I would guess that using an efficient embedding model to organize files is probably forthcoming in the next year or two.

Rather than moving similar files into folders, I can see the OS suggesting related files based on similarity to another file, or permitting search by concept rather than keyword.

ADHD is a well-established, highly heritable neurodevelopmental disorder. Large-scale twin, genetic, neuroimaging, and longitudinal studies consistently show distinct brain, behavioral, and outcome differences compared to the general population. While we don’t yet understand every mechanism or subtype, the condition is robustly characterized and recognized by all major medical bodies. The World Federation of ADHD International Consensus Statement concludes: “ADHD is a genuine neurodevelopmental disorder with a well-documented genetic and neurobiological basis” and emphasizes that claims to the contrary are “contrary to scientific evidence and risk causing harm” [1].

Medical and psychological professionals are VERY confident that ADHD is a real condition—on par with the confidence they have in diagnoses like major depressive disorder or generalized anxiety disorder.

Across psychiatry, ADHD, depression, and anxiety are all among the best-documented psychiatric conditions. There is more skepticism about disorders with fuzzier boundaries (e.g., “personality disorders” or “internet addiction”), but ADHD is NOT in that category.

I believe ADHD is stigmatized in our culture because our modern world makes us all feel distracted at times; therefore, it seems like people with the diagnosis are perhaps getting a “free ride” by blaming their poor behavior on a “condition”. But ADHD is so much more than just having a hard time focusing because of social media and phones. It manifests as a spectrum of extreme challenges that lead over time to sufferers having a significantly harder time navigating life than people without ADHD.

Merely having a hard time concentrating does not make you an ADHD candidate. You must experience a range of symptoms that interfere materially in multiple areas of life.

⸻

Reference

[1] Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., … Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience and Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022

Your hypothesis is contracted by mountains of high quality scientific evidence. ADHD is a well-defined condition and there is an accepted way of diagnosing someone with it that effectively divides those with the condition from those without it. Stimulant medications may help many people to feel and be more productive, but that does not imply that people who meet the criteria for ADHD do not represent an identifiable group.

I highly encourage you to browse the Consensus Statement on ADHD, referenced below. It’s a compilation of 202 facts about ADHD, accepted by a global consensus of experts on ADHD.

Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., … Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence‑based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022

Which part of the disgnosis do you find objective measures? There isnt a single scientific one

Take a look at studying looking at the consensus on diagnosis. Even among psychatrists the same patient gets diagnosed with different things.

QbTest [https://www.qbtech.com/adhd-tests/qbtest/]

It measures your ability to focus your attention quite objectively and there's statistically significant differences between neurotypical and adhd performance. This test was used during my own diagnosis.

There is no doubt some differences in people who experienced mental problems, and sought or were given a diagnosis, and the general population.

QbTest was retroactively designed specifically to target this subjectively diagnosed ADHD group. This may be evidence that an ADHD diagnosis does differentiate populations based on some criteria, but it says nothing to this differentiation being caused by a singular disorder/pathology

I'd like to see a study of this test done on other comorbidities. I found this for example which finds a weak relation in these tests https://pubmed.ncbi.nlm.nih.gov/38317541/ differentiating between ADHD and depression, anxiety, OCD.

Here is another study. https://pubmed.ncbi.nlm.nih.gov/37800347/ >Conclusions: When used on their own, QbTest scores available to clinicians are not sufficiently accurate in discriminating between ADHD and non-ADHD clinical cases. Therefore, the QbTest should not be used as stand-alone screening or diagnostic tool, or as a triage system for accepting individuals on the waiting-list for clinical services. However, when used as an adjunct to support a full clinical assessment, QbTest can produce efficiencies in the assessment pathway and reduce the time to diagnosis.

I'll also point out few things:

1. Attention/focus is not a simple single metric one can measure and varies entirely on the task/situation at hand. That is a computerized test with no actual risk/reward to a person is not a predictor of attention/focus in general life. Focus/attention is driven largely by the feelings, rewards, risks, outcomes someone sees, those with diagnosed ADHD are already entering this study with an entirely different mental perception/attitude.

2. There is inherent bias present in ADHD patients in they may intentionally fudge their performance to meet their diagnosis. Unlike most disorders, people actually seek an ADHD diagnosis for access to stimulants, and its incredibly easy to understand how to mimic that behavior for these tests.

3. Other computerized tests have existed aiding in diagnosis, so this becomes circular.

I think if you look hard enough there will always be fuzzy boundaries and overlaps in all the forms of neurodivergence. And yet, stereotypes and categories exist for a reason. Just because diagnosis is not perfect, doesn't mean it isn't good enough to do more good than harm in the world.

To your point 1, that's true. When there's ample motivation/inspiration, which is fickle and as far as I can tell not really up for conscious mutation, hyperfocus can occur in people with ADHD.

2: The test was actually quite long. In my unmedicated graph my attention was pretty high at first, but then I apparently got slowly distracted or disengaged. During the test I didn't feel distracted or disengaged however, and yet it showed quite clearly. Might it be harder than you think for people to "fake" this in a convincing way?

Anyway I do look forward to a better understanding of ADHD rather than "not enough dopamine" which seems to be the leading explanation. And I'm curious how much of a bimodal distribution that spectrum of dopamine deficiency is for humanity, or whether it is even bimodal at all.

What I am trying to say is that the brain is a VERY complex machine, I do not believe there is a singular cause for why people fail to be motivated/alert in their daily lives.

I refuse to call it ADHD, as that implies some known pathology. It is imo a social construction. Categorization can be useful for assessment/treatment but it isnt science. Quite frankly I dont care if people were handed amphetamines simply because they wanted to see if it improved their lives.

I will just say, I am disgnosed and take stims and the best and most motivatrd I ever felt was when I was doing some sort of physical activity almost daily, had a challenging rewarding job and friends. I was completely sober and happy, and completely depressed, ADHD like all the years prior. If youre not exercising regularly I highly suggest you try it

You’re right that there isn’t a _single_ “scientific” or purely objective test for ADHD. The consensus statements on ADHD make this explicit: diagnosis is clinical, not biomarker-based [1][2], even though biomarker tests are being developed and this is a promising area of research.

That said, there are structured and semi-objective tools that add quantifiable data to the process, even if they can’t stand alone; and, these tools in combination reveal a very real condition that is also highly treatable once diagnosed:

1. Rating scales (e.g. Vanderbilt, CBCL) use structured questionnaires to quantify symptom frequency. They’re subjective (based on parent/teacher/patient report) but standardized. Many mental health conditions are assessed using standardized rating scales [3].

2. Continuous Performance Tests (CPTs) and objective activity measures can quantify attention lapses and hyperactivity. They’re more “objective,” but consensus statements say they’re insufficient for diagnosis _in isolation_ [4]. I did a CPT test and it lit up for ADHD, which was helpful in ruling out other conditions.

3. Multi-informant reports (parents, teachers, patients) are required in good clinical practice to triangulate symptoms across contexts [5]. As I wrote in my first comment, ADHD exists only when the symptoms affect functioning in many areas of life.

4. Experimental methods (like neuroimaging or computerized neurocognitive tests) show promise but aren’t yet validated for clinical use [6].

The core of diagnosis remains a comprehensive clinical interview and history guided by DSM/ICD criteria. This is where “inter-rater variability” arises: different psychiatrists may weigh the same evidence differently. Consensus statements acknowledge this diagnostic variability, which is a limitation of current psychiatric nosology in general (not just ADHD).

So to answer directly: no, there isn’t a single objective test. But there are quantifiable tools that support diagnosis. The diagnosis itself is still fundamentally consensus- and criteria-driven, not biologically “proven.” But this limitation is minor and is common in psychiatry where many real conditions are diagnosed using a combination of approaches because no single test exists (and may never).

[1] Faraone, S. V., Asherson, P., Banaschewski, T., Biederman, J., Buitelaar, J. K., Ramos-Quiroga, J. A., Rohde, L. A., Sonuga-Barke, E. J., Tannock, R., & Franke, B. (2021). The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022

[2] Kooij, J. J. S., Bijlenga, D., Salerno, L., Jaeschke, R., Bitter, I., Balázs, J., Thome, J., Dom, G., Kasper, S., & Nunes Filipe, C. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry, 56, 14–34. https://doi.org/10.1016/j.eurpsy.2018.11.001

[3] Collett, B. R., Ohan, J. L., & Myers, K. M. (2003). Ten-Year Review of Rating Scales. V: Scales Assessing Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 42(9), 1015–1037. https://doi.org/10.1097/01.CHI.0000070245.24125.B6

[4] Hall, C. L., Valentine, A. Z., Groom, M. J., Walker, G. M., Sayal, K., Daley, D., & Hollis, C. (2016). The clinical utility of the Continuous Performance Test and Objective Measures of Activity for diagnosing and monitoring ADHD in children: A systematic review. European Child & Adolescent Psychiatry, 25(7), 677–699. https://doi.org/10.1007/s00787-015-0798-x

[5] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

[6] Cao, Q., Zang, Y., Sun, L., Sui, M., Long, X., Zou, Q., & Wang, Y. (2006). Abnormal neural activity in children with attention deficit hyperactivity disorder: A resting-state functional magnetic resonance imaging study. NeuroReport, 17(10), 1033–1036. https://doi.org/10.1097/01.wnr.0000224769.92454.5d

1. Standardized is absolutely meaningless here. We can develop any set of symptoms, develop a standardized questionnaire, and have millions of people who meet it.

2. CPT measures attention/focus in an entirely made up lab scenario. Attention and focus are not singular numbers, and are deeply tied to the actual emotions, risks, rewards present in a situation, and cannot be so easily measured. I can see the value of a test that measures noticeable difference between two groups, but that says nothing about the cause of those differences, but simply that we can identify different groups of people. You may also very well be selecting here who are depressed, stressed, low energy, or simply people who see no point in spending energy on a completely meaningless task, etc. In any case, I do not believe the evidence of CPT in differentiation is well established. https://pubmed.ncbi.nlm.nih.gov/38317541/ https://pubmed.ncbi.nlm.nih.gov/37800347/

3. Personal reports of another person's mental state is as subjective as you can get. All were selecting here is people who do not fit the defined, artificially built, educational or work systems. One may even be excellent, motivated student of music but all accounts fail in a classroom setting.

>The core of diagnosis remains a comprehensive clinical interview and history guided by DSM/ICD criteria.

Clinical interviews are guided, and their interpretation is subjective.

DSM is as subjective as you can get. Every single on of the symptoms has the wording "Often", as decided by a person evaluating another person's account of their life. Do you have an objective measure of what "often" means?".

More importantly, a collection of symptoms does not constitute a singular cause. By the admission of the DSM itself, two people with the diagnosis can share only 4 out of the 9 symptoms (me 1-6, you 3,9), meaning every single one of the symptoms has independent causes. How do you know one does not simply have 6 symptoms by caused by entirely different factors? In a population of hundreds of millions, its a guarantee. You could again, define random symptoms, give it a name and have millions of people going "Wow, no way, I meet all of this, I didnt know I have xyz!"

Lastly, I find it really interesting is that the diagnosis of ADHD came far before we had any of this technology and research you point to. Why was it so popularly pushed and accepted then? Is it possible, were simply trying very hard to fit a completely socially agreed upon disorder?

You've raised some common and valid criticisms of how ADHD is diagnosed.

1. On standardized scales being "meaningless": The term "standardized" here doesn't just mean a consistent set of questions. It means the scoring is normed against a large, representative population. So when a parent says their child "often" loses things, the scale helps a clinician determine if that "often" is statistically significant compared to other children of the same age and gender. It's a tool to quantify subjective reports. You're right that any set of symptoms can be standardized, but these scales are specifically designed to measure the frequency and severity of behaviors outlined in the DSM/ICD criteria. They aren't a standalone test, but one data point in a larger clinical picture. Most psychiatric conditions rely on this kind of structured self-reporting. The people working in this field work very hard to apply statistics properly when designing and running these tests; it's so far from random it's not even funny.

2. On CPTs: I agree that a CPT is an artificial lab scenario. That's a well-known limitation called a lack of "ecological validity." No one claims it perfectly replicates real-world focus. Consensus statements are clear that CPTs are insufficient for diagnosis on their own. Their value isn't in definitively saying "you have ADHD," but in providing an objective measure of things like attention lapses and impulse control that can supplement the subjective reports. If someone's self-report suggests severe inattention but they score perfectly on a CPT, that's a data point a clinician needs to investigate further. It can help in the process of differential diagnosis. The studies you linked highlight its limitations, which is consistent with the consensus view that it's a supplementary, not a primary, tool.

3. On multi-informant reports: You say these are "as subjective as you can get," which is true, they are subjective. The entire point is to gather subjective reports from multiple contexts to see if a pattern emerges. A core criterion for ADHD is that the symptoms cause impairment in two or more settings (e.g., home and school/work). If a child is only described as hyperactive and inattentive in a boring classroom but is a focused and motivated musician at home, a good clinician would question an ADHD diagnosis and look for other factors. The goal is to see if the problem is with the person's underlying regulation skills across environments, not just their "fit" in a single, artificial system.

4. On the DSM and clinical interviews: The word "often" is intentionally not given a hard number because it's relative to a person's developmental stage. "Often" losing homework is different for a 7-year-old than for a 30-year-old. This is where clinical judgment, guided by the DSM criteria, comes in. As for the symptom overlap, you're describing a feature of many polythetic diagnostic systems, not a flaw unique to ADHD. It recognizes that the disorder can manifest differently in different people. The clinician's job isn't just to count symptoms, but to assess the entire pattern, determine the level of impairment, and critically, rule out other potential causes for those symptoms (anxiety, depression, trauma, etc.). The diagnosis is a synthesis of all this information. Again, standardized test scoring DOES have the effect of giving a "definition" to the term "Often", because when thousands of forms are filled in, individuals' different definitions of the term converge in a statistically significant way onto a concept that is meaningfully comparative.

5. Finally, your historical point is interesting. Descriptions of ADHD-like symptoms date back centuries, long before the DSM. Sir Alexander Crichton wrote about "the incapacity of attending" in 1798. The diagnosis wasn't just invented out of thin air in the 20th century. It's a modern label for a pattern of behavior that has been observed for a very long time. The research and technology we have today are being used to better understand its neurobiological underpinnings, not to retroactively justify a "socially agreed upon disorder".

I'm really curious what the next century of study will do to illuminate this condition. I suspect we will have significantly greater understanding of the role of genetics and perhaps, one day, a blood test will diagnose ADHD.

I hold the same criticism for other psychatrist disorders, I am only talking about ADHD because its the one I personally identify with and spent the most time thinking about.

I am not disputing that it's possible to group populations on behavioral traits, long standing emotional states, etc. If you want to say "there are people who feel unmotivated, inattentive in their life and we call that ADHD", fine. However identifying a distinctive cause as a scientific fact is an entirely different matter. I.e, your behavior categorizes you as ADHD by the DSM, we found taking amphetamines often helps people with these complaints is a very different statement than something like "you lose things often BECAUSE you have ADHD"

>but in providing an objective measure of things like attention lapses and impulse control that can supplement the subjective reports.

Stick in me an abstract math class and all my neurons will be firing, put me in accounting and ill fall asleep. How is a simplified messure of attention in a single artificial scenario interesting? These labs are for profit companies trying to make a buck.

>Again, standardized test scoring DOES have the effect of giving a "definition" to the term "Often",

I dont see how this follows. You at best merely have some distribution of how often people feel like they lose things. You have no way of either knowing how often it is people actually lose things or how inattentive they are in conversations, and certainly less so that the patient in front of you is so. I urge you to think about this little more deeply.

Lets take inattentive in conversations for a second. How many conversations does the patient have, with whom? What are the patient's interests versus the type of conversations they have? Are they shy, awkward, or likewise the people around them? How long of not paying attention is considered inattentive? What is the objectively measured norm for all these behaviors? And if you can admit its way too hard to measure, all youre doing is basing your decision on your own and your patients feelings. As a psychiatrist, you have to ask yourself, are you really trying to understand the cause of this patient's inattenttion in conversations, or are you merely looking enough evidence to fit them into a bucket that you already understand? Id have a million questions before I can even answer this question intuitively, nevermind objectively.

And this is besides my greater point here. Per the DSM, it is possible for you to have ADHD and not be found to be inattentive in conversations but often be losing your keys, and for me, vice versa. So were admitting these things can have other factors. For example, I may be losing things simply because my mom never had me clean up after myself and I keep dirty place with too many visual distractions. Maybe I have a job or friends or whatever circumstances that make my life more chaotic. Perhaps going out anywhere makes me nervous so I don't think clearly about grabbing the things I need on the way out. Perhaps Im not as bothered by being inconvenienced so I dont care as much to meticulously think about the things I need.

And you will say "true, but ADHD isnt just losing your keys, its a pattern of related behaviors", and I say what is the belief that these different behaviors aren't independent?

Categorizations can be useful, but by definition are a loss of information. We have learned nothing by attaching a name, except perhaps a feeling that we have something simple we can understand.

The diagnosis criteria in that consensus is pretty weak imo and part of the subjectivity I’m talking about.

They claim there are observable differences, but none of these alone can be used for diagnosis.

> The diagnosis of ADHD has been criticized as being subjective because it is not based on a biological test. This criticism is unfounded. ADHD meets standard criteria for validity of a mental disorder established by Robins and Guze (Faraone, 2005; 1970). The disorder is considered valid because: 1) well-trained professionals in a variety of settings and cultures agree on its presence or absence using well-defined criteria and 2) the diagnosis is useful for predicting a) additional problems the patient may have (e.g., difficulties learning in school); b) future patient outcomes (e.g., risk for future drug abuse); c) response to treatment (e.g., medications and psychological treatments); and d) features that indicate a consistent set of causes for the disorder (e.g., findings from genetics or brain imaging)

I don’t find this very persuasive and it’s a problem in the field generally.

Properly designed preregistered studies are credible even if they're funded by people you don't like. All medication in the US is approved by studies funded by the company that applies to be able to sell it. Who else would be motivated to study them?

Yeah, BC chiming in. Any physician can diagnosis you with ADHD. It’s free, as are all GP appointments.

There is nothing controversial or difficult about getting a diagnosis in this province. And the stimulant-class medications are easy to access and inexpensive if a generic option is available.

This feels like the first open model that doesn’t require significant caveats when comparing to frontier proprietary models. The parameter efficiency alone suggests some genuine innovations in training methodology. I am keen to see some independent verification of the results and to see how if does on Aider’s LLM Leaderboard.

I used it to make a small change (adding colorful terminal output) to a side project. The PR was great. I am seeing that LLM coding agents excel at various things and suck at others quite randomly. I do appreciate the ease of simply writing a prompt and then sitting back while it generates a PR. That takes very little effort and so the pain of a failure isn't significant. You can always re-prompt.

I’d throw a vote in the column for Unstract. Making the code AGPL is a first class move for a company that is trying to make money from the hosted version of the same software.

The use case that immediately comes to mind is analysis of legal documents. Lawyers spend a lot of time going through piles of contracts during due diligence for any kind of investment or acquisition transaction, painstakingly identifying concepts that need to be addressed in various ways. LLMs are decent at doing this kind of work, but error-prone (as are humans, by the way). Having a way to visualize the results could be helpful in speeding up the review process of the LLM’s work.

The context will contain a record that the tool call took place. The todo list is never actually fetched.

IMHO, investors are happy to pay 23x ARR because Nvidia trades at 29x EV/sales and arguably OpenAI should support a higher multiple given it is a smaller entity with more headroom for growth.

That would imply that OpenAI has less competition to fear than Nvidia, which I’m doubtful is the case.

That doesn’t imply anything. Each investor has their own take on risk. They’d invest if they think the risks are worth it.