ATTENTION-DEFICIT HYPERACTIVITY DISORDER

Attention-Deficit Hyperactivity Disorder

Attention-Deficit Hyperactivity Disorder

Introduction

Attention deficit hyperactivity disorder (ADHD) is one of the most common, most talked about, and most vexing of the psychiatric disorders. Symptoms of restlessness, distractibility, and poor self-control have been recognized since the mid-1800s when Heinrich Hoffman, a German physician, wrote a poem about “Fidgety Phil” (Barkley, 2000) Over time, the disorder has been seen as a manifestation of brain damage, “brattiness,” and poor parenting. Diagnostic manuals have focused on the high level of physical activity, later on the short attention span, and more recently on the inadequate self-control features of the disorder (Barkley, 2000). Few disorders have been surrounded by the controversy about assessment, treatment, and even its very existence!

ADHD: Description

The primary features of ADHD are inattention, hyperactivity, and impulsivity. People with ADHD are described as often failing to attend to details, giving up on a task before completion, and having organizational difficulties. Restless, impatient, and intrusive are other common descriptors. However, individuals can show different levels of these features, and therefore, different subtypes of ADHD are currently recognized (e.g., predominately combined, hyperactive-impulsive, and inattentive types). Because these symptoms are part of the human condition, some question the legitimacy of the disorder (Barkley, 2000). Therefore, for a diagnosis of ADHD, symptoms must be so severe that the person has significant difficulty functioning in a variety of settings. Further, the symptoms must be consistently present for at least 6 months, with an onset in childhood. People with ADHD also experience a number of other symptoms. For example, it is often very difficult for people with ADHD to keep information “in mind” while trying to solve problems or follow directions. They may have difficulty getting started and, once under way, are likely to lose interest or energy to finish the project. Emotional control is often lacking, and intense, but usually brief, emotional outbursts are common. Those with ADHD may have difficulty keeping things to themselves and are excessively talkative (Worley & Wolraich, 2003). The ability to think of alternative solutions to problems is diminished. Social problems, underachievement, and conflict with authority are common to ADHD.

ADHD: Causes

Although there are many theories about the cause of ADHD, current thinking has suggested that ADHD is the result of multiple biological processes. First, ADHD has a very strong tendency to run in families, at about the same rate that height does. Second, the genetics seem to lead to differences in brain anatomy (e.g., a smaller frontal area of the brain), function (e.g., underactivity in certain brain areas), and chemistry (e.g., abnormalities in amounts of neurotransmitters) (Worley & Wolraich, 2003). Third, prenatal complications, maternal substance use, brain damage, and lead consumption increase the risk for developing ADHD. Certain psychosocial factors, such as low socioeconomic status, a chaotic environment, and poor parenting, make it more likely that one will be diagnosed with ADHD.

ADHD: Impact on Growth and Development

ADHD is a common disorder and one of the most frequent reasons for bringing a child to a professional for assessment and ...