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Tuesday, December 11, 2012

Study: Criminals who take ADD meds less likely to get caught

     Some college professors from Europe recently had the honor of having one of their scientific studies published in the New England Journal of Medicine (NEJM) - the number one medical journal in the world. The assumption is that their study must be legitimate. But as the well-known author Joel Best reminds us, even good scientific journals are prone to publishing studies that have sensational conclusions even when the science is lacking (the Journal of American Medical Association's well-known published study on bullying is Mr. Best's excellent example of this problem). After reading about this study, I think that the NEJM is not immune to publication bias either.

The Study** (reference below) used data and methods common to epidemiologists and the authors of the study made the following conclusions from the data that they acquired:
     "Among patients with ADHD, rates of criminality were lower 
      during periods when they were receiving ADHD medication. 
      These findings raise the possibility that the use of medication 
      reduces the risk of criminality among patients with ADHD."

The conclusions made in scientific studies can sometimes
be questionable, even ridiculous as in this study. There
is a tendency for bias towards a desired conclusion, especially
in studies funded by private corporations,
like pharmaceuticals.
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   The raw data may be correct, and the methods they used to determine if there were correlations between variables (ADHD meds and criminal behavior) may be correct, however, and this is a big "however," their conclusion is spurious (to put it nicely). That's why I entitled this post as I did.  The reason their conclusion is spurious is because their definition of "criminality" is conviction of a crime. So, an equally plausible conclusion is that people who take ADHD drugs are less likely to get caught when they engage in criminal behavior. The study did not follow the daily activity of these thousands of people to see how often and what type of criminal behavior they engaged in over the course of their non-treatment and treatment periods. Also, it compared the diagnosed or treated group to and non-diagnosed group; however, there's no reason to think that ADHD did not exist in the non-diagnosed group at the same or even higher rate as the general population.

Marilyn Marchione who reported on the study for the Associated Press, failed to scrutinize the research. Her lack of skepticism is to be expected of main stream media these days, but that doesn't excuse it. The public needs more than what amounts to duplicity by reporters and journalists.

Another problem with any study of ADHD is that the idea of ADHD has little, if anything, to do with attention span. ADHD itself is just a descriptive syndrome based on a nearly random set of human behaviors - each behavior can have one or more causal factors. After more about 50 years of being on the books as a "disorder," there still is no accurate test to determine if someone has problems with their attentional systems that would cause functional problems or life distress. Moreover, there is no known biological or genetic "cause" of the syndrome (set of behaviors) of ADHD. The behaviors that make-up the idea of ADHD are probably most often caused by a combination of factors, such as anxiety, the devaluing of academic achievement or homework, life stressors, parenting problems, classroom management problems, as well as a problematic home environment (alcoholism, abuse, neglect, parental illness or depression, and other factors).

Stimulant drugs and Amphetamines will not improve academic performance for most children, but will improve classroom behavior; however, the downside of these drugs over the long-term makes them not worth the risk. Our society needs to develop more effective methods to help children learn to behave better in the classroom setting instead of using and promoting the use of stimulants and amphetamines. More research needs to be conducted on the cause of these behaviors that we incorrectly label as "ADHD" and develop interventions that are safe and effective.

**  Medication for Attention Deficit–Hyperactivity Disorder and Criminality
Paul Lichtenstein, Ph.D., Linda Halldner, M.D., Ph.D., Johan Zetterqvist, M.Ed., Arvid Sjölander, Ph.D., Eva Serlachius, M.D., Ph.D., Seena Fazel, M.B., Ch.B., M.D., Niklas Långström, M.D., Ph.D., and Henrik Larsson, M.D., Ph.D.  N Engl J Med 2012; 367:2006-2014November 22, 2012DOI: 10.1056/NEJMoa1203241 

Additional Reading:,d.aWM 

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