For nearly twenty years, terrified accompany the increasing pace of new phrenology of mental disorders. Specifically, the development of that part of psychiatrists and neuropsychologists call Disorder Attention Deficit Hyperactivity Disorder, ADHD. In the U.S., about 1.5 million children diagnosed with ADHD were being treated with psychostimulants (methylphenidate) in 1996. An increase of 2.5% between 1990 and 1995 reveals an explosion in the series, featuring epidemic proportions. This framework drew the attention of public health policies and the American Congress, attracting vehement discussions on psychosocial aspects. Only in 1995, half a million children between 3 and 6 years received prescriptions for Ritalin (brand name methylphenidate), according to estimates from the American Psychiatric Association. The medicalization of ADHD, however, increased much in recent years. The American Psychological Association in June 2001 in the journal Monitor on Psychology1, reports that more than two million prescriptions for Ritalin are made each year, a staggering rate of 4 children per minute. Both that institution, as the American Academy of Child Psychiatry and Adolescent recognized the need for greater accuracy in diagnosis, recommending to the specialists who were not based only on surveys of symptoms or complaints from parents and teachers.
In Brazil, the picture follows this alarming pace stride. Dissemination programs and treatment of ADHD have been created, with the premise that childhood hyperactivity is an organic disease that needs to be medicated by regular use of psychostimulants such as Ritalin and Concerta. What nobody points out is the fact that some of these research groups and clarification of the population are funded by pharmaceutical companies that manufacture the drugs indicated for the treatment. Any one can verify these potential conflicts of interest if you take time to search the internet. Janssen-Cilag companies, Elli Lilly, GlaxoSmithKline and Novartis, which market the drug Concerta, Straterra, Ritalin and Dexedrine, all widely used in the lucrative market for ADHD, fund clinical research associations who claim to follow, among the values \u200b\u200bthat guide their programs, research ethics and universal knowledge. view of what is considered an exaggeration diagnosis and exacerbated the incidence of errors in surveys, there is a clear indication that the diagnostic criteria for inclusion, obtained most of the instruments used - ICD-10, DSM-IV, Conners Scale - lack of specificity. A 1994 study in Joao Pessoa (PB) 2 for the validation of this scale in its Brazilian version, adapted from the original English version abbreviated Conners, for example, showed strong inconsistency. According to the survey results, the ability of respondents is questioned while validating the instrument. Disagreement between parents and teachers to identify a child as hyperactive and inattentive was considered a failure in their perceptual abilities. Failure perceptive parent is justified as arising from a lack of general knowledge for a good breeding due to factors psychosocial, and for teachers, it was felt that they lacked a good preparation psicopedagógica able to detect the height of such conduct. What was then the conclusion of the research? That the number of hyperactive children should be higher than what was obtained in the survey.
One of the conclusions that any student of psychology can do is consider unfounded attributed to the cause of hyperactivity disorders it neurological or biochemical, when the development context in which the child participates in is committed. The sample of several studies that adopt the medical model of the phenomenon, points to factors such as maternal depression, alcoholism, "nervous" as indicators of genetic predisposition to ADHD and not as psychosocial factors that affect emotional and cognitive development of children. Factors that inharmonies show on the life of that relationship and compromise the quality of socialized process in its various hues. In this situation, diagnose it as having a mental disorder (ADHD) is saying that all behavior is the result of a brain that is not working properly, eliminating any environmental influence in the way of being and acting in the world.
Valente (1998) 3, in his doctoral thesis, draws attention to the trap of neofrenologia disorders mental, facilitated by the use of sophisticated neuroimaging techniques. States that findings of morphological or metabolic in samples of people with the disorder need to be interpreted as evidence of trends and not as evidence of a causal relationship. In this sense, the declaration of Maryland, National Institutes of Health Consensus Conference on Attention Deficit Hyperactive Disorders 1998, continues today: "Until now, we do not have a diagnostic test for ADHD (biochemical, physiological, anatomical, genetic, etc. .), so the validity of the disorder remains a problem. " The term ADHD
applied the children's behavior, not suitable for transforming a dynamic process in static phenomenon. Thus, behavioral modes of expression as "talking too" and "not quiet in the chair" instead of defining an activity between persons or between a person and the environment, lose their meaning and become relational in category "hyperactivity" DSM-IV. This abstraction of a dynamically interactive system that allows such behavior is reified, making them capable of cataloging a nosologic tight, as is done in the DSM-IV and ICD-10. You lose any uniqueness of human behavior to the individual to be diagnosed and medicated.
Both diagnostic aspects related to the inclusion of intensity due to issues such as, for example, "hubbub over" as the distinguishing features due to comorbidities, confuse the diagnosis and treatment. But the etiology, physiology, neurology, assessment and diagnosis of ADHD, there is no consensus on any part of the globe. There seems to be in harmony only one item of all this controversy: the appointment of psychotherapy in treatment. Advocates of medical models and models of psychosocial phenomenon to argue for a good resolution of hyperactivity and inattention. But unlike that boast groups and associations of Attention Deficit is not a necessary condition is that the CBT-Cognitive Behavioral Therapy. These groups are affiliating psychologists around the country, based on the false premise that only the CBT can help in reducing hyperactivity in children. By way of demonstration, let us search for Gorodscy (1991) 4. Under the reference of psychomotor relational, 22 children diagnosed with Attention Deficit Disorder with Hyperactivity, ADHD (abbreviation for the time of the study) were evaluated psychologically. It is observed that none was using medication. In this approach, conceives that hyperactive children use their bodies as "communicative expression." All children in the sample showed the experiences of discomfort and pain in their relationships. Ill-treatment, expulsions from school and several charges were common in their lives. In his own regard, some children wandered from one pole to another concept of Manichean be good or bad was a source of constant anxiety. As for the initial emotional development, the research highlighted the negative aspects of socializing process, such as: feelings of insecurity, poor reliability and continence. Of the 13 children who could attend the sessions and individual psychotherapy weekly for a period of six months to a year, all showed a reduction of hyperactivity, increased school performance and improvement in the psychic organization. The results were considered as strong evidence for the origin psychodynamics of the syndrome in healthy children hyperactive.
However, under the caption of that society is uninformed about the disorder, drug companies and their associations generate evidence to prove that inattentive and hyperactive children suffer from an organic disorder, the treatment is easy and is available to all , just reach out and swallow.
Monica Lavoyer Squire is a clinical psychologist and teacher in Social Psychology, UERJ (2001).
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