Commentary on the response of A. Koutsoklenis, Y. Solovieva, and L. Quintanar Rojas

 
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Abstract

This commentary continues the discussion with A. Koutsoklenis, Yu. Solovieva, and L. Quintanar Rojas on the understanding of ADHD mechanisms. It questions the authors' assertion that abandoning the term ADHD will reduce the stigma of children with this syndrome.

General Information

Keywords: cultural-historical neuropsychology, attention-deficit/hyperactivity disorder (ADHD), stigmatisation

Journal rubric: Discussions and Discourses

Article type: correspondence

DOI: https://doi.org/10.17759/chp.2025210412

Funding. The study was conducted under the state assignment of Lomonosov Moscow State University № АААА-А20-120012890168-8.

Received 29.10.2025

Revised 05.11.2025

Accepted

Published

For citation: Akhutina, T.V. (2025). Commentary on the response of A. Koutsoklenis, Y. Solovieva, and L. Quintanar Rojas. Cultural-Historical Psychology, 21(4), 114–115. https://doi.org/10.17759/chp.2025210412

© Akhutina T.V., 2025

License: CC BY-NC 4.0

Full text

I welcome the authors' response to my commentary, as it once again demonstrates the commonality of our theoretical positions—our commitment to the principles of cultural-historical psychology and Luria's syndrome analysis, as I noted in my review.

Regarding our dispute, in their response, the authors of the article ignore my main criticism regarding the inconsistency of their presentation of the current understanding of ADHD mechanisms. First, they write that "according to the DSM, which reflects the prevailing view, ADHD is a 'complex, multifactorial neurodevelopmental disorder.'" I cannot disagree with this definition (in fact, by revealing their understanding of the syndrome, the authors make the same point both in the article and in their response to my comment). However, later in the article, they express doubts about the validity of ADHD as a diagnosis and cite the lack of "biomarkers" for the syndrome, according to Stefan Schleim (Schleim, 2022), as the primary reason. I'm criticizing the "biomarker" theory specifically, but the authors of the response turn a blind eye to it. The assertion in the response that "a truly diagnostic approach must move beyond surface-level descriptions to uncover the functional syndromes responsible for a child’s difficulties " should be addressed to the author of the "biomarker" idea, and not to me, I agree with that.

The authors write that "the ADHD concept lacks internal consistency and neuropsychological validity. It is disconnected from materialist-dialectical thinking, which underpins cultural-historical psychology”. Is this referring to the concept that the syndrome is a "complex, multifactorial neurodevelopmental disorder"? Do the authors disagree with that?

The response states that "Prof. Akhutina claims that this concept (concept of the 'social situation of development' – T.A.) is unrelated to ADHD diagnosis". I don't understand how my words, "The neuropsychologist's recommendations will depend on what support is actually available in the child's social situation," can lead to such a conclusion. I also don't understand how abandoning the term ADHD will reduce the stigma surrounding children with developmental disabilities.

In my opinion, the scientific concept of ADHD shouldn't be confused with the myths about it that are widespread in the pseudo-scientific literature. Let's combat the popular medicalization of ADHD, which oversimplifies the problem, and seek optimal ways to help children.

References

  1. Schleim S. (2022). Why mental disorders are brain disorders. And why they are not: ADHD and the challenges of heterogeneity and reification. Frontiers in Psychiatry, 13, https://10.3389/fpsyt.2022.943049

Information About the Authors

Tatiana V. Akhutina, Doctor of Psychology, leading research assistant of the laboratory of neuropsychology, Lomonosov Moscow State University, Moscow, Russian Federation, ORCID: https://orcid.org/0000-0002-8503-2495, e-mail: akhutina@mail.ru

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