maandag 24 december 2012

Christmas Quiz


A. The nitty gritty – medical conceptualisation and treatment of ADHD

1) What does the DSM in DSM-IV (the influential American guide to diagnosis often used in Europe to guide ADHD diagnosis) stand for? (2)

a) Diagnostic, Standardised Manual of Mental Disorders
b) Dictionary of Symptoms of Mental Disorders
c) Diagnostic and Statistical Manual of Mental Disorders
d) Dictionary of Symptoms of Medical Disorders

2) What is the acronym of the World Health Organisations equivalent to the DSM? (2)


3) According to the DSM-IV to meet diagnostic criteria for ADHD you need to have significant difficulties with two or more from the classical triad of symptoms
What are these three symptom groups- choose from: hyperactivity, distractibility, hypoactivity, executive functions, inattention, poor working memory, poor planning, poor social skills, and procrastination? (3)

4) For which of the problems below is there good evidence that they are increased in people with ADHD (1 point for each right, -1 point for each wrong)

a) Committing a violent crime
b)    Having children at a younger age
c)     Addictive behaviours
d)    Problems at work
e)     Being victims of violent street crime
f)     Driving problems
g)    Physical health problems




5) Which of the characteristics below have evidence suggesting increased ability in people with ADHD? (Dropped the ‘good’ as ADHD advantages rarely studied by more than one researcher, whether or not ADHD has an advantage, there is no large body of evidence)(1 point for each right, -1 point for each wrong)

a)     Emotional intelligence
b)    Creativity
c)     Self transcendence (a character trait associated with spirituality and humbleness)
d)    Integrative complexity
e)     Autobiographical memory
f)     Short term memory
g)    Incidental memory
h)    Use of incidental memory in problem solving




6) Who is associated with the ‘hunters-farmers’ model of ADHD? (2)




7) The NICE guidelines on ADHD  (we gold standard UK guidelines) recommend   medication as a first line treatment for adults unless the adult themselves prefer a psychological approach.  (Contrasting with recommendations for children with moderate ADHD in which psychological treatments are recommended as the first line treatment approach, unless parents wish otherwise)

8)What reason did they give? (2)

a)     Psychological approaches have been shown to be ineffective in adults
b)    There is a lack of research into the efficacy of psychological approaches for adults
c)     Medication is cheaper than psychological approaches





B. History of ADHD
1) ADHD has had many changes of name –give three former medical names for ADHD (1 mark for each name)


2) In which decade were stimulants first used to treat hyperactive children? (2)

a)     The 1900s
b)    The 1920s
c)     The 1930s
d)    The 1950s
e)     The 1970s
f)      The 1980s


3) What did Patrick Van Kiebohm do in 2007 after a Flemish judge dismissed a joint petition from three of his neighbours to stop his three children with ADHD playing outside? (2)

a) Key the neighbours’ cars
b) Write a novel about the incident
c) Throw a street party for his local ADHD group
d) Use it as material for a stand up comedy tour
e) Countersue his neighbours for hate crime


4) How did teenager with ADHD, Michael Fay cause an international furore in 1994? (3)


5) In which of these decades (from question 8) was Ritalin first licensed for hyperactive children?
a)     The 1900s
b)    The 1920s
c)     The 1930s
d)    The 1950s
e)     The 1970s
f)      The 1980s

6) Which International body made an embarrassing goof over ADHD, in 1999 following being lobbied by scientologists?



C.ADHD and culture


1) Which Shakespearean character excused himself for not answering the summons of the Lord Chief Justice Summons because he suffered from a  ‘ disease of not listening’ or a ‘ malady of not marking’. (2)

2) ADHD is not over diagnosed in Europe- But fictional characters exhibit a high rate of false diagnosis, ADHD symptoms often lasting only one episode. Name a character or group of characters diagnosed with one -Episode -ADHD (2)


3) Sometimes a character is misdiagnosed with ADHD when a superpower is misinterpreted. Which hero of a series of popular children’s books was told?
The ADHD-you’re impulsive, can’t sit still in a classroom. That’s your battlefield reflex. In a real fight, they’d keep you alive. As for your attention problems, that’s because you see too much, not too little. Your senses are better than a regular mortals

4) Further, TV and film   characters are prone to striking medication side effects of an entertaining and salutary nature. Name such a character (1) and the side effects suffered (1)


(5) Which   three of these famous people has a confirmed diagnosis of ADHD? (3)



Russell Crowe, David Cassidy, Albert Einstein, Susan Boyle, Billy Connolly, Usain Bolt, Bart Peeters, Patrick Van Kiebohm, Oscar Schindler,



6) On what did Courtney Love blame Kurt Cobain's addiction to heroin? (2)

7) Was she right? Did your answer to the question above cause his addiction to heroin (1)? Give your reasoning (1)


8)The entity Kryon (through his human channeller, a businessman Lee Carroll) commented on the birth of increasing numbers of a new more advanced type of child into the human race. These children are often claimed by followers to be have been wrongly diagnosed with ADHD   
The children are known as

a) Indigo children
b) Rainbow children
c) Crystal children,
d) Metatranscedent children
e) Magenta children



Stephanie Clark

Adult Anglophone ADHD group
Part of Aandacht, Belgium


Answers to Quiz



Section A.  The Nitty Gritty -medical conceptualisation and treatment of ADHD

1)    C

2)    ICD (ICD-10 or ICD-11 also acceptable)


3)    Hyperactivity, impulsiveness and inattention

4) All except A

Note on answer A: although there is evidence that men and women who were diagnosed with ADHD are at ‘increased risk of police contact’, the existing evidence suggests crimes of violence are less frequent for ADHD without a comorbid conduct disorder.  See e.g. (Young, 2007)

5) A and f are wrong. Thus: a=-1, b=1, c=1, d=1, e=1, f=-1, g=1, F=1

Note: increased Self-Transcendence is supported by 2 Studies (Lynn DE, 2005) (Smilley, Loo, Hale, & Shresha, 2009)

6) Thom Hartnell

7) B


Section B. History of ADHD


1) 1 point for any of the following up to a maximum of three points: Minimal brain dysfunction, minimal brain damage, post-encephalitic behaviour disorder, defect of moral control, hyperkinetic disorder of childhood, attention deficit disorder, attention deficit hyperactivity disorder.

2) C. By Dr Charles Bradley in 1937

3) D.  Link to   newspaper report (in Dutch)

4) 1 point for any of the underlined points to a maximum of three points  -18-year-old American sentenced to 6 strokes (later commuted to 4) of the cane for vandalism in Singapore. Caused international debate over ADHD and responsibility for actions

5) J. Ritalin came on the market for hyperactive children in 1956
6) The parliamentary assembly in Strasbourg published a report on  Controlling the Diagnosis and Treatment of Hyperactive Children in 2002 partially based on a meeting in 1999. Subsequently, criticised by a reply from the Committee of Ministers
Some of the points raised in the Recommendation are at variance with the views held by the vast majority of the scientific community and that they are dangerously close to certain well-known theories which the “Church of Scientology” has promoted for some time but which do not stand up to serious scientific scrutiny.


Section C. ADHD and Culture


1) Falstaff  (portrait by Eduard von Gr├╝tzner above) in Henry IV PART 2

2) Bart Simpson. All the children in Southpark. If you know others email me –



3) Percy Jackson in The lightning thief by Riordan-.
 Notes:  Symptoms are well described by Riordan and superpowers (sort of!) plausibly extrapolated from them. Other examples of superpower / ADHD symptom confusion appear to trivialise ADHD e.g. True blood’s Sookie Stackhouse   revealed she was thought to have ADHD as a child   when her ability to read peoples minds interfered with her ability to concentrate-
1)   Films -Charlie Bartlett becomes manic on Ritalin. In Pecker, Pecker’s sister is diagnosed with ADHD and becomes zombie is on Ritalin – consuming too much sugar caused her ADHD
TV: South Park –every kid in town prescribed Ritalin. Side effect extreme dullness. Bart Simpson; medication made him insanely paranoid

4) Connolly, Kieboom, Cassidy -1 point each
Some of the others possibly had ADHD but diagnosis not confirmed.
Two worth noting are -
 Doyle has said that she had brain damage at birth, but people diagnosed with MBD (a precursor of ADHD) were told at diagnosis that they likely had brain damage at birth retrospectively.  Two adults in this group were formerly diagnosed with MBD, in one the brain damage at birth ran in the family, should have changed midwife, I guess! So it is possible that Boyle was diagnosed with MBD and nowadays would have been diagnosed with ADHD.

 Some celebrities mention childhood hyperactivity, even a medical consultation without making it clear if they were diagnosed or even formally assessed for ADHD.
E.g. Usain Bolt the’ fastest man in the world’ told the Guardian (28th August 2010) that his Grocer parents took him to the doctor: "I was all over the place, climbing things. My mum goes, 'There must be something wrong with this kid', and the doctor goes, 'Nooooo, he's just hyperactive. ‘His Mum has commented that the doctor added that she should be careful with him by the roadside. Perhaps this was the limit of available treatment when Bolt was growing up in rural Jamaica? 
  Niels Albert the Belgian Cyclist tells a similar story. In  2009 he gave an interview on lunchtime Flemish news (Een, 10th January 2011). When he was around five years old, his mum thought he was hyperkinetic (another old name for ADHD) and consulted a pediatrician who advised her to find her son’s’ ‘thing’. Great advice but did all parents so advised find their kids  ‘thing’? Luckily, Albert found his ‘thing ‘nine years later, taking up cycle racing at 14.   Again it is neither clear if Albert was assessed nor, if assessed, diagnosed, and if the advice was supplementary to a treatment regime or in lieu of treatment.

I have avoided postmortem diagnosis e.g. Einstein and making my own diagnosis e.g. Schindler screams ADHD to me!
Some on the list are rumoured to have a diagnosis, but it is hard to establish that there is not a formal diagnosis (Although Bart Peeters recently denied having ADHD).  So if you know of a link, which seems to settle the question of diagnosis for any of the others, do let me know.



6) Love thought Ritalin prescribed in childhood fostered Cobain’s addiction
7) Wrong- scientific evidence suggests that children with ADHD are less likely to develop addictions as adults then their unmedicated peers.
 Based on this, since Cobain took Ritalin for only three months when he was seven years old, had he been treated longer in childhood or received treatment in adulthood he would have been less likely to develop an addiction to heroin.   Furthermore, other factors, which likely to have contributed to an increased susceptibility to addiction include a Rock, star lifestyle and a disturbed childhood.

8) a) Indigo


Stephanie Clark, Adult Anglophone ADHD group, 24.12.2012

References

Lynn DE, L. G. (2005). Temperament and Character Profiles and the Dopamine D4 receptor gene in ADHD. American Journal of Pyschiatry , 906-913.
Smilley, S., SK, L., TS, H., & Shresha, A. (2009). Mindfulness and Ateention Deficit Hyperactivity Disorder. Journal of Clinical Psychology , 1087-1098.
Young, S. (2007). Forensic Aspects of ADHD. In M. Fitzgerald, M. Bellgrove, & M. Gill, Handbook of attention defecit hyperactivity disorder (pp. 90-105). Chichester: Wiley.