The ADHD myth: what did Leon Eisenberg really say before he died?
We debunk one of the most viral hoaxes in recent psychology.
On September 15, 2009, Leon Eisenberg, an American psychiatrist of great fame and prestige, died of cancer.
Some time later, in 2012 to be precise, the newspaper Der Spiegel would unleash a great controversy by publishing an article derived from the last interview given by Mr. Eisenberg, identifying the professional as the discoverer of adhd and indicating in the article that the famous psychiatrist had recognized that Attention Deficit Hyperactivity Disorder or ADHD was an invented disease.
Before focusing on the controversy raised by such an alleged statement, let us remember what we are talking about when we refer to ADHD.
Attention Deficit Hyperactivity Disorder: what are we talking about?
ADHD is understood as a set of diverse symptoms grouped around inattention, hyperactivity and impulsivity, presenting stably over a period of at least six months.and present in a stable manner for a period of at least six months.
The symptoms of ADHD
For the diagnosis of ADHD it has been established that there must be at least six or more symptoms of inattention (neglect of details, difficulty maintaining attention, busy mind that makes not listen, failure to complete or follow tasks or instructions by distraction, organizational difficulties, loss of items, avoidance of tasks sustained over time, easy distraction, forgetfulness of daily activities) and/or six symptoms of hyperactivity and impulsivity (constant playfulness, standing up in circumstances when he/she should remain seated, motor restlessness, excessive talking, difficulty waiting for turns, interruption of others' activities, anticipation of the other's response in a conversation by finishing others' sentences, inability to play quietly, running around in inappropriate situations).
Some of these symptoms may seem normal at certain ages, but for the diagnosis of ADHD it is required that they are maintained for six months to a degree that does not correspond to the developmental level of the subject, taking into account the age and intellectual level of the subject. In other words, the diagnosis takes or should take into account that the symptoms occur in an abnormal or exaggerated manner. It is also taken into account that the symptomatology does not occur in a single environment or situation, but that it occurs in a generalized manner in at least two different environments (thus discarding that only occur at school) and producing a clear deterioration of the individual's activities.
Although for its diagnosis it is necessary that there has been some symptom before seven years of age, attention deficit hyperactivity disorder can be diagnosed at any age, including adulthood.
In this last aspect it should be noted that although some aspects of ADHD seem to correct with age (as frontal brain maturation occurs, which in this disorder is usually slowed down), especially in the case of hyperactivity symptoms, in many untreated cases some symptoms persist, such as reduced attention span, in many untreated cases some symptoms persist, such as a reduced attention span and a certain sense of inner restlessness. and a certain sense of inner restlessness.
Leon Eisenberg: why is he called the discoverer of ADHD?
Numerous publications seem to indicate that Mr. Eisenberg was the discoverer of ADHD.. This consideration is not entirely correct: although Dr. Eisenberg had great relevance in the study of this disorder, ADHD is a disorder known since ancient times, having references to symptoms and trying to be explained by previous authors, although it was called in different ways. In fact, the "discoverer of ADHD" himself indicated on occasion that the disorder was already well known before he worked on it: there are references to children with the same symptoms as early as 1902 by George Still (who classified them as children with deficits in moral control) and even descriptions prior to this.
Despite this, Mr. Eisenberg did play a major role in the consideration of this disorder.: was a pioneer in giving due importance to genetic factors in the etiology of this disorder (before he and other authors advanced in their research from a more biological and neuroanatomical perspective), some of the etiological explanations of the disorder focused on the absence of a correct socioemotional bonding with the parents, especially with the mother, with which the parents were partly blamed for their child's disorder), as well as in introducing ADHD in the reference manual of American psychiatry and psychology, the Diagnostic and Statistical Manual of Mental Disorders (DSMD). Diagnostic and Statistical Manual of Mental Disorders or DSM. This last fact is what has probably caused Leon Eisenberg to be sometimes called the discoverer of ADHD.
The article of discord
Having said that, let us focus again on the subject of this article: the alleged confession of its non-existence. In the article published in the newspaper Der Spiegel the interviewee's words seem clear, but they appear decontextualized, making it easy to misinterpret the meaning they had in their original context. In fact, part of the problem is based on a misinterpretation of the meaning of the words in their English-German translation. The interview in question also focused on examining the increase in diagnoses of mental disorders in recent times.
With a more contextualized review of the interview situation, it is possible to observe that the criticism of the so-called discoverer of ADHD was focused on the dramatic increase in the number of supposed new cases of the problem.
Thus, the well-known psychiatrist referred to the overdiagnosis of this disorder.In many cases the disorder does not exist and if there are symptoms they may be due to psychosocial factors, such as parental divorce, changes in locality or lifestyle, or other personal losses (in which case ADHD should not be considered unless it is a problem unrelated to the life events in question).
Another critical point is the excessive tendency to prescribe medication, since although it can be a great help to those who suffer from it, it can be a detriment if administered to individuals without this disorder. In addition, it must be taken into account that these are usually minors, so special care must be taken when administering psychotropic drugs. Furthermore, in the same interview, he indicated that even if there is evidence of a certain genetic predisposition to this disorder, this was overestimated, and more research on psychosocial causes was needed.
A critique of overdiagnosis
In conclusion, it can be considered that the article stating that Dr. Eisenberg had denied the existence of ADHD is the result of a misinterpretation of his words, as the psychiatrist had not indicated that he had denied the existence of ADHD.The psychiatrist did not indicate that the disorder does not exist, but rather that it is diagnosed with excessive haste, fabricating the diagnosis in cases that do not suffer from it.
Bibliographical references:
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
- Barkley, R. (2006).Attention-Deficit Hyperactivity Disorder, Third Edition: A Handbook for Diagnosis and Treatment, Guildford Publications. New York.
- Eisenberg, L. (2007). Commentary with a Historical Perspective by a Child Psychiatrist: When "ADHD" Was the "Brain-Damaged Child". Journal of Child and Adolescent Psychopharmacology, 17(3): 279-283.
- Grolle, J. & Samiha S. (2012). "'What About Tutoring Instead of Pills?" Der Spiegel. 02.10.2012.
- Miranda, A., Jarque, S., Soriano, M. (1999) Attention deficit hyperactivity disorder: current controversies about its definition, epidemiology, etiological basis, and approaches to intervention. REV NEUROL 1999; 28 (Suppl 2): S 182-8.
- Von Blech, J. (2012). "Schwermut ohne Scham." Der Spiegel. 06.02.2012.
(Updated at Apr 15 / 2024)