Professor Judith Rapoport discusses the finding that ADHD is a highly heritable disorder and comments on the controversy surrounding ADHD medications.

Well, ADHD has generated a lot of controversy, and I think it’s for a lot of reasons, although it’s my impression that there is general agreement that ADHD runs in families. I don’t think that particular fact has been controversial. There is loads of controversy about ADHD, and it comes from two main reasons. One is that there is not a clear cutoff. It’s clear that you have quiet kids at one end and very impulsive, hyperactive kids, but there is not a lab test for it, and so it may depend on the setting, that a child on his own watching television may look very relaxed and happy, but given that when he’s in the classroom he really can’t sit still and do it for arithmetic class. So, the fact that it may vary somewhat with situations and be worse in some situations than others, and the fact that, although the twin studies show very high heritability, which means that identical twins resemble each other much more than fraternal twins. But a hard point to get across is that it doesn’t matter whether they have hyperactivity or not. If you just take very quiet people and you compare identical and fraternal twins at a lower range of activity, it’s very heritable, but it doesn’t have anything to do with disease. So, the phenomenon of heritability is high, higher for activities - at least as high as it is for height, say. But it’s nothing to do with whether you have ADHD or not. So that’s one source of controversy. The other source is that there is a lot of resistance to the heavy use of medication and that stimulant drugs may be overused or seem to be used indiscriminately, and there is a lot of concern about that. But, the fact that it runs in families, that there are these twin differences that are established, activity level does seem to be very heritable.

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