Who Needs Testing for ADHD?

Written By Cynthia Hammer, MSW

By John Kruse, MD and shared with his permission


 Bothered by mistakes you’ve made on your business accounts and missing deadlines at work, you turn to the internet to learn whether you have ADHD. You’re deluged by ads for online surveys, neuropsychological testing, genetic assays, EEGs and PET scans. They all tell you that they can help diagnose your condition. You wonder if you need all of this and how much it will cost.

 Who needs testing for an ADHD diagnosis? Nobody requires testing to determine whether or not they have ADHD. I’m not being testy, but I de-test the mindset that pretends we possess valid diagnostic tests for our common mental health conditions.

Testing may reassure some people about their diagnosis. Some testing may help rule out other conditions that might co-occur with or mimic the condition you’re concerned about. But the biggest rationale right now for mental health testing is to meet the requirements of certifying boards to obtain disability status or special accommodations.

 It is unclear why any organization would demand testing to diagnose or confirm a psychiatric condition when this is beyond what our current tests can accomplish.

 When I say testing, I’m not only referring to “squishy” rating scales that ask you to report your symptoms. I’m including neuropsychological/neuropsychiatric testing, designed to measure the brain’s abilities, neuroimaging approaches, and genetic testing. None of these approaches currently provides essential information for diagnosing common psychiatric conditions.

 Popular support for these tests is based on the fallacy that if we can demonstrate differences in some variables between those with a condition and those without, we can rely on those variables to decide who has the condition. The variables might be anything from dopamine transporter activity to cortical thickness in the prefrontal cortex, working memory, and genetic variants coding for a serotonin receptor.

 Not only does the general public repeatedly make this logical error, but many educated clinicians and even neuropsychiatric researchers do as well.

 In psychiatric research, even when we can find statistically significant differences in measurable variables, the range of responses for those with the condition almost always overlaps the range of responses of the normal control group. 

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For the full article and a detailed explanation of the various “tests” and why they don’t work, see

https://medium.com/invisible-illness/who-needs-testing-for-mental-health-conditions-6529958966f8  

Cynthia Hammer, MSW

Cynthia Hammer, MSW, was diagnosed with inattentive ADHD in 1992 when she was 49 years old. The following year she created the non-profit organization, ADD Resources, with a mission to educate adults and helping professionals about ADHD in adults. She ran the organization for 15 years before retiring.

During the Covid isolation she wrote a book about her life with inattentive ADHD which should be published by the end of this year. In writing the book, she was dismayed to learn that children with inattentive ADHD continue to be under-diagnosed and adults with inattentive ADHD often are incorrectly diagnosed with depression or anxiety.

She created a new non-profit in 2021, the Inattentive ADHD Coalition (www.iadhd.org), to create more awareness about inattentive ADHD and the need for early diagnosis and treatment.

https://www.iadhd.org
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