What Is Adhd?

ADHD

ADHD

What is ADHD?

The DSM-5 defines ADHD as, “a persistent pattern of inattention and, or, hyperactivity and impulsivity that interferes with functioning or development.”  (American Psychiatric Association, 2013)  People who have ADHD fall into one of the three subtypes: Inattentive (ADHD-IA), hyperactive-impulsive (ADHD-HI), and combined (ADHD-C): inattentive and hyperactive-impulsive.  There are nine symptoms in each of the first two subtypes. To qualify for an ADHD diagnosis, five symptoms must be present six months for an adolescent or adult and six symptoms present for a child.  The symptoms determine which of the three subtypes assigned.

Inattention is a behavior, which is characteristic of being distractible due to an inability to sustain focus on the task.  Examples include daydreaming, forgetfulness, and getting lost.  Hyperactivity is excessive and often inappropriate physical activity.  Examples include fidgeting, tapping, talking excessively, squirming in one’s seat, and running when walking is appropriate.  Impulsive behavior is behavior motivated by the pursuit of immediate gratification.  Examples include interrupting others, failing to wait one’s turn, saying something one later regrets, doing things that others judge to be dangerous risky, and not giving thought to the consequences of one’s actions. (APA, 2013).

The ICD 10’s related classification is Hyper Kinetic Conduct Disorder (HKD).  This classification is similar to (-C) but not (-IA), or (-HI) in the DSM. “HKD delineates a group that has more neurodevelopmental, academic and cognitive impairment than those meeting criteria for ADHD.” (Lee et al., 2008, p. 71)  As the result of stricter guidelines than the DSM versions, HKD classifies individuals whose behavior is further along the continuum, and are, therefore, more disruptive.  The more disruptive and severe behavior of HKD results in less prevalence, the less positive prognosis, and the greater areas of dysfunction, distress, and the greater negative impacts on self and society.  Issues exist when making a relation between statistics gathered from populations diagnosed under separate guidelines.

Causes of ADHD?

“Evidences from family, twin, adoption and association studies consistently indicate that genetic factors play a substantial role in the etiology of ADHD with a mean heritability estimate of 76%.” (Li, Chang, Zhang, Gao, Wang, 2014)  ADHD is a heritable disorder so we must look at the genetics and the environment for its cause.  AN ADHD child inherits from his parents, genes and an environment suited for their expression.  The majority of biologic risks, which increase a child’s risk for the development of ADHD, reflect common prenatal risk for detrimental genetic expression, such as, smoking while pregnant and low birth weight. (APA, 2014)  A child’s social environment is a strong risk factor for the expression of ADHD associated symptoms (behaviors). (Harold, Leve, Barret, Elam, Neiderhiser, et al., 2013)  It is possible that Genetics predisposes an individual to the risk of developing ADHD, and the social environment (particularly the family) encourages the development of symptoms.