ADHD: An Overview
ADHD is not a "new" mental health problem nor is it a disorder created for the purpose of personal gain or financial gain by pharmaceutical companies, the mental health field, or the media. It is a very real disorder and medical behavior that affects millions of people around the country. According to the National Institute of Mental Health (NIMH), ADHD is one of the most common mental disorders in children and adolescents. In accordance to research sponsored by NIMH, estimated the number of children with ADHD between 3% - 5% of the population. NIMH also estimates that 4.1 percent of adults with ADHD.
Although it took some time for our society to accept ADHD as a mental health and in good faith or medical condition, is really a problem has been observed in modern literature for at least 200 years. Already in 1798, ADHD was first described in medical literature by Dr. Alexander Crichton, who spoke to it as "mental uneasiness." A fairy tale of a young apparent ADHD, "The Story of Fidgety Philip" was written in 1845 by Dr. Heinrich Hoffman. In 1922, ADHD is recognized as post encephalitis Conduct Disorder. In 1937 he helped found that stimulants to control hyperactivity in children. In 1957, methylphenidate (Ritalin) became commercially available for the treatment of hyperactive children.
The formal and accepted mental health / behavioral diagnosis of ADHD is relatively recent. In the 1960s, ADHD was known as "minimal brain dysfunction." In 1968, the disorder became known as "hyperkinetic reaction children. "At this point, the emphasis was more on the hyperactivity symptoms of inattention. In 1980, the diagnosis was changed to" ADD - Attention Deficit Disorder, with or without hyperactivity, "which placed emphasis on equality of hyperactivity and inattention. In 1987, deficit disorder renamed attention hyperactivity disorder (ADHD) and is divided into four categories (see below). Since then, ADHD was considered a disorder medical causes of behavioral problems.
Currently, ADHD is defined by the DSM IV-TR (the diagnostic manual accepted) as a disorder that is subdivided into four categories:
1. Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type - formerly known as ADD - is characterized by decreased of attention and concentration.
2. Attention deficit hyperactivity disorder, predominantly hyperactive, impulsive
Type - formerly known as ADHD - is characterized by hyperactivity without inattentiveness.
3. Attention deficit hyperactivity disorder, combined type - the most common type -
involves all the symptoms: inattention, hyperactivity, and impulsivity.
4. Attention deficit hyperactivity disorder not otherwise specified. This category
is for disorders ADHD including prominent symptoms of inattention or
hyperactivity-impulsivity, but do not meet the criteria of DSM IV-TR for
diagnosis.
For better understand ADHD and its sub-four, may be useful to illustrate the hyperactivity, impulsivity, and / or inattention by example.
Typical symptoms of hyperactivity in young people include:
• Often "on the go" or acts as if "driven by a motor"
• Feeling restless
• Move your hands and feet or squirming nervously
• Getting up frequently to walk or run about
• Running or climbing excessively when inappropriate
• Have difficulty playing quietly or engaging in quiet leisure activities
• Talking too much or too fast
• Often leave the seat when remaining seated is expected
• They often can not participate in social activities silent
Typical symptoms of impulsivity in young people include:
• act lightly or suddenly without thinking first
• Impulsively answers before the questions asked are totally
• Having a hard time waiting for a turn
• Often the interruption of other people's conversations or activities
• Poor decision-critical or social situations that lead to the child not being accepted by his group peer itself.
Typical symptoms of inattention in young people include:
• Not paying attention to details or makes mistakes neglect
• Have trouble concentrating and easily distracted
• Appearance not to listen when spoken to
• Often forgetful in activities daily
• Has trouble staying organized, planning ahead, and finishing projects
• Lost or missing assignments, books, toys or other items
• Does not seem to listen when spoken to directly
• Failure to follow instructions and fails to complete the activities, tasks,
tasks or duties in the workplace
• Avoiding or disliking tasks that require ongoing mental effort
concentration
Of the four sub-categories ADHD, hyperactive-impulsive type is the most distinct and recognizable, and the easiest to diagnose. The symptoms of hyperactivity and impulsivity is manifested in behavior the various environments in which a child interacts, that is, at home, with friends, school, and / or during extracurricular or athletic activities. Because the features hyperactivity and impulsivity in this subcategory, these children naturally attract the attention (often negative) of those around them. Compared with children without ADHD, it is more difficult to instruct, teach, coach, and who to contact. They are also likely to be harmful, the opposition seems imprudent, accident-prone, and socially underdeveloped.
Parents of young people with ADHD often express frustration, anger, and emotional exhaustion because to the neglect of their children, impulsivity, and hyperactivity. Upon receiving the professional services that many parents of children with ADHD describe complex feelings of anger, fear, despair and guilt. Its many "bugs" in trying to get their children to focus, pay attention, and to move forward with directions, tasks and responsibilities have led to feelings of hopelessness and despair. These parents often report feeling guilty about their resentment, loss of patience, discipline and reactive style. Both psychotherapists and psychiatrists have worked with parents of youth with ADHD who "joke" by saying "if someone does not help my son, give me some medicine! "
The following statistics (Dr. Russell Barkley and Dr. Tim Willens) illustrate the consequences of long- range of ADHD in youth.
• ADHD has a prevalence rate of 6-8% of children, continuing the disease
in adolescence for 75% of patients, and 50% of cases that persist in
adulthood.
• Children are diagnosed with ADHD three times more often than girls.
• Development emotional in children with ADHD is 30% slower than their peers without ADHD.
• 65% of children with ADHD exhibit problems in defiance or problems with authority figures. This can include verbal hostility and temper tantrums.
• Adolescents with ADHD are nearly four times as many traffic citations as non ADD / ADHD drivers. They are four times as many traffic accidents and are seven times more likely to have a second accident.
• 21% of adolescents with ADHD skip school on a regular basis, and 35% drop out before completing high school.
• 45% of children with ADHD have been suspended from school at least once.
• 30% of children with ADHD have repeated a school year.
• Young people treated with drugs that have a chance six times lower risk of developing a substance abuse disorder during adolescence.
• The child justice system is composed of 75% of children diagnosed with learning disabilities, including ADHD.
ADHD is a genetic disorder transmitted. Research funded by the National Institute of Health Medicine (NIMH) and the U.S. Public Health Service (PHS) have shown clear evidence that ADHD runs in families. According to recent research, over 25% of first degree relatives of the families of children with ADHD also have ADHD. Other research indicates that 80% of adults with ADHD have at least one child with ADHD and 52% had two or more children with ADHD. The hereditary link of ADHD has important treatment implications because other children in a family can also have ADHD. By Moreover, there is a distinct possibility that parents may also have ADHD. Of course, things get complicated when parents do not diagnosed with ADHD have problems with their child with ADHD. Therefore, it is crucial to evaluate a familial occurrence of ADHD, to assess ADHD in youth.
Diagnosis of Deficit Disorder Customer Type neglect in youth is not an easy task. More harm than good is done when a person is misdiagnosed. A misdiagnosis can lead to unnecessary treatment, ie, a prescription medication for ADHD and / or unnecessary psychological behavior, and / or educational services. Unnecessary treatment as a medication for ADHD can be emotionally and physically harmful. By contrast, when an individual is properly diagnosed and subsequently treated for ADHD, potential for dramatic life changes are endless.
Psychologists, clinical social workers, licensed clinical professional counselors, neurologists, psychiatrists, pediatricians and / Family Physicians can diagnose ADHD. Only doctors (MD or DO), nurse practitioners and physician assistants (PA) under the supervision a doctor can prescribe medications. However, psychiatrists, because of their training and experience in mental health disorders, are best qualified to prescribe medication ADHD.
While the young hyperactive type ADHD are easily noticed, the inattentive type ADHD are likely to be diagnosed, or worse yet, not even attract attention. On the other hand, young people with ADHD are inattentive type often mislabeled, misunderstood, and even blamed for a disorder on which they have no control. Because ADHD apparent lack of attention of a more internally and behaviorally least these young people are so often marked for the potential treatment providers. Therefore, these young people often do not receive potentially life-enhancing treatment, ie, psychotherapy, counseling in school / training, educational services, and / or medical or psychiatric services. Unfortunately, many "falling between the cracks" of social services, mental health, juvenile justice and education systems.
Youth with ADHD unrecognized and untreated can become adults with low self-esteem poor self concepts, associated emotional, educational and employment problems. According to reliable statistics, and adults with unrecognized or untreated ADHD are more likely to develop problems alcohol and drugs. It is common for adolescents and adults with ADHD to try to calm or "self medicate" themselves through the use of addictive substances such as alcohol, marijuana, narcotics, tranquilizers, nicotine, cocaine and amphetamines illegally prescribed or street (stimulants).
There is no "cure" for ADHD. Children with this disorder rarely exceeded.
Approximately 60% of people who had symptoms of ADHD as a child continues to have symptoms as adults. And only 1 in 4 adults with ADHD is diagnosed in childhood, and even fewer are treated. Through increased public awareness and pharmaceutical companies "Marketing of their drugs, more adults are seeking help for ADHD. However, many adults who were not treated as children, bring emotional educational, personal, and professional "scars." Like children, these individuals was not "as smart, successful and / or sympathetic" than their counterparts not ADHD. With no one to explain what they were fighting at home with friends and at school, they naturally turned inward to explain their shortcomings. Eventually, internalize negative messages about themselves, creating fewer opportunities for success as adults.
Like young people, adults with ADHD have problems serious with concentration or attention, or are hyperactive (hyperactivity) in one or more areas of life. Some of the most common problems include:
• Problems with jobs or careers, losing or quitting jobs frequently
• Problems should be doing as well as at work or school
• Problems with everyday tasks such as doing household chores, paying bills, and organize things
• Problems with relationships because they miss important things can not finish tasks, or get angry over little things
• Continue to stress and worry because they do not meet the objectives and responsibilities
• Ongoing strong feelings of frustration, guilt or blame
According to the investigation of adults with ADHD:
• ADHD can affect 30% of people who had ADHD in childhood.
• ADHD develops in adulthood. Only those who have had the disease since childhood actually suffer from ADHD.
• A key criterion for ADHD in adults is the "disinhibition" - the inability to stop acting on impulse. Hyperactivity is much less likely to be a symptom of the disease in adulthood.
• Adults with ADHD tend to forget appointments and are often socially
inadequate - making rude or insulting - are disorganized.
• They find it difficult to prioritize.
• Adults with ADHD have difficulty forming lasting relationships.
• Adults with ADHD have problems with short-term memory.
• Almost all people with ADHD suffer from other psychological problems, especially depression and substance abuse.
While there is no consensus as to the cause of ADHD, there is general agreement within the medical community and mental health is biological in nature. Some common explanations for ADHD include chemical imbalance in the brain, nutritional deficiencies, head trauma early / brain injury, or disability for normal brain development (ie, use of cigarettes and alcohol during pregnancy). ADHD can also be caused by brain dysfunction or nerve damage. dysfunction in the areas in the frontal lobes, basal ganglia and cerebellum may adversely affect the regulation of behavior, inhibition, short term memory term planning, self-control, verbal regulation, motor control and emotional regulation.
Because successful treatment of this disorder can have profound positive emotional, social, and family outcomes, an accurate diagnosis is extremely important. Requirements for the diagnosis of ADHD are: vocational training (undergraduate and postgraduate), training, supervision, experience and licensing. Even with the essential skills training, collaboration and input from current or previous psychotherapists, parents, teachers, school personnel, medical and / or psychiatrists creates more reliable and accurate diagnosis. The value of collaboration can not be underestimated.
Sound medical ethics requires practice to provide less restrictive and less risky form of therapy or treating youngsters with ADHD. Drugs or intensive psychotherapeutic services be given only if the client does not respond unless treatment approaches invasive. Therefore, it is crucial to determine whether "functional impairment" is or is not present. Customers who are functionally impaired will succeed in their environment without professional assistance, services and / or psycho-therapeutic or medical treatment. Once the functional impairment is established, then work treatment team to collaborate on the most effective method of treatment.
Too often, a person is misdiagnosed with ADHD, not because of problems attention deficit, but by his unique personality, learning style, emotional makeup, energy and activity levels, and other psychosocial factors that better explain your problem behavior. A misdiagnosis could also be related to other mental or emotional disorders (discussed below), a fact of life including parental unemployment, divorce, family dysfunction, or medical conditions. In a small but significant number of cases, the diagnosis of adult ADHD best represents a need to manage a difficult child, deliberate and opposition, even with these problems can not have ADHD.
It is essential that before a diagnosis of ADHD is achieved (especially before medication is prescribed), and that a doctor examine whether other mental disorders or coexisting Doctors may be responsible for the hyperactive, impulsive, and / or inattentive symptoms. Due to other disorders share similar symptoms of ADHD, it is necessary to consider the likelihood of a mental / psychological disorder rather than another which might explain the symptoms of a client. For example, generalized anxiety disorder and depression greater share of the symptoms of disorganization, lack of concentration and labor issues to conclusion. A specialist trained and qualified in ADHD study differential diagnosis in order to reach the most logical and clinically sound diagnosis. Typical rule out disorders include: Generalized Anxiety major depression, PTSD and substance abuse disorders. Furthermore, medical explanations should be similarly sought: disorders sleep, nutritional deficiencies, hearing problems, and others.
When a non-medical professional diagnoses a client formally with ADHD, ie a licensed psychotherapist, it is recommended that a second opinion (or confirmatory diagnosis) ask a psychiatrist. Psychiatrists are physicians who specialize psychiatrists in the medical view of mental disorders. They are able to prescribe medicine that may be needed to treat ADHD. Working together, parents, staff school, the reference psychotherapist and psychiatrist, will oversee the effectiveness of the medical component of the treatment of ADHD.
In summary, ADHD is a health medical and mental disorder that has become increasingly accepted and therefore more effective treatment. To achieve high professional assessment, diagnosis, education, and standards of treatment, it is important that trained and qualified professionals understand the multidimensional aspects of ADHD: history, diagnosis, statistics, etiology and treatment. Training, experience, a keen interest in details, a solid base of information and collaboration system creates the potential for achieve positive results in the treatment of ADHD.
References
1. Genetic factors, not necessarily the child's gender, the influence of ADHD Jim Dryden
http://record.wustl.edu/archive/1999/04-15-99/articles/ADHD.html
2. What are the risk factors and causes of attention deficit Hyperactivity
Disorder
http://www.adhdissues.com/ms/guides/adhd_risk_factors/main.html
3. What causes ADHD?
http://add.about.com/od/adhdthebasics/a/causes.htm
4. History of ADHD by Keith Londrie
http://EzineArticles.com/?expert=Keith_Londrie
5. Taking Charge of ADHD, Dr. Russell Barkley
http://www.healthcentral.com/adhd/c/1443/13716/addadhd-statistics/
6. ADHD Facts by Dr. B, Murray, Ph.D.
http://www.upliftprogram.com/bob_murray.html
7. ADHD Causes
http://www.myadhd.com/causesofadhd.html
8. ADHD.org.nz (New Zealand GroupP ADHD Support
http://www.adhd.org.nz/cause1.html
9. To understand the causes of ADHD Keath Low, About.com
http://add.about.com/od/adhdthebasics/a/causes.htm
10. Interventions for ADHD: Treatment in development contexts by Phyllis Anne Teeter 1988
11. Diagnosis of AD / HD in Adults
National Resource Center children on AD / HD and Adults with Attention Deficit Disorder
http://www.help4adhd.org/en/treatment/guides/WWK9S
12. Kessler RC, Chiu WT, O Deml, Walters EE. The prevalence, severity and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun, 62 (6) :617-27.
13. The Numbers Count: Mental Disorders in the United States
The National Institute of Mental Health website
http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml KesslerPrevalence #
14. Historical Development of Margaret Austin ADHD, Ph.D., Natalie Staats Reiss, Ph.D., and Laura Burgdorf, Ph.D.
http://resources.atcmhmr.com/poc/view_doc.php?type=doc&id=13848
15. ADHD, alcoholism and other addictions by Wendy Richardson, MA, LMFCC
Soquel, CA-1998
http://www.addresources.org/article_adhd_addictions_richardson.php <b> </ b>
16. National Institutes of Neurological Disorders and Stroke
NINDS Attention Deficit-Hyperactivity Disorder Information Page
http://www.ninds.nih.gov/disorders/adhd/adhd.htm
About the Author
Ross A. Rosenberg, M.Ed. L.C.P.C.
Psychotherapist
Arbor Counseling Center
(847) 913-0393 ext 122
Rossr61@comcast.net
www.rossrosenbergtherapist.com