Research paper- branxmad

Attention Deficit-Hyperactivity Disorder (ADHD) is a neurodevelopmental disease that affects one’s ability to sustain attention and involves excessive activity and deficiencies in impulse control. Attention Deficit-Hyperactivity Disorder is a lifetime disorder that is often found in the early childhood years and affects the individual throughout their lifetime. For children who are diagnosed with the disorder, it makes it difficult for them to focus in school causing them to receive poor grades, they tend to be more awkward in social settings, and performing simple everyday tasks becomes a challenge. While they are able to learn how to cope as they get older, the problem will always exist. For adults who were diagnosed with ADHD during their childhood and still experience symptoms might end up being forgetful, disorganized and overwhelmed when it comes to their daily lives and jobs. The symptoms being experienced are more frustrating as an adult because of the impact it can have on work and an individual’s personal relationships [12]. Proper maintenance of their medication and simply learning more about their own disorder can potentially provide great help to adults diagnosed with ADHD.

I believe that in today’s times, Attention Deficit-Hyperactivity Disorder is one that is overdiagnosed and often misdiagnosed. When I was 8 years old, my baby brother was diagnosed with Attention Deficit-Hyperactivity Disorder. He showed very apparent symptoms and because I lived with him, I saw the diagnosis to be an accurate one. At that age, it seemed as if the discussion of mental disorders was taboo and my family was in denial, but of course my brother’s diagnosis appeared to be the truth because the symptoms the disorder seemed to accurately match what I saw in my brother’s behavior. When high school came around, a lot of my classmates suddenly began to claim to have been diagnosed with ADHD, as if it were a trend. When those classmates were asked why they believed they had such a life altering biological mental condition, their answers would be something like, “I can never focus in class” and “I get distracted so easily” like they were making it out to be a joke. We all get distracted and sitting through a 50 minute history class might cause one to gaze out the window and day dream or play on their phone, so I never took their claims seriously.  However, the frequency at which the topic was brought up sparked curiosity in me. It is true that more and more young children are receiving a diagnosis of ADHD and my classmates’ claims are exactly the type of claims and beliefs that lead pediatricians to make those diagnoses. While my high school classmates may have been making up stories for attention, there is no true way to know the accuracy of the growing epidemic.

The sudden increase of children being diagnosed with ADHD is growing at an alarming rate. While looking through statistical articles regarding the rise of diagnosis, I found that 6.4 million children between the ages of 4 through 17 years old have been diagnosed with the disorder in the years 2011 and 2012 alone [2]. The prevalence rate of Attention Deficit-Hyperactivity disorder between the years 2003 and 2011 went up by 35%. At the rate of which ADHD diagnosis is increasing, this disorder is now the second most diagnosed child disease, right next to childhood obesity [2]. A study conducted in September of 2010 by the Journal of Health Economics has determined that a child’s birth month has a great impact on their likelihood of being diagnosed with ADHD and their treatments [10]. According to the study, kindergarten aged children who were born in August, otherwise known as before the kindergarten cutoff date, were said to be more likely to be diagnosed with ADHD than those children who were born in September, after the kindergarten cutoff date. Those children born in August were also believed to be twice as likely to be treated with medications for their diagnosis. It was later found that the study could have possibly resulted in 900,000 cases of the misdiagnosis of ADHD [11].

The increase of this diagnosis being given to children could be the result of many different factors that could potentially begin the onset of children developing Attention Deficit-Hyperactivity Disorder, but also many professional beliefs could lead to a child finally being clinically diagnosed. Primarily, environmental factors are what is believed to cause the early onset. While it is common knowledge that ADHD is mainly a genetic disorder, many believe that other things contribute to their child being diagnosed with ADHD. For example, it’s believed that mothers who have smoked cigarettes or drank alcohol during their pregnancy could have possibly lead to their child being born with the disorder. However, the fact is that the use of tobacco or alcohol during pregnancy causes the child to be born with Fetal Alcohol syndrome, which has very similar symptoms to those of ADHD [7]. Thus, resulting in the children being treated and medicated for the wrong disorder.

Furthermore, in the case of misdiagnosis, the ADHD diagnosis is most commonly given to toddlers or young children. They don’t receive a diagnosis based off of abnormal behaviors, but because of the normal behaviors that toddlers and young children display at their age. Toddlers and young children tend be very active during play and behave impulsively. In today’s educational systems, preschoolers and kindergarten aged children have very high expectations placed upon them [2]. These children are expected to sit still in class while they listen to their teacher read a book out loud, or maybe expected to read the book themselves. The moment that the 4-year-old student starts to get impatient and squirms a little in his seat, there is suddenly a diagnosis he is labelled with.

A diagnosis of a mental or medical disorder almost always is followed up with a prescription of a stabilizing medication. Patients who are diagnosed with ADHD are prescribed with psychostimulant drugs, such as Ritalin, Adderall, Cylert or Dexedrine. These drugs are meant to regulate and improve an individual’s concentration, cooperation and the ability to stay on task. In relation to the problem of misdiagnosis, these medications can be given to a patient who does not need stimulant drugs. After many years of taking these medications, the patient can later on become dependent on the drugs or could end up abusing them. For example, the stimulant drug, Ritalin, has the chemical similarities of cocaine. Ritalin and Adderall are two of the most common drugs that are prescribed to treat ADHD, but are also the most commonly used recreational drugs. Adolescents who are misdiagnosed with ADHD and being prescribed those medications often end up abusing the drugs or selling them. As for young children who have been misdiagnosed with the disorder and are prescribed stimulant medications can eventually end up in danger due to the negative side effects of the drug [3]. These side effects could potentially cause the child to sleep disturbances, loss of appetite and stunted growth.

Another leading cause to the misdiagnosis of Attention Deficit-Hyperactivity Disorder is the possible comorbidity of another disorder overlapping. Many of the disorders that exist today could very likely have similar symptoms as one another. ADHD and Autism both share some symptoms, such as inability to stay focused and impulsivity. However, while a child who is diagnosed with autism might show some symptoms of ADHD, but that does not mean a child with ADHD is autistic [1].  But the misdiagnosis due to comorbidity does not just end at autism. An individual may experience anxiety, Post- traumatic stress disorder, bipolar disorder, or another learning disability, such as dyslexia. The symptoms of another disorder might look similar to those of ADHD. Someone with bad anxiety, or even dyslexia, is suddenly being mistreated because of the inadequate evaluation of the disorder. Mood and behavioral disorders that can possibly be found in young children could also end up being mistaken as symptoms of ADHD. Recognizing the difference between ADHD and symptoms of comorbid disorders can lead to a more accurate evaluation and diagnosis. Having a disorder with similar symptoms to ADHD is often overlooked and the inaccurate diagnosis could almost be taken as a dismissive response.

The term “Attention Deficit-Hyperactivity Disorder” is one that is broad. Similar to many other disorders, ADHD has more than one type. The three different subtypes of ADHD include ADHD Hyperactive-Impulsive type, ADHD Inattentive type and then ADHD with the two types combined [6]. The hyperactive- impulsive type is seen in children who participate in inappropriate amounts of activity and act without thinking of the consequences to their actions. Children, or adults, with ADHD hyperactive-impulsive type will often have trouble waiting their turn, interrupting others during conversation or during class, talk a lot, play loudly and aggressively, and will stand or run around at inappropriate times. ADHD Inattentive type can be seen in children who have trouble focusing or paying attention. They may not listen when being spoken to,  they can be forgetful and easily distracted, and have trouble keeping their tasks organized. And finally, there is the type of ADHD with the two combined. The individual can have the disorder and be both hyperactive-impulsive and inattentive. While I find it helpful to be able differentiate between the various types of ADHD, I also believe that further mental evaluations should be done.

Having knowledge of the different types of ADHD and being able to identify them might be helpful when it comes to making more of an accurate diagnosis. Making an accurate diagnosis, should the disorder be present, will also be helpful when it’s time to prescribe the appropriate medication.

Boys and men are far more likely to be diagnosed with Attention Deficit-Hyperactivity disorder more frequently than females. However, gender differences have a great impact on the diagnosis of the disorder because each of the genders express symptoms differently [4]. Males with ADHD usually have the hyperactive-impulsive type. Boys are naturally more aggressive than girls and with that type of ADHD, boys will exert more behavioral problems than girls with the same disorder. Due to the apparent abnormal behavior boys show, they are more likely to be seen by a doctor and receive a clinical diagnosis. As for females, their symptoms are usually overlooked or mistaken for other disorders. Girls with the disorder usually have the inattentive type and show symptoms similar to depression or anxiety. Because girls don’t have behavioral problems, they tend to go undiagnosed for the disorder and will seek treatment for depression, or another comorbid disorder. I believe that before administering treatment, other options should looked in to. For example, a 6-year-old boy who seems to be active and aggressive with his classmates in school should maybe be put into an organized sport, like football. Possibly keeping the child active in a setting that is more appropriate is a lot better, and safer, than trying to oppress the child in a situation he or she might not be comfortable in. If those other options don’t work, then a trip to the child’s physiatrist might be a good idea.

While studies have shown a significant increase in the diagnosis of ADHD, there are still some who believe that the disorder is underdiagnosed, and undertreated. In the article, Underdiagnosis of Attention-Deficit/Hyperactivity Disorder in Adult Patients, it states that adults with ADHD tend to show more symptoms of comorbid disorders, such as alcoholism or anxiety, rather than the symptoms of their ADHD. When adults go to a physiatrist for a clinical evaluation, they usually go for their comorbid symptoms and the ADHD goes undiagnosed.this can result in poor outcomes, whether or not the comorbid disorders are the ones being treated [8].  

Prior to the extensive research of Attention Deficit-Hyperactivity Disorder, it was believed that the disorder was only present in young children and they often grew out of it as they got older and began to mature. However, that belief was incorrect and ADHD is a disorder that is carried into adulthood. Adults who have ADHD will seek help for disorders other than that of ADHD because they are unaware.

Another believed case of underdiagnosis and undertreatment of ADHD could be related to an individual’s cultural and ethnic backgrounds [5].  Due to the symptoms of Attention Deficit-Hyperactivity disorder being very similar to the symptoms of another disorder such as Fetal Alcohol syndrome or problems that result from poor perinatal care, the prevalence of ADHD among different ethnic groups is unclear. African-american youth who have ADHD tend to go untreated, as well as other nonwhites. Beliefs of illness and care differ upon various ethnic groups and religions, often leaving many children to go undiagnosed or untreated. I find this the be an accurate account and very interesting. Mental illness among people of color; African-Americans, Hispanics, Indians, etc. is a very rare topic to discuss. Families that come from minority backgrounds usually don’t believe mental illness is a true and sometimes severe, disorder. Parents will often see their kids who have ADHD, and show symptoms of the disorder, as misbehaved and deserving punishment, instead of taking them to see a physiatrist for clinical help.

Although the prevalence rates of ADHD have made a dramatic increase, there are still those who disagree. My belief is that Attention Deficit- Hyperactivity disorder is overdiagnosed to young children today caused them to be mistreated. To put an end to the rising epidemic, clinicians must first, be able to accurately evaluate their young patients. Diagnosing a child with the disorder because of behavioral problems in school or at home is not always the most adequate diagnosis. The disorder needs to be further looked into over a period of time, as opposed to just a single doctor’s appointment. Secondly, finding new ways to treat a child who does have Attention Deficit-Hyperactivity disorder might decrease the risk of substance abuse in the child’s future. Changing our perspectives and treating children with apparent behavioral or mood disorders could greatly affect how we diagnose and care for our children.

 

Works Cited

  1. “ADHD and the Autism Spectrum.” ADDitude, 17 Nov. 2017, http://www.additudemag.com/autism-aspergers-adhd-symptoms-in-children/.
  2. “A True ADHD Epidemic or an Epidemic of Over diagnosis?” Psychiatry Advisor, 11 Mar. 2016, http://www.psychiatryadvisor.com/adhd/a-true-adhd-epidemic-or-an-epidemic-of-overdiagnosis/article/429034/.
  3. “Problems of Over diagnosis and Over-prescribing in ADHD.” Problems of Overdiagnosis and Overprescribing in ADHD | Psychiatric Times, http://www.psychiatrictimes.com/adhd/problems-overdiagnosis-and-over-prescribing-adhd.
  4. Gender Differences in Attention-Deficit Hyperactivity Disorder (ADHD) CPANCF.COM, cpancf.com/articles_files/art_57attached_file.asp.
  5. “Cultural Issues in Diagnosis and Treatment of ADHD.” Journal of the American Academy of Child & Adolescent Psychiatry, Elsevier, 31 Dec. 2009, http://www.sciencedirect.com/science/article/pii/S0890856709667241.
  6. Attention Deficit Hyperactivity Disorder (ADHD): Dr. Raun Mel, media.pearsoncmg.com/ph/hss/SSA_SHARED_MEDIA_1/psychology/videos/MPL/Attention_Deficit_Hyperactivity_Disorder_ADHD_Dr_Raun_Mel.html.
  7. “What Causes ADHD? 12 Myths and Facts.” Health.com, www.health.com/health/gallery/0,,20441463,00.html#tv-or-video-games-0.
  8. Ginsberg, Ylva, et al. “Underdiagnosis of Attention-Deficit/Hyperactivity Disorder in Adult Patients: A Review of the Literature.” The Primary Care Companion for CNS Disorders, Physicians Postgraduate Press, Inc., 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4195639/
  9. “Attention-Deficit / Hyperactivity Disorder (ADHD).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 13 Nov. 2017, www.cdc.gov/ncbddd/adhd/data.html.
  10. Evans, W N, et al. “Measuring inappropriate medical diagnosis and treatment in survey data: The case of ADHD among school-Age children.” Journal of health economics.,U.S. National Library of Medicine, Sept. 2010, www.ncbi.nlm.nih.gov/pubmed/20739076.
  11. Morrow, Richard L., et al. “Influence of relative age on diagnosis and treatment of attention-Deficit/Hyperactivity disorder in children.” CMAJ : Canadian Medical Association Journal, Canadian Medical Association, 17 Apr. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3328520/.
  12. “ADHD in Adults.” Vyvanse, www.vyvanse.com/adhd-adult-symptoms.

 

This entry was posted in Portfolio branxmad. Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s