ADHD OCD and ASD cannot be comorbid if the science is right

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ADHD and OCD are ostensibly caused by inactivity and hyperactivity respectively in the prefrontal cortex (OCD is actually hyperactivity) and ASD is characterised by hyperfocus on details and failure to see the bigger picture. The three should not be comorbid. I imagine that executive functioning deficiencies may present themselves in addition to hyperactivity but this does not the ADHD'er make.

Really interesting, although I'd think it's still a bit of an open question: possibly the most difficult, and interesting, book I read this year was The Brain Supremacy, which gives a neuroscientist's view of how those pictures with pretty flashing lights actually map to brain activity, and suggests that the stuff that gets into the papers isn't necessarily accurate.

I could imagine that ADHD is to some degree the opposite of autism, because it's loss of focus while AS may be monotropic or hyper-focused.

OTOH, I've seen someone describe on a forum that they have AS and OCD, and they think it's more of a question of where they file an obsession. If it's deeply destructive, inescapable, and seems to follow no logic or reasoning, it 'feels like' OCD, If they fall in love with a fandom (book, series, whatever) or suddenly decide they'd really like to learn all that's humanly possible about boatbuilding, that 'feels like' something on the Aspie or geek spectrum. It's possible for this sort of passion to become difficult, but not that likely, while OCD seems to strike people as instantly distructive and unpleasant.

>>Article: Brains of Autistics are Hyper-Connected<<

Is that meant to prove that autists and ADHD's both share neural hyperconnectivity? From what ive read global hyperconnectivity is only seen in the autistic brain and causes sensory sensitivity and overstimulation in general. ADHD is more caused by hypoconnectivity in the attention network and hyperconnectivity in affective networks (lack of attention lack of emotional/impulse control)

The human brain is much more complex than that. Every combination is possible, just some are more rare and others are more common. And also autistics don't have 100% the same brain.

Yes I agree with Raziel. To simply say that there is hyperactivity in the one case and inactivity in the other is to oversimplify the workings of the brain.

Ah but what is autism/bipolar.schizoid/borderline if we throw out the neural charts. An illness like cancer has a biological footprint. A condition or state like autism however should be defined by some common pattern otherwise its just a totally arbitrary collection of behaviourisms. I could establish my own continuum and call it the binary spectrum - people who live through extremes. Extremes of mood extremes of behaviour extreme personality shifts need adrenaline coursing through their blood, perceive the world in black and white. Without some basic neural underpinnings its all meaningless and we can chop and change and rearrange the categories as we see fit.

hyperconnectivity is a global state also which means that one hyperconnected brain can still look vastly vastly different to another. Synesthesia is said to be caused by hyperconnectivity.

Then again theres alot of debate as to what exactly causes synesthesia and there are said to be multiple causes. Disinhibited feedback in the inducer concurrent pathways, cross activation of adjacent brain regions, even abnormal serotonergic activity has been blamed.

The diagnostic criteria is the only way to define psychiatric conditions. Sience is not that far to just scan your brain and then tell you what's "wrong" with you. So it's not suprizing that there are many similarities between ppl with the same problem, but they still don't have the same brain and some will have issues in one area of the brain and others in another one leading to similar behaviour. So many researchers even believe that there are "the autisms" and "the schizophrenias" and so on, instead of just one autism who is always the same and so on.

I forget who it was who stated that ADHD is a spectrum disorder. There are aspects in common i'll grant that and the 2 are often present in families. I think that the era of high resolution brain scans will result in a psychological "renaissance" the DSM will be thrown out and we'll probably revise most of our assumptions. There'll be alot more detail. Many conditions will be broken down into constituent parts. Perhaps we'll do away with behavioural diagnostics and simply focus on connectivity and neurochemical issues. Desensitised mu opioid receptors result in low mood low appetite/motivation and perhaps hyperconnectivity between the auditory processing cortex and the Inferior parietal lobules (structures within the lobule) could cause sound sensitivity

ADHD-PH and ADHD-PI (aka hyperactive and inattentive types) are not affected the same way in the brain and it's not just the frontal lobes that play a role in ADHD.

The human brain is a highly complex network that communicates between all areas and simple saying if one thing is happening then another can't is simplistic and backward thinking.

There is a symptom overlap between disorders but those symptoms can be impairing enough to meet criteria of both disorders, and what's most important is a person gets the right treatment.

If I stayed with a single diagnosis of autism then I wouldn't know of the kind of benefits I would get on ADHD medication. You can sit there and say the two can't exist in the same person but I have the personal experience of living with both.

Some people who hardly meet the criteria of autism with ADHD can have sensory issues too.

I said that all 3 cant appear and the operative phrase here is "if the science is right". This means that my hypothesis is dependent on the scientific assumptions being correct.

As I said before the reality of mental health is that the restrictive or vague criteria we have for diagnostics is counterintuitive. adhd will probably be seperated out into different conditions eventually. The inattentivity may be deemed worthy of a seperate category at least as it has alot* in common with autism with the response delay to social stimuli executive functioning deficits multi-tasking issues and so on and so forth

I would think that it depends on what the person is doing/thinking at that moment which determines where and how these parts are used. Your statement is only true if the brain never changes which parts it uses when doing multiple different thinking/tasks. Since the brain is very dynamic, it can very well be that when person is thinking about X or faced with X situation in a closed door high amount of people this could trigger the brain to use certain parts but if you take the same X situation but now the person is outside or there are few people around then the brain fired different areas of the brain or in a different formula. This would explain how a person can have all of these- but they might not be all present in the same moment based on the brain's mechanics- which is different per person.

Logan

Well, we can pretty much chuck the idea that the scientific assumptions underlying all this are correct out the window.

Sorry but that is a fact-- there is too much we don't know to start assuming that the scientific assumptions are correct.

The assumptions are, at best, a basis to work from-- and still must be highly open to revision in the light of new evidence at this point. Too many of us have suffered too much because of the kind of scientific hubris that utters things like "The science is correct-- we know everything now."

I am absolutely certain that ASD and OCD can co-exist, just as I am certain that it is possible to develop OCD in response to a traumatic situation. I've seen that happen too many times-- hell, I've seen it almost happen to me. It was dumb luck (and a lot of credit to WrongPlanet) that I was able to see what I was doing while I could still (sort of) make it stop.

Being a self-aware Aspie, if one desires strongly to learn to fit in and be accepted (say, if one is motivated by fears for the safety of one's family, or terrified of being placed on some register of untermenschen) is ENOUGH to cause one to begin-- willfully and deliberately-- to develop symptoms of OCD.

Is it organized?? Do I smell OK?? Do my clothes look all right?? Is it organized?? Do I look OK?? Am I walking right?? Do my clothes look OK?? Is it organized?? Do I have it all scheduled?? Do I look OK?? Am I holding my body right?? Look, but don't look too long!! Do I have it together?? Do I look OK-- better duck in that bathroom and check!! Am I walking right?? Look-- look away-- look-- look away!! Is it organized?? Do I look normal enough??

Yeah-- now you know why I hit the grocery store to the tune of $400 when I am able to make myself leave the house and walk into the store. I keep 20 pounds of powdered milk on hand, because I never know when I'm going to be able to go again...

I've seen lots of documented cases of ASD and ADHD co-existing-- I cannot tell you that they're all accurate. Hyperactivity can come with autism (often does) and a defective appropriateness filter can look pretty much exactly like poor impulse control. I cannot either tell you that they're all misdiagnoses. Nor can I tell you that we won't, one day, find out that ADHD and autism are different presentations of the same disease.

For example (the case of my son)-- would a child with Asperger's, who received early intensive social skills training (being trained in eye contact and taken out to socialize and be "taught how to act" multiple times a week by his self-aware and at that time mentally healthy mother) but grew up in the rural South (where "manners" are extremely important and taught intensively from birth, but extremely active boys are "JUST BOYS") and was allowed to run a large rural yard and the surrounding woods (with adult supervision) be considered to have ADHD when he entered school in a NorthEastern suburb that is VERY concerned about being academically competitive??

Certainly the skills training taught him how to socialize (added to the fact that the Big Friendly Dog type of Asperger's runs on his maternal grandfather's side-- unless abuse makes him so, he will NEVER be the Aspie who watches out of the corner of his eye and sneers at social interaction, but rather the kind that wants to TELLEVERYONEABOUTTHEGREATROBOTHEBUILT!! !! !

Eh-- I'm rambling. And I have kids who want cereal. But-- NO, the current science is not correct. It is partially correct, at best.

So many things you're simplifying...The prefrontal cortex is not 1 unit or 1 thing. There are numerous pathways and connections within it, as well as numerous connections to other brain regions. So while what you're saying, that one cannot have both hyperactivity and hypoactivity of the same location makes sense, what you're missing is that it's NOT the same location. It's the same general area, which, in terms of specificity of the neuronal connections in the brain, is about as specific as saying 'I live in North America'...meaning not specific at all.

There's also the issue of temporal specificity...not all of this has to happen at the same time.

Knowing this, it opens whole cans of worms for the possibilities of how these disorders could, in fact, be highly linked. For instance, taking a very basic stance, hyperactivity in 1 area of the brain can cause hypoactivity in another, on a neuronal level. Take an obsessive thought or compulsive behavior for example. The very act of focussing on 1 thing (special interest anyone??) could crowd out other signals that, in general, are hyperactive but not salient enough from each other to allow someone's focus to shift.
Having a tendancy towards hyperactivity which generally means poor focus, could mean that once focus is obtained, it's much harder to get away from it, since it's rare for something to become salient enough to draw the attention away. In terms of a potential (and probably wrong and oversimplified) neuronal, explanation, take someone with ASD has a propensity for hyperactivity of their neurons. Now this person still has the capacity to focus, even though it might not happen as easily as for someone else, but it WILL happen. Now this person's neurons are more focussed, firing more regularly. But now, because all of the other neurons and thoughts are so jumbled, nothing is salient enough to overcome this thought or action, to change the mode of firing that, in a normal baseline individual, would easily be overcome, so the person's stuck with it. ASD and OCD and ADHD all in one.

But there's so many more possibilities than the one I just mentioned too. Perhaps under and over activity are both caused the same underlying cause that makes a neuron over-react to stimuli in general. Most neurons are somewhat self-regulatory, in that they'll send out neurotransmitters that will affect itself. If this mechanism is, for instance, down-regulated, then they might not be able to switch from high to low activity easily, making them be stuck with whatever they most recently were. Or perhaps they have a high threshold for change, such that instead of a nice, smooth transition of being highly active to being at rest, they tend to be highly under or over active, often skipping a happy medium of activity.

I mean, the possibilities of the exact neuronal mechanisms are nearly limitless for these mental health problems. Even if we had the ability to measure each and every individual cell in the prefrontal cortex, we'd still somehow have to make sense of that by mapping it to behaviour and experience. And then we'd still want to know what makes area A cause area B to react because sometimes they'll interact and sometimes they wouldn't...and so you'd then want to know all the individual neurotransmitters that are being used and...and it's complicated!

So no, you're postulation that these 3 things should not be comorbid based on the science is unfounded due to your's and science's gross ignorance of it all. Furthermore, you make the false assumption that the hardcore biology that we know is enough to rule out more wishy-washy behavioural descriptions, when in truth we will ALWAYS need to rely on behavioural reports to a degree. (Which goes towards a sore spot for me, because I, like so many others, have had our experiences ignored, downplayed, thought of as malingering or hypochondria, etc, all in the name of 'science' which disagrees with my experiences.)

But I think I do appreciate where you're coming from, you're just trying to make sense of it all and understand it all, and at a glance, what you said makes perfect sense. I didn't think that you were calling anyone here a liar or anything either.

Paragraph 1 and paragraph 2 aren't mutually exclusive, yet you present them as if they are. What do you think causes hyper or hypo connectivity? What on earth do you think 'cross activation of adjacent brain regions' means if it doesn't mean they're connected moreso than someone who doesn't have that connection?

The question of a basic neurological idea of synesthetes is obvious; they obviously have connections between the senses that non-synesthetes do not, such that for someone who tastes sights would have extra connectivity somewhere branching from their visual pathway attaching to some part of their taste pathway. (Unless, of course, you don't believe that brain regions being activated then maps onto our senses, but that'd be pretty medieval of a belief.) How or why this happens is the tricky part.

I think that this thread has revealed that indeed the science is flawed. If however OCD and ADHD both cause hyper/hypo activity in the same region of the prefrontal cortex it would seem unlikely that they should coexist.

Asperger's incidentally could provide a nexus point for the two. That is the asperger's brain is often governed by extreme hyperconnectivity side by side with extreme hypoconnectivity. That sort of contrast is precisely what would be observed in OCD ADHD comorbidity

The irony of this thread is that I have both ADHD and OCD with Asperger's suspected Clearly in denial aha