into adulthood? Does adhd-medication stop to be effective after 2-3 years? Should we focus treatment on symptoms or rather on impairments? Does medication cure underlying brain deficits?
aim To clarify our thinking and to further a critical, scientific attitude towards ADHD-controversies.
method We will briefly discuss some of these controversies and underlying assumptions, and illustrate this on the basis of empirical studies.
results These issues are mostly discussed in terms of empirical data. Usually, less attention is paid to conceptual and valuational issues, and to the basic assumptions underlying our thinking about adhd. For example, discussion of under- versus overdiagnosis and the boundaries of ADHD in terms of the ‘true prevalence’ of the disorder presupposes that ADHD is a natural category, as opposed to a social construct. It disregards the role of current societal values and conceptual problems, that largely determine which behaviours are subsumed under the label ADHD.
conclusion Disregard of conceptual issues easily leads to mistaken ideas and flawed reasoning about ADHD.