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How do we develop self control? Researcher investigates source of ADHD by Kathy J. Gatten College of Health Professions Russell Allen Barkley, Ph.D., gets around.  Good Morning America, Today, The Early Show. Frontline, 60 Minutes, Eye-to-Eye. Scientific American, Time, Newsweek. Speaking engagements in over a dozen countries including Russia, Kenya, Israel, Australia, New Zealand, and, of course, North America. He’s an expert on ADHD, a topic that touches lives throughout the world. The label, Attention Deficit Hyperactivity Disorder, misleads, Barkley explained. The attention part is just a symptom; the disorder is really about a breakdown in the development of self-control.  “Self-control is an instinct, it can’t be taught,” Barkley said. “This does not mean it cannot be enhanced through training to some degree, but that it is largely instinctual. The lack of self control leads to the attention problem, along with other related problems.”  One of Barkley’s predictions, confirmed by seven independent studies, is that one’s sense of time is related to self-control. ADHD sufferers simply cannot manage time as well as others. Another problem for those with ADHD is a delay in moral development, from 30 to 40 percent behind what is considered normal. About 7.5 percent of Americans have ADHD, but the number who suffer because of the disease is much greater. “This is a pervasive disorder, which affects a broad area of life,” Barkley said. His 25-year study of 158 people with ADHD at the Medical College of Wisconsin confirms his statement: 40 percent had teen pregnancies The group was four times more likely to get a sexually transmitted disease One in four suffers from major depression One in five has a substance abuse problem What causes normal to veer off to disorder? Therein lies Barkley’s major research interest: to develop a theoretical model of ADHD.  “Science can’t advance without a sound model of the normal process, and what happens to create the disorder,” Barkley said. His other research projects include neuro-psychological studies of self-control, molecular genetic research identifying candidate genes, and most recently testing the effects of Ritalin, commonly used to treat ADHD, on driving behavior. His lab houses the front end of a Ford Crown Victoria, surrounded by six computers and five, 32-inch television sets to monitor reactions.  Soon to start at MUSC will be a study of whether alcohol use causes a greater deterioration of reflexes in those with the disorder, and how frequently those who exhibit road rage have ADHD. In addition to conducting his research, Barkley travels extensively, and delights in sharing his research with health professionals. He has presented more than 600 workshops worldwide, taking the science directly those who need the information. “Ordinarily, it would take five to six years for the research to trickle down to the clinical level. We can short-circuit that process with continuing education,” Barkley said. He also edits a newsletter for clinical professionals and has produced seven videos for parents and schools on the subject of ADHD. Although ADHD has long been considered a behavior problem, science is now working to identify the genes responsible for the highly inherited disorder. In this decade, Barkley hopes this research will “put the nail in the coffin that ADHD is a myth.”  A better understanding of the neuropsychological roots of the disorder will go a long way to ease the emotional suffering of those with ADHD, and those who care about them. For more information about his research, contact him at 792-2419 or e-mail at barkleyr@musc.edu. Dr. Russell Barkley, an MUSC College of Health Professions professor, demonstrates a virtual reality driving simulator used to evaluate driving performance problems in adults with ADHD. Barkley and his research team use it to study the effects of medications, such as Ritalin, for improving driving and the deleterious effects of alcohol on these adults. The simulator is the front seat and dash board of a Ford Crown Victoria in which the person sits. In place of a windshield, five, 32-inch monitors wrap around the person’s visual field a total of 225 degrees, thus completely controlling the visual field.  Six computers generate a 3-D virtual world through this “windshield” in which the adult can drive the vehicle.  Realistic sound effects, such as engine noise, wind noise, road hum, are generated by the computers as is actual tactile feel of the roadway through the steering wheel. Weather and traffic density can be manipulated to test the person’s reaction to various driving conditions. While driving through various traffic situations, the computers also record important information about driving (speed, variation in roadway position, reaction time). This is the only such driving simulator in the state and one of only two on the East Coast available for detailed studies of driving in various patient populations. “Simulators provide a safe means to test a person’s driving ability, especially in impaired populations, and also provide a standard course for studying people’s driving, as opposed to road tests that can be hazardous and are not standardized,” Barkley said.       Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.