www.crossingdialogues.com/journal.htm DIALOGUES Crossing Dialogues Association 52 Another look at ADHD VÂNIA LÚCIA DE MORAIS RIBEIRO JOSÉ CARLOS CAVALHEIRO DA SILVEIRA Defi cit/Hyperactivity Disorder Clinic, Medical School, Federal University of Minas Gerais (Brazil) email: vaniademorais@hotmail.com DIAL PHIL MENT NEURO SCI 2009; 2(2): 52-53 Dear Editor, we would like to raise some points regarding ADHD philosophical knowledge considering initially the article by Thurber et al. (2009). The authors have analyzed ADHD from the point of view of classical science. They defend uniformity among the classifi catory models and opine that ADHD should have the status of hypothetic construct but not diagnostic entity since research has not found etiological evidence for ADHD. The criticism to the lack of methodological rigorous and to inconsistencies in this fi eld of knowledge is adequate and necessary to the advancement in understanding the ADHD. On the other hand, we would like to raise questions related to cultural variables, the patient context, ADHD's complexity expression. These aspects can be exploited under the contemporary scientifi c paradigm. According to Maturana's theory, the individual biologic structure results from all structural changes that occurred throughout the person's life as consequence of the individual internal dynamics and the interactions with the environment. The individual structure congruence with the environment determines the individual adaptation maintaining his/her organization, therefore his/her survival. In order to keep their needs, the members of a system operate selecting through their behavior structural changes of the components, therefore their characteristics. This happens in any human society. Under this point of view, there is evidence of a relationship between increase in ADHD prevalence and contemporary society demand. The social organizations nowadays demand from their members to attain social, academic and professional success, exactly those functions missing in ADHD individuals. The cerebral confi gurations of these individuals constitute source of problems from the social changes. They are not capable of processing different types of information simultaneously, to make plans, to organize themselves temporally and/or spatially, to concentrate fully in the work, among other activities missing in ADHD individuals. As a result they are victims of physical and psychological abuse, they are excluded and discriminated and live with the constant threat of failure. These factors are often the triggers of the comorbidities in this population (Ribeiro de Morais, 2008; Blachno et al., 2006). The modern science perspective, based on parameters of objective reality to validate knowledge, has tried to answer the question "where is the dysfunction and its cause in the brain of ADHD individuals?" On the other hand, the post-modern view, bringing the perspective of knowledge as a shared construct that is set in the interpersonal relationships through language, leads us to search for the understanding of the complexity of this fi eld, cultural, social and interpersonal dynamics that are implicated. Considering, for example, Thuber's suggestion (2009) that ADHD be a hypothetic construct and not a nosologic condition, we understand that this suggestion is pertinent from the scientifi c point of view. But, in terms of health and life quality of those people with ADHD there is need to consider what would be the practical aspect of this construct. The classifi cation systems offer criteria for diagnosis that can be questioned, however to invalidate them, other factors must be considered, including ethical issues. If the neurobiological factors that are in the origin of the dysfunction are not identifi ed, this means that are we not going to treat these paDialogues in Philosophy, Mental and Neuro Sciences DIAL PHIL MENT NEURO SCI 2009; 2(2): 52-53 Ribeiro de Morais & Cavalheiro da Silveira tients? Even that ADHD were considered as a problem of social origin and not as an individual dysfunction, does it mean that we are not going to treat the patient? How about their suffering? We found that to obtain the minimum satisfactory understanding of ADHD it is fundamental the interdisciplinary approach and to consider the complexity of the phenomenon; without it any study or discipline will have limitations. 53 REFERENCES Blachno M, Szamanska U, Kolakowski A, Pisula A. Parental corporal punishment in children with attentiondefi cit hyperactivity syndrome. Psychiatria Polska 2006;40:43-55. Maturana H. A ontologia da realidade. Ed UFMG, Belo Horizonte,1997. Kuhn TS. The Structure of Scientifi c Revolutions. 2 ed., enlarged. University of Chicago Press, Chicago and London, 1970. Ribeiro de Morais VL. A família e a criança/adolescente com TDAH: relacionamento social e intrafamiliar. Dissertação (Mestrado em Ciências da Saúde). Faculdade de Medicina da Universidade Federal de Minas GeraisUFMG , 2008. Thurber S, Sheehan W, Roberts RJ. Attention Defi cit Hyperactivity Disorder and Scientifi c Epistemology. Dial Phil Ment Neuro Sci 2009;2(2):33-39.