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I understand ADHD is a standard term, but I'm still a bit suspicious that it's not a useful one; Psychiatry doesn't seem like the most reliable field.

Are there good reasons for picking out the behaviors associated with ADHD and giving them a name?

Potential answers

  • Behaviors associated with ADHD strongly cluster
  • Analyzing questionnaires of attention and focus behaviors with factor analysis naturally produces an 'ADHD dimension' that explains a lot of variance (similar methodology to identifying Big 5 personality traits).
  • ADHD diagnosis is a strong independent predictor of something interesting: income or grades or some contrived but interesting lab test (controlling for obvious things like IQ)
  • Something else along these lines.
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It's certainly fine to be dubious of such things, and I don't necessarily disagree with you, but it would make your question stronger if you had some sources to back up your initial claims. – Chuck Sherrington Nov 16 '12 at 4:50
Except for my claim that ADHD is a standard term, everything else is based on vague impressions, so I think lack of sources gives my question the right amount of credibility. – John Salvatier Nov 16 '12 at 16:14

2 Answers 2

Like all psychiatric disorers, ADD and ADHD are diagnosed using a set of criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, or DSM

The latest version is the DSM-IV-TR. The DSM-V is due out in 2013 and may change these criteria.

Diagnosis is expected to be done by a licensed professional who is able to assess these criteria.

From :

(need 6 of 9)

- often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
- often has difficulty sustaining attention in tasks or play activities
- often does not seem to listen when spoken to directly
- often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (no if oppositional behavior or doesn’t understand instructions)
- often has difficulty organizing tasks and activities
- often avoids, dislikes, or is reluctant to engage in tasks or activities that require sustained mental effort (such as schoolwork or homework)
- often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
- often easily distracted by extraneous stimuli
- often forgetful in daily activities

(need 6 of 9)

- often fidgets with hands or feet or squirms in seat
- often leaves seat in classroom or in other situations in which remaining seated is expected
- often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
- often has difficulty playing or engaging in leisure activities quietly
- is often "on the go" or often acts as if "driven by a motor"
- often talks excessively
- often blurts out answers before questions have been completed
- often has difficulty awaiting turn
- often interrupts or intrudes on others (e.g., butts into conversations or games)


- Present at least 6 months, maladaptive and inconsistent with development level
- Some symptoms that caused impairment were present before age 7
- Some impairment from the symptoms is present in two or more settings (e.g., at school {or work} and at home)
- There must be clear evidence of clinically significant impairment in social, academic or occupational functioning
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None of this answers the original question: Do these traits tend to cluster strongly? Is there reason to believe that they share an underlying etiology? etc. – octern Nov 16 '12 at 21:15
The original question is "How well defined is ADD/ADHD?" The bit about traits clustering together is listed as a potential answer. There's also nothing in there about etiology. – Jeff Nov 16 '12 at 21:19
You're right, my mistake. I was thinking about the other question in the post, "Are there good reasons for picking out the behaviors associated with ADHD and giving them a name?" – octern Nov 17 '12 at 1:49
you're right though, that this isn't the best answer. it doesn't address how criteria for the DSM are chosen. my understanding is that this processes is subjective and controversial, but maybe someone can provide a more detailed explanation. – Jeff Nov 17 '12 at 2:06

Why the symptoms were picked out and given a name

Professionals used to believe ADHD was something children grew out of, but not anymore. ADHD has always been strongly related to school performance. If a child is not focused on school, and seems unwilling or unable to concentrate, everyone tends to think of ADHD as the cause.

This makes me think that ADHD was "discovered" as an explanation to why some kids are not so good at school. If you look at the symptoms for ADHD, you'll notice that each of them is completely normal behavior, but every one of them reduces performance at school.

Do the symptoms for ADHD cluster?

Yes and no. They cluster in more than 1 cluster. Studying personality psychology, I have noticed a growing number of completely normal personality traits that remind me alot of ADHD.

A stereotypical boy with ADHD (restless, fidgety, takative, forgetful, unorganized) would easily remind you of the MBTI personality type ESxP. (ESFP: ESTP: )

A stereotypical girl with ADHD (silent, daydreaming, inattentive) would remind you of the MBTI personality trait INxP. (INTP: INFP: ) Girl's ADHD:

Also note how the "boy's ADHD" and "girl's ADHD" are pretty different. The only common traits are poor attention and organization at school.

The typical ADHD behavior also matches well with several parts of the Big 5:

Substantial effects emerged that were replicated across samples. First, the ADHD symptom cluster of inattention-disorganization was substantially related to low Conscientiousness and, to a lesser extent, Neuroticism. Second, ADHD symptom clusters of hyperactivity-impulsivity and oppositional childhood and adult behaviors were associated with low Agreeableness.

Although previous research on personality and ADHD has focused primarily on extraversion and neuroticism, the present study found that agreeableness and conscientiousness were stronger predictors. This pattern of results is consistent with the clinical literature on adults with ADHD.

Conscientiousness is what measures your ability to stay focused (and more), and neuroticism measures your patience (and more). And those are exactly what primarily defines the J/P factor in MBTI - and ADHD. You're a P? Congratulations, you may have ADHD. You're a J? Nope, no ADHD there.

Additionally, several of the required symptoms for ADHD do not have any fixed requirement for frequency - they are relative. When each of these symptoms are completely normal at the same time, the whole diagnose becomes relative - Are you too unfocused to function at school, or do you manage to get your homework done despite of poor attention? Because nobody will diagnose you with ADHD as long as you are able to cope and function with school and everyday life. A bit of the problem with the ADHD diagnosis is how there are no exact measurements that can tell whether or not an individual is "suffering".

Having a hard time in everyday life is also one of the requirements to have a diagnosis, but this is more relative than all the other symptoms. Considering how modern societies are increasingly demanding for the individual, and Conscientiousness is -the- strongest predictor for academic success, there is bound to be a growing gap between the most and least successful individuals. The least successful individuals are those who struggle to stay focused, and some of these seek psychological help for it. "You struggle at school because you have trouble staying focused? Here, take this test. Yes, I can see that you have poor attention. You have ADHD"

To put it short: ADHD symptoms are all about academic capability

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