Scott Gregorio Zuniga
Ann M Stotts; Instructor
July 31, 2008
ADHD IN CHILDREN AND ADULTS
ADHD (Attention Deficit Hyperactivity Disorder) is a behavioral disorder that is being more recognized in adults and not just children and adolescents. I was diagnosed in the early 80’s as having ADHD and this disorder continued on through my adulthood. ADHD is the single most common chronic behavioral disorder in preadolescent children. Reported rates range widely from 5% to 12% depending on study methodology and population. ADHD is more common in boys than in girls, with male to female sex ratios ranging from 5:1 for the predominantly hyperactive impulse type and 2:1 for the predominantly inattentive type. (Diagnosis & Treatment in Psychiatry, pg. 577) As having this at an early age and having this condition in kindergarten, things were very bad. I could not explain the energy I was having, and not only this, but trying to sit and listen was also very difficult. Concentration was lost and almost inadequate for me. I wasn’t trying to disrupt my class with the bouncing, fidgeting, and moving around, but because of the lack of knowledge and understanding of this disorder from teachers, I was labeled as a “problem child”. Later on in life, they started noticing symptoms. There are three symptoms that can be broken down into three subtypes, which are: an inattentive type (inability to pay attention), hyperactive impulse type (fidgeting or squirming), and a combined type, which involves a combination of the other two types and is the most common. (Kids Health) Around the time when I was about 6 years old, I was given a prescribed medication called Ritalin, which is a central nervous system stimulant. At that time it was the newest drug out there that appeared to be working on children showing symptoms of ADHD. Now, while it did calm me down, I started noticing that my demeanor started to change. I was feeling more anxious, jittery, and at times, slightly depressed. But the biggest thing for me was I was extremely irritable. My neighborhood friends began to distance themselves from me and soon I felt alone, and in a way at times, that seemed okay with me. Not only did it affect me at home, but also at school. During school, the teachers did notice a change in me, but they also noticed that I became upset much easier. After years of trying to explain to family and teachers that this medication made me feel like I was crazy, I finally took myself off of it at the age of fourteen. I tried other medications, but they had a reverse effect on me. Back then, researchers did not recognize the similarity feature, such as comorbidities, neuropsychological deficits, and failures in major life domains. (Brain Function and Structure pg. 323) In the 1970’s, studies were conducted on the neuropsychological functioning of children, age group of under 12, with ADHD. Studies now show that children through the age of 19 show that the right hemisphere of the brain is 3% to 5% smaller. (Brain Function and Structure pg. 327) Researchers are indicating that subjects with ADHD comorbid LDs are at approximately 30%, because LDs such as dyslexia involve brain abnormalities. It’s necessary to know which abnormalities are caused by ADHD and which are caused by LDs. An MRI study found that both dyslexic and ADHD children had smaller right anterior width measurements than did controls. (Brain Structure and Function pg. 332)
Diagnosis across the age group is a clinical process. Biological tests and psychometric instruments are not currently available, but the DSMIV-TR has a criterion for ADHD. There is a set of 18 criteria’s for ADHD, nine are inattention and nine are hyperactivity – impulsivity symptoms. The person must display two distinct settings, six of the nine must be hyperactivity –impulsivity and six of the nine must be inattention symptoms. They must also display these symptoms for 6 months to qualify for a diagnosis. Some of these symptoms must be presented before the age of 7. ADHD is typically a lifelong disorder. It is important to understand the pattern of symptoms and impairments in all groups. (ADHD in Children, Adolescents, and Adults pg. 322) Hyperactivity in adults is frequently manifested as adaptive behaviors rather than observed behaviors. For instance, I would hate going to the local movie theater because I would try to avoid settings where there was a long period of silence or sitting. I always have to be doing something; I never slow down. You could say my throttle was stuck in “rabbit gear”. Because of this hyperactivity, it has caused a lot of tension with family members and in my relationship. In my teenage years, it had gotten worse and because of my impulsivity, I had
, I had gotten into a lot of trouble with the law. It wasn’t because I didn’t know right from wrong; it was because I would make quick and irresponsible choices not thinking about the consequences. My temper was easily aroused and my tolerance for certain activities was very low. When I would get extremely frustrated my tolerance would drop more rapidly. In ADHD it is common to have psychiatric comorbidity. Two thirds of children having ADHD have a comorbid condition: 40% of children had oppositional deficit disorder, 14% had conduct disorder, 31% had anxiety disorder, and 4% had mood disorders. (ADHD in Children, Adolescents, and Adults pg. 325) There are few studies that look at psychiatric comorbidity in adults. There is a wide variation in the reported comorbidity rates. Murphy and Barkley conducted a study involving 172 ADHD adults, which found high rates of alcohol abuse and
alcohol dependency. (ADHD in Children, Adolescents, and Adults pg 326) I tend to agree with the results of this study because I too became dependent on alcohol as an adult.
College students with ADHD may present with major problems in concentration leading to reduced grades and considerable anxiety over an inability to deal with academic pressure (Attention Deficit Hyperactivity Disorder across the Lifespan pg 88). This is very true for me especially for when I am taking a test. I become over whelmed with emotions and then the anxiety will kick in, when this happens it’s very hard to concentrate and to stay focus on the task that is at hand. Now that I am treating my symptoms, the intensity of concentration and anxiety is greatly reduced; it’s still there, but not as intense.
Approximately three-quarters of college students with ADHD are improved with a psycho stimulant (Attention Deficit Hyperactivity Disorder across the Lifespan pg 88). Since I’ve been taking classes at Gateway Technical Collage I have been getting As and Bs in my classes, a lot has to do with treating my ADHD with a prescribe medication. I take Adderal Xe 20mg, it does help with concentration, and it somewhat suppresses my hyper behavior. Back in middle school my grades were Ds and Fs and occasionally a C. In summary, ADHD is a behavioral disorder that affects many lives from childhood to adulthood. Through more advanced studies and research, ADHD can be controlled, therefore making lives easier to manage, and more productive in the world today.
Bibliography:
•Donald E. Greydanus, MD, Helen D. Pratt, PhD, and Dilip R. Patel, MD.” Attention Deficit Hyperactivity Disorder Across the Lifespan: The Child, Adolescent, and Adult.” February 2007, pg. 88
•What is ADHD?;
http://kidshealth.org/parent/emotions/behavior/adhd.html
•Larry J. Seidman, PhDa-f,*, Eve M. Valera, PhDa,b, George Bush, MD, MSa,b.. “Brain Function and Structure in Adults with attention-deficit/hyperactivity disorder.” 2004, pgs. 323, 327, 332
•Michael H. Ebert MD, Peter T. Loosen, MD, PhD, Barry Nurcombe MD. Current Diagnosis & Treatment in PSYCHIATRY. 2000, pg. 577
•Screenivas Katragadda, MDa, Howard Schubiner, MDb, c, d, e,*. “ADHD in Children, Adolescents, and Adults.” 2007, pgs. 322 , 325 – 326
