Category: uncategorized

This was written for Washington State University’s SOC-368 course. There are minor edits post submission here for readability.

Introduction

Being unable to focus on class, fidgety, and inability to sit still, might garner a diagnosis or overdiagnosis of attention-deficit hyperactivity disorder (ADHD). Yet the American Psychiatric Association, not to be confused with the American Psychological Association, defines mental disorders as reliant on comparison within a prevailing culture. This prevailing culture effectively includes those already drugged as treatments of choice in said disorders., such as stimulants for ADHD (e.g., Adderall, Ritalin etc.). It may be said, considering the American Psychiatric Associations’ acceptance of cultural benchmarks, that bars of performance are driven higher and higher under cultural influence of stimulants. This phenomenon herein is consolidated as drug-expectancy induced benchmark feedback. 

Found in the American Psychiatric Association’s (2013) Diagnostic and Statistical Manual, Fifth Edition is a cultural benchmark of human disorder: “thresholds of tolerance for specific symptoms or behaviors differs across cultures, social settings, and families” (p. 14), where these thresholds later determine “distress and disability” in the definition of mental disorders (p. 20). It is in this case that stimulant drug using groups (e.g., schools, races, ethnicities, societies, businesses, families, communities of practice etc.) themselves exhibit feedback loops in cultural thresholds used in the diagnosing of disorders. These benchmarks themselves, sociologically, are in themselves social facts pressuring individuals (i.e., strain) aspiring to greater levels of status (i.e., success, grades, merit, celebrity etc.), where incomplete understanding is run with to excess in promising the next big thing for success. The story of ADHD medication, and increasing benchmarks is not without precedent: consider the morally disengaged, euphemistically labeled (Bandura, 1999), “performance enhancers”.

A Parallel with Athletic Sports

During an Intelligence² Debate in 2008, Norman Fost of the University of Wisconsin argued for performance enhancers in sports, employing a technique of neutralization (Sykes and Matza, 1957), that Kalich (2001) titled everyone else is doing it adding “and getting away with it”. Fost argued that “everyone in this room using performance enhancing technology and drugs… every athlete in recorded history has used performance enhancing drugs. Babylonians and Romans used herbs to improve their performance in battle. Naked Greeks put on shoes to run faster, and runners everywhere carbo-loaded before races to enhance their performance” (as cited in Katz, 2008, 00:01:46). Who might this “everyone else” be in the case of ADHD? Is it those on ADHD drugs? 

In response to Fost, Richard Pound, former Chairman of the World Anti-Doping Agency lays an ethical claim against performance enhancers, “… and if everyone else is doing what they’re doing, then instead of taking 10g or 10cc of whatever it is, they’ll take 20, or 30, or 40, and a vicious circle simply gets bigger. The end game will be an activity that is increasingly violent, extreme, and meaningless, practiced by a class of chemical, or genetic mutant gladiators” (as cited in Katz, 2008, 00:05:21). And there it is, a feedback loop, and it has evidence in market economics, it’s called compounding—the stuff success is made of. Considering the parallel of competition sports, it may be worth pausing to consider the epidemiology of ADHD.

Epidemiology of ADHD

Shi et al. (2021) reported in meta-analysis, in children, an ADHD prevalence rate of 4.8% with an incidence rate of .69% (p. 4). What is striking however is that racial differences are significant, where 78% of children diagnosed are white, 32% are Asian, 6% are black, 9.1% are Hispanic, and 3% are “other” (p. 4). Even more curious is that 50% of the diagnosed come from the southern census region, where 68% come from household incomes above $75,000. While a 4.8% prevalence seems small, this prevalence is a national population statistic, where this prevalence varies significantly by locality and racial composition. Even more interesting is that ADHD drugs are now sold to more adults than children (Mosher & Akins, 2022, p. 108). While some adults self-report use of ADHD drugs for recreation, 12^thgraders in 2018 reported this at a 4.8% prevalence (as cited in Mosher & Akins, 2022, p. 109). This means that >95% of 12^th graders in 2018 used ADHD drugs for diagnosed conditions. Is it possible that there is something happening in white southern census regions? It’s time to “fact check” social facts of ADHD drug efficacy.

Are ADHD Drugs Going to Lose Angel Status?

According to a widely supported study of ADHD efficacy in the Journal of Consulting and Clinical Psychology, Pelham et al. (2022) concluded:

Stimulant medication had no detectible impact on how much children with ADHD learned from three types of evidence-based, academic curriculum units taught in small groups in a summer classroom setting. These data are inconsistent with the belief held by many physicians, parents, and teachers that stimulant medications are likely to help children with ADHD learn academic material in school (Fiks et al., 2013). (Pelham et al., 2022, p. 377; citations retained).

That may deserve reading several times (there will be a test on ability to focus and sit still after this discussion). But wait, because another study from McBride et al. (2021) found that ADHD drug use in adults, while not affecting problem-solving, did help with “originality, flexibility, and fluency” in tests of creative thinking. These results seem contradicting.

And there are more contradictions from parallels with other drugs. Alcohol’s effects are known to be not only mediated but moderated by psychological expectancy (as cited in Mosher & Akins, 2022, p. 116). There are even arguments that cannabis itself may be an “active placebo” (as cited in Mosher & Akins, 2022, p. 158). Physicians, parents, and teachers may very well be exhibiting differential associated, labeled, and socially learned social facts in the moderation of attitudes (i.e., affect, cognition, and behavior) around expected outcomes. These drug effects are on a dimension with expectancy effects, where society collectively markets the good or service that is most attributed (or most likely attributed) the cause of said effects, whether efficacious or not in serving strain adaptations. Considering that evidence is now building that there is a faulty promise of success in the use of stimulant drugs to those diagnosed with ADHD, it is worth bolstering the argument of drug-expectancy induced benchmark feedback.  

A Parallel in the Film Industry

Logan Hill (2014) of Men’s Journal authors a compelling piece on the rising bar of appearance in action films, a rising bar driven by demand no longer satisfied by those willing to play action heroes, but those willing to, according to Deborah Snyder “to transform themselves… to be big and powerful and commanding”. Gunnar Peterson who worked with Sylvester Stallone and Bruce Willis claims there is an “arms race” for action heroes (Hill, 2014). Actors can be working non-stop hours in the workouts for films (Hill, 2014). Philip Winchester in Cinemax’s Strike Back, reports that “the drug of choice is the drug that makes you look good” (Hill, 2014). Human growth hormone (HGH), testosterone, and steroids are used in the film industry; there are hormone-replacement clinics, “dozens” of them (Hill, 2014). Echoes of a medicopharmocological athletic sports industrial complex abound. How can this be any different of a strain adaptation in physicians, parents, and teachers utilizing culturally contextualized benchmarks, influenced by expected drug effects (i.e., expectancy effects) and actual drug effects (i.e., drug effects) used in the demand for accelerated pathways to success? 

Discussion

It is not surprising that the demand for big, powerful, and commanding is matched by valuations of tech companies in the largest companies of the world (Statista, 2022). These companies are demanding the big (halo effect of institutional degree), powerful (in labor efficiency ratio driving valuations), and commanding (attributing success to individualized dispositional qualities of command [i.e., male dominant ethnocentric imperialist culture]). It appears that overall, drugs used in academic, creative, and athletic domains share a common sociological phenomenon. A social sociological phenomenon whereby a dimension of expectancy effects to drug effects influence the very benchmarks used to label disorders at play in the business processes of industrial complexes’ distribution of solutions attributed efficacies expected and/or real in the acceleration of gains of… what exactly? A planet in the process of a mass-extinction event as a result of an acceleration of gains of… what exactly? A feedback loop of drug-expectancy induced benchmark feedback for… what exactly? Society’s the judge, society is as a judge—a judge that does not operate blind.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Bandura, A. (1999). Moral disengagement in the perpetration of inhumanities. Personality and Social Psychology Review, 3(3), 193-209. https://doi.org/10.1207%2Fs15327957pspr0303_3

Fiks, A. G., Mayne, S., Debartolo, E., Power, T. J., & Guevara, J. P. (2013). Parental preferences and goals regarding ADHD treatment. Pediatrics, 132(4), 692–702. https://doi.org/10.1542/peds.2013-0152

Hill, L. (2014, April 18). Building a bigger action hero. Men’s Journal. Retrieved from https://www.mensjournal.com/health-fitness/building-a-bigger-action-hero-20140418/

Kalich, D. M. (2001). Professional lapses: Occupational deviance and neutralization techniques in veterinary medical practice. Deviant Behavior, 22, 467-490.

Katz, J. (2008, January 23). Should we accept stereoid use in sports? [Audio podcast episode]. NPR Intelligence² US. https://www.npr.org/2008/01/23/18299098/should-we-accept-steroid-use-in-sports.

McBride, M., Appling, C., Ferguson, B., Gonzalez, A., Schaeffer, A., Zand, A., Wang, D., Sam, A., Hart, E., Tosh, A., Fontcha, I., Parmacek, S., & Beversdorf, D. (2021). Effects of stimulant medication on divergent and convergent thinking tasks related to creativity in adults with attention-deficit hyperactivity disorder. Psychopharmacology, 238(12), 3533-3541. https://doi.org/10.1007/s00213-021-05970-0

Merton, R. K. (1938). Social structure and anomie. American Sociological Review 3(5), 672-682. https://doi.org/10.2307/2084686

Mosher, C. J., & Akins, S. M. (2021). Drugs and drug policy, 2nd ed. Sage.

Pelham, W. E. III, Altszuler, A. R., Merrill, B. M., Raiker, J. S., Macphee, F. L., Ramos, M., Gnagy, E. M., Greiner, A. R., Coles, E. K., Connor, C. M., Lonigan, C. J., Burger, L., Morrow, A. S., Zhao, X., Swanson, J. M., Waxmonsky, J. G., & Pelham, W. E., Jr. (2022). The effect of stimulant medication on the learning of academic curricula in children with ADHD: A randomized crossover study. Journal of Consulting and Clinical Psychology, 90(5), 367–380. https://doi.org/10.1037/ccp0000725

Shi, Y., Hunter Guevara, L. R., Dykhoff, H. J., Sangaralingham, L. R., Phelan, S., Zaccariello, M. J., & Warner, D. O. (2021). Racial Disparities in Diagnosis of Attention-Deficit/Hyperactivity Disorder in a US National Birth Cohort. JAMA Network Open, 4(3), e210321–e210321. https://doi.org/10.1001/jamanetworkopen.2021.0321

Statista. (2022). The 100 largest companies in the world by market capitalization. Statista. Retrieved from https://www.statista.com/statistics/263264/top-companies-in-the-world-by-market-capitalization/.Sykes, G. M., & Matza, D. (1957). Techniques of neutralization: A theory of delinquency. American Sociological Review, 22(6), 664–670. https://doi.org/10.2307/2089195

This was written for Washington State University’s PSYCH-368.

This is a big post, again saved till later in the evening… ADHD topic is huge, and touches many… it is integrated heavily with several large issues, and it is basically at a nexus of economics, mental health, and ethics/morality. This takes into context Bandura’s (1999) concept of moral disengagement as well as there is sanitizing language detected in talk of ADHD.

Leaving It Better Than We Found It: Moral Disengagement in Moving Goalposts of ADHD Over-diagnosis

Introduction

For this week, attention-deficit hyperactivity disorder (ADHD) was chosen. It has been beneficial to operationalize keywords in questions throughout university, so it would be helpful to operationalize overdiagnosis. Curiously, while operationalizing overdiagnosis, it quickly became a greater effort in digesting various generalized perspectives of overdiagnosis. What had been helpful, however, is that this additional effort led to a generalized view of “overdiagnosis”, which bears significance in perspectives of overdiagnosis in the treatment(s) of ADHD. From here, this understanding could apply to treatments and some salient epidemiological statistics related to ethnic/racial differences and a little specificity on treatment before turning back to the topic of overdiagnosis with respect to ADHD. Because ADHD is simultaneously a clinical diagnosis and that treatments oft comprise drugs associated with stimulants and performance enhancement, it is critical to understand with respect to childhood development, because a salient sociological reality of parents wanting better futures for their children and better “control” of their children’s behaviors. When reviewing the literature, there is moral disengagement at work in ADHD overdiagnosis.

What is Overdiagnosis?

According to the German Institute for Quality and Efficiency in Health Care, overdiagnosis is “the diagnosis of a medical condition that would never have caused any symptoms or problems” whereupon it is further stated that “this kind of diagnosis can be harmful if it leads to psychological stress and unnecessary treatments” (InformedHealth.org, 2017). According to the National Cancer Institute, overdiagnosis “is finding cases of cancer with a screening test… will never cause any symptoms” (NCI, n.d.). Of particular interest are cases where the diagnosis “would never have caused any symptoms or problems” though the medical condition may be present (e.g., cancers that are benign with no symptomology or problems). Therefore, according to these definitions, this would mean that genetic or neurological predisposing factors (e.g., genetic contributions [Li et al., 2021; Kian et al., 2022; Thapar & Stergiakouli, 2008]) without symptoms or problems could be an overdiagnosis, but where is a clear operational line of symptom? The American Psychological Association itself deems symptoms as “any deviation from normal functioning that is considered indicative of physical or mental pathology”, yet seconds with “in general, any event that is indicative of another event; for example a series of strikes is a symptom of economic unrest” (APA, n.d.). It would seem, genetic deviations from “normal functioning” standard distributions of genetics could also be symptoms.

Looking at one definition alone from an authoritative source seems to exhibit face validity, yet when considering multiple definitions, one quickly realizes there is a lack of operational definition. To not reinventing the wheel, it may be worth consulting ethical perspectives. Within the Journal of Medical Ethics, Carter et al.’s (2016) review on this very subject found challenges in the definitions of overdiagnosis between various sources, arriving at a better operationalized definition via three components in search of assessing overdiagnosis with respect to populations: (a) “the condition is being identified and labeled with diagnosis A in that population (consequent interventions may also be offered)”, (b) “this identification and labelling would be accepted as correct in a relevant professional community”, and (c) “the resulting label and/or intervention carries an unfavorable balance between benefits and harms” (pp. 709-710). This is a very valuable operational framework, and lead to three kinds of overdiagnosis to consider for ADHD.

Carter et al. identify three types of overdiagnosis where harm would have been avoided, (a) predatory overdiagnosing actions, due to those diagnosing motivated by self-benefit; (b) tragic overdiagnosis, due to those diagnosing motivated by other-benefit (e.g., diagnostics or treatments that cause harm); and (c) misdirected overdiagnosis, due to diagnosing motivated by other-benefit (e.g., a new diagnostic for early detection) (pp. 710-711). There are other presentations of this issue beyond Carter et al., however it seemed salient with respect to ADHD, and therefore is presented here.

Why is Overdiagnosis So Messy?

Derek Bolton (2013) of King’s College London’s Institute of Psychiatry reviewed verbiage in both the American Psychiatric Association’s various editions of Diagnostic and Statistical Manual of Mental Disorders, and the International Classification of Diseases to clarify broad level definitions of overdiagnosis and prevailing context and came away with some valuable guidance. There are some fascinating side effects of moving the goalposts on what constitutes diagnosis, arriving at a “distress and impairment” emphasis while also accounting for “antisocial aspects” (p.615). Homosexuality historically provided a reason to re-evaluate overdiagnosis (pp. 613-614). Understanding clearly where the borders of diagnoses meet diagnosis may shed some light on overdiagnosis in ADHD, especially in children, because “distress and impairment” are culturally related. Considering an economic culture of American domestic policy for individual achievement and success, couldn’t distress be ascribed to the experience of poor(er) grades used in evaluating students for academic achievement in a meritocratic society. How far ahead of distress, is distress measured? Even more so with impairment, where impairment is an impairment relative to peers in cohorts of expected outcomes where a portion of those cohorts are benefitting from drugs in advancing again, meritocratic opportunity. It’s suddenly as if overdiagnosis is wrapped up in the same arguments that doping is wrapped up in performance enhancing drugs in sports. It’s messy, however, it may be worth turning to some statistics.

Epidemiology

Sayal et al. (2018) reported varying estimations of ADHD based in meta-analysis. For the United States, a prevalence rate of 0.6% was arrived at for people younger than 18 in 1987, to about 10% in children aged between 7 and 11 between 1995-1996 (p. 176). Most ADHD studies for Americans demonstrated a peak in the 10–14-year age group (p. 176). According to Shi et al. (2021), using a cohort of 238,0111 children, 4.8% were diagnosed with ADHD (11,401 children), with an incidence of .69% (p. 4). 78% of children diagnosed are white, 3.2% are Asian, 6% are black, 9.1% are Hispanic, and 3% are other (p. 4). A striking statistic however is that 50.6% come from the southern census region (p. 4), and that 68.4% come from household incomes above $75,000, where 22.8% are below, where 8.9% is from unknown income brackets (p. 4). Notably, comorbid speech sound disorder as a pre-ADHD condition is present in 16.5% of ADHD diagnoses (p. 6). Shi et al., discuss significant racial disparities in ADHD diagnoses “in privately insured children”, in treatment, and different patterns of comorbidity (p. 7).

Treatment

With respect to ADHD, avoiding moral disengagement of euphemistic labeling (Bandura, 1999) by using drug rather than “medication” is a course correction the author is willing to assist with. ADHD treatments consist of known pharmacological drugs related to amphetamine and amphetamine-like drugs (e.g., Adderall/Adderall XR [amphetamine]; Vyvamse [converts to dextroamphetamine]; Ritalin, Concerta, Methylin, Daytrana [methlphenidates]); these are classified as stimulants and are subject to use and abuse (Mosher & Akins, 2022, pp. 108-109). While the exact impact of these drugs is unknown, ADHD drugs not only evidence attentional enhancement but physical enhancements via elevated dopamine and norepinephrine concentrations (Berezanskaya et al., 2022). For any student (or professor) of psychology today, it is noteworthy that Ritalin effectively acts like cocaine (Vastag, 2001), and produces the same effects as methamphetamine when abused (Gahlinger, 2001, p. 209).

Drugs are not the only treatment option, as the gold standard of psychological therapy, cognitive behavioral therapy (CBT) has been demonstrated to show efficacy (Maric et al., 2015; Pfiffner, 2014). Alternative treatments are available such as “stop and think” (Miranda & Presentacion, 2000). According to Rathus, stimulants are more efficacious (as cited in Rathus, 2022, p. 364; Green & Ablon, 2001; Waxmonskly, 2005; Whalen, 2001). [TODO: Insert stimulant comparison treatments here]. While stimulants may be considered more efficacious, one meta-analysis of psychosocial treatments reveal that behavioral parent training (Corcoran & Dattalo, 2006) and behavioral school intervention practices demonstrate greater effect sizes (Fabiano et al., 2021).

Overdiagnosis of ADHD

Turning back to overdiagnosis of ADHD, it is valuable to keep race in context. According to Rathus (2022), “there has been about a 60% rise in the prevalence of diagnoses for ADHD over the past two decades, and two of three children diagnosed with the disorder are placed on stimulants such as Ritalin and Adderall” (pp. 362-363). ADHD is considered by medical professionals as overdiagnosed (p. 363). Utilizing methods focusing on consequences of favorable/unfavorable benefits (i.e., benefit/harm), in a meta-analysis by Kazda et al. (2021) reviewing 120 studies on consequences of drug treatments, there is evidence of overdiagnosis (pp. 4-10), but noted that in certain age groups, benefits outweigh harms (p. 7).

Considering varying definitions of overdiagnosis and taking a Carter et al. and Bolton model focused on benefit and harm, contextualized with cultural ideals of “dysfunction”, one could argue that s child’s future earned income and possible potential building of wealth, especially in the United States, is contingent on the meritocratic value the same child may later provide set against known and unknown in- and out-group along with systemic stereotypes, prejudices, and discriminations. While in a phenomenological perspective, in a local frame of an individual student, a student might not report distress except in the way others are treating their relatively less focus (i.e., attention deficit) and relatively greater activity (i.e., hyperactivity). Yet, impairment takes relativity into account, determining impairment against a cultural context. Therefore, the student/child stands before a growing measuring stick of prevailing changing social diagnostics. What if this every lengthening measuring stick itself is inducing distress, just as monetary inflation induces distress? Every year demanding more with less.

Unfortunately, if a significant portion of a relative demographic is being increasingly drugged to control for attentional “deficits” and activity “excesses”, then technically, one is moving the goalpost of a cultural measuring stick these same effects, where the measuring stick itself drugged. A cultural feedback-loop is due to drugs is effectively inducing a cultural addiction to performance enhancement for the benefit of bettering one’s successes in economic competition. Strangely reflective is that this is but one argument that those against performance enhancers in competitive sports deploy when debating those for performance enhancers—if the entire sport is adopting performance enhancers, then everyone will require them to compete. Is a national policy so bent toward beating other nations that it is willing to dope its children with performance enhancers to mold human diversity into productive machinery for nationalist agendas?

Conclusion

Considering a large and growing prevalence of ADHD, is it possible that ADHD is a social disorder, contingent on DSM-5’s criteria of disorder, centering on a social perspective of impairment. As Karen Horney herself had written of neurosis, neurosis and society is interrelated. Society has come to demand so much of its people that drugs are as another layer of the “food pyramid”, accommodating demands of naturally selected beings sacrificed on an artificially selecting religion’s altars of market economics centered squarely on Merton’s (1938) strain adaptation of innovation supported by a system of conformance and ritual, with occasional offramps to retreat and rebellion. The tyranny of should is at work, and look no further than ADHD. Humanity seems to have built a society of a sleeping majority ignorant to its own drug altered measuring sticks of juiced standard deviations, built on an economy on performance enhancing drugs (e.g., stimulants, depressants, etc.), that those without them are seen as “unable to sit still” and “unwilling to work”. The drugged-up measuring stick is creating social drug addiction.

And where would this ultimately lead? Consider the ecological sciences. The more humanity’s natural state devoid of performance enhancement is bifurcated from a “juiced” state of performance enhancement (i.e., the have nots vs. the haves), the greater the probability of allopatric speciation between two humanities selecting for attributes that intelligence may falsely attribute to societal dispositions. Reality is that nature favors efficiency of energy, not markets—ecology wins, even at the extinction of a dimension of what is seen today as humanity. So in departing, should children with ADHD be mainstreamed into classrooms? The answer may surprise you—it’s too late, they already were, it’s the diagnosis that’s lagging. It’s another moral disengagement, “mainstream” is a sanitized version of desegregation, and as Allport already provided evidence of, the best way to eliminate stereotype, prejudice, and discrimination is inter-group contact. The question is made more saliently human as illuminated with moral re-engagement: should children diagnoseable with ADHD be segregated from peers (i.e., humans). I don’t recommend Niccol’s (1997) Gattaca. Work together, not separate. Maybe the structure of society needs rethinking, because it’s not looking good ecologically to continue down this road that seems to look more and more, like… rebellion, but maybe that’s what’s intended. There is a growing deficit in attention to salient themes of policies past, that produced economic hyperactivity present, resulting in threatening all life on this planet. The story of ADHD and its treatment, is profound, and you can see it in the lives of your sons and daughters, please leave it better than you found it.

References

Allport, G. W. (1954). The nature of prejudice. Addison-Wesley Publishing Company.

American Psychological Association [APA]. (n.d.). Symptom. APA Dictionary of Psychology. Retrieved from https://dictionary.apa.org/symptom (Links to an external site.).

InformedHealth.org. (2017). What is overdiagnosis? National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430655/ (Links to an external site.).

Bandura, A. (1999). Moral disengagement in the perpetration of inhumanities. Personality and Social Psychology Review, 3(3), 193-209. https://doi.org/10.1207%2Fs15327957pspr0303_3 (Links to an external site.)

Bolton, D. (2013). Overdiagnosis problems in the DSM-IV and the new DSM-5: Can they be resolved by the distress-impairment criterion? The Canadian Journal of Psychiatry, 58(11), 612-617. https://doi.org/10.1177/070674371305801106 (Links to an external site.)

Kazda, L., Bell, K., Thomas, R., McGeechan, K., Sims, R., & Barratt, A. (2021). Overdiagnosis of attention-deficit/hyperactivity disorder in children and adolescents: A systematic scoping review. JAMA Network Open, 4(4), e215335–e215335. https://doi.org/10.1001/jamanetworkopen.2021.5335 (Links to an external site.)

Kian, N., Samieefar, N., & Rezaei, N. (2022). Prenatal risk factors and genetic causes of ADHD in children. World Journal of Pediatrics: WJP, 18(5), 308–319. https://doi.org/10.1007/s12519-022-00524-6 (Links to an external site.)

Li, T., Franke, B., Arias Vasquez, A., & Roth Mota, N. (2021). Mapping relationships between ADHD genetic liability, stressful life events, and ADHD symptoms in healthy adults. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics, 186(4), 242–250. https://doi.org/10.1002/ajmg.b.32828 (Links to an external site.)

Mosher, C. J., & Akins, S. M. (2022). Drugs and drug policy, 3^rd ed. Sage.

National Cancer Institute [NCI]. (n.d.). Overdiagnosis. National Cancer Institute. Retrieved from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/overdiagnosis (Links to an external site.).

Niccol, A. [Director]. (1997). Gattaca. Columbia Pictures, Jersey Films.

Rathus, S. A. (2022). Childhood and adolescence: Voyages in development, 7^th Ed. Cengage.

Sayal, K., Prasad, V., Daley, D., Ford, T., & Coghill, D. (2018). ADHD in children and young people: prevalence, care pathways, and service provision. The lancet. Psychiatry, 5(2), 175–186. https://doi.org/10.1016/S2215-0366(17)30167-0 (Links to an external site.)

Thapar, A., & Stergiakouli, E. (2008). An overview on the genetics of ADHD. Xin li xue bao. Acta psychologica Sinica, 40(10), 1088–1098. https://doi.org/10.3724/SP.J.1041.2008.01088

This was written for Washington State University’s PSYCH-361 considering media influence.

What are your thoughts regarding the pros and cons of media in the lives of young children (outside of school)? What rules concerning this do you have in place in your house? 

Albert Bandura et al.’s (1961) Boba Doll experiment helped drive further interest in social-cognitive theory after attending a Washington State University (WSU) course in psychological personality theories (PSYCH-321). Ryckman’s (2013) works had a section on “aggression and violence in films, television, and video games” (pp. 417-418), and additional learning had been gained from Albert Bandura’s own website and videos that had been posted online (albertbandura.com, n.d.). Considering pros of media in being a learning tool, the textbook offers evidence of educational media benefits (Rathus, 2022, p. 291), but I wonder if the media employed in educational benefits, being interrupted by advertising (whether educational or not) might be influencing cognitive development. There’s a lot of possible navel-gazing (i.e., analysis paralysis) that could accompany such analysis of pros and cons, but overall, I think given socio-cognitive theory, I am convinced there is an effect, it’s just that the effect is mediated by a great matter of Markov-chains in matters of nature/nurture, reinforcement, modeling, disposition, genetics, epigenetics, and then some in a giant changing graph of influence. The short is, I was biased by readings across university studies and prior.

 Bandura’s evidence, results of experiments, and results of modeling via film in foreign cultures (Bandura, 2019) has me on the cons side of media in the lives of children, but only when the cons side of socio-economic status (SES) is abated. If media (i.e., window to a better world) is better than the cons of underprivilege due to systemic inequality in socio-economic status, I can support “kids looking out the window to greener grass on the other side”. Evidence supports it (as cited in Rathus, 2022, pp. 290-291). I think it’s a matter of status relativity. For the environment children are developing in, what is the most valuable aspect of the environment serving as scaffold for continued development from where they are at now? One thing is for certain, while we do not have children, if my partners and I are at our surrogate children’s house, television and computers are not engaged with for the most part (there are exceptions of joint attention and selectivity in programming [e.g., Star Trek]). I’m not certain that interacting with a two-dimensional flat field of photon manipulation devices is a good idea, especially when that field is flat and does not align with the eyes curve of angular span. In our home, we do not really watch television that often, but do engage in film, but rarely.

What are the pros and cons of media in the classroom? The pandemic has increased media usage for children. Based on everything you have read how can we make the best out of our current situation?

I would hazard a guess that the pros and cons of the aforementioned apply to this same situation. It comes down to what the value is for development considering the environment that the child is currently in. Given that Larsen et al.’s (2006) fMRI studies revealed that real and apparent motion (i.e., real motion vs. flashing stationary objects or pictures) result in the same areas of the brain activated, how can interdisciplinary fields even differentiate media vs. reality in these discussions? Larsen et al.’s results put the media vs. reality issue to bed for me. I think what social-cognitive theory illuminates is that what you sense, in motion, is modeled. The whole topic of “real or artificial” seems a red herring. It would depend on what is being conditioned, contingently reinforced, and modeled. Since media has a greatly reduced ability to interact vs. reality, I can see why the differentiation continues, but as media comes to interact more in real time, the world would open up to even more effects, until which point hopefully the entire media vs. reality discussion can be put to bed—media sensed is still a photon received.

I think the best route out is a reset of the thing that constrains development and education altogether, and it will take raw political horsepower to right the ship to a better tomorrow. I don’t see any other way, and the rest I shall defer to another venue.

Final thoughts from everything you have read for this week. 

I think Redesky’s (2018) article is helpful if a reader or scientist can redact “media” and see the modeling etc. For example, while Redesky writes of “good media design can also be a starting point for families to play in the real world”, it might be helpful to say, “good design can also be a starting point for families to play in the real world.” That covers all bases, just get to the point going beyond functional fixation of “media”. The entire world of experience is the media. What is design, but cognitive transformation? Good design seems to be that which provides Vygotsky’s scaffold and is dynamic enough to provide the zone of proximal development.

Here’s the problem however I see—how is a zone of proximal development to work if it’s not being adjusted in real time to situationally differentiating dispositions? For example, say a television is in a room, and behavior is being modeled. Isn’t the room that television is being watched in influencing too? I know this just doing self-report antecedent, behavior, and consequence continuous recording for WSU’s Self-Control (PSYCH-328) course. It feels like the degree of stimulus control (S^D) around “media”, due to industrial mass-production mentality, is as the size of sledgehammers in society trying to control tiny finishing nails of popsicle scaffolds of developmental progress. Mass producing scaffolds aligned with one or more (if we’re lucky) standard deviations of “most kids”, hoping that they will be able develop through the scaffold’s ____ (insert any underlying psychological theory of influence of feelings, thoughts, and behaviors [i.e., attitudes] here), where “most kids” is the favored political socio-economic class of the day.

I’m becoming keener on human-to-human interactions in education because I think the world might have just automated itself into a corner much to ecological and sociological demise. This concept is reaching saturation, because it’s even in Fred Rogers’ (2012) position statement on interactive media (i.e., decreasing distance between behaviors and contingent reinforcement [i.e., consequences] in learning etc.). Yet again, where does attachment theory get recognized in mass-produced media? Where is empathy? Research supports these in providing ideal outcomes. For me, articles about “too much screen time” (Suciu, 2020), continue missing the point of social-cognitive theory, it might just be more valuable to consider “eye time” rather than “screen time”. In software startup culture, Rob Loughan once tried to mentor me that “we want to own the glass” (R. Loughan, personal communication, n.d.), meaning that a company wanted to increase the software’s proportion of screen over time to maximize its relation to users’ lives. I think that this just might rebalance thoughts in this whole debate, but another lesson is necessary. What is the most valuable thing that should be owning the eye time of children? This is exactly where Karen Horney (1950) enters the room—oh the Tyranny of the Should. Sometimes it’s ok to look at the language and change it, for it seems better to ask, what groups of eye time experiences lead to what measures of wellness and mental health in fairly distributed resources allocated to maximize base needs of Maslow’s hierarchy in advance of self-actualization, and that is where a world of should enjoins politic. 

So? I think Noam Chomsky taught me something after all in a personal email saying he had no answers (N. Chomsky, personal communication, April 11, 2022, because I’m sorry, I am out of thoughts… but unlike Mr. Chomsky, I will end it with… for now. There’s always five minutes from now, who knows, “if you don’t like the weather, wait five minutes”.

References

Albertbandura.com. (n.d.). Albert Bandura [Blog]. Albertbandura.com. Retrieved from https://albertbandura.comLinks to an external site..

Bandura, A., Ross, D., & Ross, S. A. (1961). Transmission of aggression through imitation of aggressive models. Journal of Abnormal and Social Psychology, 63, 575-582. https://doi.org/10.1037/h0045925Links to an external site.

Bandura, M. (2019). Bandura – reducing global problems [Video]. Vimeo. https://vimeo.com/338570685?embedded=true&source=vimeo_logo&owner=69085719Links to an external site.

Fred Rogers Center. (2012). Technology and interactive media as tools in early childhood programs serving children from birth through age 8. https://www.naeyc.org/sites/default/files/globally-shared/downloads/PDFs/resources/position-statements/ps_technology.pdfLinks to an external site.

Horney, K. (1950). The tyranny of the should. In K. Horney, Neurosis and human growth: The struggle toward self-realization (pp. 64-85). W. W. Norton & Company.

Larsen, A., Madsen, K. H., Lund, T. E., & Bundesen, C. (2006). Images of illusory motion in primary visual cortex. Journal of Cognitive Neuroscience, 18, 1174–1180. https://doi.org/10.1162/jocn.2006.18.7.1174Links to an external site.

Rathus, S. A. (2022). Childhood and adolescence: Voyages in development, 7^th Ed. Cengage.

Redesky, J. (2018, September 26). How smart media can help kids and parents. PBS.org. Retrieved from https://www.pbs.org/parents/thrive/how-smart-media-can-help-kids-and-parentsLinks to an external site..

Ryckman, R. M. (2013). Theories of personality, 10^th ed. Cengage.

Suciu, P. (2020, May 13). Are kids spending too much time looking at screens during COVID pandemic? Forbes. Retrieved from https://www.forbes.com/sites/petersuciu/2020/05/13/are-kids-spending-too-much-time-looking-at-screens-during-covid-pandemic/?sh=101ad025dc5fLinks to an external site..

This was written for Washington State University SOC-368 “Drugs and Drug Use”.

Introduction

In Chris Bell’s (2015) Prescription Thugs, a father says of his son’s drug use problem, that his problem is that he wants more than being an average Joe, and rather that his son should be an average Joe, “… because average Joe fights for his country, steps up the plate, and takes care of the problem” (00:56:14). Earlier in the film the same father says, “… really you have to do it for yourself, and until you’re ready, in here, you’re not going to accomplish anything” (00:13:46). It was this second line that struck me considering Sutherland and Cressy’s (1977) differential association theory (pp. 75-77). In saying this, the father is saying that the not-average Joe (i.e., his son) doesn’t fight for his country, doesn’t step up to the plate, and doesn’t take care of the problem. The father, carries an extreme forms of individualism—“you have to do it for yourself… or you’re not going to accomplish anything”. Anyone asserting this is American, forgot the entire point of unity. In this statement, an average Joe’s father expresses Sykes & Matza’s (1957) appeal to higher loyalties not toward an individual self, but an ideologization of American males as “average Joes”, a mix of Merton’s (1938) typology of strain adaptations as innovator-conformist. Becker’s (1963) labeling theory of “not average joe” is at work as well as differential association of not actually listening. It from exactly here, and nowhere else, that a lightweight model of drug enabled competitive strain adaptation is presented.

“Anywhere But Here” Model

Core Construct. Barring observations of pressured speech and knowledge of its presentation in several psychological disorders and comorbidity with substance abuse disorders noted throughout Bell’s film, I kept going back to, at the risk of cliché, a sociological phenomenon of a culture possibly leading to drug use and addiction by way of what DeGrandpre (2006) describes as an “anywhere but here” motivation (p. 149). The bounce between “uppers” (i.e., stimulants) and “downers” (i.e., depressants) seems like self-administering chemical analogues to ups (e.g., manic episodes, hypomanic episodes) and downs (depression) of bipolar disorder commanding a lifetime prevalence of 2.1% (Blanco et al., 2017). Is it possible that a valence above psychophysiological space as sociological space is merely recursively reflecting bipolar behavior? A model is forming with respect to drug use. Against a backdrop of increasing social strain of neuroticism based in desires for “nation building, industrialization, urbanization and technological hybridization of ‘nature’ and the social status of certain groups” (Simandan, 2006), moderating variables driving demand for “altered states of consciousness” are interdependent with mediating variables manufacturing internalization of attitudes (i.e., manufacture of consent) with respect to said strain inducing desires. First are moderating variables indexed by saturation of theoretical constructs (e.g., habituation [Rankin et al., 2009], psychological reactance theory [Brehm, 1966] etc.). Second are mediating variables indexed by another saturating set of theoretical constructs (i.e., halo effect, mere exposure effect [Zajonc, 1968], etc.) whereby the underlying phenomena is at work in marketing and public relations (see Edward Burnays’ [1923] Crystallizing Public Opinion and Burnays’ [1928] Propaganda).

Strain Adaptation Communities. The aforementioned seems prohibitively reductionist, however, if one considers recent advances in many fields of science, there is reason to believe that this model extends toward a factorial model of n-adaptive strategies as supported by evidence of communities of practice of language use () and life domains (Rojas, 2006; Cummins, 2003; Heady & Wearing, 1992; Veenhoven, 1996). It is helpful to consider n-adaptations as Merton’s (1938) initial five adaptation plus a suggested sixth (VI) as Scientism (cultural emphasis on study of presently attended phenomena). Considering DeGrandpre’s (2006) exposé of a medicopharmaceutical industrial complex fully representative of an innovative strain adaptation in the taking advantage of and facilitating advantage within retreating adaptation. 

Strain Adaptation Community In-Group Stereotypes, Prejudices, and Discriminations. It’s one thing to examine across groups behaviors of strain adaptations, but another to examine within-group behaviors. It is further proposed within this model that there are preferred in-group biases within these adaptations. Enter differential prohibition (DeGrandpre, 2006). Within the context of a singular non-localizable strain adaptive community, differential prohibition of drugs is at play (e.g., racial bias and segregation in the development and response to drug scares [Lopez, 2017]). Within an innovative strain adaptive group (i.e., privileged politicians, and their “meaningful” in-group relating constituents), the Harrison Act’s use targeted at Irish immigrant drinking in taverns while preserving alcohol use is exhibit A (DeGrandpre, 2006, p. 143), and the identification of crack-cocaine with black people in general, white people in poverty, and criminals are exhibit B (Mosher & Akins, 2021, p. 105).

Anywhere But Here, Inc.

Where does this seem to be leading? It is worth mentioning that differential prohibition, just like differential association does not seem to reach homeostasis (echoes of economic criticality)—incarcerations continue to accelerate with greater attempts to control adaptations. What is the strain adapting innovation of a medicopharmaceutical industrial complex in this situation? It probably already happened and is in progress. It would progress to drug facilitation of social movements between adaptations, and actively moderate and mediate accelerating social movements, essentially serving as the gateway drug of a new market of accelerating differentially associated identity exchange. The more frequently members of social groups move between adaptations, the more transactions, and the more transactions, the more opportunity for revenue growth (there’s a curious variant of the Tower of Hanoi game in here). How does this get sold to conformists? Conform to rules and regulations in a market model of identity exchange. How to sell this to ritualists? Ritualize the behavior of market models of identity exchange, with innovative drugs and treatments that both induce (i.e., stimulants), support (i.e., depressants), and maintain halos of identity (i.e., euphorics). How to sell this to the rebel? Aligning actions (Stokes & Hewitt, 1976). Of drugs, “… tolerance to the desired effects does not yield tolerance to the toxic effects…” (DeGrandpre, 2006, p. 158), perhaps it can be turned on its head, where the effects are not of drugs, but of strain, strain that has been billions of years in the making. This is rebellion—the average Joe, regardless of strain adaptation, wants—more.

References

Bell, C. [Director] (2015). Prescription thugs. Naked Edge Films.

Blanco, C., Compton, W. M., Saha, T. D., Goldstein, B. I., Ruan, W. J., Huang, B., & Grant, B. F. (2016). Epidemiology of DSM-5 bipolar I disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions – III. Journal of Psychiatric Research, 84, 310–317. https://doi.org/10.1016/j.jpsychires.2016.10.003

Brehm, J. W. (1966). A theory of psychological reactance. Academic Press.

Burnays, E. (1928). Propaganda. H. Liveright.

Burnays, E. (1923). Crystallizing public opinion. Bonni and Liveright.

Cummins, R. A. (2003). Normative life satisfaction: Measurement issues and a homeostatic model. Social Indicators Research, 64, 225–256. https://doi.org/10.1023/A:1024712527648

DeGrandpre, R. (2006). The cult of pharmacology: How America became the world’s most troubled drug culture. Duke University Press.

Headey, B., & Wearing, A. (1992). Understanding happiness: A theory of subjective well-being. Longman Cheshire.

Lopez, G. (2017). When a drug epidemic’s victims are white. Vox. Retrieved from https://www.vox.com/identities/2017/4/4/15098746/opioid-heroin-epidemic-race.

Merton, R. K. (1938). Social structure and anomie. American Sociological Review 3(5), 672-682.

Mosher, C. J., & Akins, S. M. (2021). Drugs and drug policy, 2^nd ed. Sage.

Rankin, C. H., Abrams, T., Barry, R. J., Bhatnagar, S., Clayton, D. F., Colombo, J., Coppola, G., Geyer, M. A., Glanzman, D. L., Marsland, S., McSweeney, F. K., Wilson, D. A., Wu, C. F., & Thompson, R. F. (2009). Habituation revisited: an updated and revised description of the behavioral characteristics of habituation. Neurobiology of Learning and Memory, 92(2), 135–138. https://doi.org/10.1016/j.nlm.2008.09.012

Rojas, M. (2006). Life satisfaction and satisfaction in domains of life: Is it simple relationship? Journal of Happiness Studies, 7(4), 467–497. https://doi.org/10.1007/s10902-006-9009-2

Simandan, D. (2006). Freud, Horney, and the neurotic spaces of modernity. In S. Matei (Ed.), Values, education, and multiculturality (pp. 62-105). Mirton Press.

Stokes, R., & Hewitt, J. P. (1976). Aligning actions. American Sociological Review, 41(5), 838-849. https://doi.org/10.2307/2094730

Sutherland, E. H., & Cressy, D. H. (1977). Criminology, 9th ed. Lippincott.

Sykes, G. M., & Matza, D. (1957). Techniques of neutralization: A theory of delinquency. American Sociological Review, 22(6), 664–670. https://doi.org/10.2307/2089195

Veenhoven, R. (1996). Developments in satisfaction research. Social Indicators Research, 37, 1–45. https://doi.org/10.1007/BF00300268

Zajonk, R. B. (1968). Attitudinal effects of mere exposure. Journal of Personality and Social Psychology, 9(2, Pt. 2), 1-27. https://doi.apa.org/doi/10.1037/h0025848