Facts about ADHD: What Everyone Needs to Know
Since in the opening words of a book with the same title as my blog, and which I highly recommend, “Attention-Deficit/Hyperactivity Disorder (ADHD) seems to be everywhere these days” (Hinshaw & Ellison, 2016, xv), it is important for anyone who is interested in the mental health of children to have a grasp of the some of basic facts of ADHD. This blog, in a series of 3 presentations, will highlight some of the most important facts. For a more in depth discussion, the reader should consult the Hinshaw and Ellison book. This blog will focus on answering 2 basic questions: What is ADHD? And, How Widespread is it?
What is ADHD?
In a nutshell, ADHD is a neurodevelopmental disorder that can result in a number of symptoms in two major groupings: inattention/disorganization and impulsivity/hyperactivity. Neurodevelopment means that the disorder is primarily caused by genes and typically manifests during the child development period, i.e., by age 12. Contrary to some musing in the popular press, the validity of ADHD as a real disorder has been established by numerous scientific studies. Like other mental disorders such as depression and many medical disorders (e.g., high blood pressure), ADHD symptoms vary along a spectrum of number and severity. It is only when the signs of ADHD reach a sufficient level to cause impairment in child’s functioning that a diagnosis is made. Also, and most importantly, symptoms such as inattention can vary markedly depending upon level of interest in the activity in which the child is engaging, e.g., homework or computer games. Hence an ability to focus for an extended period of time on some activities does not rule out ADHD. Lastly, with regard to symptoms, one of the foremost authorities on ADHD, Russell Barkley (2015), has made a strong case for symptoms of emotional impulsivity (e.g., low frustration tolerance, impatience, easily angered, emotional over-reaction) being as central to ADHD as the classic symptoms involving inattention/disorganization and impulsivity/hyperactivity.
How Widespread/Prevalent is ADHD in the United States Today for Juveniles and Adults?
This is a vexed question since prevalence estimates for juveniles (5-17) can vary markedly from 5% to 12% depending upon the methodology of the study. Furthermore, it is important to distinguish between true prevalence (i.e., the percentage of juveniles who truly have ADHD), as distinct from diagnosed prevalence, i.e., the percentage who have received a diagnosis from a clinician, whether or not the diagnosis is accurate. If the methodology is a response by parents to the question “Has a doctor or health professional even told you that your child has ADHD?,” the prevalence is 12%, with boys being approximately 2 to 3 times more likely to have the diagnosis than girls, i.e., 16.5% vs. 7.3% (Collins & Cleary, 2016). There are also ethnic differences with, for example, the Hispanic prevalence being 7.7%. The 12% estimate is probably too high, since, despite some under diagnosis, it is likely that ADHD is being over diagnosed largely because of superficial diagnostic procedures. This problem will be discussed in another blog.
With regard to adult prevalence, there is far less research with a commonly accepted prevalence being 5%. In contrast to the sex difference among juveniles, if anything, there might be a greater prevalence of ADHD among women based upon formal diagnosis by a clinician. However, since women might be more likely to seek out help for problems that can be diagnosed as ADHD, this difference may not be real. Lastly, since the criteria for diagnosing ADHD in adulthood are exactly the same as juvenile criteria, there is concern that these criteria are not appropriate and hence, in contrast to juveniles, there may be an under diagnosis of ADHD.
The next blog will discuss causes of ADHD and how ADHD changes over the life span.
Written by Robert Eme, Ph.d
References : Collins, K., & Cleary, S. (2016). Racial and ethnic disparities in parent-reported diagnosis of ADHD. Journal of Clinical Psychiatry, 77, (1), 52-59.
Barkley, R. (2015). Attention-Deficit/Hyperactivity Disorder, (4th ed.): A handbook for diagnosis and treatment. Guilford Press. ISBN-13:978-1-59385-210-8
Hinshaw, S., & Ellison, K. (2016). ADHD: What everyone needs to know. New York: Oxford University Press. ISBN-13: 978-0190223793
The information and opinions expressed herein represent the independent opinions and ideas of the faculty and do not represent the opinions and ideas of Argosy University.