ADHD: Cause or Result? Two News Stories

Do you ever read news stories that raise giant red flags of ADHD yet never mention it by name? I  just read two such stories, and my mind was flooded with the thousands of posts I’ve read over the years from partners of adults with ADHD that touched directly on the topics. chicken_or_egg

The first story reported a study indicating that children in day care are more impulsive and bigger risk takers than children who did not go to day care or who spent less time in day care. The second story explored the effect of  electronic  devices on the human brain, including addiction.

But first, I’d like to point out a common error with  psychological (and sometimes even medical) research: confusing association with causation.  That is,  researchers claim research shows cause-and-effect (“causation”) when really all it shows is a  relationship between two variables (“association”).  More often, researchers do not make this claim; they merely suggest “risk factors” (a risk factor for Alzheimer’s is advanced age).  But reporters overstate the connection between cause and effect.

For example,  we’ve all read studies showing that couples who argue more about money are more likely to divorce.  Does that mean that if a couple simply stops arguing about money, that all will be bliss?  That it’s the argument itself or the “different attitudes” towards money that cause the divorce and if that’s resolved, all will be well?  Maybe, in some cases.

But what if one or both of the people in the couple has Adult ADHD,  and impulsive spending or failing to pay bills is but one of a constellation of  ADHD symptoms?   That’s just one example to explain the common association-causation confusion, especially when it comes to ADHD.

Now, on to the recent stories.

Daycare Causes Impulsivity and Risk-Taking?

“Day-care kids are more impulsive, bigger risk-takers, study finds,” writes Melissa Healy for the Los Angeles Times.  It begins:

The latest findings of the federally funded Early Child Care Research Network are certain to be no exception. At age 15, according to a study being published Friday in the journal Child Development, those who spent long hours in day care as preschoolers are more impulsive and more prone to take risks than are teens whose toddler years were spent largely at home.

The researcher points to a “contagion” effect:

In classrooms and peer groups populated by kids who may be just a little more impulsive or risk-taking, “these small effects end up being spread and bounce off each other,” said Belsky in an interview. “The dynamic becomes, ‘I dare you to take a risk, you dare me to take a risk.’

That’s an interesting phenomenon, and I don’t doubt it for a minute that it’s possible. But how do the researchers prove that longer hours in daycare lead to children’s increased impulsiveness and risk-taking?  I see no evidence in this reseaerch.  Moreover, did they  consider the possibility that parents who are impulsive risk-takers might, for a multitude of reasons, be more prone to leaving their children (and genetic recipients) in daycare and for longer hours?

What I’ve witnessed for ten years now are various situations where unrecognized ADHD in a parent meant the child spent time in daycare, so I have to wonder why researchers apparently didn’t factor in the situations of parents who place a child in daycare.

Please understand: I’m not debating the relative merits of daycare or the right of working parents to have daycare as a worthwhile option, nor am I saying that people with unrecognized ADHD are bad parents.  I’m simply pointing out that daycare might  not be causing children to be risk-taking and impulsive; instead, more risk-taking and impulsive children might attend daycare in the first place!

Consider these common scenarios:

  • One parent’s ADHD flies beneath the radar screen for years until the baby arrives. Then, suddenly having to juggle a job and family responsibilities can tip the balance in Executive Functioning. The result: less efficiency at home and on the job. A two-earner household means baby not only goes to daycare but also spends more time there (children are picked up after hours because they’ve been forgotten or communications have gone askew, and so forth).
  • The female partner without ADHD has been the reliable wage-earner and money manager throughout the marriage. When the baby arrives, she plans on staying home for several years, perhaps working part-time, while her male partner “steps up to the plate” in the earning department (perhaps after getting that long-sought advanced degree).   She never suspects her partner has Adult ADHD until the baby arrives and he can’t step up;  their lives start spinning out of control, including financially. She reluctantly goes back to work full-time while he works part-time and/or takes care of the child at home (but that can present problems, too, as she worries about the  dangerous mistakes an inattentive or impulsive can make in tending to a child). Or they both work and baby goes to daycare.
  • Couples who are impulsive and risk-taking often don’t plan. They didn’t plan financially or logistically for their new child’s early years.  Even if they would prefer that one parent stay at home with the child, there is no money set aside or support lined up to allow for that.  (And often there are debts, another hazard of being impulsive and prone to risk-taking.)
  • Couples who are impulsive and risk-taking might function poorly as stay-at-home parents. Instead, they gravitate to  the stimulation of a job or  the structure of the workplace, not dragging themselves through what can be daily tedium of household chores.

ADHD as Search for Stimulation Syndrome?

The next story, “Hooked on Gadgets, and Paying a Mental Price,” continued for five pages with nary a mention of the added vulnerability Adult ADHD brings to this situation. Excerpt:

When one of the most important e-mail messages of his life landed in his in-box a few years ago, Kord Campbell overlooked it.Not just for a day or two, but 12 days. He finally saw it while sifting through old messages: a big company wanted to buy his Internet start-up.

 

“I stood up from my desk and said, ‘Oh my God, oh my God, oh my God,’ ” Mr. Campbell said. “It’s kind of hard to miss an e-mail like that, but I did.”

The message had slipped by him amid an electronic flood: two computer screens alive with e-mail, instant messages, online chats, a Web browser and the computer code he was writing. …

Scientists say juggling e-mail, phone calls and other incoming information can change how people think and behave. They say our ability to focus is being undermined by bursts of information.

These play to a primitive impulse to respond to immediate opportunities and threats. The stimulation provokes excitement — a dopamine squirt — that researchers say can be addictive. In its absence, people feel bored.

The resulting distractions can have deadly consequences, as when cellphone-wielding drivers and train engineers cause wrecks. And for millions of people like Mr. Campbell, these urges can inflict nicks and cuts on creativity and deep thought, interrupting work and family life.

——-

So, see, there is a mention of the “dopamine squirt” but no mention that people with ADHD are more prone to needing — and seeking — that dopamine squirt. Despite ADHD being all about the dopamine (not to mention a few other neurotransmitters.)

Few would argue that flooding our brains with dopamine, as many of us are doing these days, takes no toll, whether or not we have ADHD.  But to leave ADHD completely out of the equation seems a bit disingenous to me,  not to mention misleading.

As for the family profiled, the Campbells, I can’t help but wonder if Mrs. Campbell is in a bit of “denial”:

Their 16-year-oldl son, Connor, tall and polite like his father, recently received his first C’s, which is family blames on distraction from his gadgets. Their 8-year-old daughter, Lily, like her mother, playfully tells her father that he favors technology over family.

“I would love for him to totally unplug, to be totally engaged,” says Mrs. Campbell, who adds that he becomes “crotchety until he gets his fix.” But she would not try to force a change.

“He loves it. Technology is part of the fabric of who he is,” she says. “If I hated technology, I’d be hating him, and a part of who my son is,too.”

We can’t presume to know if an ADHD screening might be a good idea for Mr. Campbell. But I have heard many, many partners of adults with ADHD share Mrs. Campbell’s mindset:  that it’s impossible to separate the person from their electronic obsessions, and to do so is unloving.  I wonder if the same attitude would be shown towards other types of addictions — porn, speeding, alcohol, and so on.  The fact that many people in recent years have made heaps of money from their computer-related prowess seems to have somehow legitimatized computer addiction.

Here’s the thing, though: The partners of adults with ADHD typically stop expressing that mindset when their family started falling apart from too much impulsivity, addiction, and risk-taking.  Sadly for some, by then it’s too late.

I’d love to learn your personal perspectives on these two stories.  Please leave a comment below — no registration required.

Thanks,

Gina

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  1. Carl Morris’s avatar

    When I heard you were doing a post on this topic I immediately thought of a story that recently struck me as obviously ADHD-related, and thought maybe I’d post a link here in the comments. I see it was your second story referenced above, so no need for me to post a link. But yes, I see stories all the time that suggest ADHD and/or have correlation versus causation issues in how they are reported.

  2. Anonymous’s avatar

    I’m taking a Communications class and I just read that interrupting is a sign that somebody is establishing dominance. No mention of ADHD, Autism or who knows what other brain factors might cause somebody to interrupt. So rather than just be annoyed by the interruption, or even maybe compassionate, people will react to defend themselves against a perceived power struggle.

  3. Brain Balance’s avatar

    It is important to know the difference between causation and association when looking at studies like you describe. For example, another recent article argues the effects of sleep apnea in children mimic the symptoms of ADHD. Searching for answers and asking the right questions is key to solving a problem or at least getting to the root of it! Thanks for the great post.

  4. Les’s avatar

    Wonderful as usual G! Any time you wish to do something about the correlation of ADHD and narcissism be sure to let me know ;-)

  5. Susan’s avatar

    I just read an article on CNN (http://www.cnn.com/2010/HEALTH/06/09/sleep.deprivation.depression/index.html?hpt=Sbin&hpt=T3) about the link between depression and lack of sleep. I immediately saw this as an example of the chicken or the egg syndrome. Then near the end of the article, a psychologist also acknowledged that with the results of this study, you can’t be sure if sleeplessness causes depression, or depression causes sleeplessness.

  6. Gina Pera’s avatar

    Thanks for your comments, everyone.

    I’m listening right now to YET ANOTHER show on multi-tasking (this one on Science Friday) and, as usual, not one mention of ADHD.

    It’s as though these “cognitive scientists” are operating in a parallel universe. One said, “One AMAZING thing that we learned is that people who like to multi-task are actually lousy at it but they don’t know it.”

    To which I said out loud to the radio: “Duh!” ADHD experts have known that for years.

    The depth and breadth of academic and professional turf battles are not to be underestimated.

  7. Gina Pera’s avatar

    As for sleep and ADHD, I find that most sleep experts are especially ignorant about the contributions ADHD makes to sleep challenges.

    Too often, they want to attribute ADHD symptoms to lack of sleep. Some will even recommend sawing one’s jaw in half or cutting out throat tissue before considering that ADHD and its connection to dopamine would provide a more helpful clue to resolving the issue.

    Again, egos and the battle for grants. A dangerous combination.

  8. Sas’s avatar

    Correlation is not causation, correlation is not causation, correlation is not causation… this was drilled into us while I was studying for my psychology degree, and I’m so grateful for that!! Everybody should be taught this in school from the moment they are capable of understanding it, and we’d all be able to make much better sense of scientific findings and our everyday experiences!

  9. Gina Pera’s avatar

    So true, Sas. So true.

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