In the early 1990s, James Swanson, a research psychologist at the University of California, Irvine, faced significant challenges in the field of attention disorders.
At that time, the Church of Scientology had launched a nationwide protest against the psychiatric profession, specifically targeting the use of Ritalin, the leading medication prescribed for children diagnosed with attention deficit hyperactivity disorder (A.D.H.D.).
Swanson and colleagues often found themselves confronted by protesters at scientific conferences, who chanted slogans and waved signs, with messages like, “Psychs, Stop Drugging Our Kids,” flying overhead.
Prescription rates for Ritalin were indeed surging during this period.
Between 1990 and 1993, the number of American children diagnosed with A.D.H.D. more than doubled, increasing from fewer than one million patients to over two million, with about two-thirds receiving Ritalin prescriptions.
To Swanson, this increase appeared justifiable; approximately 3 percent of the nation’s child population was diagnosed with A.D.H.D., a figure believed to reflect the actual prevalence accurately.
However, questions about A.D.H.D. remained, casting doubt on the appropriateness of the treatment approaches being used.
Despite Ritalin’s popularity, uncertainties loomed regarding the medication’s mechanisms and its efficacy as the optimal treatment for children.
Doctors and parents often noted that many children exhibited behavior improvements almost overnight after starting stimulant medications like Ritalin, but no comprehensive, large-scale studies had been conducted to measure the frequency of this positive response or to evaluate the long-term effects of Ritalin on children’s development.
In response to these concerns, Swanson and his research team, supported by funding from the National Institute of Mental Health, embarked on an extensive, multisite randomized controlled trial.
The goal of this study was to compare the effects of stimulant treatments for A.D.H.D. against nonpharmaceutical interventions such as parent training and behavioral coaching.
Swanson managed the site in Orange County, California, where he recruited approximately 100 children aged 7 to 9 exhibiting A.D.H.D. symptoms.
These children were divided into treatment groups: some received regular doses of Ritalin, some underwent high-quality behavioral training, others were given a combination of both treatments, while the remaining group was not provided any treatment.
Similar procedures were replicated at five other research sites across the continent.
This initiative, known as the Multimodal Treatment of Attention Deficit Hyperactivity Disorder Study, or M.T.A., represented one of the most extensive investigations into the long-term impacts of psychiatric medications.
As a result of this comprehensive study, researchers hope to shed light on A.D.H.D. treatments, aiming to bridge the gap between clinical definitions and scientific findings, a relationship that appears increasingly tenuous in the light of emerging evidence.
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