What's New in Neurofeedback

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  All links at: http://news.yahoo.com/fc?tmpl=fc&cid=34&in=science&cat=brain_research

According to recent statistics, Boccaccio might have also been refering to America in the last decade. In 1990 half a million children were diagnosed with the disease. In less than 8 years it multiplied eight-fold, to 4 million school-aged victims, infecting an astounding 10 percent of the entire school-age population. In some parts of the country nearly half the school children were said to have succumbed. Adults were also not immune. As many as 13 million adults currently are afflicted. Although no infectious agent has been uncovered, these numbers suggest an epidemic is upon us. I am refering to, if you haven't already guessed, Attention Deficit Hyperactivity Disorder.

By some estimates, one in six school-aged children suffer from ADD or ADHD. "With the exception of AIDS, there are few examples of such a rapid spread of a serious condition in recent years," says Gene Haislip, a former deputy assistant administrator at the Drug Enforcement Agency. AIDS is a severe, potentially lethal disease. At its peak in the US (1993) 102,000 new cases were diagnosed each year. But that same year ADHD struck 20 times this number. Fortunately the production of Ritalin kept pace! A rise of more than 700% over the past 10 years. And although America may be ground zero for the ADHD epidemic, it crossed the pond with a vengeance: Britain witnessed a 35,000 % increase in ADD cases in five years, from 2,600 cases in 1992 to 92,000 in 1997. Seven years later and there's no stopping it: current estimates now hover at half a million, many undiagnosed. "Too many children are 'slipping through the net'", sais a Dr Val Harpin, of Sheffield Children's Trust. Only 70,000 children are receiving medication; the National Institute for Clinical Excellence recommends that 100,000 children should. A lot of small pills are not being swallowed.

Although I would object to comparing ADHD to the AIDS epidemic, mental disorders can be nearly as devastating, emotionally and intellectually. Childhood ADHD is associated with an increased frequency of psychopathology in later life (Wender, et al., 1981). About two-thirds of children continue ADD symptoms into adulthood. Researchers have consistently found higher rates of antisocial personality, conduct, oppositional defiant, substance use, and anxiety disorders in adults with ADHD. Serious delinquent and psychological outcomes are associated with ADHD. ADHD children are at greater risk for chemical dependence (Clopton et al., 1993; Wilens, et al., 1995). Substance abuse disorders were found in 28% of children with ADHD, 8% of ADHD children who no longer showed symptoms in adolescence, and in only 3% of non-ADHD children. ADD children often progress from substance abuse to addiction in a shorter time period than other children. Milin (1991) found ADHD in one quarter of all substance abusers he examined butno cases of ADHD in non-substance abusers, so this epidemic shouldn't be underestimated. Or should it? Is there really an epidemic underway? And if so, what triggered it?

Epidemics. What causes epidemics? What ignites them, fuels them? When an unfamiliar and virulent germ enters a virgin population, an epidemic often follows. True? But where did the new germ come from? Some would say epidemics are the price we pay for living together, living in crowded cities. Humans are the highways upon which microorganisms test out this year's newest models. But often the germ responsible for an epidemic isn't particularly new to the scene; the population is.

Epidemics have plague humankind since our inception. Hippocrates wrote about them two thousand years ago. He also wrote about endemic diseases, which are more common. Endemics are epidemics past their prime, making the rounds after an original assault against a more resistant folk. By this definition ADHD is an epidemic, not an endemic condition. It is Round One, people, and there have been hundreds of Round Ones throughout history.

The first documented epidemic struck the Persian army in 480 BC. Xerxes led an army of 800,000 men into Thessaly, but had to withdraw when he lost a third to plague and dysentery. History is replete with similar examples: microbes striking a target that artillery could not reach. The First Crusade ended when an epidemic killed 80 percent of the horses. I would have gone home after that, presuming the Hand of God (or Allah) was at work. The Second Crusade suffered 100,000 losses to disease. Every campaign has incurred two fronts: one manned, one microbial. By the 19th century it was not unusual for disease to create more casualties than weapons of war. Typhus, cholera, smallpox, diphtheria. World War I ended as it did, and with the problematic terms that led directly to number II, in part, because of flu.

The three most devastating epidemics in human history were the Black Death, a combination of (presumably) bubonic and pneumonic plagues which struck Europe in the mid 14th century and reduced the population by a third; the 1918 influenza epidemic which killed three times as many people than the surrounding World War; and the current AIDS epidemic.

      Ring around the rosies,
      A pocket full of posies,
      Ashes, ashes!
      We all fall down.
            (Children's rhyme, from plague-ridden England)

Black Death is thought to have been carried into Europe in 1347 by sailors from the Black Sea, and it may have been history's first and most successful act of biological warfare. As part of their seige tactics, the Tartars catapulted plague-infested bodies over the city walls of the port of Kaffa. The defending Genoese contracted plague and left, spreading the disease throughout the Mediterranean Basin. The 1918 influenza epidemic was called "Spanish flu" because of an early report in Spain, but the responsible virus evolved in American pigs and was spread around the globe by U.S. troops mobilized to fight the Kaiser. Even the peace conference at Versailles was affected as President Woodrow Wilson, the Prime Minister of Great Britain, and Premier of France all contracted the disease. As for AIDS, there are many theories about its origin, but I'm partial to the simian theory.. Milder strains of HIV have been carried with us for millions of years, but the end of European colonization in Africa lead to populations mixing as never before on the continent. Two extremely virulent strains of HIV emerged as a result. Without the increased traffic and contact between individuals, such strains would have burned themselves out in a decade or so, infecting one or two villages at the most. But truck and jet transporation changed all that.

Although epidemics can occur for any number of reasons, many share a common element. What kicks a local mutated microbe onto the world's stage? What is the epidemic catalyst?

Power. The endless human pursuit for power. Also called politics or money on occasion. Appropriation of wealth and power by any means possible. Invasion, conquest, exploration, trade. The pursuit of wealth is responsible for a large proportion of the major epidemics in history. (AIDS could be an exception, unless you place it in the context of suppressed cultures, a la slavery and colonization.) Last year 95% of the HIV infections in the world occurred in the 3rd world.

Epidemics are ignited by movements of capitol -- be they sailors, soldiers, or natives. A decision is made to transport a virgin population to a germ's homeland or to transport the germ to an unprepared city, all in the pursuit of wealth. In North America, measles and smallpox reduced a population that rivaled Europe's in 1491. The American plains and forests were not empty when Columbus arrived. But they were soon after. Disease reduced Mayan and Incan cultures to one-tenth their previous size. As many as 130 million indigenous people lived in Central and South America in 1491; 1.6 million a few generations later. Rock beats scissors, scissors beats paper, paper beats rock, but germs beats guns and nothing beats germs.

So what's it all mean?

Epidemics are political -- even when they aren't. They change the balance of power. They come about when one group is grabbing power. Be it the newest faux epidemics -- the epidemic of obesity, or school violence, or violent media -- to the more microbial sort. When epidemics appear, we should quickly try to isolate the human source of the contagion.

So is the same mechanism true for the ADHD epidemic sweeping through America's schools? Possibly. Let's ask ourselves this: Would this epidemic be so vast if money were not to be made?

-DK