Explanatory models and help-seeking behavior for attention-deficit/hyperactivity disorder among a cohort of postsecondary students

Selfcare Strategies Shown to Be Useful in Daily Life for Adults Diagnosed with Attention Deficit Hyperactivity Disorder - A Systematic Review

Adults with ADHD experience a wide range of difficulties in daily life, and RNs and other healthcare professionals need to know how to support them. The aim was to conduct a systematic review of which selfcare strategies adults with ADHD use and need in order to manage daily life. A literature review based on the PRISMA model was performed, and seven articles with a qualitative design were found. Data were analyzed with thematic analysis. The analysis generated one major theme Enabling ways to manage the consequences of disability in daily life based on three subthemes; Establishing ways of acting to help yourself, Finding encouraging and helping relationships, and Using external aids for managing daily life. Professionals may benefit from knowing about these selfcare strategies when meeting people with ADHD.

Attention Deficit Hyperactivity Disorder in Medical Learners and Physicians and a Potentially Helpful Educational Tool

Purpose

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by functionally impairing levels of inattention and/or hyperactive-impulsive behavior. It affects 3% to 5% of adults. This perspective piece aims to highlight the occurrence of ADHD in medical learners and physicians, including its reported prevalence in these groups, why reported rates may reflect underestimates, consequences of untreated symptoms, and a potentially helpful innovative educational tool to assist these individuals with a critical aspect of medical training and practice.

Results

Despite recent attention being paid to concerning levels of depression, anxiety, and burnout in medical learners and physicians, comparatively little attention has been devoted to the occurrence of ADHD in these groups. Reported rates of ADHD in medical learners and physicians, though low compared to rates of other mental health conditions and compared to rates of ADHD in the general population, may represent underestimates for a variety of reasons. The consequences of untreated ADHD symptoms are likely numerous and significant for these groups. Research has shown that about half of adults with ADHD discontinue prescribed treatment (stimulant medication) over time due to lack of perceived effectiveness, highlighting the need for durable, effective interventions to help medical learners and physicians with ADHD during and after their training. An innovative educational tool to assist medical learners and physicians with ADHD with a critical facet of their training and practice - the reading of scientific articles - is proposed, including a description of the tool, rationale for its design, practical considerations around implementation, and proposed directions for future research.

Conclusion

Untreated ADHD in medical learners and physicians may have numerous and significant consequences that can adversely impact training, practice, and ultimately patient care. These challenges warrant proper support for medical learners and physicians with ADHD via evidence-based treatments, program-based accommodations, and innovative educational tools.

Explanatory Models for Mental Distress Among University Students in Ethiopia: A Qualitative Study

Background

Socio-culturally determined processes account for how individuals give meanings to health, illness, causal attributions, expectations from treatment, and related outcomes. There is limited evidence of explanatory models for mental distress among higher education institutions in Ethiopia. The objective of this study was to explore the explanatory models for mental distress among Wolaita Sodo University.

Methods

The current study used a phenomenological research approach, and we collected data from 21 students. The participants were purposively recruited based on eligibility criteria. Semi-structured interviews were conducted from December 2017 to January 2018 using the Short Explanatory Models Interview. The interviews were audio-recorded, transcribed into the Amharic language and translated into English. Data were analyzed using framework analysis with the assistance of open code software 4.02.

Results

Most students experienced symptoms of being anxious, fatigue, headaches and feelings of hopelessness. They labeled these symptoms like anxiety or stress. The most commonly reported causal explanations were psychosocial factors. Students perceived that their anxiety or stress was severe that mainly affected their mind, which in turn impacted their interactions with others, academic result, emotions and motivation to study. Almost all the students received care from informal sources, although they wanted to receive care from mental health professionals. They managed their mental distress using positive as well as negative coping strategies.

Conclusion

The policy implication of our findings is that mental health interventions in higher education institutions in Ethiopia should take into account the explanatory models of students’ psychological distress.

Understanding parental causal explanations and help seeking in attention-deficit/ hyperactivity disorder: perspectives from a developing Asian nation

INTRODUCTION

Research on parental understanding of causation and help-seeking for ADHD comes from ethnic minorities in developed nations; research from Asia is scarce. Our purpose was to explore perceptions of Indian parents regarding causation and diagnosis of problematic childhood behaviors diagnosed as ADHD or hyperkinetic disorder, and to understand the process of decision making and help seeking using a qualitative study design.

METHOD

In-depth, semi-structured interviews were conducted with 52 parents (33 mothers and 19 fathers), focusing on initial emotional reactions and cognitive appraisals, decision making, parental causal explanations and perceptions regarding diagnosis and symptom labeling.

RESULTS

Mothers were decision makers for seeking professional help either singly or jointly in 76.1% of cases. Initial reactions ranged from those with negative valence (negative emotional reactions and cognitive appraisals) to ambi-valence (recognition of problems, but at the same time not accepting completely) and positive valence (sense of relief and hopefulness). Psycho-social explanations (63.46%) were more common than biological explanations (51.82%), with 19.23% reporting both explanations. Biological explanations included illness model (e.g. brain problem, obstetric complications), hereditary and intellectual disability. Psycho-social explanations included psychological (e.g. lack of motivation) and social (e.g. problems with disciplining at home) causations. Irrespective of initial reactions and causal explanations, a significant majority of parents were aware of the diagnosis and labeled problems as symptoms attributable to ADHD.

CONCLUSION

Our findings provide insights for development of culturally sensitive psycho-social interventions; from understanding of causal attributions, process of decision making and help seeking.

A model for parental ADHD: help-seeking and readiness to change

Attention deficit/hyperactivity disorder (ADHD) is a lifespan developmental syndrome that is associated with significant impairments. Although there is strong evidence that ADHD persists into adulthood for a majority of individuals, adults with ADHD are identified and treated at much lower rates than are children with ADHD. Considering the heritability of ADHD, there is an increased likelihood that at least one parent of a child with ADHD will also have ADHD, or exhibit prominent features of the disorder. Parental ADHD also affects help-seeking behavior regarding treatment, as well as follow through on treatment recommendations. There is a paucity of data on parental ADHD and help-seeking among underserved populations. The goal of this paper is to review parental ADHD among underserved groups in terms of factors affecting help-seeking behavior and readiness to engage in care. A model for conceptualizing and addressing issues of readiness for change for parents with ADHD is also proposed.