The Neurodiversity Approach(es): What Are They and What Do They Mean for Researchers?

Summary & key facts

This paper says many people with ADHD have big problems with emotions. These problems include over-reacting, deep shame or guilt, and a strong sensitivity to rejection called rejection sensitive dysphoria (RSD). The author explains that emotions were often left out of ADHD research and diagnosis because they are not always visible or easy to count. The paper also reviews treatments and notes that some drugs (guanfacine, clonidine, and older MAOI drugs like tranylcypromine) can help some people, but they have limits and side effects.

Key facts:

• The standard diagnostic criteria for ADHD historically did not mention problems with emotions or mood regulation, even though many people with ADHD report these issues.
• More than 30% (about one third) of adolescents and adults with ADHD list emotional instability as the most impairing part of their condition.
• The paper describes three main mood problems tied to ADHD: over-reaction, shame and guilt, and rejection sensitive dysphoria (RSD).
• Rejection sensitive dysphoria (RSD) is defined in the paper as an extreme, triggered emotional pain after a real or imagined loss of approval, love, or respect.
• About one third of adolescents and adults with ADHD list RSD as the single most impairing aspect of their ADHD.
• RSD is often mistaken for other conditions. The paper says it is commonly misdiagnosed as depression, rapid-cycling bipolar disorder, borderline personality disorder, or social phobia.
• The paper reports that 50% of people who are court-mandated to anger management treatment have previously unrecognized ADHD.
• Alpha-agonist medicines (guanfacine or clonidine), which are FDA-approved for ADHD, give a strong benefit for RSD in about 1 out of 3 people; others mainly get mild sedation. Reported side effects include dry mouth, mild sedation, and dizzi
• Older research (from the 1960s) found that the MAOI tranylcypromine was about as effective as methylphenidate for core ADHD symptoms. The paper notes MAOIs need dietary caution (to avoid high-tyramine aged foods) and have many drug interact
• The paper suggests RSD is genetic and neurological and states that psychotherapies have been found to have little benefit for RSD, though knowing the condition exists can bring relief to some people.

Abstract

This paper presents the concepts of "neurodiversity" and the "neurodiversity approaches" towards disability and discusses how confusion regarding the meaning of these concepts exacerbates debate and conflict surrounding the neurodiversity approaches. For example, some claim the neurodiversity approaches focus solely on society and deny contributions of individual characteristics to disability (a controversial stance), whereas this paper joins other literature in acknowledging the contributions of both individual and society to disability. This paper also addresses other controversies related to neurodiversity, such as uncertainty regarding the scope of the approaches - to whom do they apply? - and their implications for diagnostic categories. Finally, it provides recommendations for developmental researchers who wish to carry out neurodiversity-aligned research: scholars are urged to study both individual neurodivergent people and the contexts around them; to consider both strengths and weaknesses; to recognize their own biases; and to listen to and learn from neurodivergent people.

Topics

Assistive Technology in Communication and Mobility Autism Spectrum Disorder Research Neuroethics, Human Enhancement, Biomedical Innovations

Categories

Cognitive Neuroscience Life Sciences Neuroscience

Tags

Computer science Confusion Epistemology Focus (optics) Meaning (existential) Optics Philosophy Physics Programming language Psychoanalysis Psychology Psychotherapist Scope (computer science)