# Talk:Attention deficit hyperactivity disorder

Change "Additionally, evolutionary psychiatrist Randolph M. Nesse has argued that the 5:1 male-to-female sex ratio in the epidemiology of ADHD suggests that ADHD may be the end of a continuum where males are overrepresented at the tails, citing clinical psychologist Simon Baron-Cohen's suggestion for the sex ratio in the epidemiology of autism as an analogue.[92][93][94]"
to
"Additionally, evolutionary psychiatrist Randolph M. Nesse has argued that the 5:1 male-to-female sex ratio in the epidemiology of ADHD suggests that ADHD may be the end of a continuum where males are overrepresented at the tails, citing clinical psychologist Simon Baron-Cohen's suggestion for the sex ratio in the epidemiology of autism as an analogue.[92][93][94] However, Baron-Cohen's extreme male brain theory of autism has been heavily criticized due to the contested quality of the empirical evidence used to create it, as well as its reliance on unproven gender essentialist arguments . Contemporary research argues that the overrepresentation of males in diagnoses for both autism and ADHD is caused by diagnostic gender bias    ." Wrenched (talk) 12:10, 9 August 2025 (UTC)

 Not done for now: Malformed citations. Only one secondary source cited (The Guardian). The primary source, Journal of Women's Mental Health, is considered predatory. I don't get a good vibe from this request and think other editors with history in this article should review especially per WP:MEDRS. Xan747 (talk) 02:34, 26 August 2025 (UTC)

I agree Димитрий Улянов Иванов (talk) 08:05, 28 August 2025 (UTC)
Completely fails standards of WP:MEDRS. Lots of speculation from non-medical sources. Sundayclose (talk) 21:49, 29 August 2025 (UTC)

In the “Rejection sensitive dysphoria” subsection of the “Comorbidies” section, there is duplicate text. Specifically: 
Rejection sensitive dysphoria, while not a formal diagnosis, is also a common symptom of ADHD, estimated to affect a majority of people with ADHD. Others posit that rejection sensitivity stems from early attachment relationships and parental rejection; peer rejection is also thought to play a role. Bullying, an extreme form of peer rejection, is likely connected to later rejection sensitivity.However, there is no conclusive evidence for any of these theories.
This paragraph appears at the beginning and end of that section and should be removed from one of those places. 2600:1000:B122:EFED:6D41:4074:98DC:4C5C (talk) 16:01, 2 September 2025 (UTC)

Nice catch. I removed it from the end of the section, as it is clearly required at the beginning of the section to introduce the symptom. Xan747 (talk) 17:05, 2 September 2025 (UTC)

I thought that was the main area impacted. Mainly, reward anticipation cues in the striatum are blunted in those with ADHD and only during reward delivery does it light up, sometimes more so than in those without it. This may play a part in why we (I myself have ADHD) have a strong preference for immediate rewards over delayed ones. There was a study about this I was trying to find. But anyway, are there other areas? Because I was thinking about changing the part in the picture to the striatum instead of the basal ganglia. BlueFlare5059 (talk) 16:30, 16 September 2025 (UTC)

Don't make any changes without a reliable source. And note that medical articles have higher standards for determining whether a source is medically reliable. See WP:MEDRS. Ideally this would be one or more review articles in peer-reviewed professional journals that summarize scientific consensus. And please, no pop psychology or other popular press, including most newspaper and magazine articles. Sundayclose (talk) 17:02, 16 September 2025 (UTC)

The current version of the article has this paragraph in the Genetics section:

Natural selection has been acting against some genetic variants for ADHD over at least 45,000 years, complicating the suggestion that ADHD was an adaptive form of neurodiversity in the human evolutionary past. The disorder may remain at a stable rate by the balance of genetic mutations and removal rate (natural selection) across generations; over thousands of years, these genetic variants become more stable, decreasing disorder prevalence. During human evolution, executive functions disrupted in ADHD, likely provide the capacity to bind contingencies across time thereby directing behaviour toward future over immediate events so as to maximise social consequences for humans.

I have WP:MEDRS concerns with Keller 2008 and Barkley 2004 being dated, the former not being a review article, and the latter being the views of only a single author. At the very least, I am wondering whether we should attribute these claims. Aside from that, both sentences could use some editing. Xan747 (talk) 16:03, 8 October 2025 (UTC)

The second reference is a Genomic analysis (2020) published in Nature, one of the most reputable journals available, in which they reached that conclusion. It is a robust reference. Keller (2008) and Barkley (2004) are not outdated unless significant evidence has since overturned their research. As for the latter being the views of a single author, this is not concerning as the publication has undergone peer-review whereby an external team of evaluators have examined the results and agreed with its contents. Димитрий Улянов Иванов (talk) 13:53, 14 October 2025 (UTC)
@Димитрий Улянов Иванов, thank you for your response. I take your point about Barkley (2004) being a book chapter which likely did have some editorial oversight. There is a review of the book which I cannot now find that urged some caution about some of the chapters being leading-edge research. Though it did not mention Barkley's chapter specifically, the review did give me some pause. However, from the more recent citations given, there does seem to be support for positive selection pressure for ADHD-like traits in pre-industrial human society. To the hopper I add Barack et al. (2017) Multiple authors, reputable publisher, reinforces other citations, probably also due for inclusion. Xan747 (talk) 17:18, 22 October 2025 (UTC)

The statement that "the disorder costs society hundreds of billions of US dollars each year, worldwide" is in the lead but not substantiated in the article body. I've checked similar articles (such as the other 5 listed at Neurodevelopmental disorder as well as Dyslexia) and none of them seem to have similar statements, although Epilepsy has a bit about economic costs under "society and culture", so I'm wondering whether the statement should be moved further down the article (in general the lack of any section on societal impact seems notable, so maybe this would involve creating that section), removed entirely, or kept as is. lp0 on fire (talk) 21:01, 8 October 2025 (UTC)

Thank you for bringing this up.
@Димитрий Улянов Иванов I know we discussed this before, but this statement is not very clear, gives confusing connotations, and is not relevant to the article. Also, given the nature of mental disorder diagnostics, any change in its diagnostic criteria could potentially add or reduce the actual total societal costs. It should just be removed. Slothwizard (talk) 23:13, 8 October 2025 (UTC)
It's a well-sourced factual statement so I'm not sure we should be quite so quick to delete something we just don't like. It's currently worded to match the source, and the stuff about changing diagnostic criteria is probably not going to change the truth of wording as nonspecific as "billions", although that statement in itself is arguably WP:OR. As for relevance, I think (as I mentioned above) that this article as a whole ought to have more coverage about effects on society. However, I worry that keeping this without other significant discussion of the effects on society could be non-neutral coverage. Either way, it has no place in the lead, so I'm glad to see you've deleted it for now. lp0 on fire (talk) 08:07, 9 October 2025 (UTC)
No for the lede, yes for the body. If we withheld well-sourced and relevant information because not enough other stuff existed in its subtopic, nothing would ever get added. Xan747 (talk) 15:19, 9 October 2025 (UTC)
Do you think I should create a "society and culture" section with just that statement in it and a "needs expanding" tag? I'm not familiar enough with the topic area to write the whole section. lp0 on fire (talk) 15:36, 9 October 2025 (UTC)
Posting the sentence in question at the bottom here for now: lp0 on fire (talk) 15:39, 9 October 2025 (UTC)
As a consequence, the disorder costs society hundreds of billions of US dollars each year, worldwide.

I would add Economic impacts as a subsection of Signs and symptoms for now, and extract more from that source than just the worldwide economic impact. There is much relevant information on the financial burdens experienced at the national, individual and family levels across several nations in the 11. What is the economic burden of ADHD? section of the paper to warrant two- or three-paragraph subsection, no tagging required. Xan747 (talk) 16:52, 9 October 2025 (UTC)