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Small-Scale Question Sunday for July 2, 2023

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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Society strongly incentivized ADHD and autism diagnoses, so they rose.

I have no doubt that as it relates to ADHD diagnoses this is true, but ADHD diagnoses don’t necessarily have much to do with actual phenotype- sure, the DSM officially wants a note from a child’s teacher stating that the kid has ADHD symptoms interfering with schoolwork, but I don’t think teachers ever deny those notes, in part because all children have ADHD symptoms which don’t make school easier, and doctors also seem to waive that requirement a lot. Society incentivized diagnoses, not symptoms, and the diagnoses are virtually never denied regardless of the presence or absence of symptoms. Something has to account for the increase in symptoms, and that could be parents don’t beat their kids enough to keep them in line, it could be chemicals in the water, it could be assortative mating or what have you, but ‘people are acting crazy to get crazy pills’ isn’t a good hypothesis because people who want legal meth just lie and say they need it, and doctors don’t call them on it, and being more impulsive and less focused and socially less aware are all bad things that people avoid.

I was going to claim that trends like increasing parental age might cause an increase in diseases like autism and ADHD due to higher mutational load, but on further research I found that the trend seen in autism is reversed for ADHD, with younger parents being a risk factor instead!

I assume that's because of them likely having lower than average executive function if they're having kids that early, but this was a rather non-obvious discovery that surprised me.

At any rate, I haven't heard anyone claim ADHD or autism rates increasing in India, though the former is nigh unknown for some reason.

ADHD seems dramatically less common outside of North America. This is probably because the clinical definition is ‘sometimes impulsive or bad at paying attention to the point that it affects your life’, and for cultural factors America applies that literally while everyone else considers it to be a descriptor for people who are unable to live a normal life under any circumstances due to poor attention-paying and impulse control, which is a group that usually winds up in prison rather than a psychiatrists office.