Attention Deficit Hyperactivity Disorder (ADHD) Ashley Irving February 26, 2012 Professor Paulette Hamner HCA 240

Attention Deficit Hyperactivity Disorder (ADHD)

Mental health can affect the daily routines and quality of life for one suffering from a mental illness. ADHD known medically as Attention Deficit Hyperactivity Disorder can affect both children and adults. Many believe this is a fairly new mental illness but has been under research beginning in the early 1970s. Various lifestyle, environment, social, and emotional changes can affect the outcome of one suffering from this mental illness. ADHD labels given to both children and adults with difficulties in inattention, hyperactivity, impulsivity, and boredom. ADHD effects the neurotransmitters within the brain cause the brain the inability to process and function properly. Various steps are necessary to diagnose ADHD and can take some time but typically signs are noticed before the age of seven (Francis, 2010). Nearly 35% of adolescents sent to mental health facilities are seeking medical help for ADHD. It is the most common of all psychiatric disorders (Sibley et al, 2010). Attention deficit hyperactivity disorder causes a disruption of neurobehavioral developmental condition, which affects both children and adults marked by the presence of inattention and possibly increased activity. Delays in impulse control can be present as well. The condition appears to affect the brain areas involved in problem-solving, planning, and comprehension. The condition is thought to impact three to five percent of school age children. This condition was previously thought to be a psychiatric condition limited to childhood, but neurological evidence has been found for the condition being present in adults. A chronic disorder with a majority of those diagnosed as children continuing to demonstrate the signs and symptoms of ADHD throughout adulthood (Francis, 2010). Studies of the causes of ADHD have produced varied answers. One study showed delays in the development through the frontal cortex as well as the temporal lobe, thought to have

Attention Deficit Hyperactivity Disorder (ADHD)

involvement with exercising control and ability to stay focused (Sibley et al, 2010) Other studies have shown ADHD subjects to have areas within the brain that mature sooner than others. The motor cortex of ADHD subjects appears to mature faster accounting for the need for delayed development to control ADHD behaviors. Stimulant medication affects the growth of structures within the central nervous system. The low arousal theory exerts that ADHD patients suffer from a state of abnormally low arousal and self stimulate or engage in excessive activity to relieve the anxiety this produces. The patients are thought to be cannot exert self management and only gain control of their attention through external stimuli. When the environment does not produce enough stimulation the subject will augment the stimuli with self stimulation or excessive activities. This theory provides evidence for the therapeutic effect of stimulant medication in calming subjects and provides documentation for the dopamine connection. The neurotransmitter associated with the disorder appears to be dopamine. Variants of the dopamine receptor have been found in ADHD patients (NIMH, 2002). Higher concentrations of dopamine transporters have been observed in the striatum of ADHD subjects. Since the 1970s ADHD and its treatments have been shrouded with controversy. Opponents of the disorder typically disagree with stimulant treatments and question the existence of the disorder. Others believe the disorder has a genetic basis. Health professionals today generally accept the disorder but have disagreements regarding the diagnosis method and appropriate treatment. Diagnosed individuals must have either six symptoms of issues with attention or six symptoms of hyperactivity/ lack of patience or control present for a minimum of six months to be considered to have ADHD. Inattention is documented by such behaviors as making careless mistakes on schoolwork, not appearing to listen when spoken to, not following instructions,

Attention Deficit Hyperactivity Disorder (ADHD)

difficulty organizing, not wishing to work with others in activities requiring sustained mental effort, frequently losing items, easily distracted, and memory loss. Hyperactivity is documented by the present of behaviors such as believing to be restless, possessing difficulty remaining seated, and talking excessively. Impulsiveness is demonstrated by yelling out answers, having difficulty with patience, and interrupting others. According to the DSM-IV symptoms must prevail within the age of seven (NIH, 2008). Presence of significant difficulty proving evidence in social, school, or work must be present. The condition must negatively impact a minimum of two areas within the childs life. These areas include classroom, playground, home, community, or social settings. The symptoms must not be because of another mental disorder. The diagnosis of Adult ADHD is controversial due to the lack of developmental information available. Adults with this disorder tend to be disorganized and have hectic lives. They are impulsive often acting without thinking, moving from one activity before completing another and interrupting conversations. Hyperactivity may be demonstrated through restlessness and fidgeting as well as sleep disturbances. Inattentiveness may be evident in the individual frequently engaging in daydreaming, having difficulty concentrating and listening and not finishing assignments. Diagnosis for both children and adults has primarily limitations to practitioner observation and reports from teachers and other professionals involved with the individual. Other means of diagnosis are expensive and reserved for research settings. PET scans have shown differing results making them unreliable for diagnosis. Available treatment often includes new behavior changes, medication, life-style improvements, and counseling interventions. The most effective treatment has been found to be a combination of pharmacological treatments and management and behavioral interventions. Psychological treatments include educational interventions, therapy for controlling behaviors,

Attention Deficit Hyperactivity Disorder (ADHD)

cognitive therapy, environmental issues and the effects, family issues, training of social skills, and parental coping strategies. Parental training and education decrease the stress associated with raising children with ADHD. This intervention has been found to have short-term benefits. A higher rate of divorce is found with parents of children with ADHD than those without. ADHD support groups are available to provide information and help families cope with ADHD. Many alternative treatments are now available for ADHD. Specialized diets and dietary supplements were one of the first interventions suggested to address the symptoms of ADHD. The effectiveness of these interventions is in question due to the preliminary studies involving only small populations or follow up studies reporting conflicting results (NIH, 2008). Attention, impulsivity, and hyperactivity have been effectively treated using neurological feedback or EEG biofeedback. One advantage of this approach over medication is the lack of side effects found with biofeedback. A disadvantage is the 40-80 sessions required to impact the condition. Aerobic fitness is thought to improve cognitive functioning and neural organization during pre-adolescent development. Studies show that male athletic performance increases peer acceptance when fewer negative behaviors are exhibited. A patients environment appears to have a definitive impact on this disorder. The disorder appears to illustrate normal behavioral strategies until the child reaches the structured classroom setting at which time the behaviors are perceived as maladaptive. Behaviors that are tolerated in other settings are not permitted in this arena. ADHD appears to depend on the perception of the individuals serving the child. Five features of the disorder may contribute to its controversial nature. First, there is no laboratory or radiological tests to confirm the clinical diagnosis. Second, diagnostic criteria are frequently changed. Third, long term treatment is required due to the lack

Attention Deficit Hyperactivity Disorder (ADHD)

of a cure. Fourth, potentially addictive stimulant medication is often used to treat the condition. Finally, there are substantial differences across countries in the diagnosis and treatment rates. Impulsive-Hyperactive ADHD kids have an increased chance of getting into mischief than are the Inattentive ADHD kids, as often they enhance the activities of anti-social behaviors, and impulsively disrupt things. Because they often act impulsive, and perform without thinking actions through children are usually easily caught, making activities noticeable. Time and attention are necessary to help treat a child or adult with ADHD. ADHD is the most likely psychiatric condition diagnosed in children and adults. The chronic disorder can display in as many as 60% to 70% of adults who have the disease as children. Possible symptoms of ADHD disorder can include inattention, easily distracted, and impulsivity, which are likely accompanied by hyperactivity as well. Some therapy for the disease includes specific medications that focus on social, psychological, and behavioral therapies. This disease can be monitored and controlled with the proper medical and parental controls.

Attention Deficit Hyperactivity Disorder (ADHD)

References ADHD medications (2010). Nurse Practitioners Prescribing Reference, 17(2), 88. Retrieved from CINAHL Plus with Full Text database. 3H ADHD/narcolepsy. (2010). Nurse Practitioners' Prescribing Reference, (p.86(6)). Haymarket Media, Inc. Retrieved June 08, 2010, from Academic OneFile via Gale:http://find.galegroup.com.ezproxy.apollolibrary.com/gps/start.do?prodId=IPS&userGroupN ame=uphoenix Frances, A. (2010). Increasing the age at onset for ADHD?. The American Journal Of Psychiatry, 167(6), 718; author reply 718-9. Retrieved from MEDLINE with Full Text database. National Institutes of Health (2008). Retrieved on June 11, 2010 from: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/completeindex.shtml Sibley, M., Pelham, W., Molina, B., Waschbusch, D., Gnagy, E., Babinski, D., & Biswas, A.. (2010). Inconsistent Self-Report of Delinquency by Adolescents and Young Adults with ADHD. Journal of Abnormal Child Psychology, 38(5), 645-56. Retrieved June 10, 2010, from Research Library. (Document ID: 2050769361).