Outline

Constructing an argument depends on whether it can flow logically within its structure. Outlining a literature review sounds daunting, probably because it is.

Before I do anything, I must define ADHD according to the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), the newest edition of the publication by the American Psychiatric Association, which is nationally employed by clinicians and physicians around the United States. The DSM defines ADHD as “a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.” To contextualize the prevalence and importance of ADHD as an issue in the United States, I will present the source by Faraone S., Sergeant J, Gilberg C, and Biederman, J from the World Psychiatry Journal that states “Attention-deficit/hyperactivity disorder (ADHD) is a behavioral disorder that affects up to 1 in 20 children in the USA."

While a source from Schlachter, S. Peabody Journal of Education states, "This report describes the results of that analysis, which indicated that, in 2003, approximately 4.4 million children aged 4--17 years were reported to have a history of ADHD diagnosis; of these, 2.5 million (56%) were reported to be taking medication for the disorder.” I need to find a source with number of adults with ADHD in America. I instead have comparisons of the two, but no real number for adults specifically.

After defining and contextualizing, the argument can be delineated.

Subtopic 1: ADHD

First I have to provide information of ADHD and what part of the brain it affects.

Premise 1: ADHD is associated with certain increase of specific frequency of waves at certain parts of brain.

Support: According to Biederman, ADHD originates in the frontal-subcortical pathways and often develop with anxiety disorders, mood disorders, and learning disabilities. Through analysis of fMRI’s Vaidya for the American Journal of Psychiatry found that waves associated with ADHD were less prominent in the frontal-stratal-temporal-parietal network of the brain. Certain parts of the brain of children with ADHD exhibited lower task performance.

Another source from Clinical Psychiatry Journal found through EEG imaging that increase in frontal lobe theta activity (slow brain wave activity) when patients with ADHD were concentrating v. decreasing activity normally.   

Subtopic 2: ADHD in Adults

I need to show ADHD does exist in adults as there is controversy surrounding this issue.

Premise 2: ADHD is often defined as a “childhood disorder”, but does persist and can develop in adulthood.

Support: According to an article by the British Medical Journal, "A more robust evidence base is surely required before accepting a concept such as adult ADHD, which departs from established views of the nature of behavioral problems, has a large overlap with other diagnoses, and has only a tenuous association with childhood disorder”. However, several research studies prove that ADHD can be evidenced in adults, despite the DSM-IV stating ADHD is “a developmentally sensitive” disorder.

According to Faraone S., a study was conducted with families to see if relatives also had ADHD, and its relation to adult ADHD with 49% correlation. Furthermore, in a study by BMC Psychiatry, it was found through testing of 119 adults and 403 controls, that the most prominent traits for adults with ADHD were different from children. Adults were more likely to exhibit high novelty seeking (decision making based on impulse, exploratory activity, and reward cues) and harm avoidance (worrying, fear, fatigue), while children were more afflicted with inattention problems. Thus this shows that ADHD in adults exists and is different, therefore not a continuation or rather an evolution of the disorder into adulthood. Maybe if I can find a source that somehow manages to find a record of people who report ADHD in adulthood and did not have it in childhood. This would strengthen my argument, so any help in finding specific sources like that would be greatly appreciated. 

Subtopic 3: Medication Treatment for Children v. For Adults

Premise 3: Medication leads to harmful side effects, abusive behavior, and injurious dependency.

Support: According to Setlik, Randall, and Ho for the Journal of Pediatrics, sales data reflects that medication abuse for adolescents is on the rise. According to this source, "calls related to teenaged victims of prescription ADHD medication abuse rose 76%, which is faster than calls for victim of substance abuse generally and teen substance abuse." And in another source by UCLA research Susan Smalley, it was found that, "as skyrocketing numbers of children are diagnosed with ADHD and prescribed drugs, researchers are falling under increasing pressure to explain this disorder."

I need more sources here detailing how ADHD medication can lead to dependency and abuse. Also the harmful side effects and toxicity issues it can cause. I have already found some, but need to read through them.

Subtopic 4: Neurofeedback Therapy/Why it is better

Premise 4: Neurofeedback therapy may be the future for treating ADHD with minimal harmful effects compared to ADHD medication.

Support: Neurofeedback therapy aims to normalize abnormal EEG frequency by down-training certain wave frequencies. This is done by attaching electrodes to the scalp. A client can then watch their EEG as they play a game, watch a movie, or listen to tones. When they successful are training their waves down or up, based on their protocol dictated by their brain map, they will achieve points in the game, be able to see movie clearer, or the tones will be less high pitched. Thus, they are consciously controlling their brain waves, increasing concentration and relaxing their minds.

According to the ADNC Neurofeedback Centre of BC, “in another investigation (Fuchs, Birbaumer, Lutzenberger, Gruzelier, & Kaiser, 2003), children who had ADHD were given either medication or neurofeedback. After about 40 neurofeedback sessions the two groups were compared on a variety of traditional ADHD measures. Findings indicated that the groups performed at a comparable level.” In “A Symphony in the Brain”, it was stated that “as frequency is enhanced during a neurotherapy session and the brain is activated, more blood than usual streams to that area in the brain, the nutrients may be strengthening or reorganizing existing connections."

I need to collect more sources comparing ADHD medication to neurofeedback therapy. I will look more into this. 

Thus these sources detail the merits of neurofeedback therapy, specifically with children with ADHD. 

Gap: This is where a gap exists in the research, as no research has been done comparing adults and children being treated with neurofeedback therapy.

This all leads to my research question: Is neurofeedback therapy a viable treatment option for adults and children? Or something along those lines.

Hopefully, that was not too dense and made sense.

Word Count: 1091.. um.... oops, sorry. It is a lot of quotes??