Hyperactivity
od 1
Santiago
Introduction:
Attention Deficit Hyperactivity Disorder affects approximately six percent of the world’s population, or about 414.6 million people (Wender, 2006, 1). There are three subtypes of Attention Deficit Hyperactivity Disorder; each having its own requirements for diagnosis. There are also a significant amount of treatment options. There a number of different theories as to why people have Attention Deficit Hyperactivity Disorder. There has also been disagreement about whether Attention Deficit Hyperactivity Disorder is an actual clinical condition or whether it is just one of the extremes of normal behavior. In addition there is controversy as to whether the disorder is diagnosed too much or too little. Since Attention Deficit Hyperactivity Disorder is a disorder that begins in early childhood there are scams that take advantage of the parents fear that their child will not be successful because of this condition.
Findings:
Attention Deficit Hyperactivity Disorder is a very complicated disorder due to, among other things, the fact that it has to do with psychology. Because of the reclassification of many diseases and disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, released in 1994, there are now three subtypes of Attention Deficit Hyperactivity Disorder. The subtypes are: 1) primarily Hyperactivity and impulsive, 2) primarily inattentive which is commonly known by the public as Attention Deficit Disorder, and 3) combined which is what most people think of when they talk about Attention Deficit Hyperactivity Disorder. Primarily Hyperactivity and impulsive people have trouble sitting still or staying patient however they do not have very many symptoms that are associated with inattentiveness (Rader, 2009, 2). Primarily Hyperactivity/impulsive is the newest subtype of Attention Deficit Hyperactivity Disorder and because of this it is also one of the least known to the general public. People with this subtype show symptoms like fidgeting, trouble waiting their turn, and talking excessively.
Attention Deficit Hyperactivity Disorder Primarily Inattentive is one of the two more commonly known subtypes of Attention Deficit Hyperactivity Disorder. However more people know it by the name, used before the reclassification made in 1994, Attention Deficit Disorder. There are certain symptoms that have been observed in this subtype of Attention Deficit Hyperactivity Disorder that are not present in people with the subtype that does not include inattentiveness (Skirbekk, 2011, 3). These symptoms include daydreaming, drowsiness, and sluggishness. When one or more of this triad of symptoms are present we describe the individual as having a sluggish cognitive tempo. These symptoms however are not included in the list of symptoms required for the diagnosis of Attention Deficit Hyperactivity Disorder in either the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition or the International Statistical Classification of Diseases and Related Health Problems tenth edition. Symptoms that are used to diagnose Attention Deficit Hyperactivity Disorder Primarily Inattentive include loosing items necessary for a task, forgetfulness, and appearing not to listen when spoken to (Rader, 2011, 4). This behavior would be most detrimental at school. This is because they may forget what homework they have, forget to turn in the homework they have done, and not listen when the teacher is giving directions. However, Attention Deficit Hyperactivity Disorder Primarily Inattentive could also have a tremendous effect on the patients at their home. This is because the patient will become easily distracted and will not finish homework or finish chores they started.
People who have Attention Deficit Hyperactivity Disorder combined type, usually referred to as ADHD because it was the common acronym for the combined type before the reclassification in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, show both symptoms of inattentiveness and symptoms of hyperactivity and impulsiveness (Rader, 2009, 5). Since these patients exhibit symptoms from the primarily inattentive and the Hyperactivity/impulsive lists, this form of Attention Deficit Hyperactivity Disorder can be the hardest subtype to manage. This is especially true in situations when the disorder goes undiagnosed.
For a diagnosis of any of the three subtypes there needs to be at least six symptoms in either the inattentive category, Hyperactivity/ impulsive category or both categories, for six months in two different environments (Rader, 2009, 6). The most common way of obtaining this information currently, is through the patient’s family and the patient’s teachers or those who, while not related to the patient, are close enough to the patient that they would be accustomed to the patient’s behavior and therefore be able to provide the needed information. However this can be highly subjective making a correct diagnosis difficult. This also makes it difficult for those outside of the k-12 school system to get a correct diagnosis. Individuals who matriculate into higher education settings or to a job setting without having a correct diagnosis made, often experience difficulties in their life. There will also be difficulty in appropriately diagnosing these individuals because there are not typically people who have enough contact with the individual to complete the diagnostic questionnaires. One thing to consider after diagnosis is whether the individual may have other disorders that have a connection that has been seen between Attention Deficit Hyperactivity Disorder and the disorder. Among these is the commonly known disorder OCD (Anholt, 2009, 7).
Of the many treatment options, stimulant medications are used most often. methylphenidate, also known by the brand name Ritalin©, is the a very common. While logic would suggest giving a stimulant to a Hyperactivity individual would not be beneficial. However years of clinical experience suggests otherwise, causing stimulants to remain the most common treatment for Attention Deficit Hyperactivity Disorder. Methylphenidate improves the attention of patients with Attention Deficit Hyperactivity Disorder because it stimulates the brain by gradually increasing the levels of dopamine. The dosage is gradually increased until it reaches therapeutic levels after which the dosage is not changed. As a result the patient can stay focused, which may cause the patient to have an increase in self esteem, and will allow them to have better interactions between themselves and those around them (Anonymous, 2011, 8). Methylphenidate has also been shown to help memory in adults with Attention Deficit Hyperactivity Disorder (Verster, 2010, 9). While methylphenidate has many benefits to those who suffer from Attention Deficit Hyperactivity Disorder there are also several possible side-effects. Some of these are suppressed appetite, weight loss, headaches, and stomach pains. There are also other medicines, such as the amphetamines, in the stimulant category that have similar effects and side effects as methylphenidate although some of these other medications are known to have one or two side effect that happen more or less often than others (Rader, 2009, 10).
Even though there is evidence to prove that stimulants improve the patient’s ability to focus, some people believe that stimulants should not be used for the treatment of Attention Deficit Hyperactivity Disorder. There is thought to be a possible correlation between stimulant use in childhood and drug abuse later in life. Current research does not support this claim, particularly if stimulants are used in the proper manner. There is some question as to whether this is the same for teens that use stimulants (Anonymous, 2011, 11). However use of methylphenidate with an extended release time, as well as starting with a lower dose, may help to avoid drug abuse later in life for those suffering from Attention Deficit Hyperactivity Disorder. Longer release drugs also help children because it takes away the need for taking their medicine at school (Rader, 2009, 12).
Psychotherapy is also an often used treatment for Attention Deficit Hyperactivity Disorder. Psychotherapy has been proven effective as a treatment for Attention Deficit Hyperactivity Disorder when combined with medication (Wilens, 2011, 13). Some people advocate the use of non-stimulants in the treatment of Attention Deficit Hyperactivity Disorder. There are a few non-stimulant medications, for use with patients with Attention Deficit Hyperactivity Disorder, on the market. One such drug is an atomoxetine also known by the brand name Strattera©. This drug was the first non-stimulant drug approved by the Food and Drug Administration (FDA) for use in adults and children above the age of six with Attention Deficit Hyperactivity Disorder (Anonymous, 2011, 14).
Certain food additives have been thought to be detrimental to the treatment of those who have Attention Deficit Hyperactivity Disorder. As of now scientist do not know why this happens, however the evidence seems to support this theory. As a result parents are discouraged from giving their child foods that contain these additives. However there is no correlation seen between food additives and the development of Attention Deficit Hyperactivity Disorder (Ballard, 2010, 15).
There are a number of different theories regarding the cause of Attention Deficit Hyperactivity Disorder. One such theory is that the cause of Attention Deficit Hyperactivity Disorder is genetic. Several genes have been explored as possible connections to Attention Deficit Hyperactivity Disorder. Genes DAT1, DRD4, DRD5, 5HTT, HTR1B, and SNAP25 have been shown to possibly have a connection to Attention Deficit Hyperactivity Disorder. There have also been several genes that may be associated to different subtypes of Attention Deficit Hyperactivity Disorder, but only in certain candidates such as different genders, ethnicities, and those with certain environmental risk factors (Gizer, 2009, 16). Identifying whether there is a genetic cause for Attention Deficit Hyperactivity Disorder could help lead to more effective treatment options and better screening in order to help those patients that are afflicted by this disorder. If we can identify a genetic cause then we can develop an objective test to diagnosis the disorder. This may be particularly helpful for adults with the disorder who were never screened for the disorder when they were in school.
There are also environmental factors that may contribute to the cause of Attention Deficit Hyperactivity Disorder. One major environmental factor associated with Attention Deficit Hyperactivity Disorder is whether the child was exposed to toxins such as alcohol, lead or nutrient deficiencies (Rader, 2009, 17). There are also some that believe developmental diseases or other things, such as, may cause Attention Deficit Hyperactivity Disorder or symptoms very similar to Attention Deficit Hyperactivity Disorder (Rowles, 2010, 18).
There has been a lot of controversy on the topic of Attention Deficit Hyperactivity Disorder. The first recorded controversy under the category of Attention Deficit Hyperactivity Disorder was seen in the nineteen seventies. Some of the more recent controversy stems from the reclassification in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition because the rate of diagnosis has significantly increased since its publication in 1994 (Pomerantz, 2005, 19). Some people say that Attention Deficit Hyperactivity Disorder is a social disease. Their reasoning for this is that what we call Attention Deficit Hyperactivity Disorder is caused by the norms of society being too stiff and so those who act differently are seen as having something wrong with them. Under that theory there is nothing wrong with those afflicted with Attention Deficit Hyperactivity Disorder but everyone else is simply trying to create a uniform society. Some even say that Attention Deficit Hyperactivity disorder is a non-existent disorder because it is simply classifying a nonmedical problem, unruly or unwanted behavior, as a medical one. There are also people who believe that Attention Deficit Hyperactivity Disorder is an under diagnosed disorder and is often not treated effectively.
As with many disorders and diseases there are those who create scams to prey on the emotions of the parents of children who are diagnoses with Attention Deficit Hyperactivity Disorder. The “miracle cure” for Attention Deficit Hyperactivity Disorder is usually paired with miracle cures for other learning impairments such as dyslexia and autism. The way to avoid being drawn into an Attention Deficit Hyperactivity Disorder cure scam is the same as with most scams, whether medical or otherwise. Patient and their families are advised to be very skeptical of pitches that say “This is the only thing that will work.”
Closing:
As you can see Attention Deficit Hyperactivity Disorder is a very complex disorder. There are three different subtypes and the exact cause of this disorder is unknown. As a result there are people to believe it isn’t really a disorder but rather just the extremes of normal behavior. There is also a lot of difficulty in diagnosing patients with this disorder, especially if we try to make the diagnosis later in the patient’s life. However, with proper treatment this disorder can be effectively managed and the patient can live a normal life. There may never be an end to the controversy surround Attention Deficit Hyperactivity Disorder but there is definitely a problem, whether it is with the patients or with society’s view of what is or is not considered normal behavior.