Five Frameworks for Increasing Understanding and Effective Treatment of Attention-Deficit/Hyperactivity Disorder: Predominately Inattentive Type

The joint effect of bilingualism and ADHD on executive functions

OBJECTIVE

The current study investigated the combined effect of ADHD, previously associated with executive function (EF) deficits, and of bilingualism, previously associated with EF enhancement, on EF.

METHOD

Eighty University students, Hebrew monolinguals and Russian Hebrew bilinguals, with and without ADHD participated. Inhibition tasks were a Numeric Stroop task and a Simon arrows task. Shifting tasks were the Trail Making Test (TMT) and a task-switching paradigm.

RESULTS

Participants with ADHD performed worse than controls, but we did not find a bilingual advantage in EF. The negative impact of ADHD was more pronounced for bilinguals than for monolinguals, but only in interference suppression tasks. Bilingual participants with ADHD had the lowest performance.

CONCLUSION

Bilingualism might prove to be an added burden for adults with ADHD, leading to reduced EF abilities. Alternatively, the current findings might be ascribed to over- or under-diagnosis of ADHD due to cultural differences between groups. These issues should be pursued in future research.

Advantages of an ADHD diagnosis in adulthood: evidence from online narratives

In this article we explore the impact of a diagnosis of adult attention-deficit hyperactivity disorder (ADHD) on coping among diagnosed adults. We use grounded theory to examine 71 biographical narratives, self-published on the Internet by adults with ADHD. The findings illuminate a three-stage temporal continuum. During the first stage, the narrators suffered from lack of self-confidence accompanied by functional difficulties, stress, and guilt feelings. During the second stage, which began after the diagnosis, they began to believe in their ability to lead meaningful and more manageable lives. During the third stage, an additional effect of the diagnosis emerged: the narrators' realization or belief that ADHD might affect them for the better. Some narrators stated that their traits as persons with ADHD helped them to cope better than others unaffected by this syndrome. Consequently, those who have an ADHD diagnosis seem able to defeat unnecessary negative emotions and self-blame.

Investigating facets of personality in adult pathological gamblers with ADHD

The present study explored facets of personality in a sample of pathological gamblers with ADHD (n = 52) and without ADHD (n = 43). Participants were assessed for psychopathology and gambling disorders using the Mini International Neuropsychiatric Interview, the National Opinion Research Center DSM Screen for Gambling Problems, and the Adult ADHD Self-Report Scale. Facets of personality were assessed using the NEO Personality Inventory-Revised. Group differences emerged across several facets of personality when analyzed using multivariate statistics. Although both groups experienced difficulties in several areas compared with norming data (e.g., greater depression, higher impulsivity, lower self-esteem and lower self-discipline), these facets of personality were more pronounced in pathological gamblers with ADHD. Most notable among these differences are tendencies for gamblers with ADHD to experience greater levels of emotional instability, interpersonal sensitivity and stress proneness. Pathological gamblers with ADHD also appear to experience lower self-esteem, greater difficulty being assertive and lower levels of self-discipline. Surprisingly, both groups were comparable on facets of impulsivity. These findings suggest that pathological gamblers diagnosed with adult ADHD may experience additional challenges compared with pathological gamblers without ADHD.

Women with ADHD: it is an explanation, not the excuse du jour

PURPOSE

To call attention to attention deficit hyperactivity disorder (ADHD) as a psychiatric disorder that can limit women's potential and overall well-being.

CONCLUSION

ADHD, a legitimate neurobiological disorder that is often hidden, ignored, or misdiagnosed among women, causes them to struggle in silence. Proper interventions for women with ADHD that provide significant attention to context mitigate challenges across psychological, academic, occupational, and social domains. This should amend the diagnosis du jour concept, thereby supporting mechanisms to improve early intervention and positive outcomes.

PRACTICE IMPLICATIONS

Primary care practitioners play a central role in recognition, intervention, and recovery of women with ADHD.

Cultural proficiency: a Hispanic woman with ADHD--a case example

BACKGROUND

Guidelines for assessment, diagnosis, and treatment of ADHD have been drawn from research focused primarily on Caucasian males generating, in part, the need to redress health disparities. Diagnostic criteria may therefore be limited, especially regarding gender differences and other associated cultural, familial, socio-environmental, and individual influences.

OBJECTIVE

To examine how one woman with ADHD managed social, academic, interpersonal, and familial roles and to discuss the need for culturally proficient practice and treatment frameworks that are gender-sensitive to diagnosis and treatment.

METHOD

A case example of a 29-year-old Hispanic woman.

FINDINGS

There is a gap in early diagnosis and treatment for some woman and individuals from ethnic minority and diverse groups.

CONCLUSION

Cultural competence in practice and research are critical to mitigate the disparities in accurate and timely diagnosis and treatment of adult ADHD among the American population.

Unveiling the mystery about adult ADHD: one woman's journey

Attention deficit hyperactivity disorder (ADHD), a neurobiological disorder, affects millions of individuals and can significantly impact an individual's life course. Research guidelines used in assessment, diagnosis, and treatment have focused primarily on Caucasian males generating, in part, the need to redress how gender and other contextual factors are considered. Consequently many women and persons from diverse cultural groups can be ignored or misdiagnosed. Undiagnosed and untreated women with ADHD are therefore limited in their potential to flourish socially, academically, interpersonally, and in their family roles. This case example of a 38-year-old African American woman illustrates how her life journey was affected by undiagnosed ADHD.

ADHD in adults: a review of the literature

OBJECTIVE

ADHD presents significant challenges to adults. The current review's goals are (a) to critically examine the current state of knowledge regarding ADHD in adults and (b) to provide clinicians with practice-friendly information regarding assessment, diagnosis, and treatment.

METHOD

Searches of PsycINFO and Medline were conducted, and reference lists from articles and books were searched for additional relevant references.

RESULTS/CONCLUSION

A valid and reliable assessment should be comprehensive and include the use of symptom rating scales, a clinical interview, neuropsychological testing, and the corroboration of patient reports. Specific diagnostic criteria that are more sensitive and specific to adult functioning are needed. In treatment, pharmacological interventions have the most empirical support, with the stimulants methylphenidate and amphetamine and the antidepressants desipramine and atomoxetine having the highest efficacy rates. Scientific research on psychosocial treatments is lacking, with preliminary evidence supporting the combination of cognitive behavioral therapy and medication.

ADHD and drug therapy: is it still a valid treatment?

The purpose of this article is to discuss alternative treatments other than drug therapy for Attention-Deficit/Hyperactive Disorder (ADHD) in educational settings. There is an increasing body of knowledge that supports interventions for improving cognitive outcomes without the use of medication. The article explores the risks to ADHD children, shows the potential linkage between gifted children and ADHD, explores recent brain research, and examines various alternative treatment options. Information is presented on alternative treatments such as cognitive behavioral therapies, educational interventions, electroencephalograph (EEG) neuro-feedback, and diet.