Effects of ADHD and the Importance of Inclusion in Research
ADHD stands for Attention Deficit Hyperactivity Disorder. ADHD can have a severe impact on an individual’s life as the person tends to be inattentive, disorganized, hyperactive, and impulsive. In general, ADHD is diagnosed more often in children than in adults and more often in males than females. It is important to note that the ADHD diagnosis is based on behavioral and not clinical measures. In other words, people who potentially have ADHD are not given EEGs and MRIs to get diagnosed. Instead, there is a list of behavioral hints that an expert checks for before giving the diagnosis.
A study by Kwasa et al. (2021) shows how individuals with ADHD are impacted by the disorder. The researchers investigated with a demanding auditory task how individuals with ADHD differ from Neurotypicals in being able to concentrate on a specific sound, as well as recognizing and shifting their attention to a different sound. The researchers hypothesized that the top-down attention and performance of subjects with ADHD would be poorer compared to Neurotypicals. The researchers used encephalography (EEG) during the experiment to measure ERPs. They believed that when N1 response would be higher it would mean that the subjects used top-down attention for the “goal” sound, whereas small when they focused their attention somewhere else. In addition, they believed that when there would be positive P3a responses it would mean that the bottom-up attention was used more and therefore the subject was focusing on a salient sound and not on the “goal” sound. The participants listened to a three-syllable “target” through headphones. The stream of speech for the target sound came in from the center, and the syllables were presented in a random order in each trial. Every trial also included a “distractor” that came only from the right side. The distractor included the five syllables, the same as the target, and varied in the order the syllables were presented. Finally, 2/3 of the trials included a three- syllable “interrupter” that included, once again, the same syllables as the target presented in a different order in every trial, but it came through only from the left side. The interrupter could be introduced early, temporarily overlapping with the target sound, or late, beginning after the target. FOCAL trials asked the participants to focus only on the target sound and then repeat the order of the target syllables, ignoring the distractor syllables. BROAD trials asked the subjects to focus on the target syllables but if there was an interrupter, they needed to switch their attention to those syllables and report them. From the experiment, the researchers found some unexpected results. The P3a, although it was considered an indicator for bottom-up attention, in this study, the results suggest that both N1 and P3a can modulate top-down attention. In accordance with the hypothesis, the results showed that individuals with ADHD “have a weaker top-down attentional modulation of neural responses to interrupting sounds than neurotypical listeners do” (Kwasa et al., 2021). Finally, the experiment showed that there are no differences in behavioral response between the two groups. In conclusion, all subjects, neurotypicals and those with ADHD, are unique in their ability to control top-down attention in the presence of interruptions, but individuals with ADHD have a harder time with such tasks.
Not being able to shift your attention from one thing to the next easily can have an impact on relationships, careers, school, and other facets of one's life. An article written by Christina Caron on the New York Times (Christina Caron 2021) talks about adults with ADHD and the impact the disorder has on someone that might have gone untreated. The author points out that ADHD can look different in adults than it does in children. Children tend to be more hyperactive whereas adults have difficulty focusing, organizing, and planning, as well as regulating emotions, experiencing self-doubt and stress. In addition, the article also mentions how girls often go undiagnosed because they tend to not show the standard behaviors at the same level as boys, and they continue in their adult life still struggling and not knowing why.
Another article on BBC News (Chapple and Collinson, 2021) is interested in why women tend to get an ADHD diagnosis much later in life compared to men. Unfortunately, there are many stereotypes around the disorder that fit boys more, making it three to four times more likely that boys will get diagnosed compared to girls. The authors talk about how ADHD can affect someone that goes undiagnosed. Anxiety, depression, and eating disorders are not left out of the list, giving us a better idea of how ADHD can severely impact one’s life. These conditions can make it even harder to get an ADHD diagnosis as they can mask the disorder and experts might not look further into the problem. In the article, the authors have included many testimonies of women who finally got diagnosed with ADHD later in life and one of them said, “It was a huge relief knowing I'm not hyperactive because I'm annoying, I don't daydream because I don't care about what the person is saying, it is just the way my brain works,” while also admitting she couldn’t help but cry tears of relief when she found out.
In her talk, Dr. Kwasa was able to talk to our class not only about her research on top-down attention on people with ADHD and Neurotypicals but about inclusive research as well. Her work with the Black community, as well as other people who have typically been excluded from research, is outstanding and very interesting. Her talk helped me think twice when reading research about the subjects that were included and have a better idea about how well the results can be generalized. ADHD as a disorder affects a big portion of the population and can have different symptoms from person to person or from one group of people to another group of people. Gaps in the diagnosis of ADHD are not only present between men and women but also between Blacks and Whites. As she said at the end of her talk, it is hard to do research without excluding a portion of the population because there is just so much you can cover in only one paper. Despite that, it is important for the scientific community to keep inclusion in mind because everyone has the right to representation and to a diagnosis.
Finally, ADHD can also work as an asset in the fast-paced chaotic world we are living in, another article from The New York Times suggests (Mlodinow, 2018). The author says that his son was diagnosed with ADHD at a young age. When he told his mother that medication would slow her grandchild down and make him more manageable, she told him that the world is changing quickly, and her grandson did not need to be slowed down. The author did not take his mother’s words to heart, but they made him think. The article points out to research that says that some of people with ADHD can be able to manage living in the synchronous fast-paced world we are experiencing today. Today’s society, the author says, praises hyperactivity, and change happens quickly. Research, once again, showed that characteristics needed to cope in this kind of world are adaptability, absorption of information, and creativity in their ideas. The lack of dopamine theory for the explanation of ADHD leads to lessening of cognitive inhibition. The author, as well as research with transcranial stimulation, say that because of the lessening of cognitive inhibitions, people diagnosed with ADHD have more creative thoughts and ideas, but are also more distracted. Other research showed that groups that are more prone to ADHD have ancestors that migrated far from where they started, and therefore suggest that those with ADHD are more adaptable to change. The author concludes that ADHD in severe forms is obviously very hard to deal with and undoubtedly disrupts the person’s life, but in milder forms could be a helpful tool to navigate and thrive in today’s crazy world.
In conclusion, ADHD is a disorder that affects a lot of people in our society. Diagnosis is given based on behaviors shown by the person. Dr. Kwasa’s work shows how people with ADHD struggle more with switching their attention compared to neurotypicals. This is just one way ADHD can affect one’s life. Unfortunately, many people go undiagnosed because of biases. These people struggle even more because they develop anxiety, depression, self-doubt because everyone, including themselves, holds them up to a standard that is hard for them to achieve without medication, treatment, or simply without the diagnosis. In addition, it is important to keep research inclusive so more people can get correct diagnoses and treatment for their conditions. Finally, some people with mild ADHD might have an advantage over Neurotypicals in today’s world because they are capable of creative thoughts and ideas as well as adaptability.
Literature Referenced
Caron, C. (2021, August). How do I know if I have adult A.D.H.D.? The New York Times. Retrieved March 4, 2022, from https://www.nytimes.com/2021/08/06/well/mind/adult- adhd.html
Chapple, T., & Collinson, A. (2021, October). Why women may wait decades for an ADHD diagnosis. BBC News. Retrieved March 4, 2022, from https://www.bbc.com/news/health- 59038116
Kwasa, J. A. C., Noyce, A. L., Torres, L. M., & Shinn-Cunningham, B. G. (2021, February). Top- down attention modulates auditory-evoked neural responses in neurotypical, but not ADHD, young adults. bioRxiv. Retrieved March 4, 2022, from https://doi.org/10.1101/2021.02.11.430824
Mlodinow, L. (2018, March). In praise of A.D.H.D. The New York Times. Retrieved March 4, 2022, from https://www.nytimes.com/2018/03/17/opinion/sunday/praise-adhd-attention-hyperactivity.html?searchResultPosition=1
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