‘An unfortunate picture of ADHD in the debate’

There is no sharp line separating people who should receive an ADHD diagnosis from those who should not, but substantial knowledge about ADHD can still help people with serious needs, four Swedish researchers argue.

In a debate article, Markus Heilig, Martin Ingvar, Paul Lichtenstein and Mikael Landén say discussion of ADHD diagnosis and treatment is important but complex. They criticize what they describe as ideologically driven voices dominating media coverage. Claims that ADHD lacks a basis, or has nothing to do with brain function or heredity, are often presented as general arguments against diagnosis and treatment, they write.

The authors accept that a diagnosis is not a physical object and cannot rest on minor brain-structure differences found at group level. But they say those points are often used to support a broader criticism that most experts do not share.

They compare ADHD-related traits with characteristics such as height and weight, where people fall along a spectrum and genetic factors contribute to differences. The specific DNA variants involved can be difficult to identify, although researchers have made progress. The authors say genetic influence on height appears to account for about 80 percent of individual differences in modern populations in countries similar to Sweden.

They also cite athletic explosiveness and speed, saying hereditary contribution is around 70 percent and pointing to pole vaulter Armand Duplantis as an example of athletic ability running in families. They argue that public understanding is weaker for functional abilities, including sustained attention and the ability to suppress spontaneous impulses, which depend largely on processes involving the frontal lobes.