Help for young troublemakers: early prevention instead of psychotropic drugs

Abstract

In recent years, no diagnosis has been discussed as much, as intensely, and as controversially worldwide as attention-deficit/hyperactivity disorder (ADHD), both in professional circles and among the general public. The discussion is particularly contentious because many of the affected, predominantly male, children are conspicuous not only because of pronounced concentration difficulties and motor restlessness but also because of severe antisocial behavior. They behave so aggressively that they can hardly be socially integrated and therefore cannot make use of educational opportunities in kindergarten and, even more so, in school for their development. ADHD spreads regardless of social background: for some it blocks upward social mobility, while others are threatened with downward mobility. In contrast to behavioral therapists, psychoanalysts emphasize that attention deficit and hyperactivity should be understood as symptoms rather than as a uniform diagnostic entity, let alone a disease. ADHD can be caused by very different factors, including organic brain problems, traumatic experiences, growing up with physically or mentally ill parents, early emotional neglect, and in some cases even giftedness. To understand precisely the individual background leading to ADHD, a descriptive diagnosis as made using common diagnostic manuals (ICD-10, DSM-IV) is often insufficient. A precise understanding of the specific causes of AD(H)D is the prerequisite for deciding which educational, therapeutic, or medical approaches are most likely to help a particular child. Medication is only one of many options and should be considered only after thorough psychological and medical assessment.