2010年07月24日

成人ADHDの人間関係構築方法

まだ全部読んでいないのですが、役に立ちそうな記述があったので途中ですが投稿しておきます。

元ネタ https://www.adda-sr.org/reading/Articles/solutionsforitimacy-austin.htm

Solutions for Intimacy Problems for Adults with ADHD

By Richard B. Austin, Jr., Ph.D.

Chapter 1
How it impacts relationships and what to do about It.

どのように関係を構築するか、そして何をするべきか。

I will offer a few tools to turn the tide on ADHD's power to disrupt, disturb, and often destroy valuable relationships. In the book Driven to Distraction, Edward Hallowell, M.D., and John Ratey, M.D., who are both experts on ADHD and who wrestle with the symptoms themselves, make the point that ADHD adults often do not know ordinary social rules that most people take for granted about relationships. "Social 'reading' can be as difficult for these people as the reading of words" (p. 281), but it has a major impact on intimacy.

This article will cover key communication skills that must be working well to avoid a breakdown in successful intimacy. The following three communication problems will be addressed: (1) not listening, (2) interrupting, and (3) not keeping promises. Probably the single most important issue to address is active, careful listening with a feedback loop to make sure the listener "gets" the speaker's message.

If you have ADHD, you can improve your listening skills by asking yourself some questions. Am I really paying attention to what the person is saying, or is my mind "drifting off" to something else or being distracted by things in the environment irrelevant to the conversation? The real test is whether you can repeat the conversation back in your mind or to the person speaking. It helps to acknowledge out loud what a person says, especially when you are beginning to train yourself to be a 100% listener rather than a 40%-50% listener. After time, acknowledgement becomes automatic even if you don't acknowledge out loud.

ADHDが人間関係の構築で苦しむ理由は(1)聞かない(2)邪魔する(3)約束を守らない。で、ちゃんと人の話を聞いていれば良いわけですが、それが出来ないから障害なわけです。ここでは、自分自身に問いかけを行うことで改善できると書いてあります。「私は今、相手が言っていることに集中しているだろうか」とか「私の心はどこかにフワフワと飛んでいっていないか」とか「会話とは無関係のことで気が散っていないか」などなど

There is a gender difference here which I talk about in my booklet, "How to Talk to a Woman in Four Simple Steps" (c 1994). Women, particularly in close and family relationships, feel devalued if not listened to. If you don't really listen, you will not remember what is said which can lead to other relationship problems.

As an antidote to one's mind drifting off during a conversation, not unusual with adult ADD, put in place the rule that nothing is as important as the person I'm talking to and what that person has to say. If it's a spouse or child, this is especially true. This is training for success where it counts the most--your intimate relationships. You have to have "mental space" for information to be received and perceived at a cognitive level. How can you let someone's information in through one of your attention pathways if these pathways are crowded with what you have to say or with many thoughts unrelated to the conversation subject matter?

Interrupting is another common barrier to effective communication with ADHD adults, but one that can be easily corrected. When a person is interrupted in the middle of a sentence, thought, or dialogue, it not only breaks the flow of conversation, but also gives the message that what you have to say is more important than what the other person has to say. This is probably not true for you, but that doesn't change the message. Practicing self-awareness of everything you say is a good starting point. Make sure you are listening to yourself and thinking before you speak. Stay connected to the conversation flow. Allow pauses, even silent moments, to give the other person the opportunity to fully respond, or to not respond, before you speak.

A good training technique here is "pacing". Pacing is where you pause after saying a few things and wait for a response before continuing to talk. This helps break down the ADHD tendency to monologue, not dialogue, in conversation, which creates distance in relationships. When you have give-and-take in a conversation with two people listening and taking turns to talk, you stay connected, intimate, and meet the true emotional needs of the other person. Problems with not listening and interrupting impact intimacy satisfaction in a profound way. Although these are typical ADHD adult problems, they can be corrected with training. Medicines help that training along, but medicines do not teach you what you need to know about your ADHD related communication problems and how to solve them.

相手の会話を途中で遮るのは会話の流れを壊すだけではなく、今発言している人間の発言よりももっと良いことを言わなければいけない義務を負います。自分が何を考えているのか発言する前に一度考えましょう。良く聞きましょう。一度発言したあとは、ちょっと相手の反応のための間を起きましょう。マシンガントーク防止のために。

The third point in this series is not keeping your promises. Often a well-meaning adult with ADD promises to do something but forgets about it. Then an intimate feels betrayed or "let down" by the thing they expected to happen, like picking something up from the grocery store or calling a friend. If you are like me, you need to write down what you promise to do and place it in a clearly visible place in the house where you can check it out daily. Don't trust your memory to remember your promises. When you haven't delivered as promised, tell the person you were wrong, that you are sorry for that oversight, and that you'll make up for it. Always give yourself a target date to deliver on a promise. This way you will not procrastinate and will be able to meet expectations. Also, your self-esteem will be enhanced.

まあ、これは日本でも十分に広まっていますね。紙に書いてすぐに見える、絶対に目にする場所に貼っておく。私は玄関のドアノブ(もちろん内側)に貼り付けています。

Listening, having true dialogue and not interrupting, and keeping your promises will jump-start your intimate relationships to new levels of satisfaction-you can start seeing results right away!

Chapter 2
The effect of ADHD on relationships

This is the second in a series of articles on the effect of adult ADHD on relationships. Understanding the different styles of communication between men and women, and acting on that understanding, is essential for relationship harmony. The many barriers to overcome in communication for a person with ADD, such as overtalking, interrupting, not listening, or getting off track, are magnified with cross gender conversation issues.

If you watch same-sex communication you'll note some obvious differences. Men often talk parallel to one another, and may only occasionally have face-to-face contact. They seem to assume that the speaker was heard by the other man, while women generally acknowledge what is being said by words, or by a nod of the head. A woman may feel devalued if not acknowledged or listened to , but a man doesn't place the same importance on being heard. Let's examine some typical gender differences in response to often used phrases.

1. "Let's talk."

Women: "Great, we're finally taking time to talk. Now we can solve some problems."

Men: "Oh, no! What now? What have I done. I'd better find a way to avoid this encounter."

Men tend to avoid conflict in personal and business relationships, as studies in business show that men would prefer to avoid confrontations and unpleasant encounters. Men do not like to face an unknown situation with little control of the outcome, while women frame such a situation as one that might improve if it is faced up to and talked about. There also may be a psychological explanation for the difference as research indicates that men have more extreme, and unpleasant, physiological reactions to conflict compared to women.

The bottom line is for women to be more empathetic about the male experience of "Let's talk" being a threat, while men need to reframe the phrase to mean a win/win situation as talking about problems invariably helps. If a man refuses to talk, set up a future time to talk by agreement.

2. "Let me help you."

Women: Women respond to this offer much like they respond to psychotherapy, in a positive way; they expect to receive benefit and to get something of value for themselves.

Men: "This implies I'm needy, somewhat weak, and may mean I'm lacking in competence."

Women also may not elevate the advice of a therapist above that of their best friend or mother, and check it out carefully before accepting it. Men, on the other hand process an offer for help as suggesting that they need it (help), and further that it may imply inadequacy, which is a very sensitive male issue.

If that is not negative enough, the "let me help . ." phrase may activate the vertical hierarchy in men, which means that being helped puts them in a subordinate position to the helper. Scientific studies by linguists spell out this dynamic. Ever wonder why men avoid asking for directions, even when they are lost? That's why. The person with knowledge they do not have puts them in a superior position from the male framework.

As men and women usually respond differently to an offer of help, a preliminary statement might be useful like, "You might not need this advice but in case you find something of use let me share this information with you." An attitude of acceptance of the gender related differences to the word "help" is perhaps the most important point to keep in mind.

3."You're Wrong."

Women: "That's their opinion. I'll listen with some skepticism to see if they have a valid point."

Men: "It sounds like a putdown to me, or even a challenge. I'll defend my position. I'll prove I'm

not wrong."

Women are not necessarily threatened or have their egos on the line if someone tells them "You're wrong." They may take it with a grain of salt, throw it out, or carefully examine the reasoning behind the statement. Men, on the other hand, feel somewhat offended, or somehow diminished, by that phrase and often become defensive, which shuts down communication. As women deliver a "you're wrong" message in more subtle ways and couch it with a positive comment both before and after the phrase, it will be better received. As described in my booklet about 10 steps to get a man to talk, men need a safe place psychologically to hear that they are wrong.

However, men need to consider the reward they'll receive when they not only say "Sorry" but "I'm wrong" to the primary woman in their life. It reaps rich dividends.

4. "You're Right."

Women: "He's probably just going along, and doesn't really buy into it. Or he's just admitting how it really is."

Men: "Music to my ears. Play that melody some more. What good judgment; she finally sees the light."

Sound familiar? Of course a general theme has exceptions, but 40 years of practice and observation tell me it's so. I'm so sure I'm right here that I will not be offended if you think I'm wrong.

Make support groups and business groups, spend time validating and supporting each other with the veiled message "You're right". The underlying male dynamic, based on the male code, is that a man must continually prove himself to others; thus the need to be affirmed. This male code was summed up by writer/therapist Virginia Satir forty years ago in three edicts: "Don't cry, don't feel, and don't talk about it", which is taught to males from preschool through teenage years, reinforced by fathers, peers, and coaches. After a while, as feelings are externalized, they tend to be blocked from conscious awareness. This breeds more impulsivity in the male and acting out of feelings, which ordinarily is an issue with ADD. Holly Sweet, Ph.D., in the fall 2000 Journal of the Society for the Psychological Study of Men and Masculinity (APA Division 50) stresses "mindfulness training" associated with the Eastern wisdom tradition, that is a way to "experience freedom to be aware and accept raw emotions, memories, and unpleasant events." It is a way to become aware of the self more fully in the present moment. This training is helpful for a person with ADD, and goes beyond the relaxation/concentration training. Mindfulness training allows a person to receive negative feedback with empathy and to be more objective, countering distractibility.

In summary, four often used phrases show gender differences in processing information from the initial input in meaning to typical responses as a function of gender. Today, ADD adults, and others for that matter, will benefit to understand gender differences in communication and decide to reprogram conventional response patterns to better relationships, lower stress and support primary intimacy.

The phrases "Let's talk", "Let me help you", "You're wrong" and "You're right" may be viewed by women in terms of their impact on men, or as coded, knee jerk male reactions. Men may choose to view "Let's talk" as an opportunity to improve a relationship, "Let me help you" as adding to their competency, "You're wrong" as a valued point of view irrelevant to personal worth and adequacy, and "You're right" as not proving anything, but pleasant to hear from an intimate.

今度はボストン大学からポリフルオロアルキル酸類がADHDの原因ではないかという説が出てきました。

毎度おなじみ、化学薬品がADHDの原因説です。

今回はボストン大学のチームの研究結果です。

元ネタはこちら http://www.medicalnewstoday.com/articles/195450.php

A new study led by a team of Boston University School of Public Health researchers suggests a link between polyfluoroalkyl chemicals (PFCs), industrial compounds which are widely used in many consumer products, and attention deficit hyperactivity disorder (ADHD) in children.

PFCs are highly stable compounds used in industrial and commercial products like stain-resistance coatings, food packaging, and fire-fighting foams. In a 2003-2004 survey, NHANES examined 2,094 blood samples taken from the U.S. population and found more than 98 percent of the sample had detectable serum levels of PFCs, according to the study. Once absorbed into the body, it can take years for some types of PFCs to be partially eliminated.

今回の容疑者はポリフルオロアルキル酸類(PFCs)です。名前からフッ素が含まれている物質であろうことは分かります。

PFCsは産業で使用される非常に安定した混合物であり、汚れ抵抗のコーティング、食品包装、および消火器の泡に使われているそうです。 2003-2004調査では、米国から取られた2,094の血液サンプルを検査した。 98%以上サンプルからPFCsが検出されました。一度吸収すると、体外に出て行くのに数年かかる場合がある。

Published online, ahead of print, in the journalEnvironmental Health Perspectives, the researchers found "increased odds of ADHD in children with higher serum PFC levels." The researchers used data from the National Health and Nutrition Examination Survey (NHANES) to compare the PFC levels found in serum samples taken from 571 children, ages 12 to 15. The parents of 48 of these children reported their children were diagnosed with ADHD, one of the most common neurodevelopmental disorders in children.

で、このPFCの血中濃度が高いとADHDになる確率が上がったという結果がでました。サンプルは571人の12歳から15歳の子供、そのうち48人がADHDです。

The researchers examined the connection between four PFCs, perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) and samples from children in which there were parental reports of ADHD diagnosis.

研究者は4 PFCs間の関係を、ペルフルオロオクタンスルフォン酸(PFOS)、ペルフルオロオクタン酸(PFOA)、 perfluorononanoic酸(PFNA)、およびperfluorohexaneスルフォン酸(PFHxS)およびADHDの子供からのサンプルとで検査した。


この論文も例によって、末文にあくまで相関関係があっただけで、これが決定的な原因であるかはもっと調査が必要とコメントしています。この物質で気になったのはフッ素コーティングのフライパンでしょうかね?神経質になる必要は無いと思いますが。


2010年07月14日

test

テスト投稿

posted by hati at 11:49 | Comment(0) | TrackBack(0) | 雑記 はてなブックマーク - test

「注意欠陥障害、ビデオゲームやテレビと関連か」というニュースが出ていますが、元の論文からして論理がおかしい。鵜呑みにするのは危険です。

定期的に登場する「ゲーム有害論」。ついにADHDにお出ましです。
日本語訳があるので、そちらのURLを書きます。
内容はかなり論理的におかしいと思います。「A特性のひとはBしやすい。だからBをたくさんするとAの特性になる。」という無茶苦茶な論理です。
記事を書いたり、日本語訳した人がADHDに無理解なのかと思い、近所の図書館にこの雑誌があったので原著を読んでみたのですが、
これはテレビ・ゲーム規制論者が自分に都合の良いデータだけを引っ張って無理やりゲームを悪者に仕立て上げる論文でした。

 注意欠陥多動性障害(attention deficit hyperactivity disorder:ADHD)の原因は特定されていないが、米国立精神衛生研究所は遺伝的要因や脳損傷のほか、妊娠中のタバコやアルコール、鉛汚染などの環境要因を疑っている。この環境要因が、また1つ追加される可能性が出てきた。新たな研究で、一連の注意欠陥障害とビデオゲームの関連性が示唆されている。「Television and Video Game Exposure and the Development of Attention Problems(テレビおよびビデオゲームへの接触と注意欠陥障害の発達)」というPediatrics誌8月号で発表された研究によると、テレビやビデオゲームにさらされることと、同時注意に関する障害の間に、弱から中程度の相関関係がみられたという。この研究では、被験者がゲームをプレイした場合もテレビを見た場合も相関関係は同じだった。同研究は1323人の子ども(3年生、4年生、5年生の男子および女子)を対象とし、13カ月間にわたって行われた。子どもがビデオゲームやテレビを見る習慣について両親から情報を収集し、その子どもの注意欠陥障害の有無と程度に関して教師にたずねる調査を実施した。

ADHDを持っている子供がテレビやゲームに熱中しやすいというだけで、テレビを見たからADHDになるとはどこにも書いてない気がするのですが。「環境要因」なんて言葉を使ってあたかも原因であるかのように書くのはいただけませんな。

また、210人の大学生(男女)を対象として1回限りの調査も行い、この調査ではテレビを見る習慣、ビデオゲームとの接触、注意集中に関して抱えている問題について自由記述形式で提出させた。そして研究の結果、視聴に費やす時間が1日2時間を超えている子どもは、平均発生率を上回る確率で注意欠陥障害になりやすいことが判明した。より高い年齢の大学生を対象とした1回限りの調査でも同様の結果が出た。

この論文ちょっと論理がおかしい。この研究はADHDの傾向を持つ人がテレビに嵌りやすい(ダラダラ見かもしれない)という結果を示しているだけで、テレビをたくさん見るとADHDになるとは結論付けられていないと思う。

 この研究の中心的執筆者であるEdward Swing氏は、米GameSpotに対し、ゲームプレイと注意欠陥障害の因果関係について断定するためにはさらに調査が必要だと語った。同氏はまた、プレイするコンテンツのタイプが注意欠陥障害との相関関係に影響するかどうかを突き止めることに関心があるとも述べた。同氏は、例えばゆっくりとした、教育的な、あるいは非暴力的なゲームやテレビ番組であれば、注意欠陥障害に結びつく可能性が一般に弱まるのかどうかを見極めたいと考えている。この研究には、共同執筆者としてCraig A. Anderson氏、David A. Walsh氏が名を連ねている。いずれも以前からある、ゲームの有害な影響を非難する向きの発言者として知られている。Anderson氏の以前の研究では、暴力的ビデオゲームと攻撃性の高さとの関連性が認められた。Walsh氏は、今はなきマスメディア監視団体である全米メディアと家族研究所(National Institute on Media and the Family)の創設者である

なんだ、テレビ・ゲーム規制論者が自分に都合の良いデータだけ引っ張り出してテレビ・ゲームを攻撃しているだけか。ワザワザ図書館行って原文読んできて損しましたよ。

テレビゲームは小学生から高校生くらいまで私も非常に熱中していました。ADHDを持っているとテレビ・ゲームに熱中しやすいと言うのは有りそうな気がします。

でも、ゲームのし過ぎでADHDになるというはどうでしょう?もちろん、後天的にADHD的な要素を獲得してしまう可能性はありますけどね。

ま、ゲームやりすぎていいことは特に無いから、ゲームは程ほどにしておきましょう。