Russell Barkley, “SCT” and “a new attention disorder”?

Slate.com published an article on 9-29-14 that assesses “sluggish cognitive tempo”,  potential new mh disorder.  The article is entitled “The Daydream Disorder: is sluggish cognitive tempo a disease or disease mongering?”  This article covers a lot of territory, including background about how mental health diagnoses become established as “official,” questions about whether “big pharma” is overly involved in establishing new diagnoses (and therefore able to market their products for them), and questions about whether some mh diagnoses pathologize relatively normal behavioral problems.

The author notes, “You’d probably call someone with SCT a daydreamer. Indeed, that’s one of the main symptoms, along with lethargy and slow mental processing.”

To cut to the chase, the article makes a case for viewing the efforts, championed by the psychologist Russell Barkley, to have SCT accepted as a new mh condition, as “disease mongering.”  The author describes 3 patterns that are typical of disease mongering:

  • Taking a normal function and implying that it should be treated.
  • Describing suffering that isn’t necessarily there.
  • Defining as large a proportion of the population as possible as suffering from the “disease.”

The author interviewed Dr. Barkley and provides some interesting quotes from him in support of SCT, which he now would prefer to call “concentration deficit disorder.”  The author also notes, however, ” Barkley says that people being diagnosed with SCT should not only meet a certain number of symptoms but should also be cognitively impaired. But arguably, he sets a low bar: In the adult study, Barkley judged people impaired if they rated themselves poorly in just 1 out of 15 functional “domains”—including things like home life, social interactions, and money management.”  And, “Barkley’s findings raise a red flag for some mental health experts, who fear that we’re in danger of pathologizing normal mental variation. “You’ve got to be very careful here,” says Jerome Wakefield of New York University, who studies the validity of psychiatric diagnoses. “This is the kind of disorder that parents will see in their kids—whether they have it or not.”

The article concludes with,” if millions of kids really are suffering from a clearly defined disorder, and there’s an acceptably safe drug that can help them lead more fulfilled lives, then by all means, let’s get it approved. But on the evidence presented so far, I’m not convinced. We don’t need millions of kids to be medicated merely because anxious parents have been persuaded that daydreaming is a medical condition. “

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