Attention Deficit Hyperactivity Disorder: Current Progress and Controversies

2000 ◽  
Vol 34 (5) ◽  
pp. 719-730 ◽  
Author(s):  
Alasdair L. A. Vance ◽  
Ernest S. L. Luk
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Individual Factors ◽  
Health Issues ◽  
Comorbid Conditions ◽  
Medication Treatment ◽  
Hyperactivity Disorder ◽  
Careful Assessment ◽  
Ongoing Monitoring ◽  
Psychostimulant Medication

Objective: Attention deficit hyperactivity disorder (ADHD) is a common chronic and disabling condition in children. This paper reviews the taxonomic issues and the major comorbid conditions, neurobiological correlates, treatment and public health issues associated with ADHD. Method: Pertinent recent papers are reviewed from the psychological and psychiatric literature. Results: The two major taxonomies now define a similar group of children with ADHD of a combined type/hyperkinetic disorder. Advances in the understanding and treatment of ADHD demonstrate the complex multidimensional links between neurobiology, psychology and behaviour. Careful assessment of individual factors in treatment planning and ongoing monitoring of psychostimulant medication treatment in the longer term are recommended. Conclusions: There is much still to learn about ADHD, and increased levels of clinical research and treatment resources are required.

Attention Deficit Hyperactivity Disorder: Anxiety Phenomena in Children Treated with Psychostimulant Medication for 6 Months or More

1999 ◽  
Vol 33 (3) ◽  
pp. 399-406 ◽  
Author(s):  
Alasdair L.A. Vance ◽  
Ernest S.L. Luk ◽  
Jan Costin ◽  
Bruce J. Tonge ◽  
Christos Pantelis
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Poor Response ◽  
Significant Finding ◽  
Children With Adhd ◽  
Medication Treatment ◽  
Hyperactivity Disorder ◽  
Core Symptoms ◽  
Psychostimulant Medication

Objective: The intermediate- to long-term use of psychostimulant medication has unclear benefits on the core symptoms of attention deficit hyperactivity disorder (ADHD) and delayed onset affective symptom side effects which can mimic these core ADHD symptoms. ‘ADHD and anxiety’ has also been associated with a poor response to short-term psychostimulant medication treatment. In addition, it is unclear whether ‘ADHD and anxiety’ should be defined from the child's and/or the parent's perspective. We propose that anxiety will be increased in children with ADHD who are treated with psychostimulant medication in the intermediate- to long-term who are identified by clinicians as poor responders. Method: Twenty children with ADHD who were medicated for 6 months or more and who had ongoing core symptoms of ADHD were compared to 20 age- and IQ-matched children with ADHD who were medication-naive. Chi-squared tests were performed on the categorical dependent variables and independent t-tests on the dependent continuous variables. Results: Anxiety is significantly increased in children with ADHD treated with psychostimulant medication in the intermediate- to long-term who are noted by clinicians to have ongoing core symptoms of ADHD. This statistically significant finding is evident with both categorical and dimensional measures of anxiety from the child's perspective. Conclusions: The recognition of anxiety and its management in children with ADHD is generally poorly understood. In this particular group of children with ADHD, anxiety may be a side effect of intermediate- to long-term psychostimulant medication and/or a potential marker for a poor response to intermediate- to long-term psychostimulant medication treatment.

scholarly journals Attention-deficit hyperactivity disorder and use of psychostimulants among children in Turkey

2007 ◽  
Vol 4 (3) ◽  
pp. 71-73
Author(s):  
Sahbal Aras ◽  
Semih Semin
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Side Effects ◽  
Mental Health Professionals ◽  
Attention Deficit ◽  
Critical Evaluation ◽  
Therapeutic Effects ◽  
Diagnostic Validity ◽  
Ethical Problems ◽  
Hyperactivity Disorder ◽  
Psychostimulant Medication

Recently, the use of psychostimulant medication in children with symptoms of attention-deficit hyperactivity disorder (ADHD) has been subject to extensive debate. The problems faced while assessing and diagnosing ADHD, unnecessary prescribing of psychostimulants, the possible side-effects of psychostimulants on the developing brain, the risk of drug dependency, and the risk of stigmatising children through medicalisation of normal life events are considered among the principal objections to the use of psychostimulant medications. On the other hand, what also need to be taken into account are the increasing evidence on the genetic, biochemical and diagnostic validity of the disorder, the data showing the therapeutic effects of psychostimulants and the rarity of the above-mentioned side-effects, as well as the ethical problems created by insufficient treatment of children because of the concerns of parents. A critical evaluation of these conflicting opinions by mental health professionals might contribute to the application of ethical principles. While making this kind of evaluation, it is important to pay regard to the specific sociocultural features of the country, as well as the prevailing worldwide discussion.

scholarly journals Mapping the neuroanatomic substrates of cognition in familial attention deficit hyperactivity disorder

2018 ◽  
Vol 49 (4) ◽  
pp. 590-597 ◽  
Author(s):  
Rachel Muster ◽  
Saadia Choudhury ◽  
Wendy Sharp ◽  
Steven Kasparek ◽  
Gustavo Sudre ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Working Memory ◽  
Information Processing ◽  
Attention Deficit ◽  
Cognitive Abilities ◽  
Cognitive Skills ◽  
Spatial Working Memory ◽  
Medication History ◽  
Hyperactivity Disorder ◽  
Psychostimulant Medication

AbstractBackgroundWhile the neuroanatomic substrates of symptoms of attention deficit hyperactivity disorder (ADHD) have been investigated, less is known about the neuroanatomic correlates of cognitive abilities pertinent to the disorder, particularly in adults. Here we define the neuroanatomic correlates of key cognitive abilities and determine if there are associations with histories of psychostimulant medication.MethodsWe acquired neuroanatomic magnetic resonance imaging data from 264 members of 60 families (mean age 29.5; s.d. 18.4, 116 with ADHD). Using linear mixed model regression, we tested for associations between cognitive abilities (working memory, information processing, intelligence, and attention), symptoms and both cortical and subcortical volumes.ResultsSymptom severity was associated with spatial working memory (t = −3.77, p = 0.0002), processing speed (t = −2.95, p = 0.004) and a measure of impulsive responding (t = 2.19, p = 0.03); these associations did not vary with age (all p > 0.1). Neuroanatomic associations of cognition varied by task but centered on prefrontal, lateral parietal and temporal cortical regions, the thalamus and putamen. The neuroanatomic correlates of ADHD symptoms overlapped significantly with those of working memory (Dice's overlap coefficient: spatial, p = 0.003; verbal, p = 0.001) and information processing (p = 0.02). Psychostimulant medication history was associated with neither cognitive skills nor with a brain–cognition relationships.ConclusionsDiagnostic differences in the cognitive profile of ADHD does not vary significantly with age; nor were cognitive differences associated with psychostimulant medication history. The neuroanatomic substrates of working memory and information overlapped with those for symptoms within these extended families, consistent with a pathophysiological role for these cognitive skills in familial ADHD.

Attention Deficit Hyperactivity Disorder and Anxiety: Is There an Association with Neurodevelopmental Deficits?

1998 ◽  
Vol 32 (5) ◽  
pp. 650-657 ◽  
Author(s):  
Alasdair L. A. Vance ◽  
Ernest S. L. Luk
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Empirical Studies ◽  
Poor Response ◽  
Continuous Variables ◽  
Research Issues ◽  
Hyperactivity Disorder ◽  
Neurodevelopmental Deficits ◽  
Psychostimulant Medication

Objective: The co-occurrence of attention deficit hyperactivity disorder (ADHD) and anxiety is a well-established clinical observation. However, its status as a clinical construct is debated. We review the prevalence of ‘ADHD and anxiety’, its definitions, and its clinical correlates and we hypothesise that neurodevelopmental deficits may be increased in ‘ADHD and anxiety’. Method: The authors identified empirical studies in the psychiatric and psychological literature. The search categories included hyperactivity, attention deficit hyperactivity disorder, attention deficit disorder and anxiety. Results: ‘ADHD and anxiety’ is considerably more common in clinical than epidemiological samples. There are a range of definitions which address the situational variation in both ADHD and anxiety symptoms and the use of categorical and continuous variables to define them. Yet the nature of the anxiety is still unclear. It is associated with a poor response to psychostimulant medication treatment, and alternative pharmacotherapy approaches have been suggested. There is a controversy about whether neurodevelopmental deficits are associated with hyperactivity alone, or anxiety, or both. Conclusions: ‘ADHD and anxiety’ is important clinically because it is common and less responsive to psychostimulant medication. Important research issues include its heterogeneity which necessitates the collection of parent, teacher, and child self-reports of symptoms' presence or absence and the hypothesis that neurodevelopmental deficits may be increased in this group of children.

Module 11: Review, Wrap Up, and Planning for the Future

2020 ◽  
pp. 213-220
Author(s):  
Andrea Chronis-Tuscano ◽  
Kelly O’Brien ◽  
Christina M. Danko
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Child Behavior ◽  
Attention Deficit ◽  
Chronic Condition ◽  
Self Care ◽  
Behavioral Skills ◽  
Professional Help ◽  
Hyperactivity Disorder ◽  
Parents And Children ◽  
Ongoing Monitoring

Attention-deficit/hyperactivity disorder is a chronic condition, requiring ongoing use of behavioral skills learned in this program. Without the support of a therapist, it may be difficult for parents to use these skills consistently. The more that these skills become automatic, the more benefits parents and children will experience. A goal of this module is help parents to think about and prepare for how to apply the principles and strategies presented in this program to possible future issues they encounter with their child and personally. It is important to anticipate and catch problems early, so that parents can engage these tools before problems escalate. Another goal is to ensure that parents have, by now, realized the value of self-care so they can create a supportive, consistent environment for their children. Ongoing monitoring of their mood, parenting, and child behavior will help parents to recognize signs that it is time to seek additional professional help.

Sign in / Sign up

Export Citation Format

Share Document