The idea of adult ADHD is fairly new and somewhat controversial. Papers dealing with an adult equivalent of childhood hyperactivity/minimal brain dysfunction were found in the late 1960s and 1970s, but they did not get widespread acceptance of the adult equivalents in the fields of psychiatry and clinical psychology. In 1994 Edward Hallowell and John Ratey wrote Driven to Distraction, which became a best seller and brought adult ADHD to the public's attention. Scientists, such as S. Goldstein (1997), K. Nadeau (1995), and Paul Wender (1995) conducted serious and rigorous scientific research on adults with ADHD. During the 1990s more and more scientists began to consider the disorder as a real condition worthy of diagnosis and treatment.
Several other popular books, as well as the media, also called attention to ADHD in adults. Internet chat rooms, Web pages, and bulletin boards were dedicated to this topic, and support groups such as ADDA and CHADD began to include adults with ADHD in their discussions. Adults with the disorder began to ask questions that challenged the old idea of the 1960s that they would outgrow the condition. The adult form of ADHD was found to share many of the attribute of childhood ADHD and was found to respond to similar medications and treatments. The acceptance of ADHD in adults continues at the present time and is likely to increase in the decades ahead.
Many adults realize they have ADHD when they seek diagnosis for a son or daughter. Up to 65 percent of children diagnosed with ADHD will continue to manifest symptoms of the disorder in adulthood. Barkley (1990) found that antisocial behavior can be seen in 20-45 percent of adults with ADHD; 25 percent of these adults develop an antisocial personality. Twelve percent may develop substance abuse disorders. Interpersonal problems were reported by 75 percent of adults with ADHD, and sexual adjustment problems in about 20 percent. Serfontein in a 1994 study suggested that up to 10 percent of the jail population are adult sufferers of ADHD.
Adults are diagnosed under the same criteria as young people, including the fact that the symptoms began prior to age 7. Adults with ADHD may face challenges in self-control, self-motivation, executive functions, and inattention. They usually exhibit fewer of the impulsive and hyperactive tendencies that children have. However, they exhibit secondary symptoms such as disorganization, lack of follow-through, thrill-seeking, and impatience. These attributes may cause numerous problems in the work world.
Joseph Biederman, professor of psychiatry, Harvard Medical School, in a 2004 AMA briefing, observed that adults with ADHD had significant problems in the quality of their lives. According to Biederman, eight million adult Americans are estimated to struggle with inattention, impulsivity, and hyperactivity. He referred to his study of a large-scale survey that estimates yearly loss of household earning potential due to ADHD in the United States to be $77 billion. In the study he matched patients by educational levels. ADHD patients with high school education earn significantly less than their non-ADHD counterparts. On the average those with ADHD had household incomes $10,000 lower for high school graduates and $4,334 lower for college graduates. About 50 percent of those with ADHD reported they have lost or changed jobs because of the disorder.
Biederman also found that compared with people without ADHD, those with ADHD had the following problems:
- Higher divorce rates
- More substance abuse
- Lower level of satisfaction with all aspects of their lives
- Less positive self-image or optimistic point-of-view
He was struck by the fact that only about one-third of the adults who had been diagnosed in the past were now being treated for their disorder.
Adults that suspect they have ADHD may ask themselves some of the following questions:
- Did you have developmental delays in walking, talking, or sitting up?
- In the early grades, did your teachers complain that you were noisy or disruptive?
- Were you accused of daydreaming a lot at school?
- Did your teachers claim you were not living up to your potential?
- Did you often fail to complete homework?
- Did you have poor study habits?
- Did you experiment with drugs and alcohol?
- Do you frequently feel upset about lost opportunities of the past?
Diagnosing ADHD in an adult is very difficult because there are so many variables. It is important to contact a trained health professional who keeps up with the field. An organization like Children and Adults with Attention Deficit Disorder (CHADD) can provide information. The psychologist and physician can determine the appropriate treatment, which may involve medication, vocational and family counseling, or behavioral modification.
ADHD in adults is just beginning to be researched and reported. Dr. Russell Barkley, ADHD authority, in his book ADHD in Adults: What Science Says, has determined that adult ADHD is not well known and embarked on an educational tour in 2008 to proclaim how the seriousness of not knowing about the disease can lead to major problems in adults compared to their non-ADHD peers. According to Dr. Barkley, adults with ADHD are
- three times more likely to be currently unemployed;
- two times more likely to have problems keeping friends;
- four times more likely to have contracted a sexually transmitted disease.
Barkley's book is based on two studies:
1. A University of Massachusetts study conducted from 2003 to 2004 examined lifestyle outcomes among three cohorts of adults patients: 146 clinicreferred adults with ADHD, 97 adults seen in the same clinic who were not diagnosed with ADHD, and a general sample of 109 adults without ADHD. The study found that adults with ADHD were three times more likely to sell drugs illegally (21 percent compared to 6 percent) and that 67 percent of adults with ADHD compared to the control group (15 percent) had trouble managing their money.
2. The Milwaukee study has been ongoing since 1977, with the most recent following up from 1999 to 2003. This longitudinal study followed individuals over a period of years. The study looked at secondary life outcomes of 158 children who had been diagnosed with ADHD and who as adults either continue to experience the symptoms or who no longer have the disorder at age 27. They compared the results to a community control group of 81 children without ADHD. They found that adults with ADHD were about three times as likely to initiate physical fights (30 percent compared to 9 percent), destroy other's property (31 percent compared to 8 percent), and break and enter (20 percent compared to 7 percent).
Both studies documented behavior through a combination of data gathering techniques, such as self-reporting, patient interviews, and observation. ADHD has an impact on the lives of many people. However, Dr. Barkley encourages people with adult ADHD to seek help from their physicians to manage these destructive behaviors.
Although the existence and burden of ADHD have previously been questioned, ample data now support the validity of ADHD as diagnosis. Many successful people proclaim their struggle with ADHD as children and adults. James Carville, a political consultant whose skills as an organizer of campaigns and television commentator are well known, told of his difficulties with the condition but how it has given him positive creativity and ability to think out of the box. He revealed his ADHD in and interview on CNN in 2004 and is featured in the book Positively ADD: Real Stories to Inspire Your Dreams. David Neeleman, founder of JetBlue Airways, discussed his ADHD in ''Career Advice from Powerful ADHD Executives: Flying High'' in the December/January 2005 issue of ADDitude magazine. Several athletes have ADHD; Scott Eyre, pitcher for the Chicago Cubs, acknowledged his ADHD as an adult.
Medications for the treatment of adult ADHD are being developed. On April 24, 2008, Shire, a global biopharmaceutical company, announced that the FDA had approved Vyvanse or lisdexamfetamine dimethysylate for the treatment of ADHD. Vyvanse was introduced in July 2007 for treatment in children, aged 6 to 12. Currently, it is the only once-only prodrug stimulant approved to treat adults with ADHD. The Phase III trial that led the FDA to approve the drug for adults was a double-blind, placebo-controlled, 4-week study with 414 adults aged 18 to 55 years. Within this study adults' ADHD symptoms improved within 1 week of treatment with once-daily Vyvanse.
In May 2008 a presentation at the 161st Annual Meeting of the American Psychiatric Association reported new insights into treatment of adult ADHD with OROS methylphenidate extended-release tablets. The findings included efficacy and safety analyses from a randomized, double-blind, placebo-controlled, dose-titration trial completed in 2007 and final results from a longterm open-label safety trial. In the placebo-controlled trial 226 patients with ADHD ages 18 to 65 were randomized to receive placebo or OROS for 7 weeks. The patients showed significant results, with improvements in symptom management compared to the placebo group.
Patient education is the heart of therapeutic success in adults. When people with ADHD realize that perceived shortcomings have a neurological basis, they can begin to accept that training can assist in changing those shortcomings. Personal coaching can provide strategies and encouragement and help individuals set and achieve goals. Physicians are just now beginning to recognize the challenge of adult ADHD in America. Proper screening and education will continue to be the imperative for the mental health of our society. However, the outlook is good because treatment for adult ADHD comes at a relatively low annual cost and does not require inpatient treatment, but has the potential to improve the human condition.
1) Barkley, R. A. 1990. ADHD adolescents: Family conflicts and their management. Grant from National Institute of Mental Health, MH41583
2) Barkley, Russell, Kevin R. Murphy, and Mariellen Fischer. 2007. ADHD in adults: What the science says. New York: Guilford Press
3) Biederman, J. 2004. ''Breaking News: The Social an Economic Impact of ADHD.'' Discussion presented at the Attention Deficit Hyperactive Disorder (ADHD) AMA Briefing: September 9; New York, NY
4) Corman, C. A., and E. Hallowell. 2006. Positively ADD: Real stories to inspire your dreams. New York: Walker and Company
5) Goldstein, S. 1997. Managing attention and learning disorders in late adolescence and adulthood. New York: Wiley
6) Murphy, Kevin R. 1995. Out of the fog treatment option and coping strategies for adult attention deficit disorder. New York: Hyperion
7) Nadeau, K. 1995. A comprehensive guide to adults with attention deficit hyperactivity disorder. New York: Brunner/Mazel
8) Serfontein, Gordon. 1994. ADD in adults. New York: Simon & Schuster; Wender, Paul. 1995. Attention deficit hyperactive disorder in adults. New York: Oxford University Press.
EssayEmpire offers you the best custom essay writing services, along with term paper, thesis paper, and research paper writing help. Our company employs professional essay writers who are fully qualified in a variety of academic fields.
If you require a high quality writing service that is capable of writing authentic essays, term papers or research papers because you simply don't have the time or resources to do them yourself or maybe they seem too complicated and time consuming, you don't need to look any further. EssayEmpire is the perfect place for all your needs.
If you need high quality Research Paper on Adult ADHD at affordable prices please use our essay writing services offered by EssayEmpire.