Re-Visioning Attention Deficit Hyperactivity Disorder (ADHD)

Constructionist notions have become commonplace in theoretical discussions of the self, but are seldom translated into consideration of specific social work practice concerns such as ADHD. Explorations of ADHD, on the other hand, typically emphasize a narrow, medically-oriented symptom picture that is devoid of the psychosocial context in which the so-called symptoms emerge. A transactional approach to the understanding of ADHD is advanced. This article promotes a link between constructionism and social work's psychosocial or person-in-environment perspective. Such a perspective supports approaches to the assessment of ADHD that illuminate larger cultural messages and their constraining influence on individual meaning-making. Intervention, conducted at multiple levels, must be geared to the establishment of more hopeful and affirming narratives.     

Attention Deficit Hyperactivity Disorder (ADHD) and Diverse Populations

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavioral disorder of childhood. Given the high prevalence of ADHD and its significant impact on children and families, it is important for social workers to understand and know how to respond. This paper looks at Attention Deficit Hyperactivity Disorder, explores its causes, and gives special attention to its effect on diverse populations. In addition, it discusses empirically supported treatment interventions used for children with ADHD, particularly the role of parent training in the management of ADHD. Finally, it discusses the applicability of using parent-training programs with diverse populations.     

The Relationship Between Problem Gambling and Attention Deficit Hyperactivity Disorder

Recent studies indicate that treatment-seeking problem gamblers display elevated rates of ADHD and that adolescents who screen positive for ADHD are more likely to engage in gambling, develop gambling problems, and experience a greater severity in gambling problems. This study aimed to (a) compare the prevalence of ADHD in treatment-seeking problem gamblers to the general population; (b) investigate the relationships between ADHD and problem gambling severity, cluster B personality disorders, motor impulsivity, alcohol use, substance use, gender, and age; and (c) investigate the degree to which these factors moderate the relationship between ADHD and problem gambling severity. Participants included 214 adults (154 males, 58 females, 2 unspecified) who sought treatment for their gambling problems at a specialist gambling agency in Melbourne, Australia. Almost one-quarter (24.9 %) of treatment-seeking problem gamblers screened positively for ADHD, which was significantly higher than the 14 % prevalence in a community sample. ADHD was significantly positively correlated with problem gambling severity, motor impulsivity, and cluster B personality disorders, but was not associated with alcohol and substance use, gender or age. None of the factors significantly moderated the relationship between ADHD and problem gambling severity. These findings suggest that a considerable proportion of treatment-seeking problem gamblers report ADHD and that their clinical profile is complicated by the presence of high impulsivity and cluster B personality disorders. They highlight the need for specialist gambling agencies to develop screening, assessment, and management protocols for co-occurring ADHD to enhance the effectiveness of treatment.     

Gambling Behavior Among Adolescents with Attention Deficit/Hyperactivity Disorder

Impulsivity is inherent to both problem gambling and ADHD. The purpose of this study is to examine ADHD key symptoms, and gambling behaviors and problem severity among adolescents. Additionally, internalizing and externalizing behaviors exhibited among these individuals and the role of these symptoms in gambling are examined. We used a cross-sectional study design and survey 1,130 adolescents aged 12–19. Results indicated that adolescents who screened positive for ADHD were significantly more likely than non-ADHD adolescents to engage in gambling and significantly more likely to develop gambling problems. Those who screened positive as predominantly inattentive and those who screened positive for ADHD Combined (Inattention and Hyperactivity–Impulsivity) were equally likely to gamble, but the latter were twice as likely to have gambling problems. However, we found no significant interaction between the key ADHD symptoms and gambling as the severity of hyperactivity–impulsivity or inattention did not significantly differ with respect to gambling pathology. Emotional problems and depressive affect were the only variables that could significantly differentiate the ADHD types and gambling severity. Our Results highlight the clinical importance of considering the subtype of ADHD among gamblers and the greater association of depressive affect and emotional problems with gambling among adolescents.     

College Students and the Diagnosis of Attention Deficit Hyperactivity Disorder

Abstract

Background: When H1N1 emerged in 2009, institutions of higher education were immediately faced with questions about how best to protect their community from the virus, yet limited information existed to help predict student preventive behaviors. Methods: The authors surveyed students at a large urban university in November 2009 to better understand how students perceived their susceptibility to and the severity of H1N1, which preventive behaviors they engaged in, and if policies impacted their preventive health decisions. Results: Preventive health behavior messaging had a mixed impact on students. Students made simple behavior changes to protect themselves from H1N1, especially if they perceived a high personal risk of contracting H1N1. Although policies were instituted to enable students to avoid classes when ill, almost no student self-isolated for the entire duration of their illness. Conclusions: These findings can help inform future decision making in a university setting to best influence preventive health behaviors.     

Professor Perceptions of College Students With Attention Deficit Hyperactivity Disorder

Objective: From April to June 2005, the authors investigated professor perceptions of college students with attention deficit hyperactivity disorder (ADHD). Participants: 253 participants completed the ADHD Beliefs Survey-Revised, a 40-question survey measuring professor perceptions of ADHD. Methods: Analysis of variance measured false and reasonable beliefs related to ADHD. Results: Results indicated that professors with differing levels of education, years of teaching experience, colleges in the university or community college, previous experiences with a student with ADHD, and ADHD training did not differ significantly in perceptions regarding general ADHD knowledge or college students with ADHD.     

Pemoline in Adult Attention Deficit Hyperactivity Disorder: Predictors of Nonresponse

Abstract

The psychostimulants are the most widely used treatment modality for attention deficit/hyperactivity disorder (ADHD). Although positive responses to psychostimulants have been demonstrated, 46% of adults with ADHD, on average, are nonresponsive or cannot tolerate the medications because of adverse effects. We reviewed the charts of 43 students treated with pemoline and studied parameters of nonresponse. Sixteen (37%) met the study definition of nonresponse. Of these, 5 (12%) were symptom nonresponders and 11 (25%) were nonresponders because of adverse effects. We found a significant relationship between age and nonresponse resulting from adverse effects, yet no other factors predicted nonresponse to pemoline. Clinicians should consider using smaller starting doses of pemoline in adults to minimize adverse effects.     

A New Understanding of Attention Deficit Hyperactivity Disorder: Alternate Concepts and Interventions

This paper explores alternate concepts for increasing our understanding of the intra/interpersonal difficulties that are observed in those with Attention Deficit Hyperactivity Disorder (ADHD). Language theory in correlation with under inhibition of responses, (not inattention, impulsivity, and hyperactivity), is explained, and demonstrates how those with ADHD are more vulnerable for developing intra/interpersonal struggles. Comorbidity as it presents with ADHD is examined as the resulting psychopathological symptomolgy possibly caused by untreated psychological, social and cognitive distress. This is in contrast to the prevailing idea that comorbid symptoms are always separate and distinct diagnoses. The psychoanalytic theories of object relations and affect attunement are defined and are linked to under inhibition of responses via dynamic intra/interpersonal processes and the presenting psychological, social and cognitive problems. Interventions are proposed that are behavioral and psychopharmacological, with a systems approach. Two cases are presented to illustrate how these treatment techniques translate into actual practice. All proposed interventions are aimed to address and anticipate the potential that individuals and families with ADHD experience under inhibition of responses with accompanying, maladaptive intra/interpersonal functioning.     

Parents of Children with Attention Deficit/Hyperactivity Disorder: A Meta-Synthesis,Part II

In 2011 6.4 million children in the United States ages four to 17 years had a diagnosis of ADHD. Quantitative studies have indicated that parenting stress for parents of children diagnosed with ADHD is high. The purpose of the current meta-synthesis was to conduct a comprehensive review of both the published and unpublished qualitative studies involving the experience of parents raising children diagnosed with ADHD. Searches in online scholarly databases yielded an initial 1217 hits, which were narrowed down to eighty studies that met the criteria. A “meta-ethnography” framework was used for the synthesis. Results of the first part of the analysis were reported in Corcoran et al. (2016) and had to do with the personal impact on parents. The themes in Part II have to do with the processes parents go through in accepting the diagnosis of ADHD and in deciding whether their children should take medication. Parents struggled to make sense of their child’s problems and came to terms with the diagnosis in a series of stages. Regarding medication use, parental attitudes varied greatly, with both costs and benefits noted. Though there was considerable ambivalence towards medication use, some parents reported relief after their child began using medication. Implications from this study are that providers should recognize the processes involved in making decisions about an ADHD diagnosis and the use of medication. Social workers should allow sensitive exploration of parents’ attributions and understanding of their children’s behavior and level of acceptance of the diagnosis. Keeping an ethical and critical stance toward the use of medication, social workers should also have full exploration with parents around the potential benefits and risks associated with the treatment of their children’s ADHD, taking into account parents’ preferences.     

Parents of Children with Attention Deficit/Hyperactivity Disorder: A Meta-Synthesis,Part I

In 2011 6.4 million children in the United States ages four to 17 years had a diagnosis of Attention-deficit/hyperactivity disorder (ADHD). Quantitative studies have indicated that parenting stress for parents of children diagnosed with ADHD is high. This meta-synthesis compiled and analyzed a systematic review of the qualitative studies of parents’ lived experience of having a child with ADHD. Searches in online scholarly databases yielded an initial 1217 hits, which were narrowed down to seventy-three studies that met the criteria. A “meta-ethnography” framework was used for the synthesis. One major finding involved the emotional burden of caring for a child with ADHD. Parents struggled with a variety of intense and painful emotions as they attempted to manage family routines. Disciplining children only worked in a limited way and took constant effort throughout the day. The challenges of parenting spilled into other areas of the parents’ lives, such as their health, psychological, marital, and occupational functioning. Implications for practitioners are discussed, including the need to validate parental stress and the difficulty of applying behavioral management strategies with their children, the need for increased support of partner relationships, and the need to connect parents with support to prevent poorer outcomes for the child.     

Impact of age and symptom severity on parent-child relationships and self-perception among Chinese children with Attention Deficit Hyperactivity Disorder

Little information is available on the effect of parent-child relationships on self-perception among Chinese children with Attention Deficit Hyperactivity Disorder (ADHD) in Hong Kong. This study examined the impact of children’s age and symptom severity on the linkage of quality parent-child relationships to perceived competence/hope among children with ADHD. A clinical sample of 81 school-age children (ages 5–11, mean age = 8.38) who were diagnosed with ADHD were recruited in this study. Separate questionnaires were employed to collect data among children and their parents in the pre-treatment phase. Parent-child relationships were positively correlated with self-perception of children with ADHD, with physical competence to be father-child specific. Children’s age had moderated the correlation between mother-child relationship and children’s hope. Maternal role on children’s hope was significant for the mild symptom group; paternal role on children’s hope was significant for the severe symptom group. No moderation effect was found for symptom severity on the correlation between parent-child relationship and children’s self-perception. The study’s findings helped mental health professionals in a Chinese context to develop psychosocial interventions to foster quality parent-child relationships, which in turn will maintain children’s self-perception. Implications for social work practice are discussed.     

Building partnerships with low-income families of students with Attention Deficit Hyperactivity Disorder: Implications for professional school counselors

Parental involvement is vital in helping students with attention deficit hyperactivity disorder (ADHD) perform successfully in schools. Often, low-income families are not involved in their children's education. Therefore, the school counselor's role in partnering with families of students with ADHD to work for their children's academic and social success in school is addressed. Effective ways professional school counselors can encourage parental involvement, such as trainings and family education programs, are also explored.     

Comparing the Utility of a Modified Diagnostic Interview for Gambling Severity (DIGS) with the South Oaks Gambling Screen (SOGS) as a Research Screen in College Students

The South Oaks Gambling Screen (SOGS) is compared in reliability to a modified version of the Diagnostic Interview for Gambling Severity (DIGS-S) for use as a pathological gambling (PG) screen in college students. Seventy-two undergraduates (83.3% male, mean age of 18.8) from the University of Georgia completed the measures, completing a longitudinal design with 3 sessions over a 2-month time period. The DIGS-S and the SOGS demonstrated good internal consistency over the 3 sessions, with Cronbach’s Alphas ranging from 0.73 to 0.89, as well as strong concurrent validity, with correlations of .50 to .80 (Ps < .001) between the 2 measures across the 3 sessions. Both Cronbach’s alpha and test–retest reliability were higher with the DIGS-S than the SOGS. Given this, and given that the DIGS directly measures symptoms of pathological gambling, future research could benefit from the use of the DIGS-S as a PG screening tool in a college-aged sample.     

Gambling and Correlates of Gambling Among Minnesota Public School Students

This study examines the prevalence of gambling and measures the relationships between gambling behavior and a number of demographic, psychosocial, and behavioral variables among Minnesota public school students. The sample includes 78,582 male and female Minnesota public school students enrolled in the 9th and 12th grades. Students were administered the 1998 Minnesota Student Survey, a 121-item, anonymous, self-administered, paper-and-pencil questionnaire that inquires about multiple health-related content domains, including gambling behavior. The majority of students were found to have gambled at least once during the past year, however, most students did not report gambling frequently, nor did they report problems associated with their gambling. Boys reported gambling more often than girls, and older students gambled more often than younger students. A larger percentage of Mexican/Latin American, African American, American Indian, and mixed race students gambled at weekly and daily rates than Asian American and Caucasian students. Variables associated with gambling frequency included antisocial behavior, gender (being a male), alcohol and tobacco use, age, feeling bad about the amount of money they bet, a desire to stop gambling, and increased sexual activity. Gambling appears to be related to other risk-taking behaviors and may be a part of the adolescent experimentation with adult behaviors.     

The Clustering of Psychiatric Disorders in High-Risk Gambling Populations

The aims of this study were to examine the associations between psychiatric disorders and pathological gambling (PG) and the clustering of psychiatric disorders in high risk gambler populations. The sample comprised 140 regular gamblers who were recruited from the general public. A variety of self- report and semi structured questionnaires was administered, including the Mini International Neuropsychiatric Interview, The Personality Diagnostic Questionnaire-4th Edition, NORC DSM-IV Screen for Gambling Problems Self- administered and Problem Gambling Severity Index. Axis I and Axis II psychiatric disorders and personality disturbances were found to be more prevalent amongst pathological gamblers than other gamblers with the strongest differences observed for mood and anxiety-related disorders. Almost two-thirds of pathological gamblers reported both an anxiety or mood disorder in conjunction with another type of disorder. These differences between the gambling groups existed even after controlling for gender. The results highlight the high rates of co-morbidity in pathological gamblers in the community and the extent to which anxiety and mood disorders co-existing with other forms of pathology. These results highlight the significant challenges facing treatment services in the treatment of PG and the extent to which this should be treated as the primary disorder.     

The Victorian Gambling Screen: Reliability and Validation in a Clinical Population

There is a need to establish reliability and the various forms of validity in all measures in order to feel confident in the use of such tools across a wide diversity of settings. The aim of this study is to describe the reliability and validity of the Victorian Gambling Screen (VGS) and in particular one of the sub-scales (Harm to Self—HS) in a specialist problem gambling treatment service in Adelaide, Australia. Sixty-seven consecutive gamblers were assessed using a previously validated clinical interview and the VGS (Ben-Tovim et al., The Victorian Gambling Screen: project report. Victorian Research Panel, Melbourne, 2001). The internal consistency of the combined VGS scales had a Cronbach’s alpha of .85 with the HS scale .89. There was satisfactory evidence of convergent validity which included moderate correlations with another measure of gambling—the South Oaks Gambling Screen. There were also moderate correlations with other measures of psychopathology. Finally, how the VGS may best be used in clinical settings is discussed.     

Misbeliefs About Gambling in a Convenience Sample from the General Population

We examined knowledge about the role of randomness in gambling and the principle of independence of events, in a community sample. We also investigated whether this knowledge varies according to gender and age. A convenience sample of 1257 residents in French-speaking Switzerland, aged 18–88 years (28.5% of women) completed a short online questionnaire. This assessed the perceived role of human skills in four different games as well as beliefs relating to the principle of independence of events. The results show that 19.5% of the respondents perceived Roulette as a game for which the outcome is determined by skill. They also showed that 15.1% of the respondents did not hold beliefs about the independence of events principle. Gender and age differences were also observed: Men were proportionally more likely to hold erroneous beliefs about gambling skills and the independence of events, compared to women. The 18–25 year-old age group attributed Roulette outcomes to the gambler’s skill more frequently than the older categories. The implications of these findings for prevention and social support are discussed.     

A Canadian Population Level Analysis of the Roles of Irrational Gambling Cognitions and Risky Gambling Practices as Correlates of Gambling Intensity and Pathological Gambling

Using population data (N = 11,562) drawn from five Canadian gambling prevalence surveys conducted between 2000 and 2005, the current study investigated the relationship between irrational gambling cognitions and risky gambling practices upon (a) gambling intensity, as measured by percent of income spent on gambling and (b) tolerance, a diagnostic indicator of pathological gambling. First, we found irrational gambling cognitions and risky gambling practices to be positively related. Second, irrational gambling cognitions moderated the relationship between risky gambling practices and gambling intensity. Specifically, people engaging in risky practices, spent less of their income on gambling when they had fewer irrational gambling cognitions compared to those with more irrational cognitions. Third, irrational gambling cognitions moderated the relationship between risky gambling practices and tolerance. Of the people engaging in risky practices, those with no irrational cognitions reported lower levels of tolerance than those with at least one irrational cognition. Interactions with gender are reported and discussed. These findings demonstrate the importance of both gambling cognitions and gambling practices upon the intensity of gambling and pathological gambling.

The Prevalence and Course of Pathological Gambling in the Mood Disorders

The objective of the current investigation was to examine the prevalence of pathological gambling (PG) in a psychiatric sample with a history of mood disorder, and the concurrent and longitudinal association of PG and mood disorder symptoms according to retrospective report. A total of 275 (100 male, 175 female) psychiatric outpatients in Ontario, Canada, with a lifetime diagnosis of a depressive (n = 138) or bipolar disorder (n = 137), completed the Canadian Problem Gambling Index, South Oaks Gambling Screen and Longitudinal Interval Follow-up Evaluation. Correlational and cross-lagged panel analyses evaluated the relation between PG and mood disorder symptom course. The prevalence of PG was elevated within patients with a mood disorder; there was no difference across diagnosis. Concurrent PG and mood disorder symptoms were positively correlated; however, longitudinal analyses revealed no evidence for an association between PG and mood disorder symptoms when symptom stability was taken into account. Despite the elevated prevalence of PG within mood disorders, and the concurrent association between PG and mood disorder symptoms, no direct association was found between these types of pathology. Prospective designs and intervening variables are required to advance understanding of the etiological associations between these disorders.     

Italian Adolescent Gambling Behaviour: Psychometric Evaluation of the South Oaks Gambling Screen: Revised for Adolescents (SOGS-RA) Among a Sample of Italian Students

Since no Italian validated instrument focuses specifically on the measurement of pathological gambling in very young people, with this study, we aim to adapt an international instrument (SOGS-RA) and assess its psychometric properties in a sample (n = 14.910) of young Italian students aged between 15 and 19 years. Cross-cultural adaptation of the instrument was performed through translation, synthesis of translation, back-translation, expert committee review, and pre-testing. The kappa statistic for test–retest concordance ranged from 0.53 to 0.80. Internal validity was assessed by the MCA that identified one principal component with eigenvalue equal to 3,875: the Divgi index and very simple structure analysis also pointed out one common factor, so uni-dimensionality of the SOGS-RA was accepted. Moreover the SOGS-RA was found to have acceptable internal consistency (α = 0.780). Cronbach’s alpha was also assessed separately among males and females (respectively 0.786 and 0.707). The SOGS-RA was assessed in relation to gambling frequency, alcohol and drug use: Chi squared test revealed a strong association both for males and females with gambling frequency (p value ≤ 0.0001), frequent use of illicit drugs (for each drug p value ≤ 0.0001) and having had 3 or more occasions of binge drinking in the last month (p value ≤ 0.0001). At the end we can say that, the results of our study suggest that the SOGS-RA screen may be useful to assess at-risk or problem gambling for both genders in comprehensive youth surveys.