ADHD – October is Awareness Month for attention deficit disorder

October is Awareness Month for attention deficit disorder (ADHD).

I’m not sure this was the big mystery issue it used to be … but the implications of it can sometimes be blown off.


http://www.additudemag.com/adhd/article/4000.html

Attention-deficit hyperactivity disorder (also known as attention-deficit disorder) is biologically based. Research shows that it’s a result of an imbalance of chemical messengers, or neurotransmitters, within the brain. Its primary symptoms are inattention, impulsiveness, and, sometimes, hyperactivity.

Everyone I know has mentioned how impressive the study of ADHD in the last 20 years.


I think some big myth’s about the disease are spelled out pretty well in here…I’ve just got the topic headings posted here, the explanations are in the link.

7 Myth’s of ADHD

  • Myth #1: ADHD isn’t a real medical disorder …

  • Myth #2: Children who are given special accommodations because of their ADHD are getting an unfair advantage …

  • Myth #3: Children with ADHD eventually outgrow their condition …

  • Myth #4: ADHD affects only boys …

  • Myth #5: ADHD is the result of bad parenting …

  • MYTH #6: Children who take ADHD medication are more likely to abuse drugs when they become teenagers. …


A little deeper on the subject, from a white paper on the Cognitive Behavior Therapy study hosted on US National Library of Medicine & National Institutes of Health … “Current Status of Cognitive Behavioral Therapy for Adult Attention-Deficit Hyperactivity Disorder” … [Link].

I was afraid it would be a complete yawner, but turned out ok.  I need to learn to navigate the resources better in order to find these types of documents myself – not just when they float to the top of random google searches.

When reading it – one of the things that stuck out at me was that all of the Cognitive Behavior Therapy techniques rely on a person having good self confidence to carry out and trust that their being mindful of their condition will be worthwhile and helpful.  People already held deep in the clutches of depression or with anxiety will have more difficulty executing the things coping mechanisms that are healthy for them.

Quoting the description of several effective treatment styles:   [Link]

  1. ‘ “…The intervention involved teaching patients to stop, re-evaluate, and modify thoughts contributing to intensifying emotions and maladaptive behavior. Patients learned about in negative biases in thinking, and were taught to monitor and systematically re-evaluate their thoughts. The therapy also included psychoeducation and environmental modification strategies (i.e., organization, scheduling of activities, and problem solving). …” ‘
  2. ‘ “… A group of investigators in Germany have adapted Linehan’s Dialectical Behavior Therapy (DBT) skills training group treatment [19] for the treatment of ADHD in adults … DBT is a cognitive-behavioral approach developed for the treatment of borderline personality disorder that blends traditional change-oriented CBT skills with acceptance- and mindfulness-based skills  … The authors adapted DBT skills training based on the premise that ADHD and borderline personality disorder share overlapping features including problems with affect regulation, impulse control, self-esteem, and interpersonal relationships. The modified DBT treatment for ADHD was delivered in … discussion topics including: psychoeducation about ADHD, neurobiology and mindfulness training …, “Chaos and Control”: A discussion of disorganized behavior followed by concrete advice about how to plan and organize aspects of participants lives, dysfunctional behavior/behavior analysis …, emotion regulation, psychoeducation about depression, psychoeducation about impulse control, psychoeducation about stress, psychoeducation about substance dependency, discussion of relationships and self-respect … ” ‘
  3. Group Metacognitive Therapy– ‘ ” … Solanto and colleagues [22] developed a group treatment for adults with ADHD targeting problems in time management, organization, and planning. They describe Metacognitive Therapy as a cognitive-behavioral intervention intended to “enhance the development of an overarching set of executive self-management skills,” emphasizing repeated practice of skills to make them more habitual and automatic [22] (p. 2). Skill modules included time management, behavioral activation, procrastination, organization, and planning. During each weekly 2-hour session, groups of 5-8 participants first discussed at-home application of skills, received feedback from group members, and were given new skill information and homework assignments from group leaders. …” ‘
  4. Combined Behavioral & Cognitive treatment – ‘ “…In an open study of 43 adults diagnosed with ADHD, Rostain and Ramsay [24] examined the effects of 6 months of combined medication and cognitive-behavior therapy (CBT). Participants received 16 50-minute individual CBT sessions and Adderall titrated to the participant’s optimal dose, up to 20 mg b.i.d. CBT focused on teaching individualized coping strategies and identifying and modifying maladaptive patterns of thinking that could interfere with effective coping. Content included psychoeducation about ADHD, helping the client to conceptualize their difficulties from a CBT perspective, training coping strategies, working on treatment-interfering behavior both behaviorally and cognitively, and building on strengths….. Significant reductions in comorbid anxiety and depression symptoms were also observed. …” ‘
  5. Mindfulness Meditation Training – CBT approaches have, in recent years, been successfully incorporating mindfulness-based skills to address mood and anxiety symptoms. Zylowska and colleagues [27] conducted an open trial of modified mindfulness meditation training with 24 adults and 8 adolescents with ADHD. Their hypothesis was that the attention control cultivated during mindfulness exercises would improve sustained attention and emotion regulation for patients with ADHD. … As a group, treatment completers self-reported significant decreases in inattentive and hyperactive-impulsive symptoms, with 30% of participants showing a treatment response of 30% symptom reduction or more. Completers also showed pre-to-post improvements on neuropsychological attention conflict and set-shifting. … This approach is unique compared to the other interventions described here, in that it proposes to change cognitive processing directly rather than to train skills that compensate for symptom-related deficits.
  6. Cognitive Remediation Program – An Australian research group examined both a therapist-delivered [29] and self-directed [30] psychosocial treatment for adults with ADHD. Their cognitive remediation program consisted of 8 two-hour group sessions led by a clinical psychologist, the provision of a support person or coach, and a participant workbook for use in completing homework assignments. The researchers’ three-pronged approach involved retraining cognitive functions, helping participants develop internal and external coping strategies, and work on restructuring the environment to support success for adults with ADHD. Individual sessions targeted motivation, concentration, listening, impulsivity, organization, anger management, and self-esteem. Each session involved review of prior skills and homework assignments, introduction of a new skill, and assignment of new homework. The support person—either someone known to the participant or an assigned coach—worked with the participant to remind them of sessions, take notes in session, and have at least weekly supportive telephone contacts with the participant between sessions. … The more self-directed version [30] utilized a self-help book that included the following topics: 1) education about ADHD, 2) how to overcome attention and motivational difficulties, 3) listening skills, 4) organizational skills, 5) impulse control techniques, 6) cognitive strategies for anger management, and 7) cognitive strategies for self-esteem. Three therapist-led sessions (beginning, middle, and end of treatment) were included which were geared toward review and monitoring of progress. Support people—in this study, trained undergraduate and graduate students—were again assigned to aid participants.

http://www.dsm5.org/documents/adhd%20fact%20sheet.pdf

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