神经科学与心理学2020ncbi.nlm.nih.gov
ADHD 成人脑内多巴胺奖赏通路功能减弱
Adults with ADHD show decreased function in brain dopamine reward pathway (2010)
入门 · 约 30 分钟读完前置知识：神经科学基础、多巴胺奖赏通路、ADHD 基本概念
导读
这篇 2010 年的论文研究了成年 ADHD 患者的大脑多巴胺奖赏通路功能。研究者通过脑成像发现，与普通人相比，成年 ADHD 患者在奖赏与动机相关的脑区（多巴胺通路）活动减弱，这解释了为什么他们需要更强的激励才能改变行为、更偏好即时的小奖励而非延迟的更大奖励。
HN 关注点：是因为许多成年 ADHD 患者程序员在评论中分享亲历经验，讨论焦点集中在药物治疗的利弊、ADHD 对学业和职业的影响，以及社会对 ADHD 的污名化。
HN 评论精选
这几条评论里：亲历 4
亲历亲历者描述 ADHD 的双面性：兴趣驱动的超专注与日常任务的严重分心
我是成年 ADD 患者，参加编程比赛或考试时感受尤其明显：我讨厌做这些事，任何一点注意力来源都会把我吸走，比如手机通知或有人把笔掉在地上，我走神就是这么快。但另一方面，如果是我喜欢的事，我能进入极度专注的状态，有一次连续写了 7 小时代码。ADD 对我既是祝福也是诅咒：我从 13 岁起靠它自学了编程和各种 IT 技能，但它也毁了我的考试和社交生活。我试过用节奏游戏控制专注，最终失败了。唯一稍微有点用的是利他林……也只够让我'正常'专注一小时。
stevefan1999查看英文原文
I'm an ADD adult and this especially hits me when I'm participating competitions, be it leetcode coding competition or examination. I just hate to do it and every other bits of attention source will got me seeked on, like a notification from my phone, or someone dropped a pen to the ground. That's how fast I lost focus. But on the other hand sometimes I can be extra-focused, with a prerequisite it's something I enjoyed -- where I truly focus on one single task nonstop, like I finally got the ebb and flow in a tranced out state. This resulted me in one case coding straight for 7 hours. It's not until my body started to crave for food or I don't know how long will this loose cannon shoot. ADD is both a blessing and a curse to me. This is how I accquired coding and various IT skills since 13, all self-taught. But this also fucked me over exams, and my so life experience is greatly impacted. I also tried to play rhythm games to control focus, only to see it ultimately failed. The only thing I had to deal with it slightly is my Ritalin...only so slightly I can "normally" focus for an hour. I just hope things go right in the rest of my life.
亲历作者反思拒绝用药多年是自我设限，呼吁消除对 ADHD 药物的污名
作为成年 ADHD 患者，我从这篇论文得到的结论是：药物对真正难以应对 ADHD 的人益处更大。我一直'硬扛'，但看着弟弟们靠药物顺利度过学业后，我意识到自己其实是在自我设限。现在我每天上班前服药，基本能撑过整个工作日。小时候吃利他林会犯困就停了，现在用更现代的药物效果很好。对药物的负面污名害了我，我常想如果 16 岁而不是 25 岁就开始有效用药，人生会有多大不同。
_dibly查看英文原文
This was an interesting read but, as an adult with ADHD, all I get out of this is that medication is even more of a benefit to those with real difficulties coping with their ADHD. I've always been one to 'just deal with it' but after a few years of working through school and seeing my younger brothers go through the same thing with medication, I realized that I was essentially just handicapping myself. Now I take medication in the morning before I get to work and it basically lasts me through the work/school day. When I was younger I was perscribed ritalin, and it just made me sleepy so I stopped taking it. Now I take a more modern medication and it works wonders. The negative stigma against medication really harmed me in school, and I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.
亲历引用论文中关于延迟满足障碍的段落，讲述 ADHD 毁掉学业、靠运气才找到工作的经历
'ADHD 儿童需要比常人更强的激励才能改变行为，且难以延迟满足、偏好小而即时的奖励'——这段描述完全就是我，虽然小时候更严重。五年级我第一次拿了 D，之后七年父母用尽各种办法激励我提高成绩。大学里我挂科留校察看的学期比正常学期还多，花了 5.5 年加两个暑期学期才以低 C 平均分毕业。最后录用我的恰好是唯一没问 GPA 的公司。我想如果我智力稍微差一点，可能早就完蛋了。
aidenn0查看英文原文
> children with ADHD require stronger incentives to modify their behavior than those without ADHD5; they also show a failure to delay gratification, have impaired responses to partial schedules of reinforcement, and preference for small immediate rewards over larger delayed rewards6,7. I'm an adult with ADHD and that paragraph describes me to a T, though it definitely was worse as a child I got my first D grade in a subject in fifth grade, and the next seven years were basically my parents trying every tool at their disposal to motivate me to get better grades. I was on academic probation four more terms than I wasn't in college, and graduated with a low C average after 5.5 years, plus two summer terms. I got hired at the only company that forgot to ask for my GPA. I think if I were just sightly less intelligent, I would have been in a world of hurt and possibly dead by now.
亲历控诉大学以苛刻证明要求拒绝为 ADHD 学生提供考试便利
我要狠狠吐槽我的前 20 名公立大学：他们以 ADHD 不被政府认定为正式残障为由，要求我提供大量证明材料甚至脑扫描来证明我难以在规定时间内完成考试，拒绝给我任何额外时间的便利。我差点因为需要大量死记硬背的微积分和有机/生物化学课挂科退学。尽管我现在在科技行业拿着高薪很成功，但被当成'装病'、被冷血的学术管理者无视的经历，至今仍让我愤愤不平。有人有同感吗？
sizzle查看英文原文
A big middle finger to my ~top 20 public university who wouldn't give me any accommodations of extra time because they required some ridiculous hoops to jump through proving I had trouble concentrating and finishing an exam in the allotted time, they wanted substantial documentation with brain scans showing I had a deficit all because ADHD isn't considered a bonafide disability by the government. I almost flunked out cause of some calculus and organic/biochemistry classes that required tons of rote memorization (pre-med before switching to computer major). Even though I'm successful now in tech with a huge salary, this experience of being treated like I had a made-up disorder (can't easily perceive it with no physical impairment/more obvious mental issues), and was invisible to the system full of cold-hearted academic administrators quick to academically disqualify me still makes me seethe and feel wronged to this very day. Can anyone relate?
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