Sugar highs, birthday party frenzies and playground hysterics: These are rites of passage for children. Some, however, suffer from more than situational behavior disruptions. According to the National Institute of Mental Health, the NIMH, attention deficit/hyperactivity disorder, ADHD, remains the most common mental disorder of childhood and adolescence, also affecting 4.1 percent of adults in a given year. No single cause exists for ADHD, and scientists think it is a result of a combination of environmental, biochemical and genetic factors.
Significance
Undiagnosed, ADHD can be mistaken for emotional or disciplinary problems. Michael Bloomquist, director of the Attention and Behavior Problems Clinic at the University of Minnesota, warns that poor self-control can lead to problems in academic and social functioning, and can progress to more severe disorders. In 2004, Dr. Jonna Kuntsi at the Institute of Psychiatry at King's College in London found that those with ADHD scored an average of nine points lower than those without ADHD on IQ tests. A 2002 study led by Erik Willcutt at the Institute of Behavioral Genetics, and published in the American Journal of Medical Genetics, noted that reading disabilities and ADHD commonly occur together. ADHD also often coexists with anxiety and depression, Tourette's syndrome, sleep disorders, bed-wetting and substance use. Wendy Richardson, author of "ADHD and Addiction," notes that like addiction, ADHD affects every member of the family.
Identification
Childhood ADHD inattentive symptoms can include: being easily distracted; forgetting; having difficulty focusing; trouble organizing and completing tasks; daydreaming and moving slowly. Hyperactive and impulsive symptoms can include: fidgeting, talking nonstop, having difficulty staying seated, impatience and blurting out inappropriate comments. Adults may have similar symptoms, in addition to a history of failure at school, problems at work or difficult relationships. Although adults may not acquire a diagnosis until adulthood, their symptoms will have been present since childhood. Both children and adults require proper evaluation by a licensed mental health professional to insure accurate diagnosis and treatment.
Causes
No single cause for ADHD exists. The NIMH notes that a combination of genetic and environmental factors, such as genes, brain injuries, toxins and nutrition may contribute to ADHD. Research does support a strong neurobiological basis for ADHD. Research conducted in 2005 by Dr. Stephen V. Faraone, director of Medical Genetics Research at the State University of New York, and a 2005 review of the literature published in Current Psychiatry Reports on ADHD and genetics by Faraone and Dr. Sajjad Khan, show that ADHD often runs in families. Estimates indicate a 30 percent chance of a child with ADHD having a parent with it. Sponsored by the National Institute of Mental Health, Phillip Shaw, M.D., conducted a study in 2007 that demonstrated that those with a particular version of a particular gene had thinner brain tissue in areas associated with attention deficit. The National Center for Biotechnology Information cites more than 40 studies identifying genetic mutation and chromosomal associations with ADHD. Imaging studies indicate difference in brain glucose metabolism in those with ADHD. Environmental factors also matter. The NIMH lists studies suggesting a potential link between cigarette smoking and alcohol use during pregnancy and ADHD. Preschoolers exposed to high levels of lead also may be at higher risk. Behavior of those with brain injuries mimics ADHD behavior, suggesting a possible relation. Food additives, such as artificial flavors or colors, remain another potential source of hyperactive behavior.
Misconceptions
Contrary to popular belief, three studies published in professional journals in 1994 discount the myth that sugar worsens ADHD. Children and adults with ADHD are not merely misbehaving or stubborn. Medications that increase levels of dopamine and norepinephrine help reduce impulsivity and hyperactivity, suggesting a biochemical determinant to their behavior. ADHD is not a result of poor discipline or bad parenting. According to the Metro Area Adult ADHD Network, MAAAN, family interaction research led by Dr. Russell Barkley, currently clinical professor of psychiatry at the Medical University of South Carolina and an internationally recognized ADHD expert, found that simply adding more discipline without other intervention actually worsened ADHD symptoms.
Solutions
Medication and psychotherapy remain the most common and effective treatments for ADHD. With proper treatment, those with ADHD have a lower risk of alcohol and drug problems than they would without intervention for ADHD. Children with ADHD generally don't outgrow it. Seventy percent of children with ADHD have symptoms that extend into adolescence, and 15 percent to 50 percent exhibit symptoms into adulthood. Continued and refined research will help delineate the causes of ADHD, leading to proper diagnosis, early intervention and critical treatment to reduce disability for those who suffer from it.
References
- NIMH: The Numbers Count: Mental Disorders in America
- NIMH: Attention Deficit/Hyperactivity Disorder
- "Skills Training for Children With Behaivor Problems"; Michael Bloomquist, PhD.; 2006
- National Center for Biotechnology Information: ADHD
- AD/HD and Addiction: ADD and the Family
