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2 years ago  ::  Jun 13, 2012 - 11:18AM #11
mindis1
Posts: 7,741

Jun 11, 2012 -- 5:10PM, Erey wrote:


Here is a study Mindis:


abcnews.go.com/Health/Healthday/story?id...



Thank you, Erey. Did you bother to read the study referred to at your link, or any of Barbaresi’s studies? I will be happy to discuss any of them with you. I spent some time yesterday reading his studies.


The article you linked to says, “By age 13, those taking medication had improved reading scores compared with children with ADHD who didn't receive the drugs”. What can you tell us about the group referred to here as “children with ADHD who didn’t receive the drugs”? What does one need to know about this group? Is this group demographically similar to the study group? Do you understand why demographic similarity between the two groups is a crucial factor in this study, and why having that information is crucial?


If you learned that the control group in this study was not only children who didn’t receive stimulant drugs for ADHD, but a large percentage of them were taking a variety of other psychotropic and other drugs and had a variety of not just other mental disorder diagnoses but serious medical conditions, would you say that is a proper control group for this study?

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2 years ago  ::  Jun 13, 2012 - 11:22AM #12
mindis1
Posts: 7,741

Jun 12, 2012 -- 11:47AM, Girlchristian wrote:


Jun 12, 2012 -- 4:37AM, DotNotInOz wrote:


It'd be the rare student who hasn't at some time or other put in an all-nighter aided by prodigious amounts of caffeine in order to prepare for a major exam or complete a paper.


The only difference I see between students using drugs to keep going today and the NoDoz and endless cups of coffee of my years as a college student is that a wider array of pharmaceuticals is available to contemporary students. They also probably have less hesitancy about using whatever drug seems most expedient for the situation, we've gotten to be so much a society of pillpoppers for whatever is deemed to be the need that a drug can fulfill.




When I was in my early 20's I was working two jobs, one from 7am - 3pm and the other from 3:15pm - 11pm with an hour drive to home each way. NoDoz enabled me to maintain that ridiculous schedule!



You guys are amateurs.


Obviously both of you were using these stimulants for their stimulant effect--the same reason the school students snort their addies--not because you had the idea that you were correcting some biochemical imbalance. Right?


I know for a fact that people can have multiple long periods of daily use of amphetamines or cocaine without adverse consequences, without even developing any significant amount of tolerance; and can have multiple occasions of ceasing such daily use of amphetamines or cocaine without any significant events, without needing to go to rehab, without needing to declare that one must abstain forever, etc., etc. Amphetamines are probably the most innocuous drug prescribed for “mental disorders”. Regular, self-limiting use of amphetamines, cocaine and other stimulants probably only shortens people’s life expectancy a little.

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2 years ago  ::  Jun 13, 2012 - 1:49PM #13
CharikIeia
Posts: 8,301

Jun 13, 2012 -- 11:18AM, mindis1 wrote:


Jun 11, 2012 -- 5:10PM, Erey wrote:


Here is a study Mindis:


abcnews.go.com/Health/Healthday/story?id...



Thank you, Erey. Did you bother to read the study referred to at your link, or any of Barbaresi’s studies? I will be happy to discuss any of them with you. I spent some time yesterday reading his studies.


The article you linked to says, “By age 13, those taking medication had improved reading scores compared with children with ADHD who didn't receive the drugs”. What can you tell us about the group referred to here as “children with ADHD who didn’t receive the drugs”? What does one need to know about this group? Is this group demographically similar to the study group? Do you understand why demographic similarity between the two groups is a crucial factor in this study, and why having that information is crucial?


If you learned that the control group in this study was not only children who didn’t receive stimulant drugs for ADHD, but a large percentage of them were taking a variety of other psychotropic and other drugs and had a variety of not just other mental disorder diagnoses but serious medical conditions, would you say that is a proper control group for this study?



What if, what if?


Erey, based on own experience, I'd recommend not walking that extra mile.


It doesn't pay. One side may be willing to compromise, while the other is not willing to lay down arms, but intent on shooting holes into whatever you present (see the "what ifs" above as a telltale sign).

tl;dr
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2 years ago  ::  Jun 13, 2012 - 2:00PM #14
CharikIeia
Posts: 8,301

Jun 13, 2012 -- 11:22AM, mindis1 wrote:


You guys are amateurs.


Obviously both of you were using these stimulants for their stimulant effect--the same reason the school students snort their addies... Right?



Well, I guess the stimulant effect is what the thread is about.


What about a very similar case: the abuse of painstillers among sport-active people?


It seems to be a widespread practice to pop some painstillers before doing sports, just 'prophylactically' or to suppress the body's natural warning signals that might make you not go to your limits.


www.aerzteblatt.de/archiv/66748 (for the German-reading audience)

tl;dr
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2 years ago  ::  Jun 13, 2012 - 4:49PM #15
mindis1
Posts: 7,741

Jun 13, 2012 -- 1:49PM, CharikIeia wrote:


Jun 13, 2012 -- 11:18AM, mindis1 wrote:


Jun 11, 2012 -- 5:10PM, Erey wrote:


Here is a study Mindis:


abcnews.go.com/Health/Healthday/story?id...



Thank you, Erey. Did you bother to read the study referred to at your link, or any of Barbaresi’s studies? I will be happy to discuss any of them with you. I spent some time yesterday reading his studies.


The article you linked to says, “By age 13, those taking medication had improved reading scores compared with children with ADHD who didn't receive the drugs”. What can you tell us about the group referred to here as “children with ADHD who didn’t receive the drugs”? What does one need to know about this group? Is this group demographically similar to the study group? Do you understand why demographic similarity between the two groups is a crucial factor in this study, and why having that information is crucial?


If you learned that the control group in this study was not only children who didn’t receive stimulant drugs for ADHD, but a large percentage of them were taking a variety of other psychotropic and other drugs and had a variety of not just other mental disorder diagnoses but serious medical conditions, would you say that is a proper control group for this study?



What if, what if?


Erey, based on own experience, I'd recommend not walking that extra mile.


It doesn't pay. One side may be willing to compromise, while the other is not willing to lay down arms, but intent on shooting holes into whatever you present (see the "what ifs" above as a telltale sign).



You sound disgruntled, Chari. You may always speak to me directly if you have some dispute about anything I’ve said.  


I didn’t raise any irrelevant issue about Barbaresi’s study, did I? Have you ever critiqued a study? Are you disinterested in scientific issues?


If you are interested in scientific issues, why don’t you try to answer the questions I asked? I would be interested in your answers.

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2 years ago  ::  Jun 13, 2012 - 4:57PM #16
mindis1
Posts: 7,741

Jun 13, 2012 -- 2:00PM, CharikIeia wrote:


Jun 13, 2012 -- 11:22AM, mindis1 wrote:


You guys are amateurs.


Obviously both of you were using these stimulants for their stimulant effect--the same reason the school students snort their addies... Right?



Well, I guess the stimulant effect is what the thread is about.



The kids are not prescribed their addies because they are in need of CNS stimulation. If you read the OP article you saw that the kids admit to lying to the docs in order to get their addies. The premise on which the docs prescribe the addies is something else entirely, a baseless delusion (fortunately profitable for the docs and drug companies). Why not just be honest about what’s going on? There is no evidence that amphetamines correct any biochemical imbalance.

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2 years ago  ::  Jun 13, 2012 - 5:19PM #17
CharikIeia
Posts: 8,301

Jun 13, 2012 -- 4:49PM, mindis1 wrote:


You sound disgruntled, Chari.



That's right, and I don't like myself that way.


I am sorry, shouldn't have written what I wrote. Your concerns are completely legitimate.



You may always speak to me directly if you have some dispute about anything I’ve said.



Not now, and not on this topic.



If you are interested in scientific issues, why don’t you try to answer the questions I asked?



To be honest, I AM disinterested in this particular scientific issue.



I would be interested in your answers.



Fair enough, and thanks for the interest...

tl;dr
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2 years ago  ::  Jun 13, 2012 - 8:50PM #18
REteach
Posts: 14,549

Dr. Barbaresi has certainly been busy--lots of publications in peer reviewed journals. 


Apparently the control group did not have comorbid mental health issues: " who were identified as having partially fulfilled research criteria for AD/HD (i.e., subjects who fulfilled one of the three criteria described above) or who had any of the following psychiatric diagnoses: severe mental retardation, pervasive developmental disorder not otherwise specified. autistic disorder, Asperger's disorder, any psychotic disorder."


They also mention :" Previously, we reported that there were no differences between our subjects with AD/HD who were treated with stimulants versus those not treated, both with respect to sociodemographic variables (maternal age and education, paternal age and education, parents' marital status at the time of the child's birth), presence of comorbid learning disability (LD) and/or psychiatric diagnoses, or duration of follow-up (median age at last follow-up was 18.3 years for treated and untreated cases)"


Maternal education had a huge impact on reading as well. 

I know you believe you understand what you think I said, but I am not sure you realize what you heard was not what I meant...
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2 years ago  ::  Jun 14, 2012 - 11:59AM #19
mindis1
Posts: 7,741

Jun 13, 2012 -- 8:50PM, REteach wrote:


Dr. Barbaresi has certainly been busy--lots of publications in peer reviewed journals. 


Apparently the control group did not have comorbid mental health issues: " who were identified as having partially fulfilled research criteria for AD/HD (i.e., subjects who fulfilled one of the three criteria described above) or who had any of the following psychiatric diagnoses: severe mental retardation, pervasive developmental disorder not otherwise specified. autistic disorder, Asperger's disorder, any psychotic disorder."


They also mention :" Previously, we reported that there were no differences between our subjects with AD/HD who were treated with stimulants versus those not treated, both with respect to sociodemographic variables (maternal age and education, paternal age and education, parents' marital status at the time of the child's birth), presence of comorbid learning disability (LD) and/or psychiatric diagnoses, or duration of follow-up (median age at last follow-up was 18.3 years for treated and untreated cases)"



What are these quotes from?


The study referred to in Erey's article is apparently here:  www.ncbi.nlm.nih.gov/pubmed/17700079. The method of identifying this group of “370 children with research-identified AD/HD from a 1976-1982 population-based birth cohort” is described in here:


Identification of ADHD incidence cases consisted of applying research criteria to the 1961 children (34% of the birth cohort) from our birth cohort who had any recorded behavioral or learning concerns. Subjects were defined as having research-identified ADHD if their school and/or medical records included various combinations of the following 3 different categories of information: (1) meets Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for ADHD; (2) positive ADHD questionnaire results21; and (3) clinical diagnosis of ADHD (with or without specific subtype) was documented. Details of information regarding those criteria as well as the identification process of subjects with ADHD were described elsewhere.15 A total of 379 ADHD cases were identified (Table 1).


pediatrics.aappublications.org/content/1...


Of this population of 379 “research-identified” cases of ADHD, 77.8% were prescribed stimulants:  www.ncbi.nlm.nih.gov/pubmed/16511362 .


Thus, in the study referred to in the article, the control group consists of the ~82 children (22.2%) who were not prescribed stimulants, and the study or treatment group is the ~288 children (77.8%) who were prescribed stimulants.


Barbaresi does not say in the abstract that the two groups are demographically matched. He does say that “sociodemographic risk factors, presence of comorbid learning or psychiatric disorders, and receipt of special educational services) were also examined and found to be associated with poorer outcomes.”  


In other studies he says that this population of 379 had high rates of “adjustment disorders, conduct/oppositional defiant disorder, mood disorders, anxiety disorders, tic disorders, eating disorders, personality disorders, and substance-related disorders”:  www.ncbi.nlm.nih.gov/pubmed/22647074, reading disorders (see above), and that there was an association with multiple exposures to procedures requiring general anesthesia before the age of 2: www.ncbi.nlm.nih.gov/pubmed/22305025 . More astonishingly, the control group was more likely than the treatment group to have epilepsy, and tended to have more frequent seizures: www.ncbi.nlm.nih.gov/pubmed/20399385


So, quite obviously this population, including the group of kids who were not prescribed stimulants, had a variety of mental disorder diagnoses and epilepsy. I know of no reason not to assume that these not-stimulant-prescribed children were taking other drugs. I have not seen where Barbaresi included or collected information on the other drugs used nor the medical conditions among this group.


It also needs to be understood that this population of 379 children, made up entirely of Rochester children born between 1976-1982, is not demographically representative of the US.


But in the end, none of these problems with Barbaresi’s study really matter, because the “improvements” in reading scores and drop-out rates that Barbaresi claimed for the stimulant-prescribed children are nothing. Barbaresi describes these “improvements” in the abstract thus:


There was a modest positive correlation (r = .15, p = .012) between average daily stimulant dose and last reading score. Cases treated with stimulants were 1.8 times less likely to subsequently be retained a grade (95% confidence interval: 1.01-3.2; p = .047). 


In other words, these two single “improvements” are trivialities. The important facts are:


‘‘The average reading score at the time of the last assessment was similar between the groups of cases that were treated versus not treated with stimulant.’’ ‘‘The proportion of school dropout was similar between treated and not treated cases.’’


www.plosone.org/article/fetchObjectAttac...


So, we’re back to the question I asked you in the beginning:  You don’t know of any scientific evidence that taking amphetamines improves anyone’s grades in the long term, do you?  Barbaresi’s studies fail to provide any such evidence.


BTW, how about if we restrict ourselves to studies that are not industry-sponsored, since we know that industry-sponsored studies are so often just junk.




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2 years ago  ::  Jun 19, 2012 - 3:40PM #20
mindis1
Posts: 7,741

Well, it seems no one is able to defend Barbaresi’s study. And apparently no one disputes that there is no evidence that anyone diagnosed with ADHD has a biochemical imbalance, and that there is no evidence that amphetamines correct any biochemical imbalance.


Above, I asked: Why not just be honest about what’s going on? It was and is a quite sincere question. I wouldn’t say it’s a sign of mental health to lie to oneself and to others about the reasons for one’s drug-taking or drug-pushing.


There is no evidence that people diagnosed with ADHD have a biochemical imbalance, and there is no evidence that amphetamines and other stimulants correct any biochemical imbalance. If there were evidence that ADHD and other behaviors labelled "mental disorders" are caused by biochemical imbalances, then it only raises the issue of why these mental disorders are neither defined nor diagnosed on the the basis of objective measurements of these biochemical imbalances.


What is the problem with just being honest about these facts?

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