| My name is Dr. Tim Bilkey. I am currently coauthoring a self help book for people with ADHD and I think it is very important to get the thoughts and ideas from people with ADHD that may help others who are yet undiagnosed and/or who continue to have challenges.
This will be the first of a series of questions on this blog for public input. Sort of along the lines of “what helped you cope with a particular issue, what worked best for you”. We have a chapter on distraction so I want to ask how you manage those distractions in your life you have trouble with. What helps you stay on track? What changes have you made in your life to dial in your focus? Where do you focus best and how do you manage distraction when you’re studying or working. Do you get other people to help you with this? I will be posting a summary of this data later on so dive in! We need lots of ideas from you. Comment below! |
(Am J Psychiatry 2011; 168:617–623)
Craig B.H. Surman, M.D.
Joseph Biederman, M.D.
Thomas Spencer, M.D.
Dayna Yorks, B.A.
Carolyn A. Miller, B.A.
Carter R. Petty, M.S.
Stephen V. Faraone, Ph.D.
Objective: A growing body of research suggests that deficient emotional self-regulation (DESR) is prevalent and morbid among patients with attention deficit hyperactivity disorder (ADHD). Family studies provide a method of clarifying the co-occurrence of clinical features, but no family studies have yet addressed ADHD and DESR.
Method: Participants were 83 probands with and without ADHD and 128 siblings. All were assessed for axis I DSM-IV conditions with structured diagnostic interviews. The authors defined DESR in adult probands and siblings using items from the Barkley Current Behavior Scale. Analyses tested hypotheses about the familial relationship between ADHD and DESR.
Results: Siblings of ADHD probands were at elevated risk of having ADHD, irrespective of the presence or absence of DESR in the proband. The risk for DESR was elevated in siblings of ADHD plus DESR probands but not in siblings of ADHD probands. ADHD and DESR cosegregated in siblings. The risk for other psychiatric disorders was similar in siblings of the ADHD proband groups.
Conclusions: The pattern of inheritance of ADHD with DESR preliminarily suggests that DESR may be a familial subtype of ADHD. Our data suggest that DESR is not an expression of other axis I DSM-IV disorders or of nonfamilial environmental factors. The authors cannot exclude contribution of non-axis-I DSM-IV disorders to risk for DESR and cannot determine whether the cosegregation of ADHD in DESR within families is a result of genes or familial environmental risk factors. Further investigation of DESR and its correlates and treatment both in and outside the context of ADHD is warranted.
Is ADHD caused by a chemical imbalance; is it hereditary?
ADHD is a strongly inherited neurodevelopmental condition. Other causes of ADHD include maternal smoking and obstetrical difficulties.
Is ADHD related to intelligence?
No, it is not an intellectual deficit. It refers only to a state of impulsivity and inattention.
Are there typical ADHD traits?
ADHD is contextual in that it effects the mundane activities of every day life, such as paying bills, household chores, etc.
Can anxiety and depression overlap with ADHD?
Some conditions commonly occur with ADHD. Conditions such as anxiety and depression, substance abuse disorder and learning disabilities are examples.
How did Dr. Bilkey train to treat Adult ADHD?
Dr. Bilkey is an adult psychiatrist and medical doctor. He regularly attends clinical seminars with scientific researchers who lead the world in the study of ADHD at Harvard University
The first clinical description of ADHD was reported in the British journal, Lancet, by Dr. George Still in 1902. He was a British physician treating children who noticed some of his patients were disinhibited and impulsive.
In the 1930s in the United States, Dr. Charles Bradley made further observations on the effect of stimulant medication on children.
Since that time, the descriptive terms that have been used to identify ADHD people have reflected the current scientific understanding of the day as to what this condition represented biologically.
In the 1960s, the emphasis was primarily on hyperactivity and at that time a caricature of an ADHD child would have been “Dennis the Menace” – that is, a child with tremendous energy who could be seen, perhaps, as intrusive.
In spite of this impulsiveness, Dennis was always seen as a good child.
An important development occurred in the early 1970s when Canadian researcher Dr. Virginia Douglas began to focus on cognitive impulsivity, or the daydreaminess and lack of focus in addition to the outward manifestations of motor impulsivity, such as being fidgety.
There are five DSM-IV Criteria required for the diagnosis.
- Symptom criteria must be met for 6 months.
- Some symptoms must be present before the age of 7 years.
- Some impairment from symptoms must be present in 2 or more settings .
- Symptoms lead to significant impairment in the context of social, academic or occupational functioning.
- Symptoms are not exclusively due to other medical, neurological or psychiatric disorder.
ADHD DSM-IV-TR CRITERIA HYPERACTIVITY/IMPULSIVITY SYMPTOMS
6 or more of the following manifested often:
HYPERACTIVITY SYMPTOMS
- Unable to stay seated.
- Inappropriate running, climbing. (adults have internal restlessness)
- Difficulty engaging in leisure activities quietly.
- On the go.
- Talks excessively.
- Fidgets with hands or feet or squirms in seats.
IMPULSIVITY SYMPTOMS
- Blurts out answers before questions finished.
- Difficulty awaiting turn.
- Interrupts or intrudes on others.
ADHD DSMIV-TR CRITERIA INATTENTIVE SYMPTOMS
6 or more of the following manifested often:
- Inattention to details, makes careless mistakes.
- Difficulty sustaining attention.
- Seems not to listen, fails to finish tasks.
- Does not follow through on instructions and fails to finish school work, chores or duties in the workplace.
- Difficulty organizing.
- Avoids tasks requiring sustained attention.
- Loses things.
- Easily distracted.
- Forgetful.
Reference: APA, DSM-IV-TR, 2000
Adult Scale:
A scale has been created to assist with the diagnosis of ADHD in the adult population. The Adult ADHD Self-Report Scale (ASRS) Symptom Checklist was developed in conjunction with the World Health Organization and the Workgroup on Adult ADHD.
Information on this rating scale and a copy of the ASRS can be found at this web address:www.med.nyu.edu/psych/assets/ adhdscreen18.pdf
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