Child Ritalin use doubles after divorce

A study just published in the Canadian Medical Association Journal reports that children are twice as likely to be prescribed Ritalin after their parents have divorced.

Ritalin is the trade name for the amphetamine-like drug methylphenidate. It is typically prescribed for ADHD, a diagnosis which describes problems with staying focused, impulsiveness and / or hyperactivity.

Drug companies and some charities have invested a lot in selling the idea that ADHD is a purely neurological disorder and that the child’s family life has little to do with it.

This study suggests that this isn’t the case, and that the child’s environment and relationships, in combination with possible genetic and neurological differences, have a significant effect on their behaviour.

Actually, this won’t be news to most clinicians, who know that relationships and the environment have an effect even on conditions known to have a clear and defined neurological basis. For example, loneliness is known to contribute to the risk for Alzheimer’s disease.

In a sense, all psychological problems are problems with the brain, because the brain and the mind are just different ways of describing the same thing, and the environment has its effect through our neurons.

But this doesn’t mean it is possible to explain all human behaviour on only one level, and doing so will only give you part of the picture.

This study provides evidence that child behavioural problems are not best understood as neurological problems only, or that Ritalin is being used inappropriately to manage the behaviour of distressed children. Most probably, it’s a bit of both.

To be fair, this isn’t the only interpretation. The researcher notes that the known genetic component of ADHD could mean that the parents of children with behavioural share similar traits and so might be more likely to divorce because of this. It would be surprising if this accounted for the whole effect though.

People often use psychiatric diagnoses as if they’re explanations when really they’re nothing more than descriptions. The idea is that science will ‘fill in the gaps’ and explain how these differences occur.

The trouble is, the behaviour described by an ADHD diagnosis could occur because of genetic influences on brain development, because divorce is causing emotional distress, because the child is being bullied, or for any number of other reasons.

Ritalin is likely to help regardless of what is causing the child to be disturbed, because it helps the child focus by boosting attention.

The question is, should children be prescribed drugs because they are distressed by a divorce? There’s no definite answer in every case as each child and each situation is different.

But perhaps we should be concerned that children are likely being prescribed psychiatric drugs as a ‘quick fix’ for emotional distress and behaviour problems when research shows that parent training programmes are safe and effective.

Link to full-text scientific paper.
Link to write-up from Yahoo! News.

2 Comments

  1. dragon-vs-ostriches
    Posted June 7, 2007 at 3:40 am | Permalink

    “The trouble is, the behaviour described by an ADHD diagnosis could occur because of genetic influences on brain development, because divorce is causing emotional distress, because the child is being bullied, or for any number of other reasons.”
    I doubt the above is true, you might see similar behavior caused by each of these factors, but that behavior will likely only persist over a large number of environments in genuine ADHD. If ritalin is being over-prescribed for children distressed by divocre, the fault likely lies not with the diagnostic criteria but the careless psychiatrists poorly diagnosing the condition.
    I don’t understand why this post dances around the issue of ADHD and its genetic causes, referring to “*possible* genetic differences,” studies have already born out the disorder’s high heritability.

  2. Posted June 7, 2007 at 6:33 am | Permalink

    Presumably ‘genuine’ ADHD would be present before and after divorce. This study suggests that there must be some cases which are influenced by situational factors.
    In terms of possible genetic influences, the post refers to the individual in that instance. So while heritability has been found in group studies, it doesn’t follow that all individuals will have equal, if any, of the genetic effect.


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