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.     

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.     

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.     

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.     

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.     

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.     

Attention-Deficit/Hyperactivity Disorder in Community College Students

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is often unrecognized and infrequently treated in community college students. Since students with disabilities including ADHD are more likely to attend a 2-year rather than a 4-year college and to drop out before graduating, this article describes current conceptualizations of adult ADHD for community college social workers, psychologists, faculty, counselors, and staff. It presents counseling and educational interventions, which can result in greater academic success and an increase in self-esteem for individual students, as well as an increase in retention rates for the college.     

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.     

Medication for Children with Attention-Deficit Hyperactivity Disorder

When making assessments and planning interventions, social workers adopt a biopsychosocial perspective. One important area where biologically based treatments influence psychosocial functioning is the area of psychopharmacology. However, even though many clients take medications, social workers often feel poorly prepared to address a subject that could be very important to their clients; that subject is the meaning of the medication to the client. The meanings that clients ascribe to medication can have a significant impact on medication adherence. Using attention-deficit/hyperactivity disorder (ADHD) to illustrate, I provide an overview of ADHD and common forms of treatment, discuss the possible meanings and acceptability of stimulant treatment for ADHD, provide practice guidelines for helping families reduce ambivalence about medication, present two clinical vignettes, and suggest resources for social workers and families.     

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.     

Not Just about Posttraumatic Stress Disorder: A Call for Military-Centric Social Work

Most warriors do not get PTSD but can still be affected by war. The “military gestalt,” defined as the complex myriad of “all things military” including the functions, processes, and human elements related to combat, is seriously impacted by the warrior-in-combat construct that is reflective of the person-in-environment construct. Thus, it suggests that problems within the gestalt can be understood and addressed from a military-centric social work perspective and approach. The situation is so insidious that it requires a call to action from all disciplines but, most important, for the social work profession to take the lead.     

Motherhood,Resistance and Attention Deficit Disorder: Strategies and Limits*

Étant donné son ambiguïté sur les plans culturel et historique, l'ap‐pellation psychiatrique de trouble déficitaire de I'attention (hyperac‐tivité) entraîne les mères dans un conflit avec les discours sur l'image de la bonne mère, la normativité familiale, les compétences profes‐sionnelles et la notion de risque. L'éude d entretiens avec 34 femmes au Canada et en Angleterre a permis de comprendre, du point de vue des femmes, les mécanismes de la connaissance et du pouvoir qui sous‐tendent les relations avec des professionnels de la médecine, de la psychiatrie et de l'éducation. Les mères se sont approprié une vaste gamme de méthodes discursives afin de se présenter elles et leur famille comme des personnes méritantes, louables et cultivées. Elles se sont engagées dans l'examen scrupuleux des méthodes éduca‐tionnelles et psychiatriques par l'intermédiaire du bénévolat, de la contribution à la conception de politiques, de la tenue de dossiers et du recours à des témoins externes afin de renforcer leur légitimité. Par ailleurs, de nombreuses femmes se sont engagées dans le jeu de la vérité, ont choisi la confrontation et, finalement, le refus. Toutefois, étant donné que des enfants vulnerables sont en jeu, la capacité des mères a résister véritablement reste limitée. The psychiatric category Attention Deficit Disorder (Hyperactivity), because of its cultural and historical ambiguity, brings mothers into conflict with discourses of good motherhood, family normativity, professional knowledge and risk. Interviews with 34 women in Canada and England were conducted as a way to understand, from women's perspectives, the workings of knowledge and power encountered in dealing with medical, psychiatric and educational professionals. Mothers took up a wide range of discursive practices in attempts to position themselves and their families as worthy, deserving and knowledgeable. They also engaged in scrutiny of educational and psychiatric practice through volunteering, policy contributions, record keeping and using outside witnesses to shore up their legitimacy. As well, many engaged in knowledge/truth games, confrontation and, ultimately, refusal. However, because vulnerable children are at stake, mothers' ability to truly resist remains limited.     

Assessing adult attention deficit hyperactivity disorder (ADHD) in the university setting

Objective: To address the increasing demand for assessments of Adult Attention Deficit Hyperactivity Disorder (ADHD), the primary author developed a protocol for Counseling and Psychological Services (CAPS) at Stanford University's Vaden Student Health Center to improve the efficiency of such evaluations. Participants: As part of quality assurance, we reviewed the charts of Stanford students who sought assessment for ADHD before the protocol was implemented (September 2011–June 2013) and after the protocol was established (October 2013–August 2014). An IRB exemption was obtained. Methods: The protocol includes questionnaires that solicit detailed clinical information from a variety of sources prior to the student's initial visit. Results: A peer chart review of 35 randomly selected charts showed that students completing the protocol are receiving a more thorough assessment. Conclusion: The new Stanford ADHD protocol, designed to improve clinic efficiency, also increases the availability of relevant clinical information.     

The Making of Multiple Personality Disorder: A Social Constructionist View

This article explores the social construction of multiple personality disorder by analyzing professional agreements about the nature of the diagnosis, while locating these within their historical and cultural context. First, a historical review of the disorder traces various overlapping streams of discourse that have shaped the construction of the diagnosis. This is followed by a cross-cultural comparison of MPD and dissociative phenomena in several non-Western societies. The article concludes with some reflections on the cultural meanings of MPD in contemporary America.     

Dysfunctional Career Thoughts and Perceived Quality of Parental Relationships in Adolescents With Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is known to cause significant difficulties in interpersonal relationships. Empirical research in career development has demonstrated that close, supportive relationships are associated with positive vocational behaviors (Kenny et al., 2018). We examined dysfunctional career thoughts and perceived quality of parental relationships in high school students with ADHD. One hundred two adolescents (76 boys, 26 girls) with ADHD responded to measures of career thoughts and interpersonal relationship quality. Preliminary exploratory analysis, using multiple linear regression, showed that male participants' dysfunctional career thoughts were statistically significantly related to their relationships with their mothers. For female participants, relationships with fathers represented an area for further exploration. Results suggest that career professionals can enhance positive outcomes of decision-making and problem-solving issues in adolescence with additional focus on relational interventions. Future research should incorporate the influence of gender and race/ethnicity on crucial relationships and focus on paternal relationships using cognitive information processing–based interventions with this population.