[HN Gopher] NIH Researchers Identify Brain Connections Associate...
       ___________________________________________________________________
        
       NIH Researchers Identify Brain Connections Associated with ADHD in
       Youth
        
       Author : bookofjoe
       Score  : 82 points
       Date   : 2024-03-14 12:03 UTC (10 hours ago)
        
 (HTM) web link (www.nimh.nih.gov)
 (TXT) w3m dump (www.nimh.nih.gov)
        
       | _fat_santa wrote:
       | I've always been a cautious skeptic of ADHD in children. On the
       | one hand I know ADHD is a thing and that it legitimately affects
       | some children, but on the other hand I realize that alot of ADHD
       | symptoms overlap with the general nature of children, especially
       | boys.
       | 
       | My wonder is when does it to go from a kid just being a kid to a
       | child actually affected by ADHD. Often times it's described as
       | just not being able to pay attention but in my personal
       | experience I remember finding it hard to focus as a child.
       | 
       | The drugs also scare me. I remember taking Adderall in college to
       | help study for tests and crunch on projects but I distinctly
       | remember anytime I took one I always wondered how people could
       | take it every day, Adderall (and Vyvance) were amazing drugs for
       | helping to stay focused, but wow did they f** me up, I remember
       | it always felt great at first and by the end of the study session
       | I couldn't imagine how people could take it every day because of
       | the side effects (especially the lack of hunger). Adults taking
       | the drug is one thing but the idea of giving something like that
       | to a child profoundly scares me.
        
         | corobo wrote:
         | > My wonder is when does it to go from a kid just being a kid
         | to a child actually affected by ADHD
         | 
         | The second D - disorder. When it affects the kid's ability to
         | learn, socialise, etc
        
           | lolinder wrote:
           | The problem is that what is perceived as "disordered" is
           | different across time and space.
           | 
           | Behavior patterns that were once totally normal may get in
           | the way of living the kind of life that some parents have
           | come to _expect_ of their kids--running from school to dance
           | to piano to soccer to tutors to therapy to whatever. Are
           | these kids disordered because they can 't keep up, or are the
           | demands unreasonable?
        
             | user_7832 wrote:
             | Or counterpoint- in my case I was helped at home a good bit
             | with structure. It wasn't until I was independent at uni
             | that this facade started to fall off, revealing "issues".
        
               | corobo wrote:
               | Aye same - I did great up until I had to make my own
               | structure.
               | 
               | Decent enough in school but dropped out of college twice.
               | Fell into an entry level IT job with loads of scripts,
               | processes, and procedures but the more I progressed the
               | more autonomy I was given and the worse I performed.
               | 
               | Was mostly terrible but occasionally amazing (enough to
               | keep my job at least) for ~10 years then bumped into the
               | ADHD symptoms at some point, got myself checked out, got
               | the diagnosis.
               | 
               | Doing pretty well now (tho never perfect) with medication
               | and a stint of cognitive behavioural therapy to help set
               | up my own structure. Getting there!
        
               | user_7832 wrote:
               | Could you explain what/how the CBT helped? Where I am in
               | Europe the default treatment is only medication which
               | feels inadequate on its own.
        
               | corobo wrote:
               | I think this is where things diverge depending on what
               | troubles the ADHD brings you. It's kinda like debugging a
               | program except the program is your brain - and yeah in
               | the UK it's medication only by default, had to sort out
               | the CBT side of things myself when I realised the meds
               | were helping but not quite doing enough alone.
               | 
               | I originally went for help with low confidence which
               | expanded out to digging into and addressing self-esteem,
               | confidence, social anxiety, procrastination, and
               | perfectionism.
               | 
               | If I'd taken one general thing from it though it's "do I
               | have evidence or is this an assumption?" - if I have no
               | evidence (that I'm terrible at my job, I did bad, that
               | guy hates me, etc) then I should reevaluate if it's even
               | accurate before doing anything with the thought
               | 
               | Writing things down when things go wrong was a big part
               | of it too - what's the situation, what led to the
               | situation, is it possible to view the situation in a
               | better light, if not how can I fix the situation, if I
               | can't fix things myself is there anyone that can help me
               | with this situation rather than wallowing in it. That
               | sort of thing.
               | 
               | As I say I imagine it'll differ from person to person so
               | other people may have an entirely different experience
               | with it, I'm not sure. Definitely worked for my
               | systems/coding flavoured brain though, really was like
               | debugging faults in a program. Figure out the underlying
               | issue, try a fix, did it work? y/n? If no, try another
               | fix. If yes, work on the next problem.
        
               | chimeracoder wrote:
               | > Could you explain what/how the CBT helped? Where I am
               | in Europe the default treatment is only medication which
               | feels inadequate on its own.
               | 
               | Where are you? I can't think of a single place in Europe
               | where medication alone is the treatment standard for
               | ADHD.
        
             | corobo wrote:
             | I dunno to be honest, I don't know of any kids diagnosed
             | with ADHD to think of as examples.
             | 
             | Looking back on my own life (diagnosed early 30s, but part
             | of the process was looking at how I was in school): I
             | struggled to keep up with the bare basics outside of
             | lessons - getting ready for school on time, remembering
             | books, remembering to tell my parents I/they needed to do
             | stuff on specific dates, doing (small amounts of) homework.
             | 
             | On the social front - Billy no mates until college (where I
             | met people who were as weird as me), constantly bullied for
             | reasons I couldn't figure out, could not work out how
             | people managed to make friends. Felt like I'd missed the
             | day of school where they taught everyone how to socialise
             | and be normal. It was also like my prime directive was
             | "don't speak unless spoken to" haha. So damn quiet.
             | 
             | Unless someone directly invited me or gave me permission to
             | do an activity that activity was just for other people, not
             | for me. Dancing, sports, and pianos weren't even on the
             | table lol.
        
           | detourdog wrote:
           | This is where it gets weird for me. I certainly can learn but
           | school was torture. I had no problems socializing. I'm signed
           | up for a neurological exam. I have had a personality exam
           | with nothing jumping out.
        
         | digibeet wrote:
         | No need to be skeptical of children that are diagnosed. It is
         | often (and I am speaking solely about boys, just as you do)
         | quite obvious if you are trained in recognising those markers.
         | This doesn't mean all are found and the current training is
         | severely lacking in recognising symptoms for girls.
         | 
         | Regardless, yes it is often described by others and those who
         | are not diagnosed with ADHD as " just not being able to focus".
         | This simplification misses out on a whole scala of symptoms and
         | experiences.
         | 
         | As for the medication, it is true that it is sometimes
         | mis/abused by some students. One thing to realize is that for
         | those who have ADHD drugs and the stuff may have completely
         | different effects on the person. Uppers making some people
         | sleepy for example. Lastly children are often not given those
         | drugs you mention but alternative without those side effects.
        
         | thfuran wrote:
         | Are you also skeptical of obesity in teens because eating a lot
         | is just the general nature of teens, especially boys? Are you
         | appalled that diabetics take insulin every day because you once
         | injected yourself with insulin you didn't need and experienced
         | severe side effects?
        
           | lolinder wrote:
           | These comparisons feel like bad faith. This is what they
           | actually said:
           | 
           | > I've always been a cautious skeptic of ADHD in children. On
           | the one hand I know ADHD is a thing and that it legitimately
           | affects some children ...
           | 
           | They explicitly say that they know it affects some children,
           | but they're concerned that it's overdiagnosed because the
           | symptoms have overlap with normal child development. This
           | isn't some kind of uninformed conspiracy theory, it's a
           | legitimate concern shared by experts in the field [0].
           | 
           | My fear isn't that experts get confused and mix up real ADHD
           | with normal childhood, my fear is that parents expect too
           | much of their kids and convince their family doctor (who
           | isn't an expert) to diagnose the child and prescribe
           | Adderall. That fear is totally compatible with ADHD _also_
           | being a real thing that actually needs treatment in other
           | children.
           | 
           | [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042533/
        
             | remotefonts wrote:
             | Wait... Which barbaric country is that where a simple
             | family doctor can prescribe amphetamines like that? Not in
             | my EU country. It's a controlled medication and can only be
             | prescribed by psychiatrists.
        
               | nick__m wrote:
               | Canada is one of them, my family doctor put me on
               | Vyvanse, after seing me for the second time for an
               | unrelated problem, because he noted that I was
               | alternating between hyperfocus and zoning out when he
               | talked to me.
               | 
               | It positively changed my life and I am quite happy that a
               | "simple family doctor" can prescribe amphetamines if he
               | thinks that it's appropriate.
        
             | thfuran wrote:
             | >These comparisons feel like bad faith. This is what they
             | actually said:
             | 
             | Taking prescription medication without a prescription or
             | the condition it's meant to treat and then using its
             | effects on you to decry its use by those with both seems
             | like bad faith.
        
             | adastra22 wrote:
             | He took prescription medication that was not prescribed to
             | him and is now judging the people it is meant for based on
             | his own interaction with the drug. A drug that quite
             | famously has entirely different effects on the target
             | population.
             | 
             | That is either extremely ignorant or bad faith. Either way
             | it's below HN's standards.
        
           | improv wrote:
           | Diabetes is a biological disease which can be objectively
           | proven and diagnosed based on biological tests.
           | 
           | There are no objective biological diagnostic criteria for
           | anything in the DSM.
           | 
           | "psychiatric diagnosis still relies exclusively on fallible
           | subjective judgments rather than objective biological tests"
           | -Allen Frances, _The New Crisis of Confidence in Psychiatric
           | Diagnosis_
           | 
           | https://en.m.wikipedia.org/wiki/Allen_Frances
        
         | fsociety wrote:
         | I guarantee that you took Adderall IR, and a higher dose than
         | those typically prescribed by a doctor. It's like slamming back
         | 10 cups of espresso instead of sipping one over a day. And then
         | judging people who drink a coffee a day.
         | 
         | Slow release and a therapeutic dose is significantly different
         | than slamming back meds in school like that. Therapeutic dose
         | means you can't even tell you took the med, until you either
         | stop or look back at the day and record how much you were able
         | to achieve.
         | 
         | Yes, some doctors are bad and calculate a dosage based on
         | weight or other arbitrary means. Good doctors and psychiatrists
         | start you on the lowest dose and slowly titrate you up based on
         | DSM guidelines.
         | 
         | Lastly, medication for ADHD is something that makes all the
         | actual effective treatments do-able. It's a first step not a
         | crux.
        
           | samtho wrote:
           | > Lastly, medication for ADHD is something that makes all the
           | actual effective treatments do-able. It's a first step not a
           | crux.
           | 
           | This is a nuance that is lost on a lot of people. Medication
           | needs to be taken in conjunction with re-learning how to
           | study/organize/prioritize. This actually allows for new
           | neuro-pathways to be forged and reinforced in the brain,
           | which actually _fixes_ many of the negative effects of ADHD,
           | lessening the need for medication over time for many people.
           | This effect is easy to observe in children because their
           | brains are still extremely very plastic, but it also causes
           | people to question why we need to prescribe medication if
           | kids just end up "growing out of it".
        
         | mirsadm wrote:
         | If you have a child with ADHD you will know. They are
         | different.
        
           | kypro wrote:
           | Even if true, the problem is those who don't but think they
           | do.
           | 
           | I suspect you might also have parents who kinda like the idea
           | that there child's behaviour can be explained by ADHD. My
           | sister's kid often gets in trouble at school for example, and
           | whenever this happens she will try to excuse it by saying she
           | has ADHD. I'm not at all convinced given that imo it's far
           | easier to explain the misbehaviour with bad parenting.
        
             | mirsadm wrote:
             | I don't think you understand. "Bad" behavior is one aspect
             | of it but there are many others. Girls also have different
             | symptoms (and are severely under diagnosed compared to
             | boys). This is not a situation of excusing behavior you
             | need to live and deal with a child every single day to
             | understand.
        
           | weweersdfsd wrote:
           | The problem is that often a child with ADHD may also have
           | autism, or various other difficulties (learning disabilities,
           | anxiety disoder) that may mask, or have similar symptoms. And
           | then you can also have such disorders without having ADHD.
           | The same structural differences in brain can cause lots of
           | things.
        
           | teamonkey wrote:
           | Especially clear if you have one who does and one who
           | doesn't.
        
           | permalac wrote:
           | Absolutely. Take my two kids, they are wildly different,and
           | so equal. One can focus a bit the other is impossible to get
           | focused. He gets distracted when doing a wee, is astonishing,
           | sometimes I'm speechless.
        
         | user_7832 wrote:
         | Iirc adhd is a neurodevelopmental condition. So if a 5 year old
         | has similar executive function as the average 5yo he's probably
         | fine. But if a 10 yo has a 7yo's levels it's worth looking at.
         | And if this same person has this even later to the point where
         | it affects life in multiple situations it's a disorder,
         | medically speaking. Also, some people (not all) grow out of
         | adhd in their adulthood as the brain develops.
        
           | mtlmtlmtlmtl wrote:
           | Many of the people who grew out of it did it not naturally
           | but because they were on medication. Medication during
           | childhood has been well proven in longitudinal studies to
           | reduce the incidence of adult ADHD.
        
         | 2four2 wrote:
         | > The drugs also scare me... The idea of giving something like
         | that to a child profoundly scares me.
         | 
         | It works differently in people with the disorder. I took
         | Adderall as a child and as an adult for adhd. It didn't get me
         | wired nor did I have withdrawal symptoms, I simply felt more
         | centered and capable of starting tasks. I know that we can only
         | draw on our own experiences to judge things, but understand
         | that people with this disorder experience the drug completely
         | differently than you did.
        
           | tstrimple wrote:
           | This was pretty much my experience as well. I didn't feel
           | high or up when taking adderall. It was almost unnoticed
           | while on it, but reflecting back on what I was able to
           | accomplish during the day it clearly had an impact. After
           | taking it for close to a year, I just stopped cold turkey and
           | had zero issues with any withdrawal symptoms.
           | 
           | My brother has been known to take adderall recreationally.
           | Apparently he would crush it up and snort it. He definitely
           | gets a high from it. I'm not sure how much the difference in
           | our experience is due to the delivery method versus
           | differences in how our bodies processed it.
        
         | faeriechangling wrote:
         | Hmm, I've become less and less sceptical over time simply
         | because I've seen the research on how medicating those with
         | ADHD drops all cause mortality enough to extend lifespan by
         | several years. It's possible there's overdiagnosis even still
         | but I think people overestimate the potential scale of it, 25%
         | overdiagnosis seems plausible to me but people act like ADHD is
         | just all made up and a way to drug children into being study
         | zombies because they act too much like typical children. It's
         | profound how often people diagnosed with ADHD, when off
         | medication, will just kill themselves accidentally in car
         | accidents and drug overdoses far more than the general
         | population.
         | 
         | ADHD is not just labelling children with being disordered for
         | being children. It's labelling like the most inattentive,
         | dysregulated, and hyperactive 5% or so of children. Children
         | that act like 5 year olds when their peers act like 7 year
         | olds. ADHD has been observed for centuries as well. ADHD in
         | women tends to be diagnosed later in life and if you study
         | certain subpopulations of women like teen mothers you will trip
         | over ADHD and the diagnostic gap narrows with age.
         | 
         | There's also evidence like.. from the OP where we can observe
         | neurological differences. I think my main problem with ADHD is
         | labelling something that's probably evolutionarily adaptive
         | (People with ADHD love having unprotected sex early in life) as
         | a disorder and deficit, but this gets into the philosophy of
         | medicine.
         | 
         | Dr. Russell Barkley is a good source of information and
         | champion of the scientific mainstream view of ADHD.
        
         | pornel wrote:
         | There is a huge difference between the common stereotype of
         | ADHD (just rowdy children who can't sit still), and actual
         | symptoms and diagnostic criteria. The difference is almost as
         | comically warped as an image of a "hacker" in media vs actual
         | hackers.
         | 
         | ADHD includes many other things like weak short-term memory,
         | defunct perception of time, hard to control hyperfocus,
         | overwhelming inner monologue, and executive dysfunction that
         | makes some tasks physically impossible to start even when the
         | person wants to do them. And it comes with a bunch of other
         | comorbidities. Doctors diagnosing ADHD also have obligation to
         | exclude other causes of the symptoms, like bipolar.
         | 
         | The stimulant medication does not actually cause stimulation in
         | people with ADHD. When people have a deficit/insensitivity to
         | the neurotransmitters, the meds merely bring them up from a
         | dysfunctional level where the brain lacked ability to function
         | properly to the normal-ish level.
        
           | bluefirebrand wrote:
           | I really like that you list a whole lot of things that ADHD
           | includes that most people are unaware of, but I wanted to
           | call attention to the two that probably had the largest
           | negative impact on my own life
           | 
           | Rejection Sensitivity and Emotional Disregulation
           | 
           | I have always been paralyzed by being afraid of failure
           | (rejection), and that has kept me from pursuing a lot of
           | things in the past
           | 
           | And I've always been prone to anger outbursts, even over
           | seemingly trivial silly things. It has damaged so many of my
           | relationships and overall left me pretty lonely throughout my
           | life. And when the dust settles I'm sitting there thinking
           | "Why was I so angry about that thing. I don't even care that
           | much about it"
           | 
           | My ADHD diagnosis and medication, starting in my early 30s,
           | has almost entirely turned my life around
        
             | weweersdfsd wrote:
             | I wonder if the symptoms you described can be also
             | explained by being on autism spectrum. And then there's
             | generalized anxiety disorder - a common comorbidity with
             | ADHD, which could also cause worrying about failure.
             | 
             | I fairly certain I have either ADHD, autism, or probably
             | both, and have existing diagnosis pointing to being
             | "neuroatypical". But coming up with exact diagnosis seems
             | to be pretty difficult, because many other diagnosis can
             | explain specific symptoms.
        
               | teamonkey wrote:
               | It's possible, sure. There's a blurry line between ADHD
               | and autism, and ADHD is often comorbid when diagnosed
               | with autism.
               | 
               | I would say, though, that ADHD medication _can_ help with
               | rejection sensitivity disorder and help regulate some
               | emotional stress on top of the more well-known ADHD
               | symptoms. Practically speaking, it doesn 't matter where
               | it comes from if it can be treated.
        
               | bluefirebrand wrote:
               | It definitely is.
               | 
               | For ADHD in particular I think you have to zero in on
               | executive function. It does bring along a lot of friends,
               | but poor executive function is absolutely the keystone of
               | any ADHD diagnosis
               | 
               | If you don't struggle with that, then you can probably
               | safely eliminate it as a suspect... Or at least put it
               | much lower on the list
        
             | itp wrote:
             | Thank you both for adding these comments. I'm older than
             | you, mid-40s now, and I'm _just_ starting to get treatment
             | for ADHD after a lot of unnecessary struggles.
             | 
             | I'm sure that people like the root of this thread mean
             | well, but at the same time that attitude is exactly what
             | kept me from receiving treatment or care when I was
             | younger.
        
         | lawlessone wrote:
         | I have started on Ritalin in my 30's.
         | 
         | I have to say the first time I took I suddenly felt very calm.
         | Noises from neighboring apartments, dogs barking, children
         | outside playing ceased to be annoying distractions.
         | 
         | I took 5mg to be precautious. And spent hours doing an overdue
         | cleaning my room / apartment. And i felt ok doing it when
         | normally i'd feel irritated. Normally i'd have trouble deciding
         | where to start this, but with this i just started.
         | 
         | I started properly paying bills. To be clear i had the money to
         | pay these bills. But i would always tend to leave them until I
         | was getting notices to remind me.
         | 
         | Vyvanse was interesting though. It made me a lot more
         | assertive, when most people would describe me as the opposite.
         | I liked that but it was double edged sword. I stopped because I
         | was working as sales assistant in a shop and I found I was
         | getting just a bit too angry at belligerent customers.
        
         | rayiner wrote:
         | We've been prescribing amphetamine salts since the 1950s, and
         | Adderall specifically since the 1990s. It's extremely well
         | studied at this point.
         | 
         | Obviously we don't give kids the doses college students might
         | take for cramming. Stimulant sensitivity varies quite widely in
         | the population--a dosage that might be appropriate for a
         | particular child may make an adult feel "wired." But there's a
         | lot of science showing that Adderall in appropriate doses is
         | neither habit forming nor do people develop a resistance to it
         | (which is what typically causes escalating usage).
        
         | fatnoah wrote:
         | > My wonder is when does it to go from a kid just being a kid
         | to a child actually affected by ADHD
         | 
         | That's the multi-billion dollar question. From grades K-3, my
         | son got straight A's and was a typical "boy" in the classroom.
         | Occasionally not the best at paying attention, but no big deal.
         | 
         | Fourth grade was another story. He'd come home exhausted, and
         | cry himself into a nap nearly every day. Not coincidentally,
         | that's what the academics shifted from pure memory, associative
         | reasoning, and recall to tasks that also required planning and
         | executive function. That, plus the expectations of better
         | ability to sit still and pay attention were just too much.
         | 
         | We eventually paid the big $$$ for a full, two-day neuro-psych
         | evaluation. It was eye-opening for both my wife and I. For me,
         | it showed how differently my son's brain was working, and for
         | my wife it shined a light on her undiagnosed ADHD.
         | 
         | We did resist giving our son medication, and waited until he
         | decided that he wanted to try it (16 years). It made an amazing
         | difference in his ability to study and stay on task, but it did
         | come with the weight loss and a serious 4-6pm crash every day,
         | though those effects seemed to mitigate over time.
        
           | faeriechangling wrote:
           | >We did resist giving our son medication, and waited until he
           | decided that he wanted to try it (16 years)
           | 
           | I sincerely think this is a good thing to do and gives people
           | a healthier relationship to mental health than being coerced
           | into taking drugs with harsh side-effects.
        
       | ryandvm wrote:
       | > They found that youth with ADHD had heightened connectivity
       | between structures deep in the brain involved in learning,
       | movement, reward, and emotion (caudate, putamen, and nucleus
       | accumbens seeds) and structures in the frontal area of the brain
       | involved in attention and control of unwanted behaviors (superior
       | temporal gyri, insula, inferior parietal lobe, and inferior
       | frontal gyri).
       | 
       | So... ADHD is a symptom of an overly integrated brain.
       | 
       | Not going to lie - I've always been kind of fond of my mild ADHD.
       | There's something enjoyable about being interested in
       | _everything_ going on around you (or in your head). It just
       | happens to be a liability in schools or jobs where you 're only
       | supposed to be doing "just this one thing".
        
         | qpingo wrote:
         | All quirky fun and games until you realize you can't do high-
         | paying jobs that requires consistent focus. Which is not really
         | a problem unless you want a family or to live in nice parts of
         | cities.
        
           | techcode wrote:
           | There's a lot of high-paying tech jobs that can be playing
           | into ADHD (and other not neuro typical brains) strengths and
           | focus thats more like running 42 1km "sprints" than mostly
           | consistent pace 42km marathon.
           | 
           | Things that come to mind are data science/analysis, debugging
           | and fixing outages (finalizing follow up RFO might be hardest
           | part ), security/hacking (hopefully white hat)...
           | 
           | And basically whatever else one personally finds interesting
           | to dig into deep and/or wide.
        
           | whoknowsidont wrote:
           | >All quirky fun and games until you realize you can't do
           | high-paying jobs that requires consistent focus.
           | 
           | This is not a good understanding of ADHD. People with ADHD
           | have hyperfocus tendencies, and this in fact can apply to
           | their job while they ignore everything else.
           | 
           | That is to say extremely successful people might be that way
           | BECAUSE of their ADHD, not in spite of it. A programmer who
           | devotes the majority of their life to learning their craft,
           | or an artist who spends all their attention on their next (or
           | first) hit album.
           | 
           | But it's an even worse understanding of what high-paying jobs
           | actually require.
        
         | oldstrangers wrote:
         | This tracks with my own theory on ADHD. It often times feels
         | like a super power when it isn't ruining your life. If you
         | manage it, it's remarkable. Left to its own devices, it's
         | debilitating. When I was younger I tried to medicate the issue
         | away, and then eventually came to the realization that I was
         | doing more harm than good. So I learned to appreciate myself as
         | just "different" as opposed to "dysfunctional".
         | 
         | Perhaps there's some evolutionary advantage to these 'mental
         | disorders' that'll make sense when they're more fully formed in
         | another few hundred years.
        
           | el_benhameen wrote:
           | Have you found a good method for self-management?
        
             | Mkengine wrote:
             | Not OP, but for me the following combination works great:
             | 
             | - Obsidian for knowledge management to help with the
             | forgetfulness - Todoist to get the daily stuff done and
             | personal project management - Timetree to coordinate with
             | my wife and be able to plan ahead more than a week - any
             | alarm app for the critical stuff the next day
        
       | light_hue_1 wrote:
       | This is a no-op paper. They found nothing useful. Maybe an
       | inkling of something extremely weak. Maybe. Certainly nothing
       | that should be popularized, taken up by the media, or used to
       | make any decisions about anything.
       | 
       | The kicker is:
       | 
       | > Effect sizes were small (largest peak d, 0.15).
       | 
       | To put that into language more people here would understand, it's
       | like publishing a paper where your classifier gets 52% accuracy
       | on a binary task (this is the zeroth order equivalent of a
       | Cohen's d of 0.15), but you run it over so many ADHD patients
       | that your confidence interval for that 52% accuracy is very
       | small. Most people would still ignore it because it's likely
       | still noise from other small confounds.
       | 
       | That is a paper that you should not put your name on. I certainly
       | would not. Their effects are also more like 0.11 not 0.15; the
       | largest peak misrepresents all of the rest of the results.
       | 
       | What they did is aggregate so much data that even a small
       | inconsequential difference between groups that may account for
       | nothing at all, that would go away with slightly different
       | controls for confounds, becomes statistically significant.
       | 
       | A lot of the comments here drawing conclusions like, ADHD is
       | about an overly integrated brain or whatever are really
       | frightening. This means nothing. Science communication at its
       | worst.
        
         | bookofjoe wrote:
         | What does "no-op" mean?
        
           | bookofjoe wrote:
           | >That is a paper that you should not put your name on. I
           | certainly would not. Their effects are also more like 0.11
           | not 0.15; the largest peak misrepresents all of the rest of
           | the results.
           | 
           | >What they did is aggregate so much data that even a small
           | inconsequential difference between groups that may account
           | for nothing at all, that would go away with slightly
           | different controls for confounds, becomes statistically
           | significant.
           | 
           | >A lot of the comments here drawing conclusions like, ADHD is
           | about an overly integrated brain or whatever are really
           | frightening. This means nothing. Science communication at its
           | worst.
           | 
           | Here are the paper's authors' affiliations:
           | 
           | Office of the Clinical Director, NIMH, Bethesda, Md. (Norman,
           | Shaw); Section on Neurobehavioral and Clinical Research,
           | Social and Behavioral Research Branch, National Human Genome
           | Research Institute, NIH, Bethesda, Md. (Sudre, Price, Shaw).
           | 
           | It's hard for me to believe that the authors should not have
           | put their name on this paper.
           | 
           | Do you have a background and credentials as valid?
        
             | light_hue_1 wrote:
             | > Do you have a background and credentials as valid?
             | 
             | I do. But we live in a world where people write you letters
             | for promotion, review your grants, etc. Using your own name
             | to say these things in public is bad for your career. So
             | I'd rather not.
             | 
             | Plenty has been said in scientific publications about how
             | junk like this leads to most papers being false, how we
             | shouldn't do statistics this way, etc. Scientists know, but
             | it hasn't been communicated to the public yet.
             | 
             | That being said, the beauty of science is that you don't
             | need to see my CV.
             | 
             | A basic understanding of what Cohen's d is, or a simple
             | translation (with some heavy assumptions) into accuracy as
             | I provided, is enough to see that the paper is total trash.
             | They found nothing, but they found it at huge scale, so the
             | p value was very small.
             | 
             | By no-op I mean that it contributes nothing and means
             | nothing. It's a waste of time for everyone. In a world were
             | bean-counting publications wasn't how science was measured,
             | I'm sure the authors would never have considered even
             | writing this up worthwhile, never mind submitting it.
             | 
             | The term comes from assembly which often has a no-op
             | instruction https://en.wikipedia.org/wiki/NOP_(code)
             | Something that does nothing (although, that nothing may be
             | critical depending on the instruction set).
        
           | Implicated wrote:
           | Waste, space/time/etc.
        
             | bookofjoe wrote:
             | I still don't understand how "no-op" translates to "Waste,
             | space/time/etc." Help!
        
           | tech_ken wrote:
           | "No operation"; in machine language it's an instruction that
           | doesn't do anything, in broader tech lingo it's something
           | that's moot or which requires no work. Commenter is basically
           | saying that nothing actionable can be concluded from the
           | paper's findings.
        
           | cpburns2009 wrote:
           | No-op is computer jargon for "no operation". It comes from
           | CPUs having instructions (or commands) that do effectively
           | nothing. Programming languages sometimes use the no-op term
           | for functions (or procedures) that are placeholders that do
           | nothing. These placeholder functions can be replaced later
           | and perform some action. TL;DR: A "no-op" is something that
           | does nothing, or as used by the parent, a paper that doesn't
           | contribute anything.
        
         | rmbyrro wrote:
         | https://chat.openai.com/share/37623c40-fe0e-4a5a-a973-75b7c8...
         | 
         | ChatGPT gave me a more balanced view to understand OP's
         | criticisms. Sharing if anyone would like to read a more
         | dispassionate (machine) version.
        
       | improv wrote:
       | As mentioned by light_hue_1:
       | 
       | > Effect sizes were small (largest peak d, 0.15).
       | 
       | It also doesn't look like they considered what effect a daily
       | prescription of ADHD medications might have on brain connections
       | versus the inherent condition itself.
        
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