ADHD in the DSM-5-TR: What has changed and what has not

In this opinion paper, we critically review the changes made to the DSM-5 Text Revision published in 2022 regarding the diagnostic entity of Attention Deficit / Hyperactivity Disorder (ADHD). We structure our critique around three points. The first discusses the acknowledgement of ADHD as a neurodevelopmental disorder. The second examines the definition of ADHD provided in the updated edition of the manual. The third scrutinizes the changes in the diagnostic criteria for ADHD and assesses whether these changes make the diagnosis more accurate. We point out how DSM-5-TR keeps the faith in the neo-Kraepelinian paradigm by explicitly and implicitly cultivating the essentialist medical scientific metaphor of disorder.In this article, we critically review the changes made to the DSM-5 Text Revision published in 2022 regarding the diagnostic entity of Attention Deficit/Hyperactivity Disorder (ADHD). We structure our critique around three points. The first discusses the acknowledgment of ADHD as a neurodevelopmental disorder. The second examines the definition of ADHD provided in the updated edition of the manual. The third scrutinizes the changes in the diagnostic criteria for ADHD and assesses whether these changes make the diagnosis more accurate. We conclude that DSM's latest edition does not escape the logical and scientific pitfalls of its predecessor. DSM-5-TR keeps the faith in the neo-Kraepelinian paradigm by explicitly and implicitly cultivating the essentialist medical scientific metaphor of disorder, creating the illusion that it represents scientific progress that validates ADHD as a neurodevelopmental disorder.Peer reviewe

The (Un)real Existence of ADHD — Criteria, Functions, and Forms of the Diagnostic Entity

The contemporary conceptualization of Attention Deficit Hyperactivity Disorder (ADHD) as a complex, multifactorial neurodevelopmental disorder cannot be understood as such without a complex assemblage of political, economic, and cultural processes that deem the conceptualization to be valuable and useful. In this article we use the notion of psychiatrization as a lens through which to see parts of these processes that make up ADHD what it is. In the first part of the article, we critically assess the scientific basis of the ADHD diagnosis via examining its diagnostic criteria as presented in the current fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM), the so called “Bible” of modern psychiatry. The second part of the article asks what is done with the ADHD diagnostic entity and with the idea that it represents a natural neurodevelopmental state within an individual—something an individual has—as represented in the DSM-5. Drawn from our previous research, we analyze how ADHD becomes real in discourse practice as a powerful semiotic mediator through analysis of the various functions and forms in which it takes shape in institutional, social, and individual levels. We conclude that the frequent changes in the diagnostic criteria of ADHD do not reflect any real scientific progress. Among other reasons, they change to match better the maneuvers of individuals when navigating an increasingly psychiatrized society in the search for recognition, support, category membership, immunity, sympathy, and sense of belonging.The contemporary conceptualization of Attention Deficit Hyperactivity Disorder (ADHD) as a complex, multifactorial neurodevelopmental disorder cannot be understood as such without a complex assemblage of political, economic, and cultural processes that deem the conceptualization to be valuable and useful. In this article we use the notion of psychiatrization as a lens through which to see parts of these processes that make up ADHD what it is. In the first part of the article, we critically assess the scientific basis of the ADHD diagnosis via examining its diagnostic criteria as presented in the current fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM), the so called “Bible” of modern psychiatry. The second part of the article asks what is done with the ADHD diagnostic entity and with the idea that it represents a natural neurodevelopmental state within an individual—something an individual has—as represented in the DSM-5. Drawn from our previous research, we analyze how ADHD becomes real in discourse practice as a powerful semiotic mediator through analysis of the various functions and forms in which it takes shape in institutional, social, and individual levels. We conclude that the frequent changes in the diagnostic criteria of ADHD do not reflect any real scientific progress. Among other reasons, they change to match better the maneuvers of individuals when navigating an increasingly psychiatrized society in the search for recognition, support, category membership, immunity, sympathy, and sense of belonging.Peer reviewe

The role of touch, hearing and olfaction in the construction and of cognitive maps by individuals with visual impairaments

The present doctoral dissertation explores the role of touch, hearing and olfaction in the construction of cognitive maps by individuals with visual impairments. The theoretical part of the dissertation includes a review of the fundamental terms used in the field of orientation and mobility and cognitive mapping. It also focuses on key concepts related to sensation, perception and memory. The theoretical part of the dissertation also reviews the existing literature regarding the role of remaining senses in the acquisition of spatial information by individuals with visual impairments.The research has been organized in three stages. The first research stage examines which haptic, auditory and olfactory cues individuals with visual impairments use most often and determines which of these cues these individuals deemed to be the most important for wayfinding in urban environments. It also investigates the ways in which these individuals use the most significant haptic, auditory and olfactory cues. The second research stage sought to examine the role of touch, hearing and olfaction in the cognitive mapping of an unfamiliar environment by individuals with blindness. The third research stage aimed at investigating the type of environmental attributes that individuals with blindness recall from their cognitive maps for familiar environments. To meet the research aims a mixed methodology was used, including a focus-group interview, questionnaires, closed-ended interviews and two spatial tasks.The findings reveal that individuals with visual impairments use several haptic, auditory and olfactory cues in various ways to orient themselves and navigate within urban environments. The findings also show that individuals with visual impairments use a variety of informational stimuli, picked-up through touch, hearing and olfaction to determine the nature and position of environmental attributes in an unfamiliar environment. Finally, the results indicate that the cognitive maps of blind individuals for familiar environments contain information about several environmental attributes that can be perceived through touch, hearing and/or olfaction during novel navigation

Reviewing and reframing the influence of relative age on ADHD diagnosis : beyond individual psycho(patho)logy

Attention Deficit Hyperactivity Disorder (ADHD) is a controversial phenomenon and the link between schooling and the burgeoning occurrence of ADHD diagnoses is problematic. This paper contributes to the discussion regarding the issue by providing a literature review of the evidence on the influence of relative age effect (RAE) on being diagnosed with ADHD. Firstly, the review presents a general cross-national trend for a positive association between relative age and the probability of being diagnosed with ADHD compared to peers, thus showing that the younger-in-class children are more likely to be diagnosed with ADHD. Secondly, this paper outlines and discusses the suggested explanations of the phenomenon as depicted in the reviewed literature. Finally, the paper proceeds to provide alternative frameworks for the explanation of the RAE on ADHD diagnosis that go beyond individual psychopathology and instead take into account the broader social, cultural and political contexts in which the phenomenon takes place.Peer reviewe