Research Paper On Attention Deficit Hyperactivity Disorder
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Much as people aspire to stay healthy, there comes a time when they no longer have control over their health. Whether in maternal womb or during the conscious life, people can have their organism rendered susceptible to neuropsychiatric disorders like attention deficit hyperactivity disorder characterized by the lack of concentration hyperactivity, and impulsivity that is hard to control if not impossible at times. Genetic transmission or adverse environment created by substance and alcohol abusing mothers, or the concentration of lead can prove conductive to ADHD development as much as brain traumas do. All of such can lead to depression, poor self-respect, self-harming conduct, and self-medication with all that these imply. While there is the possibility of mistaking visual signs of ADHD for natural impulsivity and hyperactivity, symptoms give clues like poor productivity and performance at school or work, concentration issues, and restlessness. Once developed in the early years, the disorder does not necessarily disappear with time often continuing into adolescence and adulthood.
Symptoms and Signs of the Disorder
Every disorder or disease has certain symptomatic signs, by which it is identifiable, and attention deficit is no exception to the rule. Visual signs allow predicting the possibility of disorder persistence and aggravation. However, Biederman and Faraone (n.pag.) and Faraone and Biederman (n.pag.) state that the symptoms of ADHD tend to wane with age (qtd. in Cheung, Rijdijk, McLoughlin, Faraone Asherson, and Kuntsi 92). Gittelman, Mannuzza, Shenker, and Bonagura (n.pag.) and Loney, Kramer, and Millich (n.pag.) and Taylor, Chadwick, Heptinstall, and Danckaerts (n.pag.) suggest that simultaneously occurring behavioral issues, aggression, and severity in the symptoms of attention deficit hyperactivity disorder in childhood were capable of predicting disorder persistence in later years (qtd. in Cheung, Rijdijk, McLoughlin, Faraone Asherson, and Kuntsi 92). Brocki, Nyberg, Thorell, and Bohlin (n.pag,) state that IQ, general cognitive ability, recorded in early childhood allowed predicting the symptoms of the deficit evaluated in middle childhood with the median age of 7.5 years (qtd. in Cheung, Rijdijk, McLoughlin, Faraone Asherson, and Kuntsi 93). Molina, Hinshaw, Swanson, Arnold, Vitiello, Jensen (n.pag.), in turn, note the ability makes it possible to predict the symptoms in early adolescence, with children aged 14 on the average at the time of evaluation (qtd. in Cheung, Rijdijk, McLoughlin, Faraone Asherson, and Kuntsi 93).
The National Institute of Mental Health (n.pag.) suggests that symptoms surface at the early stage of life in children aged between 3 and 6. More importantly, the disorder is easy to mistake for children’s unique temperaments, personality, the level of energy, easy distractibility, impulsivity, and concentration issues. However, children suffering from the medical issue show the symptoms of impulsivity like letting out improper comments, being exceedingly impatient, or interrupting conversations, hyperactivity like talking nonstop, squirming and fidgeting in the seats, dashing around, or staying in motion ceaseless, and inattention like growing bored, failing to listen, or attention focusing issues. In adults, ADHD signs make themselves seen through organization difficulties, the poor capacity of concentrating on a job, keeping and remembering appointments. Work productivity, a well-timed arrival at work, morning arousal, and the preparation to leave house for work can all be difficult for ADHD individuals serving as signs. Failed relationships, a history of school failures, and work-related troubles point to the disorder.
Current State of Affairs and Disorder Epidemiology
Rowland, Lesesne, and Abramowitz (162) and Buitelaar, Kan, and Asherson (9) note that ADHD is the most widespread neurodevelopmental disorder that affects children. According to Rowland, Lesesne, and Abramowitz (162), based on a recently conducted systematic assessment of its prevalence, the percentage of the affected stands at somewhere between 2% and 18%. American Psychiatric Association (n.pag.) reports 3% to 5% of the children of school age to have the disorder (qtd. in Rowland, Lesesne, and Abramowitz 165). Shaffer (n.pag.) is of the opinion that ADHD is less prevalent among adults, whereas Barkley (n.pag.) states the opposite (qtd. in Buitelaar, Kan, and Asherson 9), which finds its numerical reflection in statistical trends provided next. ADHD Institute (n.pag.) suggests that the median prevalence of ADHD worldwide is 5.29% in children and 7.1% in adolescents, or the population under 18. In Europe, the estimates place the percentage of prevalence at below 5%. Faraone and Biederman (n.pag.) and Langley, Fowler, Ford, Thapar, van den Bree, and Harold (n.pag.) hold that the attention deficit continues well into adolescence and even adulthood for plenty of individuals. The level of the disorder persistence ranges from 15% to 70% (qtd. in Cheung, Rijdijk, McLoughlin, Faraone Asherson, and Kuntsi 92).
Biederman, Petty, Clarke, Lomedico, and Faraone (n.pag.) note that anxiety disorder, oppositional defiant disorder, psychiatric comorbidities, family factors like maternal psychosocial adversity and psychopathology can determine ADHD persistence in individuals in adolescence and adulthood (qtd. in Cheung, Rijdijk, McLoughlin, Faraone Asherson, and Kuntsi 92-93). ADHD Institute (n.pag.) also reports that comorbidities like anxiety disorder and oppositional defiant disorder are co-occurring disorders. Biederman, Newcorn, and Sprich (n.pag.), Cantwell (n.pag.) and Barkley (n.pag.) add Tourette syndrome, bipolar and behavior disorders, depression, and learning disability to the list of comorbid diseases (qtd. in Rowland, Lesesne, and Abramowitz 164). Rowland, Lesesne, and Abramowitz (162) claim that the emergence of comorbid conditions or simultaneous chronic disorders like behavior disorder, learning disability, and anxiety disorder can complicate ADHD diagnosing. Loney, Kramer, and Millich (n.pag.) are inclined to believe that socioeconomic status has the potential of predicting the perseverance of disorder symptoms in children (qtd. in Cheung, Rijdijk, McLoughlin, Faraone Asherson, and Kuntsi 93).
Molina, Hinshaw, Swanson, Arnold, Vitiello, and Jensen (n.pag.) state that experts can use the status as a predictor of ADHD severity during the period of early adolescence (qtd. in Cheung, Rijdijk, McLoughlin, Faraone Asherson, and Kuntsi 93). These are the principal family and behavioral causal factors of ADHD emergence and perseverance (Cheung, Rijdijk, McLoughlin, Faraone Asherson, and Kuntsi 93). Rowland, Lesesne, and Abramowitz (162) opine that, although the etiology or the study of disease causes remains largely unknown, there is likely to be a strong genetic connection along with environmental factors like maternal smoking during pregnancy or the history of premature delivery. Nomura, Marks, and Halperin (n.pag.) and Millichap (n.pag.) also note that alcohol consumption and smoking in the course of pregnancy can cause ADHD in newborns emerging in childhood (qtd. in the National Institute of Mental Health (n.pag.).
Froehlich, Lanphear, Auinger, Hornung, Epstein, Braun, and Kahn (n.pag.) claim that the concentration of lead is another environmental factor, with preschool children exposed to the chemical element paint in old buildings or plumbing fixtures contain (qtd. in the National Institute of Mental Health n.pag.). After sustaining a brain trauma, children may display a conduct resembling that of ADHD. There is an assumption that correlates food additives with ADHD since a small number of children have sensitivity to artificial flavors, food dyes, preservatives, and other types of food additives (the National Institute of Mental Health (n.pag.). Millichap and Yee (n.pag.) maintains that the theory of sugar influence, while often presented, have thus far received scientific refutation (qtd. in the National Institute of Mental Health n.pag.).
According to ADHD Institute (n.pag.), the variability of the disorder is dependent on three major factors. Firstly, children starting with the pre-school age are susceptible to the hyperactivity disorder. Now scholars are increasingly recognizing the fact that the disorder can continue into adulthood. Secondly, males most often constitute the reported risk group. Thirdly, scholars believe all age groups affected by combined-type disorder equally well. Whatever the factors, ADHD is fraught with a number of adverse effects. Timberline Knolls (n.pag.) states that ADHD can potentially damage school, work, or personal relations. When it goes untreated, the disorder can stimulate addictive disorders in the event of sufferers’ using substances or alcohol to alleviate the symptoms. The most widespread effects of attention deficit hyperactivity disorder are depression, low self-respect, self-harming and self-mutilation conducts, social anxiety that evolves into anxiety disorder, and efforts to treat the attention disorder by means of binge eating, alcohol or drugs.
Just as children should undergo an assessment conducted by a licensed mental health expert, so too should adults. Due to the varied nature of symptoms in adults, a professional will need to consider a broader range of symptomatic signs (the National Institute of Mental Health n.pag.). Post and Kurlansik (n.pag.) state that ADHD is diagnosable given that symptoms first emerged in childhood and continued uninterrupted into adulthood (qtd. in the National Institute of Mental Health n.pag.). In order to establish an adult meets the diagnostic standards of ADHD, heath experts apply specific rating scales. In addition, experts will interview associates, close friends, parents, partners or spouses and review the school experiences and the history of childhood conduct of the adult under examination. Psychological tests and physical exams will follow on afterwards (the National Institute of Mental Health n.pag.). As mentioned above, children’s unique temperaments and natural impulsivity can make diagnosis challenging. Parents can diagnose ADHD through visual signs like the lack of focus, uncontrollability, and the loss of interest in things. Spacing out on the playground or in classrooms and difficulties complying with the rules can help teachers diagnose the disorder. For want of tests, licensed health experts can collect information on children, their environment, and behavior. Pediatricians will most likely refer child’s family to mental health experts who have often dealt with children’s brain disorders. Specialists can review medical and school records, school or home environment, its disruptive or stressful nature, collect information as regarding the teachers and parents of ADHD children. Consultation with babysitters, coaches and other adults who have contacted a child may turn out efficient at diagnosing the disorder (the National Institute of Mental Health n.pag.).
The Treatment of the Disorder
Rowland, Lesesne, and Abramowitz (162) note that, in case of the presence of simultaneous chronic disorders, experts may prescribe psychosocial interventions. Stimulant medication remains an optional remedy. According to The National Institute of Mental Health (n.pag.), as with children, adults may have the disorder treated via psychotherapy, medication, or the combination of both. Ramos-Quiroga, Corominas, Castells, Bosch, and Casas (n.pag.) notes that individuals suffering from the neuropsychiatric disorder can be prescribed ADHD medications, extended-release drugs included (qtd. in the National Institute of Mental Health n.pag.). When taken by children, ADHD medications, such as amphetamines or methylphenidate, for the most part can decrease the level of impulsivity and hyperactivity as well as improving their physical coordination and the capacity of focusing, learning, and working.
While prescribing stimulants to treat hyperactivity may appear illogical, the medications have been proved to trigger brain circuits that act as the supporters of focused conduct and attention, which renders individuals less hyperactive. Beyond that, medical specialists may resort to non-stimulant remedies, such as guanfacine, atomoxetine, and clonidine (the National Institute of Mental Health n.pag.). Wilens, Haight, Horrigan, Hudziak, Rosenthal, Connor, Hampton, Richard, and Modell (n.pag.) states that such antidepressant bupropion as Wellbutin has proved beneficial to adults since it has an effect on the chemical dopamine of the brain (qtd. in the National Institute of Mental Health n.pag.). The so-called older antidepressants known as tricyclics are applicable inasmuch as they have an effect on the chemical norepinephrine of the brain as atomoxetine or stimulants do (the National Institute of Mental Health n.pag.).
As far as psychotherapy and education go, a professional therapist or counselor can assist adults with the organization of their lives by means of date books, big calendars, reminder notes, and list or through the assignment of specific places for paperwork, bills, and keys. Specialists can help master the way to divide bigger tasks into smaller steps that are easier to manage in order that ADHD patients will develop a sense of accomplishment after finishing each part of the task. The concept of psychotherapy comprises cognitive behavioral therapy that may teach people to scrutinize the experiences a poor self-perception has created. By engaging in the therapy, adult patients can adapt to life changes accompanying the procedure of treatment, such as resisting the urge of taking needless risks and thinking prior to acting.
As far as younger age groups are concerned, behavioral therapy can assist children to modify their conduct. From a practical perspective, specialists may help ADHD children with schoolwork, assist with task organization, or resolve emotionally difficult situations. The therapy technique can teach children to give themselves rewards or praise for acting the right way when it comes to thinking prior to acting or anger management or monitor their conduct. Chore lists, well-marked rules, and structured routine activities can contribute to children gaining control of their conduct. It is recommended for parents to have their children taught social skills like sharing toys, waiting their turn, responding to teasing, and asking for assistance. The social skill training sessions can include learning to perceive the tone of other people’s voice and facial expressions and to react in a proper way (the National Institute of Mental Health n.pag.).
Current Theories and Research Areas
The cognitive-energetics theory, according to Sergeant (n.pag.), suggests there is a shortage of activation to maintain functions on energetic, computational, and executive levels (qtd. in Killeen 17). Solanto, Abikoff, Sonuga-Barke, Schachar, Logan, Wigal, Hechtman, Hinshaw, Turkel (n.pag.) and Sonuga-Barke, Sergeant, Nigg, and Willcutt (n.pag.) suggest that delay aversion theory stresses one executive function, the capacity of tolerating delays (qtd. in Killeen 17). Sonuga-Barke (n.pag.) considers cognitive theories that place emphasis on neurophysiology (qtd. in Killeen 18). Thus, for example, Nigg and Casey (785) scrutinize dysfunctions in relation to the role of joint operations of frontocerebellar and frontostriatal neural loops in identifying and predicting when and what essential events will happen (qtd. in Killeen 18). Todd and Botteron (n.pag.) consider ADHD to be a cortical energy-deficit syndrome produced by the hypofunctionality of glycogen metabolism and astrocyte glucose mediated by catecholamine (qtd. in Killeen 19). There are theories that define environment as the causal factor of the disorder. Organophosphate pesticides, lead, and flame-retardants are presumed capable of provoking the medical issue in people susceptible to the environmental stimulants (Killeen 19).
Contrary to theories, treatment approaches, and diagnosis techniques, much remains to be researched in the field of ADHD. Centers for Disease Control and Prevention (n.pag.) cites the examples of current studies. Thus, the National Center on Birth Defects and Developmental Disabilities of CDC has allocated funds to the epidemiological studies of the disorder based in large American communities, which will increase the understanding of the medical issue along with accompanying conditions in children. Its aim is also to provide recommendations on intervention and public health prevention strategies. Prioritizing the development and health of children, researchers conducting the Project Learn about Youth have set themselves similar objectives. The Children’s Hospital of Philadelphia (n.pag.) asserts that their research covers issues like the understanding of ADHD neurobiology, ADHD assessment in teenagers and younger children, factors increasing risks for children with the disorder, and the development of ADHD management strategies in the practices of primary care.
ADHD is a neuropsychiatric disorder that tend to be no respecter of age affecting both children and adults, with the ratio being 5.29% vs. 7.1%, as it stand right now. People can develop the disorder through genes, brain traumas, and environmental factors like maternal substance or alcohol abuse or exposure to lead. While unlikely and often scientifically dismissed, food additives and sugar are possible factors. ADHD can have unpleasant effects like low self-respect, depression, and self-harming conduct, to name but three. Signs and symptoms are often not difficult to notice since they come in the form of flaring low productivity, restlessness, and poor concentration. However, there is a chance of mistaking them for natural impulsivity and hyperactivity. To detect the disorder correctly, people need to book an appointment with certified specialists who will review medical or school records, interview friends, parents, or coworkers, and develop an intervention strategy, provide practical help by giving tips on efficient timetable organization, or prescribe cognitive behavioral therapy to help individuals change their behavior and personal perception. Cognitive and environmental are among the most prevalent theories rationalizing ADHD. Although scholars seem to have gained a sufficient understanding of various disorder aspects, much is still to be studied by hospitals and research centers.
ADHD Institute. “Epidemiology.” ADHD-Institute.com. April 2015. n.pag. Web. 22 Apr. 2015.
Buitelaar, Jan K., Kan, Cornelis C., and Philip Asherson. Eds. ADHD in Adults. Characterization, Diagnosis, and Treatment. New York: Cambridge University Press, 2011. Web. 22 Apr. 2015.
Centers for Disease Control and Prevention. “Attention-Deficit/Hyperactivity Disorder (ADHD).” CDC. 6 October 2014. n.pag. Web. 22 Apr. 2015.
Cheung, Celeste H.M., Rijdijk, Fruhling, McLoughlin, Grainne, Faraone Stephen V., Asherson, Philip, and Jonna Kuntsi. “Childhood Predictors of Adolescent and Young Adult Outcome in ADHD.” Journal of Psychiatric Research 62 (2015): 92-100. Web. 22 Apr. 2015.
Killeen, Peter. The Four Causes of ADHD. Academia.edu. 2015. 1-49. Web. 22 Apr. 2015.
Rowland, Andrew S., Lesesne, Catherine A., and Ann J. Abramowitz. The Epidemiology of Attention-Deficit Hyperactivity Disorder (ADHD): a Public Health View. Mental Retardation and Developmental Disabilities Research Reviews 8 (2002): 162–170. Web. 22 Apr. 2015.
The Children’s Hospital of Philadelphia. “Center for Management of ADHD.” CHOP.edu. 2015. n.pag. Web. 22 Apr. 2015.
The National Institute of Mental Health. “What Is Attention Deficit Hyperactivity?” NIMH. n.d. n.pag. Web. 22 Apr. 2015.
Timberline Knolls. “ADD/ADHD Symptoms and Effects.” Timberline Knolls. Residential Treatment Center. n.d. n.pag. Web. 22 Apr. 2015.
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