header_piece

ADHD, Substance Abuse, and Impulsivity

A  recent study from the journal Nature Neuroscience suggests that teens who struggle with substance abuse and those with ADHD have somewhat different cerebral profiles, specifically in terms of impulsivity, a feature of both conditions. Both groups exhibit impulsivity, but that trait appears to derive from different areas of the brain. Among the teens who had tried alcohol, cigarettes or other drugs, like marijuana, brain scans showed different patterns of brain activity in the right inferior frontal gyrus and in the orbital frontal cortex compared to teens who had not touched these substances before. These differences showed up in self-control tests during which activity in their brains was monitored. Prior research has found that the right inferior frontal gyrus is involved in the ability to control, or inhibit, impulses. People with head injuries that damage that area of the brain have problems with inhibition. The orbital frontal cortex has been known for years to be involved in drug use.

What’s interesting is that the ADHD teens who were administered this self-control test also showed difficulties with controlling impulses, but their patterns of brain activation were quite distinct. The teens with ADHD exhibited differences in the bilateral frontal lobe and the basal ganglia, both of which are known to play a significant role in ADHD symptomology. So the same end behavior, impulsivity, appears to be linked to different parts of the brain.

The reason this study is important is that ADHD people have a significantly increased risk for substance abuse. The data from this research effort strongly suggest that atypical functioning of certain cerebral networks, those involved in impulse control, underlies addiction.  But impulsivity in addiction, as opposed to ADHD, appears to be a different animal. The study did not examine ADHD people who also were substance abusers. What will be interesting to see is if ADHD people with substance issues look more cerebrally similar to the ADHD group or to the substance abuse group.

Overall, this study shows us that the brain is an incredibly complex organ that we are just beginning to understand. Also, we see that impulse control does not always indicate the presence of ADHD. While it is easy to judge others who show what appears to be a lack of “willpower,” this study points to the underlying biology that is involved, and thus invites us to consider addiction as a bona fide disease.

With ADHD and addiction, many people who are not afflicted presume that a lack of willpower is to blame. “I know when to stop,” they will righteously declare. “They just need to learn their limits.” This scientific information gives us reason to pause and reflect, and perhaps reevaluate how we view both ADHD and addiction, and to consider having more compassion for people who deal with these challenging conditions. So many people presume expertise when dealing with mental health conditions. If you really want to understand mental health, go to school on the brain. I recommend the following books to help you in that endeavor:
1.  Howard, P. (2007). The Owner’s Manual for the Brain. Austin, TX: Bard Press.
2.  Nigg, J. (2006). What Causes ADHD?: Understanding What Goes Wrong and Why. New York: Guilford Press.
3.  Stoehr, James D. 2006. The Neurobiology of Addiction. 1st ed. Philadelphia: Chelsea House.

The Seduction of the Screen

This blog is an interview with Kendra Wagner, who has devoted herself to helping ADD people succeed, especially in becoming better readers. This blog offers great insights into why ADDers have a penchant for the “screen,” and offers some great solutions on how to confront that.

How can we help ADD-ers become engaged with non-screen activities?
That is a long answer, and much of it ties in to the list of common-sense treatments for ADD that the experts have drawn up for us. We need to take care of our whole selves, we always hear. Screen time takes care of well, our need for retreat, and helps eye-hand coordination. Research shows little more than that for the positives. As ADD-ers we know we need train our brain to crave down time, to insert physical activity into our day, to take medication, supplements, or both. The “pull” of TV, movies, video games, online activities, and cell phones is especially strong for ADD-ers, because it is the novelty and newness factor is ever-present. You can switch channels in TV, fast forward in movies, switch levels in video games, and switch entire websites on the internet. Oh yes, and text several people at a time on phones. So for those of us who dread tedium or slower pacing, screens are very enticing.

What is a screen addiction?

A screen addiction is characterized by insatiability and also an inability to gauge your time spent online, or in front of a particular game or program. Screen addiction means that use of the screens are mood-altering and the addict is dependent on it—that they have an anxiety or identity crisis (no matter how small)when they try to stop using screens for a day or two.

How does screen addiction impact learning?
We take in a lot every moment through the eyes, more than more than a few decades ago, which is only part of how we learn. Kids in school in their average day take in a lot visually and auditorally but to really learn something we need more. Screens cannot take us there. Also, the rate in which kids in school process what is coming in needs to vary in pacing or rate.  Varied rates of processing are necessary because we are all individuals. Some kids need fast/slow/average pace, and some need all of that, with repeated exposure, depending on their own brain make-up, or the subject being learned.

Neurologically, how are we wired to learn?
The three ways we learn are:
Visual: through the eyes
Auditory: via the ears
Kinesthetic: through the skin, this includes touch, internal sensations, and hands-on experience.
As a culture we are not encouraging kinesthetic learning as much as we could be. A child who is watching the world of today sees people interacting with screens and concludes that is how to communicate, learn and to entertain oneself.

How do screens hijack the learning process?
Often screens with video games, TV shows, or movies, and many educational websites or software, have very fast moving images. The speed of the images does not mirror the pace that our human brains are wired to move or process. In the same way that pornography doesn’t mirror the natural pace of a relationship, video games do not mirror the natural pace of engaging with the world or learning something deeply. So then the child or adult addicted to screens grows to expect that pace to be how off screen life responds to them.

Children and teenagers can become frustrated with the steps and time required to develop mastery. They will ask “can’t I just go to another game?” when playing an educational game that requires mastering a subset of skills before moving on. In a video game you can always start over and often you are able to go to a level you are comfortable. There are even “cheat codes” that can be used to “fake” mastery.

Can you talk about frustration tolerance and screen addiction?
For adults, frustration tolerance is required for creating a personal change. For children, it’s required when learning a new social or academic skill. Frustration tolerance is a willingness to have small, micro failures or frustrations while keeping an end goal in mind. Kids and adults without long term gratification skills (AKA Frustration Tolerance) expect things to be instantaneous. They also lack “gray area” thinking and will assign rigid categories to themselves and others such as smart/dumb and then not want to keep going with effort once they have put themselves in these boxes.  I’ve noticed that my clients who have screen addictions don’t take real interpersonal risks.  Right, because in real life there is no “reset” button.

So what do you suggest?
We are in a world of screens so we don’t want to pretend they don’t exist. I suggest that parents have a good mix: provide an equivalent amount of face to face time that matches the screen time your children have. A four hour play date equals four hours of screen time, on the weekend. And I always suggest no video games during the school week. That honors the fact that school and homework are the child’s “job” and the weekend is their time off, so to speak. Also it is harder to get addicted when you have five days without it.

Research shows that kids learn best when screen exposure is short. An enormous part of learning, in both reading and in doing, from sports to medical school, involves making pictures in your head. Apraxia, an uncommon learning disability, and related disorders of language comprehension, is becoming more common because the part of the brain that creates images is “getting less exercise” in screen culture.

Visual processing (seeing and making sense of images) is different than generating (creating one’s own image based on imagination) processing. We know this from brain imaging research. So with screen over-use, that part of the brain is not going to the gym.

If we want to become an expert in anything or to feel we have a special skill, then we need to give our attention and a slower pace to that learning process. Screens are a tool in being a learner. They cannot substitute for mentors, concentrated time, or kinesthetic learning.

Kendra Wagner is a learning specialist in private practice in North Seattle, who primarily teaches children reading, writing, and thinking skills. She also consults in schools and advocates for children. Her specialty in ADD and Dyslexia grew out of her work in schools as a reading specialist and consultant, when she saw so many students being mislabeled, mistreated, and mis-instructed. She has a particular interest in how the brain develops, learns, and adapts to family and school environments.

Footer_Piece
This blog is monetized using Are-PayPal WP Plugin