Not-So-Quick Fix: ADHD Behavioral Therapy May Be More Effective Than Drugs in Long Run

tarkay · 3 days

Well, I see what you mean, but I don't think it works like that. Not if what I've read of modern research is correct. I'm no expert, but I've read a lot lately since I was diagnosed as an adult last year.

The medication doesn't magically suppress impulsivity so the brain doesn't have to, it increases the ability to control impulses (and other executive functions that are lacking) so that the brain can do it. So the brain will actually become better at controlling impulses because it actually gets to do it and learn how it is supposed to work and develop supporting mechanisms (like proper dopamine responses to future events which is usually lacking). Without medication it will not be able to do it effectively and in addition there is the deficiency that limits the development of the necessary functions. Most will probably have to train these functions for it to work properly. For some the medication will be enough and the brain will start to develop these skills normally, but many are so lacking or so far behind in development that they need to practice these skills specifically. And some are permanently damaged and will never function normally and they need to practice different skills to control the executive functions. Like externalizing everything into lists and schedules and develop very strict routines and learn that they can never trust their brain to do what they expect it to do.

So it's not an electric wheelchair, it is a crutch to support you while you move around trying to learn to walk again after an accident. (You can probably do that without a crutch, but if people yell at you and call you stupid and lazy every time you fall down it's hard to get much practice!) Most people need some support while doing that, and some people will recover completely by just moving about. Some will need special physical therapy, and some people will have to learn a new and different way to walk (if there is nerve damage or something) and may also require the crutch for the rest of their life. I think it's a little like that.

tarkay · 3 days

Russel Barkley talks a good deal about this. (He has some great talks online, google him if you haven't.) According to him it is a deficiency in the brain that causes parts of it do develop slower and less than "normal" children. They can see this on the MRIs. The medication helps the deficiency so that the brain can start to develop normally, but it has already been delayed. So the brain probably needs training to learn the things it missed, and it may be difficult since everybody else already learned these things. In some cases people sort it out by themselves with or without training and/or medication. There are degrees to this, and often development catches up with the rest of the population sometime in adulthood. If medication is started early and proper training is done it greatly increases the chance of doing well without medication later. But medication is absolutely essential according to him, because there is an actual physical deficiency and development problem.

He also says that behavioural therapy by itself doesn't work very well with children (it usually doesn't last) and if it does it has to be in the actual problematic situation and not removed from it. It can sometimes work OK in adults though. It may be that these therapies have focused on the wrong things in the past and that they work better if they focus on training and developing the parts of the brain that need it. We get more knowledge about what is actually going on all the time.

So helping them cope until their brain catches up definitely makes sense, but helping the brain to actually catch up is the most important thing.

Bezbojnicul · 3 days

I support women's right to choose, but at the same time I don't think that abortion is perfectly OK. It is a very complex picture and abortion is definitely not a positive thing by itself. It's just that there are many other factors that are worse and make it a reasonable decision in many cases. But if 100% of pregnancies are aborted there is something very wrong in the rest of the picture.

For one thing it shouldn't be necessary. People should prefer other forms of contraception that are safer, more cost-effective and also protect against diseases. There are risks to abortion and it isn't reasonable to take it so lightly.

And it is in fact termination of a potential life, no matter where you set the bar for where life starts. If someone thinks it is perfectly OK to go around starting new lives willy-nilly and then aborting them without a second thought, I really don't think they have thought it through properly, and I don't think that is OK. No religious agenda here, I just think life if precious and there are many open questions and things we don't understand about it, as well as many psychological aspects regarding parenthood, offspring and genes and it really is a mistake to see abortion as a simple solution.

I'm not arguing against abortion here, I think abortion is reasonable and defendable in many situations, maybe especially in these countries that are often poor, extremely socially conservative and have low education levels and lacking social safety nets for single mothers. I think that this explains to a large degree why the percentage is so high, but I think it is a symptom of other problems and that the governments in these countries should work to lower them.

And it would certainly matter if 100% of pregnancies in a country is aborted! That would be a huge fucking problem! (No pun indented ;-p)

BabyStevie · 3 days

So while we wait for the day when skin color is the same as hair color we should act like it actually isn't? Got it. It's a good plan.

BabyStevie · 3 days

But racism is considering race when race is irrelevant to the issue at hand. In this case it is relevant, because this kid wants to look like MLK and MLK was black.
And making a big deal of it is actually racism because it considers race as relevant to this issue, when it is not. If you try to look like what MLK looked like you have to look like what he goddamned look like! Race should have nothing to do with it!

TheBananaKing · 3 days

I don't have the same problem exactly, but I do have problems listening to music while I work. I'm a programmer and need to use music to block out what's happening around me, but most music also distracts me, especially if it has lyrics.

Listening to stuff that I've heard a million times before works sometimes, but it gets boring.

But what I've found works really well for me is ambient jazz noir/doom jazz like Bohren & Der Club of Gore or The Kilimanjaro Darkjazz Ensemble/The Mount Fuji Doomjazz Corporation which is very, very slow and also (mostly) without lyrics. It isn't repetitive so it's interesting enough to listen to in the background, but my brain doesn't really focus on it. At the same time the extreme slowness and calmness kind of slows my crazy brain down to a point where I can actually control it and get stuff done. It's magical.

If you don't like the jazz-thing there is also a lot of ambient electronica and stuff like that that might work the same way, but I guess that's often more repetitive and I've never really heard that kind of slowness and calmness in any other music.

JackieOrgasm · 7 days

Then he is indeed the greatest!

tomrhod · 8 days

...and due to its content it should not be read by anyone.

JackieOrgasm · 8 days

Did he play the bongos?

JackieOrgasm · 8 days

Thank you! How did I not know about /r/askhistorians?!!

rollingalong · 9 days

So he was the first to make it relevant, not the first to find it.

Populoner · 15 days

Tywin also immediately knew Arya was a girl. Speculation

isinned · 19 days

There is a clear danger of that, and that's another reason he probably can't be released. He's already showed and even bragged about how he planned by himself for years and even invented these tricks for hiding what he was doing and avoiding any suspicion and how good he is at fooling everyone. Even if he did somehow change in prison, everybody would just think that it is just a trick to fool everybody and continue the plan.

But the best possible outcome of all this (or maybe even the only good outcome) is if he actually wakes up at some point and sees what a fucking complete moron he's been and (if he can bear what he did somehow) then turns around and starts talking about it in schools and work against fundamentalism and this kind of ideology. If he dedicated his whole life to that, it could maybe be some kind of redemption.

But he's obviously a pompous idiot so I can't really see him being much use for that either, really..

ccgeogeek · 19 days

While I understand what you mean, the "something shiny" cliché really annoys me too. I feel it implies that I get extracted by just any stupid thing as long as it's "shiny", and I definitely don't. I actually hate most of the "shiny" things and think they are annoying, and noisy and boring.

The things that distracts me are interesting (to me, at least) and usually complex but most people would find them boring and pointless. Like how to build an underground bunker (didn't actually do that, but sounds good to me), or where I can buy a secret door that looks like a bookshelf (did that), or the history of the Eastern Roman Empire, or the roots of Scandinavian geographical names that end in -hammer, or whether there is really MAO inhibitors in tobacco and what that actually means for peoples use of tobacco and my own. Or reading for days about how to do something, like moving a huge SVN repo at work with several projects in it to Git while also splitting ut up and cleaning up the history, but end up never actually doing it because it requires.. you know.. actually doing something. I think maybe it was a little bit different when I was younger, but these days I'm usually most distracted by suddenly remembering something that I want to do or learn or should do and then 1 minute later I remember something else, and then something else.

Oh, crap! I'm very sorry, I really didn't mean to rant! I just feel that "shiny" is a very ill-fitting word for describing what distracts (or attracts?) me, and I feel it makes me sound mindless and stupid which is far from the truth. I would far prefer "Oh! Something interesting!" or something like that. I don't know what irritates GB20, but that's what irritates me about it.

I'd like to hear how you experience it by the way!

isinned · 19 days

But of someone is a sociopath[1], and sociopaths are unfixable, they belong in a mental institution and not in prison. The whole point of prisons is generally to act as a deterrent and an attempt to reform the offender. None of these applies to a sociopath who cannot be deterred and is unfixable, and so it is absurd and counter-productive to put them in prison. If it is in fact true that sociopaths are unfixable and will reoffend they should be drugged down and kept somewhere. But sociopaths aren't really a big problem, thats just a strawman. How many sociopaths are there in US prisons? The problem is that US prisons makes NO attempt to reform people and actually tries pretty hard to break them down. And at the same time the US teaches its population that violence is perfectly OK, as long as you have a good reason. And it also lets a large part of the population live in poverty without a reasonable hope for a better future, and that breeds crime like flies. It also lets people run for-profit prisons, which is so sick I have no words. In short, it's fucked up.

And if someone is NOT a sociopath, and there are other reasons or incentives for them to do what they did, it is NOT "pure sentimentality" to help them. What do you gain from not helping them? Nothing at all. What is the risk that you are actually increasing the threat to you and your loved ones (or whoever you care about) by not helping them? Pretty fucking high! What is the chance that you are increasing the risk by breaking them down in a brutal prison system, either to "teach them a lesson" or purely for revenge? Even higher! So, lets just kill them all then? Nope. For one thing, who decides who gets killed and where do you draw the line? And second, that is guaranteed to escalate conflict, violence levels and end in revolution and bloodbath. And a multitude of other problems. In short, a fucking stupid idea.

So what you end up with is that in the end it is in your best interest that society and people in it functions well. And you can't just get rid of people who you think isn't fitting in. You can punish unwanted behaviour to a degree and try to reform people, but you MUST live with them afterwards (a few special cases excepted maybe). And that means that some times you have to give people things that you think they don't deserve. Because if you don't it only gets worse. The best way to get someone to function well in society is to integrate them well in society. And that means giving them an education, skills, respect, help to develop themselves as a person if they need it (who doesn't?) and the means to survive so that they are able to do these things. Revenge NEVER makes anyone function better in society. It is entirely counter-productive and nobody gains anything from it.
This is what the Norwegian prison system is based on. Making society better. It's not about feelings or sentimentality or being kind or naive. It's about being rational about it.

But when it comes to Breivik, I hope they lock him up for life. Not for revenge or even punishment, but I think what he did is so monstrous that the system and society can't really handle it in any meaningful way. It kind of overloads. I don't think it's possible to do anything meaningful to punish or reform him, and so he just has to go away for good.

[1] I'm just going with your definition of a sociopath here, whatever it is. I don't know the correct one and it doesn't really matter.

matlem · 1 month

I don't know anything about arvixe.com but with GWT you need a server component to handle the database access. Typically this will be a Java Servlet or something like that, but it doesn't look like arvixe.com supports that.

But you can use GWT with any webservice that can produce JSON data (and maybe other formats, I'm no expert on that) so you can write the server-side logic in PHP, Python, Ruby or whatever the hosting provider supports.

If you have a VPS that you can install Tomcat on that would be the easiest, as you can deploy your whole app as one war file and then use GWT RPC or RequestFactory for communication, but also more expensive.

I recommend looking into how to use GWT with Python, PHP or Ruby or whatever they support if you want to stay on arvixe.com. I think I've seen articles on the GWT developers site about that. Or maybe consider deploying your application on Google AppEngine instead. AppEngine runs Java and is free for small-scale use and is well integrated with GWT and the Eclipse tools as far as I know (although I never actually used it).

MrSpite · 1 month

Hardly the worst EVER. It might actually be a pretty good idea for making money. It's certainly pretty bad idea for making good books, but I can think of lots of ideas that are much, much worse than this, generally speaking.. :-P

MrSpite · 1 month

The things is that if it became popular it would have to have a name. It would have to be "The Adventures of Huckleberry Finn - The Texas Board of Education Edition" or something like that, because people would have to know which one to get.

And besides, lots and lots of books are in the public domain, and this doesn't seem to be happening a lot.

I think the free exchange and development of ideas would outweigh any negative effects of people making crap versions of books. I think books (which of course are just stories) in many ways are much like Dawkin's memes, they are essentially ideas with their own life and they evolve over time. This happens even now as new versions and translations of many classics, especially if they are meant for children, are updated to a more modern language or the illustrations are updated and other such things. Unless essential parts of the story are changed it doesn't matter very much. If essential parts are changed it may result in the book becoming worse and nobody wants to read it, but it may also result in it getting better and more people want to read it. I think these things will regulate themselves.

jokes_on_you · 1 month

Then it can't by definition be strong. It just happened to suit our (average) circumstances.

What?! I don't think you understand evolution. There is no such thing as strongest, fittest, best. Only survival of the surviving. Nothing else. So a system that works is the very definition of a strong system.

If soon is just a few centuries, then this might very well be happening.

Ok, anything "might very well be happening", but where do you see ANY sign of this happening? If there are any signs of this it sure as hell isn't caused by people helping each other too much!

SmellyPhish · 1 month

But "I" can never be another, so that's a bit meaningless. He only knows that he exists, because he doubts that he does, he can't know that any other people, or even anything, exists. So it's meaningless to speculate if it would be different if he was another or if he was different, because he isn't. It's like asking if things would be different if they were different. Yes, they would. But that doesn't say anything about what is.

But it's a very interesting question if or what you would think if you had no senses!

tonker · 1 month

I didn't know what to call it in English, maybe car sharing club is a better word. This is in Bergen, Norway. (More about the concept here.

In our case it is like a non-profit co-op where people buy a share and the co-op owns all the cars. One person has been hired as an administrator and runs the whole thing. I think we have around 70 cars of different kinds, from small cars like Ford Fiesta and Peugeot 207 to 7 and 9 seaters and some vans like Peugeot Partner and Ford Transit.
We book cars online and you can book one for how long as you like, a few hours or several days. Some people drive on vacations for weeks during the summer.
You pay a small amount per hour and per kilometer (invoiced at the end of the month), but that includes gas and even most toll roads (Autopass in Norway). Everybody has a Shell-card for gas (and lightbulbs and carwash and such) and should refill after use.

I live in the town-center and need a car maybe once a month so this is ideal for me. Much cheaper than owning a car, I never have to think about service and repairs or winter tires, and I also have access to different kinds of cars if I need them. I've almost never had problems getting a car when I've needed it, although a few times I've had to take a bus to pick one up because all the cars close to me was taken. Typically during holiday weekends and school holidays when everybody is traveling somewhere, you usually have to book well in advance then.

Recommended if it exists in your area!

tonker · 1 month

I'm a member of a car sharing ring and we use key tubes like that for the car keys. All the members have a key to open them. The cars are parked all over town and you just book one online and go find the key in a locked tube like that in a wall near the car.

tim0 · 1 month

I don't think physical publication will ever disappear completely. In fact it will probably be good for those that love physical books as it will change towards hardcovers and it will create a culture of competing to create the coolest and most elaborate hardcovers. It will be more like collectors items for people who love books in general and that book in particular. It will be sold in specialty stores where people really care about books.

The main consumption of content will shift from cheap inefficient paperbacks to digital, but the quality of books as a physical product will improve. Just look at music. The CD is dead, consumption is digital, but vinyl is the future for physical music. Beautiful, elaborate vinyl productions with their huge sleeves and booklets filled with interesting content, that you can enjoy and smell and caress and have on display in your living room. That's the future for books too.

BlankVerse · 1 month

But if you manage to get into politics you won't need to change it anymore. By then you will have excellent healthcare and you have other needs to fulfill and fuck all those lazy bastards, they should just get into politics if it's so damn important to them! And so it goes.

maxwellhill · 2 months

Most students also dislike harder teachers

No they don't. Students respects hard teachers who demand discipline as long as they are fair and respect the students. It's the dicks and the idiots they don't like. Of all the teachers I've had or known through life, the strict but fair ones has always been the most popular and respected.

Birk

TROPHY CASE

Birk

TROPHY CASE

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