Monitor on Psychology - March 2012 - (Page 65)
underlying negative thoughts that can lead to procrastination and frustration, Ramsay says. The public controversy about overmedication and overdiagnosis of ADHD is really a problem of misdiagnosis, which can result from quick visits to primary-care physicians, Ramsay says. “Some patients may get a diagnosis based on an all-too-brief evaluation and therefore may start treatment with a medication when maybe their symptoms are not a result of ADHD,” he says. “Other people with ADHD may be misdiagnosed with some other mental disorder.” Stimulants on campus Several studies have shown that stimulants such as Ritalin or amphetamine salts (Adderall) are effective in treating ADHD in adults, but the drugs also can be abused, especially by college students who believe stimulants will boost their academic performance. In a survey of more than 1,800 students at the University of Kentucky, a third of the students reported they had illegally used ADHD stimulants, mainly by obtaining pills from fellow students with prescriptions. Most of the illegal users said the stimulants helped them stay up late and cram for exams, and they believed the drugs increased their reading comprehension, attention and memory. The study was published in 2008 in the Journal of American College Health. Every college in the United States faces problems with misuse of ADHD stimulants, but most students with ADHD are not faking their symptoms to get medication, says Lorraine Wolf, PhD, a neuropsychologist and director of the Office of Disability Services at Boston University. “Most students with ADHD are serious, hard-working young people who struggle in a college environment, but with accommodations and support they are very successful,” says Wolf, an assistant psychiatry professor who researches adult ADHD. Wolf ’s office offers time management skills for students with ADHD and provides academic accommodations, including extra time on tests and computer use during exams to help with spelling and grammar. Students must provide extensive documentation of severe ADHD symptoms before accommodations will be granted, Wolf says. “People who come to college with symptoms are pretty much going to have ADHD for the rest of their lives,” Wolf says. “People become more refined in how they deal with it. They just get better at handling ADHD.” Almost 5 percent of teenagers in the United States were prescribed stimulants to treat ADHD in 2008, compared with just 2.3 percent in 1996, suggesting that many children aren’t outgrowing their symptoms, according to a study by the National Institutes of Health and the Agency for Healthcare Research and Quality. The study was published online in September in the American Journal of Psychiatry. Some college students who illegally use stimulants may have undiagnosed ADHD, according to a study of 184 college
M a rc h 2 0 1 2 • M o n i to r o n p s yc h o l o g y
New guidelines for ADHD among children
After six years of study, the American Academy of Pediatrics (AAP) has expanded its guidelines for the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) to cover both preschoolers and adolescents. the previous guidelines issued a decade ago were limited to children ages 6 to 12, but advances in research have allowed the new guidelines to include children ages 4 to 18. “ADHD is a chronic condition, and it requires treatment on an ongoing basis,” says Mark Wolraich, MD, lead author of the report announcing the new guidelines. “We’re trying to provide clinicians with more specific criteria for making a diagnosis.” the report, published in november in Pediatrics, recommends that preschoolers with ADHD receive behavioral interventions first, such as parent training in behavior management techniques. If those interventions fail, then methylphenidate (ritalin) may be considered only for moderate to severe symptoms. there is some evidence showing benefits of methylphenidate in preschoolers with ADHD, but its effects on brain development in young children aren’t clearly understood. the Food and Drug Administration hasn’t approved the use of most stimulants for children under age 6, although physicians are allowed to prescribe the drugs off label, says Wolraich, director of the Child Study Center at the University of oklahoma Health Sciences Center. About 9.5 percent of kids age 4 to 17 in the United States have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. More than half of them take prescription drugs. Most children with ADHD don’t take medications for more than three years, with many youths developing coping mechanisms as they get older, Wolraich says. the report recommends both FDA-approved medications and behavioral interventions for elementary school children and adolescents. the AAP also created a single algorithm to guide clinicians in the diagnosis and treatment of ADHD, along with the consumer guide ADHD: What Every Parent Needs to Know. —B.L. SMiTH
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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
https://www.nxtbook.com/nxtbooks/apa/monitor_201206
https://www.nxtbook.com/nxtbooks/apa/monitor_201205
https://www.nxtbook.com/nxtbooks/apa/monitor_201204
https://www.nxtbook.com/nxtbooks/apa/monitor_201203
https://www.nxtbook.com/nxtbooks/apa/monitor_201202
https://www.nxtbook.com/nxtbooks/apa/monitor_201201
https://www.nxtbook.com/nxtbooks/apa/monitor_201112
https://www.nxtbook.com/nxtbooks/apa/member_benefits
https://www.nxtbook.com/nxtbooks/apa/monitor_201111
https://www.nxtbook.com/nxtbooks/apa/monitor_201110
https://www.nxtbook.com/nxtbooks/apa/monitor_201109_test
https://www.nxtbook.com/nxtbooks/apa/monitor_201109
https://www.nxtbookmedia.com