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References for “Attention deficit disorder”, February 2006

Nigg JT, et al. Pelham WE, et al. Posner MI, et al. Ramsay JR, et al. Rappley MD. For some children with ADHD, academic skills such as learning to read, preparing for a spelling test, writing a book report, and keeping track of homework assignments are acquired as readily as for most others of similar age. However, for some, such tasks may be as challenging as it would be for a 3-year-old to cross a busy street alone. Some children with ADHD are very quick to pick up academic skills, but they consistently struggle more than most of their peers with social skills.

They are slower to pick up cues from others about when they are being too pushy or too demanding. They may repeatedly be too bossy and be excluded by playmates, or they may simply retreat into solitary activities, avoiding the risk of peer rejection by immersing themselves in playing video games.

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  8. This need for extra support may emerge early in preschool years, or it may not become noticeable until the child enters middle school or high school when more independent self-management is expected. For some, the need for extra support does not emerge noticeably until the adolescent is preparing to move away from home to go to college. For those who need such support and do not receive it or who receive too much support and do not have ample chances to learn to manage for themselves, such activities at various stages of development may become almost as perilous as trying to cross a busy street before they have learned how to do it.

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    Some children and adults report a long history of having been told frequently while growing up that they were hopelessly lazy, stubborn, and stupid and destined for a life of failure. Such frustration is often intensified as the adult witnesses the child showing strong ability to focus and work persistently on a few self-selected tasks while consistently acting incapable of devoting comparable attention and effort to tasks the adult views as important.

    Individuals with ADHD have a greatly increased likelihood of suffering from one or more psychiatric disorders at some time in their lifetime than do most others. This is a threefold increased risk of a comorbid disorder for those with ADHD.

    A nationally representative study found that adults with ADHD were more than six times as likely as the comparison sample to have an additional psychiatric disorder Kessler et al. For many individuals, ADHD impairments are made worse by their struggles with excessive anxiety, persistent depression, compulsive behaviors, difficulties with mood regulation, learning disorders, or other psychiatric disorders that may be transient, recurrent, or persistently disruptive of their ability to perform the tasks of daily life.

    A study based on pooled samples of more than 4, persons with ADHD and more than 6, control subjects without ADHD assessed at an average age of Those with ADHD had 1.

    Attention Deficit Disorder: The Unfocused Mind in Children and Adults

    Overall, those with ADHD had more than two and a half times the risk of having a substance use disorder with one or more of these addictive substances by early adulthood Lee et al. For many persons with ADHD, the overuse of alcohol, marijuana, or other drugs begins with an effort to self-medicate. Often, they struggle daily with feelings of frustration, embarrassment, disappointment, or shame resulting from their ADHD impairments.

    Occasional use of these substances may, for a time, bring welcome, although very temporary, relief from these painful emotions. The problem is that occasional use can readily lead to more chronic use, which can rapidly lead to a persistent cycle of addiction from which it may be extremely difficult to recover. Addiction to these substances can result in worsening of ADHD impairments in multiple aspects of schooling, employment, social relationships, and other aspects of daily life. Although the primary causes of ADHD are genetic, adverse environmental factors may have considerable negative impact on the life experience of children and adults with ADHD.

    Examples of environmental adversities include serious medical or psychiatric illness of a parent or other close family member, domestic violence, living in a dangerous neighborhood, separation or divorce of parents, layoff or loss of employment, multiple changes of residence, lack of or loss of health insurance, and serious disability or death of a parent or other close family member. Such adversities may occur in isolation with just transient effects followed by full recovery.

    In other cases, adversities may be persistent and may trigger additional adversities. For example, if a parent who has been the primary wage earner for the family suffers a major injury or protracted disabling illness, the parent could lose his or her job and with it health insurance for himself or herself and the family; this could also result in eviction, forcing a move into a more dangerous neighborhood. Although such adversities can create overwhelming difficulties for any family, their impact may be compounded in a family in which one or more family members have ADHD; the difficulties can worsen considerably if one or both parents have ADHD and are trying to cope with the added stress that results from raising children with ADHD.

    Many discussions of ADHD refer to it as a developmental disorder, but generally, the focus of such discussions is limited to the first decade or two of life; they do not encompass the full range of development across the lifespan.

    Attention Deficit Disorder: The Unfocused Mind in Children and Adults

    Yet the few studies that have explored ADHD during adulthood, especially those that have looked at midlife and beyond, clearly indicate that for those individuals whose ADHD persists into middle adulthood and beyond, significant impairments tend to remain and sometimes worsen. One population-based study of more than 2, men and women ages 47—54 years found that 6.

    With or without ADHD, there are a number of physical changes associated with aging in both males and females. Imaging studies have demonstrated age-related decline in various elements of the brain that provide infrastructure for executive functioning, even for healthy adults without ADHD Backmanet al ; Gazzaley et al ; Raz Nora Volkow and her colleagues found a 6. Age-related decline in brain dopamine activity even in healthy volunteers has also been documented in several other regions of brain important for executive functions. White matter decreases in the brain are also associated with aging in the general population.

    It should be noted, however, that these percentages of decline in the general population are based on averages that may mask considerable variability among various individuals. Very little research has assessed ADHD in the geriatric population. Many health care practitioners tend to assume that any attentional difficulties experienced by elderly individuals are due simply to the slow degenerative processes of aging or, possibly, to the early stages of dementia. Currently, there is no evidence to support that assumption.

    masdecorta.tk ADHD in the older population may be mistakenly diagnosed as mild neurocognitive disorder, a disorder that involves some cognitive decline that does not interfere with the capacity for independence in everyday activities. Mild neurocognitive disorder is sometimes, but certainly not always, a prelude to onset of dementia.

    Screening for ADHD in any elderly person who presents with symptoms of mild neurocognitive disorder may be helpful not only for increasing understanding of possible relationships between these two disorders but also for identifying adults whose cognitive impairments may be due to lifelong problems with ADHD rather than to geriatric deterioration Ivanchak et al.

    Changes associated with menopause are an aspect of aging that is associated with cognitive impairments similar to ADHD.