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Monday, April 11, 2011

Kids on speed and the birth of misbehaviour

Dr Charles Bradley first reported the effects of amphetamine on children with behavioural problems in 1937. An article in The Yale Journal of Biology and Medicine takes a look at how this early study opened the door to treating ADHD with Ritalin and how it tied in with changing ideas about child misbehaviour.

Bradley was a psychiatrist and director of the Emma Pendleton Bradley Home for children with behavioural problems. In the days where ad-hoc experimentation was not considered out-of-the-ordinary, he decided to try administering Benzedrine sulfate, a type of amphetamine, to his young patients.

After only a week, he observed that “The most striking change in behavior occurred in the school activities of many of these patients. There appeared a definite ‘drive’ to accomplish as much as possible. Fifteen of the 30 children responded to Benzedrine by becoming distinctly subdued in their emotional responses. Clinically in all cases, this was an improvement from the social viewpoint.”

The paper appeared in a top psychiatry journal and echoes the now common idea that amphetamine, which includes Ritalin (known generically as methylphenidate), has the seemingly paradoxical effect of calming over-active or out-of-control children.

It turns out that Bradley’s experiment was carried out as the social significance of childhood was changing, as was the concept of what was considered to be ‘child misbehaviour’:

During the 19th and 20th centuries, a new conceptualization of childhood and how children ought to behave emerged in both popular culture and the medical world. A model child embodied the ideals necessary for the new industrial economy: self-regulated behavior and orderly social relations.

Childhood became the critical period for learning restraint and developing a proper social identity in order to grow up to be a successful adult. This prevailing characterization of a good child generated its opposite: the troublesome child. A broad range of social problems fell into this category of misbehavior and could include difficulty in schoolwork, fighting, and failure to obey authority.

That’s not to say that there wasn’t a concept of a misbehaving child before, but just that a lack of social self-regulation and focus was not considered to be as important in defining ‘doing wrong’.

The article describes how Bradley’s work was forgotten for 25 years, owing to the fact that the drug company who made Benzedrine felt they couldn’t market the drug, because it would be difficult to ‘sell’ the seemingly contradictory effects of a stimulant having a calming effect.

However, it opened the door for the first studies of treating hyperactive kids with Ritalin in the mid-1950s which exploded in the 1980s when the diagnosis of ADHD first emerged.

The article is a fascinating look at how social changes, drug tests and scientific understanding interact to influence our modern-day understanding of psychiatric disorder and even childhood.

Link to article on Bradley’s Benzedrine studies.


View the original article here

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