Caution is needed with any of the diagnostic manuals such as Merck’s, the DSM, or any other “manual”. Those works often represent high science but they come with “pre-understanding” directed at solving a problem with a toolkit.
Any human behavioral pattern such as ADHD results from individuals operating in a society and interacting with an environment. Change any part of the three areas and the result will be different, often in a disturbing way.
For example, I have seen rural families in Mongolia move into one of the few urban environments. Life on the steppes is a hard existence is animal herding. Children grow up free to roam in the outdoors and expend countless energy running and playing. Put them in a classroom or shopping mall in Ulaanbaatar and disaster strikes. The children simply go wild with energy but now in a confined space. For sure they would be classified as ADHD if such a model is even of interest in Mongolian society.
As the world moves towards 60%+ urbanized, we need to move beyond clinical models built on an 19th and 20th Century industrial medicine. Perhaps we should start asking how to develop urban environments that are suitable for hunters and gathers.
Caution is needed with any of the diagnostic manuals such as Merck’s, the DSM, or any other “manual”. Those works often represent high science but they come with “pre-understanding” directed at solving a problem with a toolkit.
Any human behavioral pattern such as ADHD results from individuals operating in a society and interacting with an environment. Change any part of the three areas and the result will be different, often in a disturbing way.
For example, I have seen rural families in Mongolia move into one of the few urban environments. Life on the steppes is a hard existence is animal herding. Children grow up free to roam in the outdoors and expend countless energy running and playing. Put them in a classroom or shopping mall in Ulaanbaatar and disaster strikes. The children simply go wild with energy but now in a confined space. For sure they would be classified as ADHD if such a model is even of interest in Mongolian society.
As the world moves towards 60%+ urbanized, we need to move beyond clinical models built on an 19th and 20th Century industrial medicine. Perhaps we should start asking how to develop urban environments that are suitable for hunters and gathers.