Monitor on Psychology - March 2012 - (Page 64)

“ADHD is a disorder characterized by the inability to regulate one’s behavior, emotions and attention. As we get older, we have fewer people telling us what to do,” Faraone says. “When we get to college or a job, we’re expected to show up without having someone tell us what to do.” Paul Wender, MD, a pioneer in ADHD research, developed one of the first rating scales for measuring ADHD in adults — the Wender Utah Rating Scale — in the 1990s, when he was a psychiatry professor at the University of Utah School of Medicine. The questionnaire, published in the American Journal of Psychiatry in 1993, helped retrospectively diagnose adults with ADHD based on their childhood symptoms. “The diagnosis of ADHD in adults has occurred more and more frequently in recent years, and it has improved dramatically over the past decade,” says Wender, now a psychiatrist in private practice in Andover, Mass. While the DSM-IV lists symptoms for ADHD that are mostly geared toward children, the upcoming fifth edition most likely will contain symptoms that apply more readily to adults, such as having racing thoughts instead of racing around the room. “Adults obviously aren’t on top of their desks, but they are restless and unable to sit still,” Wender says. Several other scales have been developed to help diagnose ADHD in adults since Wender’s work. Faraone helped develop a self-reporting screening scale that was adopted by the World Health Organization. Published in Psychological Medicine in 2005, the 18-question survey translates childhood ADHD symptoms from the DSM-IV into adult situations. In a nationwide telephone survey of 966 adults, published in the Journal of Attention Disorders in 2005, almost 3 percent of respondents reported they often had ADHD symptoms, while almost 16 percent reported occasional symptoms. The study by Faraone and Harvard Medical School researcher Joseph Biederman showed that individuals who reported ADHD symptoms were less likely to graduate from high school or college than those who reported no symptoms. Individuals who reported more severe ADHD symptoms were almost three times more likely to be unemployed than adults with no symptoms. “In the workplace, we know from studies of work productivity and income that adults with ADHD are not likely to achieve as well as their peers,” Faraone says. “The estimates range into billions of dollars each year in lost productivity related to adult ADHD.” 64 In a nationwide survey, almost 3 percent of respondents reported they often had ADHD symptoms, while almost 16 percent reported occasional symptoms. ‘Playing defense every day’ Drew Brody, a 39-year-old father with two young children in Santa Monica, Calif., says he used to struggle through his daily routine because of ADHD. As a high-school tutor, he would lose track of time, miss deadlines and feel overwhelmed. “You’re walking around with a fog around your brain. Just getting through normal daily behavior is hard, getting up, getting dressed, getting shaved, getting out the door on time,” he says. “All of that stuff is 10 times harder than it should be.” Brody was diagnosed with ADHD about seven years ago after his wife, a middle-school vice principal, suggested that he be evaluated. Brody began cognitive-behavioral therapy with a psychologist to identify coping mechanisms, such as time management skills, exercise and a healthy diet. But his persistent symptoms interfered with the therapy. “After a year, I never really got my act together to do any of the improvements on a regular basis,” he says. Brody then was prescribed Concerta, the extended-release version of methylphenidate (Ritalin), and his life changed. He was able to start his own tutoring company, The Scholar Group, which now has 16 tutors who help students in more than 40 academic subjects and on standardized tests such as the SAT. “It was a revelation,” he says. “I don’t think I would have created my business if I hadn’t started taking Concerta on a daily basis. It’s made a substantial change in my life. For bigger life decisions, I am able to think more clearly and work through the steps on how to get there.” His problems from ADHD haven’t disappeared, but Brody says his symptoms are more manageable now than they were in the past. “Life with ADHD is like playing defense every day. Things happen to you and you have to address them,” he says. “You’re not proactively dealing with life. You’re waiting to be late or to get in trouble because you can’t get ahead.” Brody’s experience is common for adults with ADHD who try cognitive-behavioral therapy without medication, says Ramsay, who wrote the 2010 book “Nonmedication Treatments for Adult ADHD.” Therapy can be very helpful in teaching time management and organization skills, but ADHD symptoms can lead to late or missed appointments, failure to complete homework, and little progress on a treatment plan. Medication in conjunction with therapy can help bring ADHD symptoms under control through life coaching skills and counseling for M o n i to r o n p s yc h o l o g y • M a rc h 2 0 1 2

Table of Contents for the Digital Edition of Monitor on Psychology - March 2012

Monitor on Psychology - March 2012
Letters
President’s column
Contents
From the CEO
Supreme Court rejects eyewitness protections
New member benefit: prevention screenings
A psychodynamic treatment for PTSD shows promise for soldiers
Was ‘Little Albert’ ill during the famed conditioning study?
New research identifies ways to improve eyewitness identifications
In Brief
‘Our health at risk’
Perspective on Practice
APA endorses higher education guidelines
TIME CAPSULE
QUESTIONNAIRE
Random Sample
Judicial Notebook
Help for struggling veterans
Driving out cancer disparities
In the Public Interest
SCIENCE WATCH
Practice, virtually
The legal and ethical issues of virtual therapy
Psychologist PROFILE
EARLY CAREER PSYCHOLOGY
Bringing life into focus
Pay attention to me
AMERICAN PSYCHOLOGICAL FOUNDATION
Division Spotlight
Personalities

Monitor on Psychology - March 2012