Monitor on Psychology - March 2012 - (Page 70)

“Not only was I trying to organize my own busy personal, professional and domestic life, but I was also trying to steer her. I felt alone and also really desperate.” Max is quick to add that Elizabeth is incredibly creative and wonderful in many ways. But for years, her untreated attentiondeficit hyperactivity disorder (ADHD) threatened to pull them apart. Their story is not unusual. Troubled relationships are all too common among adults with unmanaged ADHD, says Kevin R. Murphy, PhD, president of the Adult ADHD Clinic of Central Massachusetts and associate research professor in the department of psychiatry at SUNY Upstate Medical University in Syracuse. “In fact, it would be rare that ADHD wouldn’t affect the marriage,” he says. The good news, though, is that adult ADHD is highly treatable, says Ned Hallowell, MD, a psychiatrist who specializes in treating ADHD at the Hallowell Centers in New York and Boston, and coauthor of “Driven to Distraction,” a best-selling book on adult ADHD. “The right diagnosis can turn marriages and lives around,” he says. Most of the research on ADHD is focused on children. According to the Centers for Disease Control and Prevention, 9.5 percent of kids age 4 to 17 have been diagnosed with the disorder. Some of those children seem to outgrow it, but for others symptoms persist into adulthood. In a 2006 study, Russell Barkley, PhD, a clinical neuropsychologist at the Medical University of South Carolina in Charleston, and colleagues determined that about 4.4 percent of the adult population suffers from ADHD (American Journal of Psychiatry, Vol. 163, No. 4). Although the disorder afflicts millions of adults, it remains badly underdiagnosed, Barkley says. His study also found that only about 10 percent of adults who met the diagnostic criteria for ADHD had been diagnosed and treated for it. Partly, that’s due to misconceptions about the disease. “For decades it was thought to be just a childhood disorder, and everyone thought it declined markedly by adolescence,” he says. “For many decades, many mental health professionals received no training in this disorder, particularly if they were specializing in adults.” That finally started to change in the mid- to late 1990s, he says, and awareness of and education about adult 70 F or Max Stevenson,* another missed mortgage payment was almost the last straw. His wife, Elizabeth,* intended to pay the bill but hadn’t followed through — yet again. “I had two children with Elizabeth, but I also had Elizabeth in the role of a third child,” he says. ADHD continue to improve. It’s true that the hyperactivity component of ADHD often declines with age. But other, equally insidious symptoms can linger into adulthood. Classic signs include difficulty with focusing, organizing, planning and follow-through. “It feels like there’s a carnival in my head,” Elizabeth Stevenson says. “My brain is going in so many different directions, it’s very difficult to look at a list and pick out what I need to do first.” ADHD is a neurobiological disorder. Symptoms are thought to stem from underactivity in the frontal cortex — the brain’s control panel for attention, self-control and executive functioning. People with ADHD typically show a decrease in blood flow, glucose metabolism, and levels of the neurotransmitters dopamine and norepinephrine in that part of the brain, Murphy says. Despite the name, the syndrome is far more than a deficit of attention. “Research shows it’s a disorder of executive functioning,” Barkley says. Executive functioning involves five areas of daily behaviors, he explains: time management, organization, motivation, concentration and self-discipline. He and Murphy recently reported in the Journal of Psychopathology and Behavioral Assessment that 89 percent to 98 percent of adults with ADHD are impaired in all five areas. “There’s no domain of your life that this disorder does not interfere with. It produces more significant impairment in more areas of life than other outpatient disorders,” including anxiety and depression, Barkley says. “School, occupation, money, credit, sex, work life, raising children — it hits them all.” Marriage teeters As the Stevensons learned, undiagnosed ADHD can hit relationships hard. Research findings on the relationship between divorce rates and ADHD are somewhat mixed, but several studies have turned up a link. In a paper in Comprehensive Psychology, Barkley and Murphy reported that patients with ADHD had a higher mean number of marriages, and that they and their spouses reported lower levels of marital satisfaction, than did people without ADHD. Together with coauthor Mariellen Fischer, PhD, Barkley and Murphy also touch 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

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