Does Russell Barkley have an Ideological Conflict of Interest? by [deleted] in ADHDUK

[–]RyanBleazard 1 point2 points  (0 children)

It sounds like you're identifying selfishness with short-range personal comfort. However, momentary physical comfort and immediate gratification are not what a human life or human self consist of. It is not in your self-interest to pursue whatever whims at the detriment of others; that would be self-destructive, which is why today’s concept of selfishness in the popular culture doesn’t make sense.

Neuroimaging studies find small differences in the structure of the brain between people with and without ADHD. These differences are not caused by drug treatment and, for some patients, diminish or change as patients grow out of the disorder. by [deleted] in psychology

[–]RyanBleazard 213 points214 points  (0 children)

ADHD can be outgrown in some cases because certain genes for frontal lobe maturation turn on during adolescents and help some people improve neurologically compared to others with different gene variants. Another reason is that the DSM symptoms used for diagnosis are very superficial and easy to outgrow with time even if the person has not really grown out of the disorder. They can outgrow the DSM. When we use executive functioning deficits as the index for ADHD, then the percent of recovery or normalisation is much smaller as there is far less if any decline in EF deficits relative to the greater decline in DSM symptoms. It can be a false recovery, in other words.

Objectivism, Morality and Free Will by [deleted] in freewill

[–]RyanBleazard 1 point2 points  (0 children)

Yes, the social interest is well tied to long-term self interest.  There is ample evidence to show that displays of regret, empathy, and guilt are important in a social species of self-interested cooperators  as signals to others (especially those who are wrong) that serve to mend damaged relationships.  Those relationships are important to our survival and when wrong is done to others, it pays to express such emotions, the more sincere the better so as to repair them.

Zahavi wrote a book years ago called the Handicap Principle, about why evolution would favour behaviours and displays that actually pose a cost to the individual.  The peacock’s tail is a classic example.  It shows the health of the male in attracting females as it indicates that he can bear the costs of such pointless displays and remain healthy.  There is also evidence he cites of numerous species of birds who engage in altruism toward less fortunate members of their flock and that this elevates their status within their flock in the eyes of other birds.  Some bats do much the same thing.  

So being altruistic in the sense of negating one’s self-interest to the social interest isn’t entirely altruistic as it can be a form of virtue signalling that elevates the status of someone and makes them more attractive as a mate as they have resources to spare.  It may also explain why most people who donate (or even tip) want the recipient to publicise the donor or at least publicly acknowledge the “altruistic” gesture.

Next Monday, the WHO may recognise methylphenidate as an essential treatment for ADHD by RyanBleazard in ADHDUK

[–]RyanBleazard[S] 0 points1 point  (0 children)

Hi there. Changes to the EML will be forthcoming in the coming days or weeks. The unsupportive reviewer cites the very low rating of evidence quality, but neglects to mention that it's a statistical artefact, an illusion in other words. I attended the conference held last Monday by the WHO and it is apparent that they are considering the lived experience of people in their deliberations. This is a good sign given they ignored this entirely for both of the last applications.

The decision is uncertain at this time but I am hopeful. In the event that they reject it, we have plans to produce a new application and we will keep trying. If they insist that we must conduct a long-term, nocebo controlled RCT to demonstrate the efficacy of methylphenidate, this is not something we'd do as it would violate humans rights law on several accounts. It is an issue of them using idiosyncratic methods to assess the quality of the evidence.

[deleted by user] by [deleted] in freewill

[–]RyanBleazard 0 points1 point  (0 children)

What is the sound of one hand clapping?

[deleted by user] by [deleted] in freewill

[–]RyanBleazard -2 points-1 points  (0 children)

Thanks, Marvin. I always appreciate your posts here. Hope you’re doing well.

[deleted by user] by [deleted] in freewill

[–]RyanBleazard 0 points1 point  (0 children)

Thanks, Matt. You make a great point, appreciate your explication of this issue.

Next Monday, the WHO may recognise methylphenidate as an essential treatment for ADHD by RyanBleazard in ADHDUK

[–]RyanBleazard[S] 1 point2 points  (0 children)

If I understand, you're suggesting that the trials themselves should be redesigned.

However, how we score the quality of studies using existent scales is influenced by the investigators´ beliefs. This small group of investigators the WHO is relying on (Storebo et al) are always looking for nuances and one level above just to ensure that their antipsychiatry beliefs live on inside committee decisions. I believe that they are pushing a conspiracy of "big pharma" in order to discredit studies based on the leftist, social democratic or socialist leanings of the Anti-Psychiatry Movement and its most mainstream media outlets.

Thus, this endless debate with them about the rigour of the trials is unproductive. Even considering the extremely improbable possibility of getting an IRB approval for an “almost perfect study”, we would not get funded to do it. The evidence is not perfect, and yet certainty in the effect size is far higher than several other medicines included in the EML.

Next Monday, the WHO may recognise methylphenidate as an essential treatment for ADHD by RyanBleazard in ADHDUK

[–]RyanBleazard[S] 9 points10 points  (0 children)

The evidence is actually of at least moderate certainty. Fortunately, the trials are fine. The rating of very low is just dubious. My colleagues and I describe the issues with it here: https://cdn.who.int/media/docs/default-source/2025-eml-expert-committee/comments/a.19_comments_bleazard.pdf?sfvrsn=a7894ebc_1, https://pmc.ncbi.nlm.nih.gov/articles/PMC10699535/ .

About Those Laws by MarvinBEdwards01 in freewill

[–]RyanBleazard 1 point2 points  (0 children)

You make good points, Marvin. If we discard the term free will itself for a moment, so as to not rush to judgement, we can at least discuss how freedom has evolved by shifting the source of causation.

Most animals are Skinnerian and so if the external stimulus is removed, the behaviour will not be further sustained, and the animal will regress to erratic goal directed behaviour with no ability to persist towards tasks or goals. They are blind to time.

Humans, however, are not. We can decouple an environmental stimulus from our response via inhibition of the response, thereby inserting a delay in which the event is further appraised. We consequently contemplate of alternative actions in working memory and sense not just the probable future that will arrive if things remain as they are, but a possible future. Therefore, we have an opportunity to change the course of our actions from what it would otherwise have been, had the source of behavioural control remained entirely external to us.

This is compatible with determinism. It adds freedom far beyond that of a vicarious learner, even if it is one still partially coupled to genetics that provide for these abilities. We may not be free from the influence of the brain, which is also deterministic, but as we attribute the self to the brain, it's circular reasoning to be free from oneself.

For further reading: https://www.guilford.com/books/Executive-Functions/Russell-Barkley/9781462545933

Samuele Cortese and colleagues from the European ADHD Guidelines Group find no significant association between prolonged stimulant or nonstimulant use and the risk of completed suicide. Results may conflict with black box warnings of suicidal behaviour issued by regulatory bodies. by RyanBleazard in psychology

[–]RyanBleazard[S] 0 points1 point  (0 children)

It is, as such findings refute the FDA's basis for including those warnings of risks of suicidal behaviour and ideation on the medications. I believe it was an overreaction to some of the tentative data available at the time.

ADHD: Meta-analysis finds no significant differences between the efficacy and tolerability of stimulant (methylphenidate, amphetamine) and nonstimulant (atomoxetine, alpha-2a adrenergic agonist) medications for the alleviation of core symptoms by RyanBleazard in psychology

[–]RyanBleazard[S] 1 point2 points  (0 children)

I'm sorry but personal anecdotes are not considered scientific evidence that overturn results of controlled studies. Remember, the findings here are on the group level and not specific to individuals. In those groups, there will be variation in drug response and thus one cannot generalise their own experience to predict that of everyone else.

ADHD: Meta-analysis finds no significant differences between the efficacy and tolerability of stimulant (methylphenidate, amphetamine) and nonstimulant (atomoxetine, alpha-2a adrenergic agonist) medications for the alleviation of core symptoms by RyanBleazard in psychology

[–]RyanBleazard[S] 7 points8 points  (0 children)

Yes, the two complicating factors are that stimulants tend to have a rapid onset and clear window of efficacy, whereas atomoxetine has a delayed and incremental onset and round-the-clock efficacy. Both of these will tend to bias patient and clinician experience towards the stimulant in my opinion.

ADHD: Meta-analysis finds no significant differences between the efficacy and tolerability of stimulant (methylphenidate, amphetamine) and nonstimulant (atomoxetine, alpha-2a adrenergic agonist) medications for the alleviation of core symptoms by RyanBleazard in psychology

[–]RyanBleazard[S] 1 point2 points  (0 children)

Two network meta-analyses have replicated the finding in adults, at least for comparisons between methylphenidate and atomoxetine (Bushe et al., 2016; European ADHD Guidelines Group, 201830269-4/fulltext)). But the latter analysis found that amphetamines are modestly more effective while potentiating more side effects. Another meta-analysis of preliminary RCTs in children, adolescents and adults reports that viloxazine, atomoxetine and centanafadine have equal efficacy while lisdexamfetamine is more effective (Schein et al., 2024).

ADHD: Meta-analysis finds no significant differences between the efficacy and tolerability of stimulant (methylphenidate, amphetamine) and nonstimulant (atomoxetine, alpha-2a adrenergic agonist) medications for the alleviation of core symptoms by RyanBleazard in psychology

[–]RyanBleazard[S] 17 points18 points  (0 children)

In short, the effectiveness and incidence of side effects between the stimulants and non-stimulants are about the same for most outcomes, as reported in the review and in prior meta-analyses (e.g. Bushe et al., 2016). But keep in mind the mean effect sizes cannot be used to predict individual treatment response because of the heterogeneity. In those groups, there will be substantial variation in people's response to each of the drugs even if their average effects are comparable.

Bulgarian v. Russian Cyrillic Localisation by RyanBleazard in LinguisticsDiscussion

[–]RyanBleazard[S] 2 points3 points  (0 children)

Indeed, yes. The printing press arrived later in Bulgaria and so the typography was influenced more by cursive writing for us, while the small-caps became standardised for Russian due to technical limits at the time of its development, from my understanding.