How we overdiagnose ADHD

1/30/2014 02:16:00 PM
Over diagnosis of ADHD really isn't fair to people who actually have it.
On facebook, I got an ad sending me to this "ADHD screening quiz" where it asks a few questions like "How often do you have trouble siting still for long periods of time?" and spits out a score that supposedly indicates your likelihood of having ADHD, along with whether you should talk to a doctor.

I thought it would be informative for me to take the quiz. Not because I think I might have ADHD, but because I'm absolutely sure I don't--I am more or less the dead opposite of ADHD, capable of focusing and concentrating for long periods of time with very little effort. I'd say that few cases could be more clear-cut than mine. Yet, the test gave me a score of 10--we never learn what the scale was--and said that I was "ADHD possible" and that "it would be advisable for you to seek further diagnosis from a trained mental health professional." Um, no, it that would be the very definition of frivolous waste.

Obviously, the quiz was designed to tell almost everyone, if not everyone, that they might have ADHD--this was not a screening test but a Siren. I think that messages like these largely explain the over-diagnosis of ADHD in the US. ADHD can be quite hard to accurately diagnose, so we end up being overwhelmed by Bayes' theorem: if a relatively small percent of the population actually has ADHD, there is some small amount of innacuracy in the diagnosis, and tons of non-ADHD people are being sent to be tested for it, then we end up with a situation in which the vast majority of ADHD diagnoses are actually false positives.