Girls with ADHD More Prone to Self-Harm, Suicide in Later Years

by Traci Pedersen on August 16th, 2012

Girls with ADHD More Prone to Self-Harm, Suicide in Later YearsAs girls with ADHD become adults, they are especially prone toward internalizing their problems and feelings of inadequacy — that in turn can lead to self-injury and even attempted suicide, according to new findings from the University of California, Berkeley.

In the US, over 5 million children (about one in 11) ages 3-17 have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. The disorder is characterized by distractibility, poor concentration, impulsiveness and hyperactivity.

The research was based on the  largest-ever sample of girls whose ADHD was first diagnosed in childhood.

“Like boys with ADHD, girls continue to have problems with academic achievement and relationships, and need special services as they enter early adulthood,” said lead study author Stephen Hinshaw, UC Berkeley professor of psychology.

“Our findings of extremely high rates of cutting and other forms of self-injury, along with suicide attempts, show us that the long-term consequences of ADHD females are profound,” he added.

The findings are consistent with previous research by the UC Berkeley team showing that, as girls with ADHD get older, they exhibit fewer visible symptoms of the disorder, but continue to suffer in less visible ways.

The study challenges the idea that girls can “outgrow” ADHD, and highlights the need for long-term monitoring and treatment of the disorder, said Hinshaw.

Beginning in 1997, Hinshaw and his colleagues followed a racially and socio-economically diverse group of girls (ages 6-12) with ADHD in the San Francisco Bay Area through early childhood summer camps, adolescence and now early adulthood.

Ten years later, 140 of the girls were given an evaluation, ages 17-24, in which researchers compared their behavioral, emotional and academic development to that of a demographically similar group of 88 girls without ADHD.

The study also measured the symptoms of two major ADHD subtypes: those who entered the study with poor attention alone versus those who had a combination of inattention plus high rates of hyperactivity and impulsivity.

Most importantly, researchers found that the girls with combined inattention and hyperactivity-impulsivity during childhood were significantly more likely to attempt self-injury and suicide in early adulthood.

Furthermore, over half of the members of this group were reported to have engaged in self-injurious behavior, and more than one-fifth had attempted suicide, Hinshaw said.

“A key question is why, by young adulthood, young women with ADHD would show a markedly high risk for self-harm. Impulse control problems appear to be a central factor,” said the authors.

In the first study on this group, published in 2002, the 6- to- 12-year old girls attended five-week camps where they were closely watched as they engaged in art and drama classes and outdoor activities.

Girls who had been taking ADHD medication volunteered to go off the drug treatment for much of the summer camp study. The counselors and staff observing all the participants were not informed as to which girls had been diagnosed with ADHD.

According to the findings, girls with ADHD were more likely to struggle academically and to be rejected by the other kids, compared to the comparison peer group.

When these girls were 12 to 17 and experiencing early to mid-adolescence, the fidgety and impulsive symptoms seemed to drop. But the learning gap between these girls and their non-ADHD peers had widened, and eating disorders and substance abuse had also come into play.

For the latest study, in which 95 percent of the original sample of girls participated, the researchers interviewed the participants and their families about behaviors such as self-harm and suicide attempts, drug use, eating habits and driving behavior.

“The overarching conclusion is that ADHD in girls portends continuing problems, through early adulthood,” said the authors.

“Our findings argue for the clinical impact of ADHD in female samples, the public health importance of this condition on girls and women, and the need for ongoing examination of underlying mechanisms, especially regarding the high risk of self-harm in young adulthood.”

Hinshaw also added, “ADHD is a treatable condition, as long as interventions are monitored carefully and pursued over a number of years.”

The study is published in the Journal of Consulting and Clinical Psychology.

Source:  University of California, Berkeley


Depressed and anxious young woman photo by shutterstock.

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Colleges Gear Up to Help Students with ADHD

by Rick Nauert PhD on August 3rd, 2012

Colleges Gear Up to Help Students with ADHDSummer is winding down and colleges are ramping up for a new influx of recent high school graduates.

Given the steady increase in students diagnosed with attention-deficit hyperactivity disorder (ADHD), some colleges are proactively developing programs to help the student make a successful transition to college.

Attention-deficit hyperactivity disorder, or ADHD, affects 1 to 4 percent of college students, according to national studies. For freshmen with ADHD, the transition to college can be especially difficult.

Many previous studies have shown ADHD among college students can be a serious disorder that is an everyday struggle.

Kristy Morgan, a recent Kansas State University doctoral graduate in student affairs and higher education, studied how students with ADHD make the transition from high school to college.

“Nobody had really studied the transition from high school to college,” Morgan said.

“Transitions can be the toughest time for people. This can be especially true when the transition is from the home environment where parents have been involved in daily plans, schedules and medication.”

“Kristy’s research is an important contribution to understanding and facilitating the transition to college for students with ADHD,” said Kenneth Hughey.

“The results and the recommendations that followed are intended to help students with ADHD make a successful transition, their parents as they support their children in the transition, and student affairs professionals who work with the students once they are on campus.”

In her small exploratory study, Morgan interviewed eight freshmen — four men and four women — to talk about their transition during their first semester of college. The freshmen were all living on campus and were at least an hour away from home.

Morgan found a common thread among these students with attention deficit disorder was a failure to adequately plan their college transition.

The students did not factor ADHD into their decision-making about college, but rather chose a college based on how the campus felt, the reputation of the school or that it was where they had always wanted to attend.

“Most of the students found college to be tougher than they had expected,” Morgan said. “Even with the availability of resources, they still felt overwhelmed with accessing these resources.”

Morgan found that preplanning was a significant factor for success. Students who had established an ADHD management strategies — such as ways to keep a schedule or study for tests were able to adjust to the new college life — while students who did not have strategies in place before they went to college, felt overwhelmed.

“A big struggle for students was adjusting to increased freedom and increased responsibility,” Morgan said.

“They anticipated loving the freedom of college and being away from their parents. But they also realized that college required responsibility and that responsibility was overwhelming to them.”

Morgan was amazed to find that parents were very involved in the transition from home to college. She discovered that some parents were instrumental for students’ college activities — they served as alarm clocks, organized their rooms and continued to manage medical care.

“The parents filled prescriptions and contacted doctors even while the student was at college, which was surprising to me,” Morgan said. “The students really did not handle it independently.”

Morgan discovered the reliance on parents became a negative as students often lacked basic knowledge of ADHD and how their medication worked. However, students did understand that medication was crucial to their success in college because they needed it to help focus during lectures and studying time.

“There were some students who took medication sporadically prior to college,” Morgan said. “They realized that to be successful in college, their medication moved from optional to mandatory.”

Morgan discovered that side effects influenced how often students took medication. For example, some students would not take medication because they felt it made them not as fun in social situations.

The women in the study were more likely to consistently take medication because it helped suppress their appetites and manage weight. The men were more likely to skip their medication to have a good time.

Helping Students with ADHD

The findings suggest that a combined effort between families, students and the university staff is needed to help students with ADHD adjust and succeed in college.

Morgan has developed the following recommendations for universities and families to support college students who have ADHD:

  • Families should inform students about their diagnoses. All too often, families have not educated students with ADHD because they think it might be just a childhood condition that they will outgrow.
  • Universities can streamline processes and make it easier for students to access resources. Students with ADHD are not likely to wait in long lines or fill out a lot of paperwork for resources.
  • Academic advisers can help students carefully structure their schedules for success. Many students with ADHD benefit when classes are scheduled close to each other, rather than spread out during an entire day. Advisers can also help students schedule classes with engaging professors and in rooms that have few distractions, such as windows or high-traffic hallways.

Source: Kansas State University

Young college student with books photo by shutterstock.

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Delay in Brain Development Associated with ADHD

by Rick Nauert PhD on July 31st, 2012

Delay in Brain Development Associated with ADHDA new NIH study suggests a delay in brain development, rather than a total alteration in normal development, is the instigating factor for attention-deficit/hyperactivity disorder (ADHD).

In the current investigation, researchers expanded an earlier study that found thickening of the brain’s cerebral cortex is delayed in children diagnosed with ADHD.

The cerebral cortex is the folded gray tissue that makes up the outermost portion of the brain, covering the brain’s inner structures. This tissue has left and right hemispheres and is divided into lobes.

Each lobe performs specific and vitally important functions, including attention, cognition, language, and sensory processing.

Two dimensions of this structure are cortical thickness and cortical surface area, both of which mature during childhood as part of the normal developmental process.

In the study, published in Biological Psychiatry, researchers set out to measure whether surface area development is delayed in a similar manner to the thickening process. To do this they recruited 234 children with ADHD and 231 typically developing children.

Each child was scanned with neuroimaging equipment up to four times. The first scan was taken at about age 10, and the final scan was around age 17.

Using advanced neuroimaging technology, researchers were able to map the trajectories of surface area development at over 80,000 points across the brain. They found that the development of the cortical surface is delayed in frontal brain regions in children with ADHD.

For example, the typically developing children attained 50 percent peak area in the right prefrontal cortex at a mean age of 12.7 years, whereas the ADHD children didn’t reach this peak until 14.6 years of age.

“As other components of cortical development are also delayed, this suggests there is a global delay in ADHD in brain regions important for the control of action and attention,” said Dr. Philip Shaw, a clinician studying ADHD at the National Institute of Mental Health and first author of this study.

“These data highlight the importance of longitudinal approaches to brain structure,” commented Dr. John Krystal, Editor of Biological Psychiatry. “Seeing a lag in brain development, we now need to try to understand the causes of this developmental delay in ADHD.”

Investigators believe the finding suggests genes that control the timing of brain development are linked to development of ADHD.

As such, Shaw believes researchers should “search for genes that control the timing of brain development in the disorder, opening up new targets for treatment.”

Source: Elsevier

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Monkey Study Suggests Long-Term ADHD Drug Use Appears Safe

by Janice Wood on July 19th, 2012

Monkey Study Suggests Long-Term ADHD Drug Use Appears SafeDrugs used to treat Attention Deficit Hyperactivity Disorder (ADHD) do not appear to have long-term effects on the brain, according to new research done with monkeys.

Between 5 to 7 percent of elementary school children are diagnosed with ADHD, according to researchers from the Wake Forest Baptist Medical Center who undertook the new study.

Many of these children are treated with psychostimulant drugs, and while doctors and scientists know a lot about how these drugs work and their effectiveness, little is known about their long-term effects, the researchers note.

The research team, headed by Linda Porrino, Ph.D., professor and chair of the Department of Physiology and Pharmacology, and fellow professor Michael A. Nader, Ph.D., conducted a study with monkeys to determine what the long-lasting effects may be.

“We know that the drugs used to treat ADHD are very effective, but there have always been concerns about the long-lasting effects of these drugs,” she said. “We didn’t know whether taking these drugs over a long period could harm brain development in some way or possibly lead to abuse of drugs later in adolescence.”

The researchers studied 16 monkeys, whose ages were equivalent to 6- to 10-year-old humans. Eight animals were in the control group that did not receive any drug treatment. The other eight were treated with a therapeutic-level dose of an extended-release form of Ritalin or methylphenidate (MPH) for over a year, which is equivalent to about four years in children.

Imaging of the monkeys’ brains, both before and after the study, was conducted on both groups to measure brain chemistry and structure. The researchers also looked at developmental milestones to address concerns that ADHD drugs adversely affect physical growth.

Once the drug treatment and imaging studies were concluded, the monkeys were given the opportunity to self-administer cocaine over several months. Nader measured their propensity to acquire the drug and looked at what amounts to provide an index of vulnerability to substance abuse in adolescence.

The researchers found that there were no differences between the two groups — monkeys treated with Ritalin during adolescence were not more vulnerable to later drug use than the control animals.

“After one year of drug therapy, we found no long-lasting effects on the neurochemistry of the brain, no changes in the structure of the developing brain. There was also no increase in the susceptibility for drug abuse later in adolescence,” Porrino said.

“We were very careful to give the drugs in the same doses that would be given to children. That’s one of the great advantages of our study is that it’s directly translatable to children.

The research was conducted simultaneously with a “sister study” at John Hopkins with slightly older animals and different drugs and their findings were similar, she added.

“We feel very confident of the results because we have replicated each other’s studies within the same time frame and gotten similar results,” she said. “We think that’s pretty powerful and reassuring.”

This study is published online in the journal Neuropsychopharmacology.

Source: Wake Forest Baptist Medical Center

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Timing of ADHD Meds Influences Academic Performance

by Rick Nauert PhD on June 26th, 2012

Timing of ADHD Meds Influences Academic PerformanceNew research has found a correlation between the age at which children with attention-deficit hyperactivity disorder (ADHD) begin taking medication, and how well they perform on standardized tests.

Researchers from the Mount Sinai School of Medicine and University of Iceland discovered medication initiation during the fourth grade was linked to better academic performance than when ADHD meds were started in the sixth or seventh grade.

The study appears in the journal Pediatrics.

Researchers studied 11,872 Icelandic children born between 1994 and 1996. The children started medication for ADHD at different times between fourth and seventh grades.

The findings showed that children who began drug treatment within 12 months of their fourth-grade test declined 0.3 percent in math by the time they took their seventh-grade test, compared with a decline of 9.4 percent in children who began taking medication 25-to-36 months after their fourth-grade test.

The data also showed that girls benefited only in mathematics, whereas boys had marginal benefits in math and language arts.

“Children who began taking medications immediately after their fourth-grade standardized tests showed the smallest declines in academic performance,” said the study’s lead author Helga Zoega, Ph.D.

“The effect was greater in girls than boys and also greater for children who did poorly on their fourth grade test.”

While the use of medications for ADHD is relatively widespread in America (and to a lesser degree in Iceland), research tracing the stimulant use and academic performance is limited.

Source: The Mount Sinai Hospital / Mount Sinai School of Medicine

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Memory Practice Does Not Help ADHD or Improve IQ

by Rick Nauert PhD on June 1st, 2012

Memory Practice Does Not Help ADHD or Improve IQMemory training does not appear to be helpful for children suffering from dyslexia or attention-deficit/hyperactivity disorders.

Researchers also determined memory practice does not appear to provide significant benefit to healthy adults who want to improve school performance or enhance their cognitive skills.

“The success of working memory training programs is often based on the idea that you can train your brain to perform better, using repetitive memory trials, much like lifting weights builds muscle mass,” said the study’s lead author, Monica Melby-Lervåg, Ph.D., of the University of Oslo.

“However, this analysis shows that simply loading up the brain with training exercises will not lead to better performance outside of the tasks presented within these tests.”

The study is found online in the journal Developmental Psychology.

Working memory enables people to complete tasks at hand by allowing the brain to retain pertinent information temporarily. Activities to train working memory generally involve trying to get people to remember information presented to them while they are performing distracting activities.

For example, participants may be presented with a series of numbers one at a time on a computer screen. The computer presents a new digit and then prompts participants to recall the number immediately preceding. More difficult versions might ask participants to recall what number appeared two, three or four digits ago.

In the current review, researchers from the University of Oslo and University College London examined 23 peer-reviewed studies with 30 different comparisons of groups that met their criteria.

The studies were randomized controlled trials or experiments that involved some sort of working memory treatment and a control group. The studies involved a variety of participants including young children, children with cognitive impairments, such as ADHD, and healthy adults. Most of the studies had been published within the last 10 years.

Comparing and consolidating multiple studies in the form of a meta-analysis improves generalizability of the research, helping to translate research findings into practical advice.

Researchers determined that working memory training improved performance on tasks related to the training itself, but did not have an impact on more general cognitive performance such as verbal skills, attention, reading or arithmetic.

“In other words, the training may help you improve your short-term memory when it’s related to the task implemented in training, but it won’t improve reading difficulties or help you pay more attention in school,” said Melby-Lervåg.

The findings cast a dark shadow on the commercial, computer-based working memory training programs that conceptually have been developed to benefit students suffering from ADHD, dyslexia, language disorders, poor academic performance or other issues.

Some of the software claim to boost people’s IQs. These programs are widely used around the world in schools and clinics, and most involve tasks in which participants are given many memory tests that are designed to be challenging, the study said.

“In the light of such evidence, it seems very difficult to justify the use of working memory training programs in relation to the treatment of reading and language disorders,” said Melby-Lervåg.

“Our findings also cast strong doubt on claims that working memory training is effective in improving cognitive ability and scholastic attainment.”

Source: American Psychological Association

Memory mind illustration photo by shutterstock.

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Change of Diet Helps Some Kids with ADHD

by Rick Nauert PhD on April 25th, 2012

Change of Diet Helps Some Kids with ADHDA new report suggests a change in diet can relieve attention deficit hyperactivity disorder (ADHD) symptoms in some children.

ADHD is a developmental disorder characterized by the co-existence of attention problems and hyperactivity with symptoms typically beginning before the age of seven. ADHD is believed to affect about 3 to 5 percent of children globally and is diagnosed in about 2 to 16 percent of school aged children.

Although more research is necessary, some studies show that by changing their diet, it is possible to improve the condition for some ADHD children, said Kim Fleischer Michaelsen, Ph.D., from the Department of Human Nutrition at the University of Copenhagen.

“Several of the studies show, for example, that fatty acids from fatty fish moderate the symptoms. Other studies detect no effect. Elimination diets are also promising. These look at whether there is anything in the diet which the children cannot consume without adverse side effects.

“However, we still lack knowledge about which children with ADHD benefit from dietary changes, how positive the effect is in the long term and what the changes mean for children’s health.”

In the research report, investigators found that not all ADHD children benefit from changes to their diet, and that there are still many unknown factors. This finding is consistent with the premise that multiple factors may contribute to ADHD development.

Tine Houmann, M.D., a consultant at the Centre for Child & Adolescent Psychiatry, said:

“There are different types of ADHD, and the disturbance is probably due to both genetic and environmental factors. We know that children with ADHD react very differently to both medication and dietary changes. We therefore need to study which children benefit from dietary changes, and whether we can identify genetic or environmental factors that can predict this.”

Researchers believe future studies will allow clinicians to reduce the use of medications and/or substitute dietary advice for some children.

“It is promising that many research results indicate that dietary changes can help some ADHD children. However, it is crucial that bigger studies on dietary changes are conducted on children with ADHD to see how effective this is and how long the benefits last,” said Michaelsen.

Researchers stress that parents should always seek professional advice before changing their children’s diet.

Source: University of Copenhagen

Child in school balancing a pencil on his nose photo by shutterstock.

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ADHD Drug Shortage to End Soon

by Psych Central News Editor on April 6th, 2012

ADHD Drug Shortage to End SoonAfter months of Americans being unable to fill their drug prescriptions for medications that are commonly used to treat attention deficit hyperactivity disorder (ADHD), the U.S. Food and Drug Administration (FDA) said yesterday that the shortages are expected to end this month.

Many ADHD medications, such as Adderall, have been in short supply since 2011.

Two federal government agencies have been finger-pointing to lay the blame. The Drug Enforcement Administration (DEA) has the final say over the active ingredients in many ADHD medications, however, because the active ingredients are considered controlled substances. Active ingredients include amphetamine salts and methylphenidate.

The FDA only oversees the safety and efficacy of prescription drugs in the U.S.; it has no control over drug availability.

In 2011, the DEA steadfastly refused to raise the annual manufacturing quotas of these ingredients, suggesting it was the manufacturers to blame for the shortages. In January 2012, the DEA finally relented after increasing public pressure to fix the shortage, and raised manufacturers’ quotas by one-third.

The problem resulted in a shortage of lower-dose ADHD drugs, such as 5 mg pills and too many larger-dose versions of ADHD medications being available on the market that couldn’t be split into smaller doses.

In continuing to lay the blame at the feet of manufacturers, a DEA spokesperson said, “Companies take their allotments and produce various sorts of Adderall-type products — extended relief, extra strength — in different amounts.

“Sometimes their calculations are not what they had hoped.”

The DEA apparently assumes market conditions for medications remains static and has no allowances for market shortages.

The symptoms of attention deficit disorder include inattention, impulsivity and hyperactivity, or a combination of these. They must occur in more than one setting (e.g., at work or school and at home), and the symptoms usually must be present for more than six months in order for a diagnosis of ADHD to be made.

There are two options for people looking to fill their ADHD prescription. One is to call around to different pharmacies and drugstores, as you may find a pharmacy that has access to the drug while another one does not.

Second is to talk to your doctor about switching to a different ADHD medication in the meantime, as some medications are more readily available than others.

Source: FDA

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Multiple Forms of ADHD?

by Rick Nauert PhD on April 3rd, 2012

Multiple Forms of ADHD?New research may help explain the dramatic increase in attention-deficit hyperactivity disorder cases. The answer, according to Oregon Health & Science University researchers, is that ADHD is more than one disorder.

Investigators believe ADHD symptoms may actually represent an entire family of disorders, similar to the classification of various subtypes of cancer.

The research, which highlights various versions of the disease, each with differing impacts, demonstrates that there is likely not going to be a “one-size-fits-all” approach to treating patients.

Experts believe that new methods will be required to improve the diagnosis, prognosis and treatment of the disease.

Researchers believe scientists will need to shift their thinking when it comes to conducting research. New objectives should be directed at understanding the cause and impacts of ADHD. Moreover, experts believe that child behaviors should be examined in a more comprehensive format including non-affected children as well.

The research, led by OHSU scientists Damien Fair, Ph.D., and Joel Nigg, Ph.D., will be published online this week in the Proceedings of the National Academy of Sciences.

“Traditionally, physicians and psychologists have diagnosed patients through the use of the Diagnostic and Statistical Manual of Mental Disorders, commonly known as the DSM,” explained Fair. “The problem with this approach is that it often relies on secondary observations of parents or teachers, where even if the descriptions are accurate, any given child may be behaving similarly, but for different reasons. Just as if there might be many reasons why someone might have chest pain, there might be many reasons why a child presents with ADHD.

“However, unlike diagnosing countless other well-understood diseases, there is no one test that can differentiate individuals when it comes to psychiatric and developmental conditions like ADHD.

“The data here highlights ways to recognize such individual variability and shows promise that we might be able to identify why any given child presents with ADHD, thus allowing for future examinations of more personalized treatments.”

In the study, Fair, Nigg and colleagues used an approach to isolate ADHD’s variations to allow a better understanding of the various disorder permutations. Their methodology compared test results for several cognitive skills among a large sampling of ADHD patients and a control group. The testing focused on memory, inhibition, attention, comprehension, and several other categories.

“We have known for some time that there is wide performance variation in both the ADHD group and the control group,” explained Nigg, “but this has never been formally described.”

Although, overall, the ADHD group did more poorly than the control group on all the measures, they noted that in some areas, certain control group patients outperformed the ADHD patients.

However, in those same areas, other ADHD patients outperformed the control group. Simply put, not all study participants – ADHD and control – consistently showed the same strengths and weakness.

Furthermore, researchers found that ADHD patients can be subcategorized depending on their deficits and relative strengths, showing unique subgroups among all children with ADHD.

Researchers believe some of the testing methods may lead to a more precise way in which to sub-categorize and perhaps diagnose children with ADHD. Psychologists and physicians could provide patients with a series of cognitive tests, determine their strengths and weaknesses, and subcategorize them based on these traits.

Source: Oregon State University

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Is ADHD Overdiagnosed?

by Rick Nauert PhD on April 2nd, 2012

Is ADHD Over-diagnosed?Depending on whom you ask, attention-deficit hyperactivity disorder (ADHD) is either over- or underdiagnosed. A new European study weighs in on the question suggesting gender, both of the clinician and of the client, plays a significant role in the diagnosis.

German researchers from Ruhr-Universität Bochum (RUB) and University of Basel  believe the study shows that child and adolescent psychotherapists and psychiatrists tend to give a diagnosis based on heuristics or rules of thumb, rather than adhering to recognized diagnostic criteria. This suggests that ADHD is over-diagnosed.

Clinical psychologists Drs. Silvia Schneider and Jürgen Margraf (both from RUB) and Dr. Katrin Bruchmüller (University of Basel) believe that boys in particular are substantially more often misdiagnosed compared to girls.

In the study, researchers presented one of four available case vignettes to 473 child and adolescent psychotherapists and psychiatrists across Germany. The practitioners were asked to give a diagnosis and a recommendation for therapy.

In three out of the four case vignettes, the described symptoms and circumstances did not fulfill ADHD criteria. Only one of the cases fulfilled ADHD criteria based strictly on the valid diagnostic criteria. In addition, the gender of the child was included as a variable resulting in eight different case vignettes.

As the result, when comparing two identical cases with a different gender, the difference was clear: Sam has ADHD, Sarah doesn’t.

The researchers believe that many child and adolescent psychotherapists and psychiatrists seem to proceed heuristically and base their decisions on prototypical symptoms. The prototype is male and shows symptoms such as motoric restlessness, lack of concentration and impulsiveness.

In connection with the gender of the patient, these symptoms lead to different diagnoses. A boy with such symptoms, even he does not fulfill the complete set of diagnostic criteria, will receive a diagnosis for ADHD, whereas a girl will not.

Also the therapist’s gender plays a role in the diagnostic: Male therapists give substantially more diagnoses for ADHD than their female counterparts.

In Europe, as in the U.S., diagnoses for ADHD have exploded over the past two decades. Between 1989 and 2001, the number of diagnoses in German clinical practice increased by 381 percent.

The costs for ADHD medication, such as for the performance-enhancing psychostimulant methylphenidate (Ritalin), have grown nine times between 1993 and 2003. In Germany, the government health insurance company, Techniker, reports an increase of 30 percent in methylphenidate prescriptions for its clients between the ages of 6 and 18. Similarly, the daily dosage has increased by 10 percent on average.

Researchers say that despite these statistics, there is a remarkable lack of research on the diagnostics of ADHD. In spite of strong public interest, very few empirical studies have addressed the issue, Schneider and Bruchmüller noted.

Nevertheless, the current study shows that in order to avoid a misdiagnosis of ADHD and premature treatment, it is crucial for therapists not to rely on intuition but strictly adhere to well-defined, established diagnostic criteria.

The researchers recommend that standardized diagnostic instruments, such as diagnostic interviews be used to determine a definitive diagnosis.

Their research is published in the Journal of Consulting and Clinical Psychology.

Source: Ruhr-University Bochum

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