ADHD is genetic

ABOUT one in 20 children (those under 18) have a group of symptoms that has come to be known as attention-deficit hyperactivity disorder (ADHD). About 60% of them carry those symptoms into adulthood. For what is, at root, a genetic phenomenon, that is a lot-yet many studies have shown that ADHD is indeed genetic and not, as was once suspected, the result of poor parenting. It is associated with particular variants of receptor molecules for neurotransmitters in the brain. A neurotransmitter is a chemical that carries messages between nerve cells and, in the case of ADHD, that chemical is often dopamine, which controls feelings of reward and pleasure. The suggestion is that people with ADHD are receiving positive neurological feedback for inappropriate behaviour. The surprise is that the variant receptors are still there. Natural selection might have been expected to purge them from the population unless they have some compensating benefit.

Of course, this analysis turns on the definition of "inappropriate". The main symptom of ADHD is impulsiveness. Sufferers have trouble concentrating on any task unless they receive constant feedback, stimulation and reward. They thus tend to flit from activity to activity. Adults with ADHD tend to perform poorly in modern society and are prone to addictive and compulsive behaviour. But might such people do well in different circumstances?

One hypothesis is that the behaviour associated with ADHD helps people, such as hunter-gatherers and pastoral nomads, who lead a peripatetic life. Since today's sedentary city dwellers are recently descended from such people, natural selection may not have had time to purge the genes that cause it.

Dan Eisenberg, of Northwestern University in Illinois, and his colleagues decided to test this by studying the Ariaal, a group of pastoral nomads who live in Kenya. The receptor Mr Eisenberg looked at was the 7R variant of a protein called DRD4. Previous work has shown that this variant is associated with novelty-seeking, food- and drug-cravings, and ADHD.

The team looked for 7R in two groups of Ariaal. One was still pastoral and nomadic. The other had recently settled down. As they report in this week's BMC Evolutionary Biology, they found that about a fifth of the population of both groups had the 7R version of DRD4. However, the consequences of this were very different. Among the nomads, who wander around northern Kenya herding cattle, camels, sheep and goats, those with 7R were better nourished than those without. The opposite was true of their settled relations: those with 7R were worse nourished than those without it.

How 7R causes this is not yet known. It may stem from behavioural differences or it may be that different versions of DRD4 have different effects on the way the body processes food. Nevertheless, this discovery fits past findings that 7R and a set of similar variants of DRD4, known collectively as "long alleles", are more common in migratory populations.

One suggestion is that long-distance migration selects for long alleles (see chart) because they reward exploratory behaviour. This might be an advantage in migratory societies because it encourages people to hunt down resources when they constantly move through unfamiliar surroundings.

As for the Ariaal, there remains the question of why 7R-although it is apparently beneficial to a nomadic way of life-is found in only a fifth of the population. One possibility is that its effects are beneficial only when they are not universal, and some sort of equilibrium between variants emerges. A second is that the advantage is gained when 7R exists along with another version of DRD4 (the genes for the two variants having come from different parents). Unfortunately, the way Mr Eisenberg collected the data does not allow these hypotheses to be tested.

Either way, his research raises the question of whether people suffering from ADHD and conditions related to it, such as addiction, are misfits coping with a genetic legacy that was useful in the evolutionary past, but is now damaging. As society continues to diverge from that evolutionary past, the economic and social consequences of being such a misfit may become increasingly important.

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The nanny state has spoken on binge-drinking. But who’s listening?

By Australian columnist Janet Albrechtsen

The nanny state has apparently spoken. I went to bed last night feeling happy after a night out with friends. I wake up in the morning to news that I am a binge drinker because I indulged in more than three glasses of wine.

If you had four middies of beer last night, join the club. You are a binge drinker. That is according to the boffins at the National Health and Medical Research Council who have reportedly drafted new guidelines on safe drinking for Australians. While the Council is refusing to confirm reports in the Fairfax media until the release of its final report next month, perhaps the Council could do with some community feedback on their apparent eagerness to label so many of us binge-drinkers.

Yes, binge-drinking is a problem. Yes, alcohol driven violence is a problem. But surely that means addressing these real problems rather than conflating the issue of alcohol abuse by setting consumption limits at ridiculous levels. Health bureaucrats, whatever their well-intentioned beef, be it setting down eating and drinking guidelines for pregnant women or these latest drinking rules for the rest of us, always seem to frame their rules for the lowest common denominator brain. They treat us all like a bunch of feather-brained numskulls incapable of making sensible decisions about just about anything to do with our lifestyle. Now, we apparently have to endure being labelled a “binge-drinker” if we exceed 4 drinks during a pleasant evening out with friends.

There is another label that comes to mind. It applies to this kind of bureaucratic overreach. It’s called infantilisation. Reducing us to the status of children, they set down rules that end up neutering our ability to take personal responsibility for our actions. Like moves to ban the advertising of fast food, this is just another step by Big Brother to interfere in our choices by applying scary labels of binge-drinking to behavior that many of us would regard as normal.

Former federal health minister Tony Abbott is right to describe these new guidelines as fostering a “moral panic, which is taking over the land.” There is, says Abbott, “no doubt that binge drinking is a problem, but it is no worse than in the past. I am in favour of people improving society but you have to be reasonable about it. Usually these debates are more about establishing the virtue of the people leading the way. In the end what an individual does is his or her responsibility particularly with something that is legal.”

The medical boffins so keen to mould their own vision of utopia should keep in mind that this kind of dogmatic overreach comes with its own risks. When health guidelines are set at patently unreasonable levels, it might just mean people stop listening to these bodies about anything they have to say. It might undermine what is an important educative function if they start laying down rules that seem so preposterous to the social drinker. As Lenore Taylor said on the ABC’s Insiders today in response to claims that the delightful Belinda Neal MP had been the victim of sexism, we need to be careful about devaluing the currency by flinging about inappropriate labels. Likewise, binge drinking should be reserved for real alcohol abuse.

Before the chaps who are so keen to impose new nanny state drinking rules on us conclude their final report next month, they need to get out more. Perhaps have a drink or two with a few social drinkers who take umbrage at this new Puritanism. Labelling us all as binge-drinkers will do nothing to address the real problem of alcohol abuse.

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