H. Russell Searight

Complementary and Alternative Therapies for Pediatric Attention Deficit Hyperactivity Disorder: A Descriptive Review

Attention deficit hyperactivity disorder (AD/HD), characterized by impulsivity, distractibility, and inattention, has an estimated pediatric population prevalence of 6–8%. Family physicians and pediatricians evaluate and treat the majority of children with this condition. The evidence-based treatment of choice for ADHD, stimulant medication, continues to be a source of public controversy. Surveys suggest that among parents of children with ADHD, there is considerable interest in complementary and alternative medicine (CAM). These therapies include herbal preparations, mineral supplements, sugar restriction, and polyunsaturated fatty acids. Other AD/HD therapies include neuro-feedback, cognitive training, mindfulness meditation, and exposure to “green space.” In order to assist physicians and mental health professionals in responding to patient and parent queries, this paper briefly describes these CAM therapies and current research regarding their effectiveness. While investigations in this area are hampered by research design issues such as sample size and the absence of double-blind placebo-controlled trials, there is some evidence that omega three fatty acids, zinc supplements, and neuro-feedback may have some efficacy.

The Biopsychosocial Model: “Reports of My Death Have Been Greatly Exaggerated”

In 1952, The British psychologist, H. J. Eysenck published a landmark study essentially concluding that psychotherapy was ineffective. Coincidently, at the time that Eysenck announced his findings, the number of psychologists providing psychotherapy was increasing dramatically (Norcross et al. 2011). Eysenck’s (1952) study was an obvious threat to a rapidly growing profession. The next 25 years were characterized by multiple studies refuting Eysenck’s claim culminating in one of the earliest published meta-analyses which concluded that the average person receiving psychotherapy was better off than 75 % of untreated individuals (Smith and Glass 1977) To date, The Rise and Fall of the Biopsychosocial Model has not incited a scholarly response comparable to that provoked by Eysenck. However, in the 5 years since the book appeared, Ghamei’s (2010) work has been widely cited by both advocates and critics of the biopsychosocial (BPS) model. As the book’s title suggests, Ghaemi devotes over 200 pages to challenging and systematically dismantling a theory that has become a mainstay of North American medical school curricula and postgraduate psychiatric education. Yet, it appears that the BPS may still be alive and well with recently published applications to orthopedics (Ayers et al. 2013), cardiology (Kirian et al. 2012), obstetrics and gynecology (Edozien 2015), as well as pediatrics and internal medicine (Crosby et al. 2015). While the psychiatrist, Roy Grinker used the term ‘‘biopsychosocial’’ in 1952, Engel (1977) is typically credited with describing the current version of the BPS in a 1977 Science article, ‘The need for a new medical model: A challenge to biomedicine.’ Engel argued that the prevailing biomedical worldview was outdated