ADHD - Head in the clouds: 100 questions and answers about attention deficit hyperactivity disorder E-Book

Paulo Mattos

• Herausgeber: Autêntica Editora
• Kategorie: Ratgeber
• Sprache: Englisch
• Veröffentlichungsjahr: 2021

Seitenzahl: 239

Beschreibung

Suddenly, you realize there is something different about that person who you like so much, or even that something about you does not fit into normality. Initially, the difficulty to learn, to socialize or to perform daily tasks seems natural. As time goes on, however, these obstacles start to mount, making the person's life more painful, more stressful and more difficult than would be reasonable – a suffering that also affects the lives of the people who live with them. What may be happening? It was in order to clarify this and many other doubts that Dr. Paulo Mattos wrote Head in the clouds: 100 questions and answers about Attention Deficit Hyperactivity Disorder ( ADHD ). As a psychiatrist and researcher, Dr. Mattos is one of the world's leading authorities on  ADHD , having published more than a hundred scientific articles, in addition to dozens of books and chapters on the topic. However, his main contribution to families living with  ADHD  has been, without a doubt, this book. Dr. Mattos gathered here the 100 most relevant questions asked by parents, spouses, healthcare professionals, educators, patients and many others who deal with the disorder. With direct, scientific answers and written in a way that is accessible to the general public, Head in the clouds it has become the main reference in Brazil when the subject is  ADHD . Recommended by psychiatrists, psychologists, neurologists, psychopedagogists, occupational therapists, physiotherapists, speech therapists and educators, the book Head in the clouds has become a must-read for people and families seeking clear, correct and safe information about  ADHD , amid so much misinformation. circulating in digital world. In this 17th edition, revised and expanded by Dr. Paulo Mattos, and with the preface written by Iane Kestelman – psychologist, psychoanalyst, neuropsychologist and voluntary president of the Brazilian Association for Attention Deficit (Associação Brasileira do Déficit de Atenção –  ABDA ) -, you will find the most up-to-date information regarding  ADHD , with the endorsement of the highest authority on the subject and the recommendation of the most important association of  ADHD  patients in Brazil. We hope this book will help you better understand  ADHD  and learn to live with the disorder in a peaceful way, with less suffering and a better quality of life.

Leseprobe

ADHD

Head in theclouds

100 QUESTIONS AND ANSWERSABOUT ATTENTION DEFICITHYPERACTIVITY DISORDER

Copyright © 2020 Associação Brasileira do Déficit de Atenção (ABDA)

All rights reserved by Autêntica Editora Ltda. No part of this publication may be reproduced, either by mechanical or electronic means or via xerographic copy, without prior authorization from the publisher.

The publisher is not responsible for the content, operation, maintenance or updating of links or other resources presented by the author in this book.

EDITOR

Marcelo Amaral de Moraes

ASSISTANT EDITOR

Luanna Luchesi

REVISION

Conor Hennessy

GRAPHIC PROJECT

Diogo Droschi

LAYOUT

Christiane Morais de Oliveira

International Cataloging Data in Publication (CIP)(Brazilian Book Chamber, SP, Brazil)

Mattos, Paulo

ADHD - Head in the clouds : 100 questions and answers about attention deficit hyperactivity disorder / Paulo Mattos ; tradução Rafael Bozzola. -- Belo Horizonte : Autêntica, 2021.

Título original: No mundo da lua : 100 perguntas e respostas sobre o Transtorno do Déficit de Atenção com Hiperatividade (TDAH)

ISBN 978-65-5928-043-8

1. Deficiência de aprendizagem 2. Distúrbio do déficit de atenção com hiperatividade - Miscelânea 3. Perguntas e respostas 4. Transtorno de déficit deatenção com hiperatividade (TDAH) I. Título.

21-63701

CDD-616.8589

Índices para catálogo sistemático:

1. Distúrbio de déficit de atenção com hiperatividade : Neurologia : Medicina 616.8589

Maria Alice Ferreira - Bibliotecária - CRB-8/7964

Belo Horizonte

Rua Carlos Turner, 420 Silveira . 31140-520 Belo Horizonte . MG

Tel.: [phone]

São Paulo

Av. Paulista, 2.073, Conjunto NacionalHorsa I, 3º andar . Sala 309Cerqueira César . 01311-940 São Paulo . SP Tel.: [phone]

www.grupoautentica.com.br

SAC: [email protected]

DR. PAULO MATTOS M.D.

ADHD

Head in the clouds

100 QUESTIONS AND ANSWERSABOUT ATTENTION DEFICITHYPERACTIVITY DISORDER

TRANSLATIONRafael Bozzolla

17TH EDITION | REVISED AND EXPANDED            

To my parents, thanks for everything.

Summary

About the author

Preface to this edition

  CHAPTER 1 – INTRODUCTION

1

What is ADHD, Attention Deficit Hyperactivity Disorder?

2

But is this enough to reach a diagnosis of ADHD?

3

Is ADHD a made-up disease?

4

And why is there so much fuss around an ADHD diagnosis?

5

Wouldn’t this be an attempt to control children’s behavior?

6

Why isn’t ADHD just a more flamboyant behavior?

7

But the media often disagrees regarding ADHD!

8

What are the problems associated with ADHD?

9

Can ADHD bring about benefits for the patient?

10

Is it possible to have ADHD without it causing troubles?

11

Why a Q&A book?

  CHAPTER 2 – THE SYMPTOMS

12

Are all patients similar to each other?

13

Is it difficult to reach an ADHD diagnosis?

14

So, the criticism that an ADHD diagnosis isn’t rock solid, is correct?

15

Are there different types of ADHD?

16

Does ADHD exist only with inattention?

17

Can ADHD persist into adult life?

18

But why did doctors use to think that ADHD didn’t affect adults?

19

How is an ADHD diagnosis reached in adults?

20

Can other disorders have similar symptoms to ADHD?

21

How can ADHD symptoms affect the life of an adult?

22

Why are relationship problems associated with ADHD?

23

Why is it that adults with ADHD keep changing what they are doing?

24

Is drug abuse more common in people affected by ADHD.

25

I have ADHD!

26

But everybody thinks I am inattentive!

27

Are there lab tests to diagnose ADHD?

28

Isn’t it strange that there are no lab tests to diagnose it?

29

How are parents able to notice if their daughter or son has ADHD.

30

From what age are parents able to detect ADHD symptoms?

31

Is there a difference in ADHD in boys and girls?

32

In what time in child’s life is an ADHD diagnosis made?

33

Are there other ADHD symptoms that are not listed in the DSM system?

  CHAPTER 3 – THE CAUSES

34

Is ADHD a secondary effect of the use of digital media?

35

Is ADHD a genetic condition?

36

Is there an ADHD gene?

37

What role does the environment play in all of it?

38

Can family problems cause ADHD?

39

Can emotional conflicts cause ADHD?

40

Can ADHD be a consequence of how children are raised?

41

Can I have a genetic test made to confirm an ADHD diagnosis?

42

What is the main conclusion of the genetic studies of ADHD?

43

Are there biological risk-factors that are not genetic?

44

What is altered in the brain of ADHD patients?

45

Can I have a CT scan to diagnose ADHD?

46

What about other kinds of tests?

47

Are there other tests employed in ADHD cases?

  CHAPTER 4 – COMORBIDITIES

48

What other disorders can appear together with ADHD?

49

But doesn’t ADHD by itself cause emotional problems?

50

What learning problems are associated with ADHD?

51

Are there clinical problems connected to ADHD?

52

How can the consequences of ADHD be mitigated?

  CHAPTER 5 – TREATMENT OVERVIEW

53

Will my son have to be medicated?

54

Can the attitude of parents towards their children “aggravate” their ADHD?

55

Is it normal for the parent to feel tired and hopeless?

56

What can parents do to help with treatment?

57

Shall we start right now?

58

But isn’t it difficult to the advantages of changing the behavior?

59

And what about those days when I am boiling with anger?

60

Why don’t they ever learn, even when I punish them?

61

What other social and family problems may occur?

62

Is it possible to “manage” impulsivity?

63

How is it possible to help with relationship problems?

64

Is there a solution for poor memory?

65

What is the most effective way to communicate with people with ADHD?

66

How to deal with the constant fight that is studying when they are home?

67

Where to start when it comes to school?

68

How should the study environment at home be?

69

How to reward positive behavior?

70

Is it possible to stimulate someone who doesn’t want to study?

71

Are there special tips regarding the time to do the homework?

72

What other items are important to motivate studying?

73

Are there ways to improve memorization?

74

My child gets poor grades because they do not study!

75

Is there any general advice?

76

And what about tips for adults?

  CHAPTER 6 – THE SCHOOL

77

What are the ideal characteristics of a teacher of children and teenagers with ADHD?

78

What should teachers expect in terms of academic performance?

79

How may teachers suspect of a coexisting problem?

80

And the behavioral problems that may be connected to ADHD

81

What are the main tips for teachers?

82

Is there a type of school that is a better fit for the student with ADHD?

83

Should the student with ADHD receive special treatment?

84

Won’t special treatment embarrass the student?

  CHAPTER 7 – MEDICATION

85

Is it mandatory to treat ADHD with drugs?

86

How do ADHD drugs work?

87

Which drugs are used to treat ADHD?

88

Is it possible to use more than one medication?

89

Do stimulants cause dependence?

90

Are there serious side effects to the use of stimulants?

91

Well, I am still unsure whether I should take the drugs or not.

92

Does medication cure ADHD?

93

How long should drug treatment last?

94

Am I going to be a “prisoner” of the medication?

95

Does medication build up in the body?

96

Are there instances in which the medication does not work?

97

When is it time to start psychotherapy?

98

What is neurofeedback?

99

Is treatment with a speech therapist mandatory?

100

Are there other important measures to be taken?

ABOUT THE AUTHOR

DR. PAULO MATTOS is a psychiatric doctor at the Federal University of Rio de Janeiro (Universidade Federal do Rio de Janeiro – UFRJ), he holds Master’s and PhD titles in psychiatry and Postdoc in biochemistry. He is also a founding member of the Brazilian Association of Attention Deficit (Associação Brasileira do Déficit de Atenção – ABDA) scientific committee. Member of the Brazilian Association of Psychiatry (Associação Brasileira de Psiquiatria), Brazilian Academy of Neurology (Academia Brasileira de Neurologia) and of the American Psychiatric Association. He is also neurosciences coordinator of the D’Or Institute of Research and Education (Instituto D’Or de Pesquisa e Ensino – IDOR).

All copyrights were donated by the author to the Brazilian Association of Attention Deficit, a non-profit organization.

Get to know ABDA’s website atwww.tdah.org.br

PREFACE

Life imposes multiple challenges. Many of them transform our lives and, as a result, also the fate of millions of people. First our family, then our neighborhood, our city, our country and, in the end, we realize that we have touched the whole world.

Head in the Clouds has definitely changed the reality of people with ADHD (Attention Deficit Hyperactivity Disorder).

In the mid-2000s, ADHD was still an unknown topic in Brazil. And I was just a mother of two children with undiagnosed ADHD, in a desperate search for answers to the difficulties that plagued their lives.

In anguish of finding a solution, I tried countless treatment options and I visited different professionals: psychologists, psychoanalysts, physicians … The conclusion was always the same: “it’s the parents’ fault” and, more precisely, the mother’s.

This statement proved the absurdity of the ignorance that, even today, is repeated by many professionals. Amid so many types of treatment and so many unprepared professionals, experiences like mine fail and generate countless losses: emotional, financial and health ones, as well as losses to family stability.

Despite my best efforts, I could not see a light at the end of the tunnel.

As unusual as this may seem, the answers that would clarify the reason for my anguish would reach me through my office door.

I am a psychologist, neuropsychologist and psychotherapist, specialized in psychoanalysis. My professional role and my life purpose have always been to bring light and understanding to those in need. At that time, however, it was I who needed a light, some help for my two children. And that light came to me through the hands of a patient, who was carrying a book in her bag. I found the title Head in the Clouds funny. But the subject seemed interesting.

Although the book’s title suggested a trip to the skies, in reality, what it proposed was a way back to earth. A definite encounter of a person, who did not know what ADHD was, with themself. Little did I know of the power contained in those pages. They were just words printed on paper, but they brought the most precious and necessary contents for that moment in my life: psychoeducation and knowledge. This allowed me to let go of that feeling of “I don’t know anything about this” and to change to the belief that “now, I understand and know what to do with all of this”.

After reading Head in the Clouds, Dr. Paulo Mattos stopped being just the author of the book, and to me he became the voice of hope. And how I heard that voice! This voice not only changed my children’s lives, but redirected mine, teaching me everything I know today about ADHD and what I keep on learning.

From the meeting with the author of Head in the Clouds, who became my children’s doctor and my professional guru, the need arose to create an institution that fought for the awareness, diagnosis and treatment of ADHD. It was then that the Brazilian Association for Attention Deficit (ABDA) was born, with the aim of disseminating scientific information about this disorder in Brazil. Today, almost 20 years after its foundation, ABDA is the only non-profit association that fights for people with ADHD in Brazil. It is the largest patient association in Latin America and is recognized by professionals and other patient associations around the world.

Head in the Clouds was the passport that allowed me to start a new journey with my children and my patients. Undoubtedly, like me, health and education professionals, people and families who still struggle against ignorance about ADHD, have in this book a real manual, with scientific questions and answers about the disorder. A kind of exit screenplay against stigma and disinformation.

I dedicate my eternal gratitude to the master, partner and friend, Professor Dr. Paulo Mattos, for having generously ceded the copyright, as well as all the proceeds from the book to ABDA projects, since its first edition.

To Autêntica Editora (our publisher in Brazil), which honors us greatly by taking over the rights to publish and disseminate this work, I also extend my sincere thanks for betting, supporting and believing in our cause.

Iane Kestelman

Psychologist, Psychoanalyst, neuropsychologist andVoluntary Head of the Brazilian Associationof Attention Deficit (ABDA)

PHOTOGRAPHEE.EU/SHUTTERSTOCK

What is ADHD, Attention Deficit Hyperactivity Disorder?

1

THIS BOOK IS ABOUT CHILDREN, teenagers and adults who have difficulty holding their attention for extended periods of time. They are often said to “have their heads in the cloud”, meaning that they think about something else (or many other things) during a conversation, when they are studying, reading, working, anyway, in many different situations. Research shows that ADHD affects around 5% of children, and 2.5% of adults in several parts or the world.

In most instances, but not always, these people are restless, cannot keep still or quiet for a long period of time, they hate everything that is monotonous or repetitive, and act on impulse in their daily lives. These are people who have ever-changing interests and plans and have difficulty finishing a project. They tend to be disorganized and to forget things more easily than others.

They may face problems in their academic lives (the complaints usually start at school), as well as in the professional, social and family realms. Despite causing, from an early age, several problems to one’s life, these symptoms may, for a long time — even for a person’s whole life — not be considered as a display of a disorder, that is, never lead to a diagnosis.

In more than half the cases of this disorder there are other associated conditions, especially situations of anxiety and depression, which may become the sole cause of concern of the individual, their doctor or therapist. This condition is called Attention Deficit Hyperactivity Disorder (ADHD). It has previously been known as Attention Deficit Disorder (ADD), as a reference to the cases in which there is no occurrence of Hyperactivity — the “H” in ADHD —, but this practice has been discontinued.

But is this enough to reach a diagnosis of ADHD?

2

ADHD IS RECOGNIZED by the World Health Organization (WHO), the agency in charge of elaborating the International Classification of Diseases, which includes the most mundane illnesses as well as the rarest ones.

New diseases come up, like COVID-19; others vanish, like smallpox, and some undergo a name-change — Reiter’s syndrome, for example, had its name changed, in order for it not to pay tribute to a Nazi physician. Syphilis and Hansen’s disease, the latter used to be known as leprosy, were considered the same disease for a long time because the skin symptoms were, at times, similar. Some behaviors were excluded from the official classification because it has been considered that there was no scientific basis to classify them as medical conditions, such as in the case of homosexuality. Scientific support is in no shortage when it comes to ADHD, as we shall see in this book.

Is ADHD a made-up disease?

3

IN ORDER TO ANSWER THIS QUESTION, the best course of action is to quote what the American Medical Association (one of the most diligent and influential medical associations in the world) had to say about the subject when the same question was raised in 1998.

“ADHD is one of the most extensively researched disorders in medicine and the general data regarding its validity is more persuading than most mental disorders and more so than even several medical conditions.

And why is there so much “ado” around an ADHD diagnosis?

4

THERE ARE POSSIBLY SEVERAL REASONS FOR THIS PHENOMENON. There are people who insinuate that ADHD might be a mere label to classify certain children who behave differently. As we will see in this book, ADHD is linked to a series of negative outcomes throughout one’s live: higher rates of academic failure, higher number of divorces, higher occurrence of accidents and higher unemployment rates. Therefore, it is not only about children who behave in a different way from other children.

Our brains are naturally structured to automatically classify things and group them into categories — categories per se are not the problem, but the problem lies in how they are used. Any diagnosis is a category and it means that a dysfunction is present. There are others who, unbelievably, understand that it is about social issues, a late manifestation of Jan-Jacques Rousseau’s ideas: “men are born good and pure, it is society that makes them different”.

There are still some who do not believe in an ADHD diagnosis simply because the symptoms may, to some extent, be noticed, in any person. There are two types of diagnoses in medicine. For some diseases, like cancer or hepatitis, you either belong to the group of those who have it or who do not have it. In this case, the situation is of a categorical diagnosis. However, in several other situations, the diagnosis is determined from a specific starting point, even though every person possesses or exhibits that trait or behavior to some extent. In this case we call it a dimensional diagnosis. There are many well-known examples of such diagnoses: hypertension (high blood pressure), diabetes, glaucoma among others.

Dimensional diagnoses are fairly common. Despite us all having blood pressure (in some it is lower, others average, in some people in the higher threshold of normalcy), some individuals have a very high blood pressure. Higher than the vast majority of the members of a population. And what happens to them? Each increase of 20mm in the systolic pressure (the upper pressure) or 10mm in the diastolic one (the lower limit) doubles the chance of death due to a cardiovascular disease. The same happens with diabetes mellitus: everybody has sugar in their blood, some have more, some have less. Some people have levels of sugar that most of the population does not, and that causes a number of problems for them. We call them diabetics.

The diagnosis of ADHD, like that of hypertension or diabetes, is dimensional. Every person displays symptoms of a lack of attention and restlessness, but some people — around 5% of the child population — have many more symptoms than others, and this “excess” of symptoms, that 95% of people do not possess, causes many problems to their lives, as we will see in this book.

Therefore, it is not a matter of having or not having symptoms of a lack of attention or hyperactivity. What defines whether there is a problem or not, is how much you have of such symptoms. There is not the group of the absolutely attentive and that of the completely inattentive.

Wouldn’t this be an attempt to control children’s behavior?

5

REGARDING ADHD, we are faced with a significant difficulty in paying attention, keeping quiet and enjoying leisure time, in being able to manage one’s emotions and control impulsive behavior. Let’s start with adults. What would you think if your dentist did not pay attention to your mouth and got up constantly to do other things? And what if your doorman did not pay attention to your greetings and, on top of that, “had no idea where the heck he put the letters delivered to your address”? What if the cashier at the supermarket simply decided to engage in a heated argument with you because of a mistake with the change that they made and did not realize? And what if your girlfriend did not pay enough attention while you were declaring your love to her, or if she decided to constantly keep checking the messages on her cellphone?

I believe it is fairly reasonable that parents should want their children to pay attention to what the teacher is saying in the classroom, not to get up all the time and mess around — disturbing others who have absolutely nothing to do with any of this mess — and to be able to study when they get home from school. I honestly cannot understand why these behaviors are such a horrible thing for some individuals. Children frequently do not quite realize how important education is to them. Why exactly shouldn’t the parents have expectations regarding their behavior?

I think that many people mistake these expectations for intolerance towards the differences that exist between individuals such as: the way we dress, personal beliefs, daily habits, religion, sexuality, etc. One thing is to be intolerant to personal differences, another quite different thing is not wanting your child to have symptoms of a biologically based disorder that will interfere in their ability to learn, develop and to have a healthy relationship with other people.

Having the desire to treat ADHD is wanting your child to make up for a deficiency — everybody is able to pay attention and keep seated, focused, except for them — and that they are on par with the other students. It is wanting them to develop like the others.

Going back to the notion of dimensional diagnosis: it is precisely because there is a range of variation from what is normal, that we know when we need to treat someone whose blood sugar is too high or whose blood pressure is too high. If we were to consider that each person is made in a particular way, then we would not treat diabetes, hypertension or obesity, and a countless number of diseases. Yes, we do treat both categorical and dimensional diseases alike.

Why isn’t ADHD just a more flamboyant behavior?

6

I DO NOT quite understand why some people insist on asking this question. I have developed several hypotheses regarding this issue. One of them is that these people have enormous difficulty accepting that there are diseases that affect our behavior. Neuropsychiatric diseases then, no way. Let alone in children!

By the way, I have always asked this question to myself: how is it possible to admit that there are countless organic disease that affect our bodies (diabetes, hepatitis, asthma, cancer, hypertension, etc.) but, from the neck up (i.e. in our brains) almost everything is psychological?

Well, some people acknowledge the existence of organic problems in the head, but, funnily enough, only in some very specific cerebral regions, such as in the cases of Alzheimer’s or Parkinson’s. But what about the cerebral regions responsible for behavior, impulse control and attention, don’t they ever experience organic problems? Billions of circuits that utilize thousands of different neurotransmitters and nothing goes wrong in these areas either? Give me a break! As there is a lot of prejudice and stigma regarding mental disorders in society, some people have difficulty accepting that there is a chemical problem or a biological one, affecting their central nervous systems.

Some people, who I believe to be well-intentioned, but misinformed, believe that only severe and incapacitating conditions can be considered “mental disorders”, as is the case of schizophrenia.

Depression, something that is much more frequent than ADHD, is also considered a mental disorder. Again, the issue of dimensional diagnosis: to be sad, down, mourning or experiencing a broken heart, are ordinary feelings in all of us. However, some people have more severe and long-lasting symptoms, with or without triggering factors. These symptoms represent a disorder that must be treated.

Here is the definition used by the World Health Organization of mental disorder:

“(…) a significant behavior, a syndrome or psychological pattern of an individual that is associated with current stress… Or inability… Or significant increased risk of suffering.”

Therefore, ADHD is clearly considered a mental disorder, just like depression, anxiety, alcoholism, etc.

A researcher of learning difficulties once said something quite interesting: “Each child is like all other children, like some, and like none”. By saying that, he meant that there are aspects in the behavior of a child that are the same in all other children, that is, they are normal for that age. To enjoy playing or messing around a bit are some of these behaviors. In some cases, however, there are groups of children who display specific characteristics that are not seen in children in general. Such is the case of children with ADHD, who comprise close to 5% of the population. They display a behavior that is not observed in other children, that is, the other 95%, with the same frequency.

But the media often disagrees regarding ADHD!

7

IT MIGHT BE DIFFICULT FOR A LAYPERSON to know who they should believe in, as there is an abundance of diverging info being put out by the print media, TV and the internet.

One major Brazilian newspaper, after interviewing one of the world’s most renowned researchers on ADHD — and I was an eyewitness of the occurrence! — decided to confront his opinions, all of which were based on scientific evidence, with the opinions of another individual who has never published a single scientific article on the subject (and I investigated this fact in depth), and has never taken part in any scientific research. The story was entitled “Specialists disagree on ADHD”. It is not known why the other individual was considered a specialist. Even worse, it is not known why their opinion was relevant at all.

It so happens that the media raise unsubstantiated fears when they go on about non-existing side effects — and invariably interview someone who is not a researcher nor a specialist on the subject — or associate the use of drugs to a “lack of patience to help the kid in school”, as was recently published in a magazine. In Brazil and in the world, there is no shortage of stories in which “specialists” state that ADHD is a made-up disease, that it is nothing but an invention from doctors — to justify treatment — and from pharmaceutical companies — to make money selling drugs. Recently there was a hoax was on the internet claiming that one of the “creators” of the ADHD diagnosis was remorseful and, at the dawn of their life, admitted that ADHD did not exist.

Firstly, try to find out who the so-called “specialist” is; on many occasions they are a professional who simply saw an opportunity to make themself heard by generating controversy. Consult scientific research databases, such as PubMed and Scielo, readily available online. How many scientific articles have they published? How many scientific research projects have they taken part in? None? It is difficult to believe in someone with such a controversial opinion and who has never conducted rigorous research on the matter, one that has been published in a scientific journal.

It is obvious that writing on the web or publishing a book — like this one you are reading now — does not count. Anyone can do it, as long as they can afford the associated costs!

What was truly unbelievable was a meeting, widely publicized and with the backing from official agencies in Brazil, in which several professionals went on to give their opinions on ADHD. In fact, the correct term would be guess and its relevance tends to be irrelevant or none at all in medicine. I made a point of looking up the resume of each one of the participants: none — that is correct — none of them had ever taken part in any research project on the subject. Some had written theoretical texts in which they simply digressed on the subject, that is, again, guesses