Chapter 16. Treatment

16.1 Section Title

Topic: How Has the Rate of ADHD Diagnosis Changed over Time?

Statistical Concepts Covered:

In this applet, you will continue to investigate issues with research design related to sampling and measurement by using meta-analysis, which is the analysis of many studies at once.

Introduction

The text chapters discuss various mental disorders and their symptoms, including Attention Deficit/Hyperactivity Disorder (ADHD), and the role of various treatment options in helping those who have a mental disorder. ADHD is observed via a pattern of problems at home and school due to difficulty paying attention, hyperactivity, and/or impulsiveness. The data for this applet comes from a meta-analysis by Faraone, Sergeant, Gillberg, and Biederman (2003). A meta-analysis is a study using the results from multiple studies are evaluated to determine the overall effect or difference. During this evaluation we must keep in mind the importance of sampling and measurement involved in the various studies.

Faraone and colleagues evaluated multiple studies conducted around the world to compare the percentage of individuals who met the criteria for ADHD based on location (U.S. or non-U.S.), gender (males or mixed), measurement type (rating scale, interview, or both), and rater (parent, teacher, or subject). In this applet we will also evaluate the diagnosis rates in relation to when changes were made to the diagnostic criteria for ADHD and when new drugs were released for this disorder. The dates for these are listed below:

Diagnosis Date Drug Introduction Date
1902: ADHD first described by Sir George Still
1922: "Post Encephalitic Brain Disorder"
1937: Benzedrine
1952: DSM-I
1955: Ritalin
1960: Adderall
1968: DSM-II
1968: DSM-III
1982: Ritalin SR
1987: DSM-III-R
1994: DSM-IV
1999: Metadate ER
2000: DSM-IV-TR
2000: Concerta
2001: Focalin
2001: Adderall XR
2002: Strattera
2005: Focalin XR
2006: Daytrana
2007: Vyvanse
2009: Inutniv
2010: Kapvay
2013: DSM-5
Table : Example data:

Richard Alan Hullinger, Indiana University, Bloomington
Melanie Maggard, University of the Rockies

Question 1

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Correct.
Incorrect. Both locations reported their highest percentage of children diagnosed with ADHD between 1990 and 1995. However, there doesn’t seem to be any clear differences between the two sample locations as sometimes U.S. studies reported higher rates and other times non-U.S. studies reported higher rates.

Question 2

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Correct.
Incorrect. We cannot draw any conclusions regarding this relationship as these studies do not allow us to compare males to females since the data provided is not for each sex but as one group.

Question 3

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Correct.
Incorrect. Rates were highest when teachers were used, while they were lowest when subjects were used.

Question 4

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Correct.
Incorrect. Parents are more likely to evaluate subjects as having ADHD symptoms since they are more critical of their children than anyone else.

Question 5

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Correct.
Incorrect. Rates were typically higher when rating scales were used than when only interviews were used.

Question 6

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Correct.
Incorrect. Rating scales provide detailed information that help eliminate those who don’t have ADHD.

Question 7

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Correct.
Incorrect. Greater differences were found based on rater and measurement type, implying that the person who provides the data and the type of measurement used may impact the results obtained.

Question 8

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Correct.
Incorrect. No, rates sometimes increased and sometimes decreased after a change was made to the diagnosis criteria.

Question 9

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Correct.
Incorrect. There is not enough data on ADHD rates from 2000 to 2010, when most drugs were released, to determine if there is any relationship.

Question 10

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Correct.
Incorrect. There appears to be no clear relationship between when drugs are released, diagnosis criteria changes, and rates of ADHD diagnoses.

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