Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Attention deficit hyperactivity disorder (ADHD) is well recognized in children and is increasingly recognized in adults. The labels used to describe this cluster of problems have changed many times over the past 100 years, but currently the term attention deficit disorder (ADD), or attention deficit hyperactivity disorder (ADHD), are most
popular. ADHD is distinguished from other disorders by differences in intensity and persistence of particular groups of symptoms. ADHD develops from a combination of genetic inheritance and life experiences. In general, these qualities often result in a lack of fit between expectations and the individual's performance.
The exact characteristics or symptoms defining this set of problems continue to be defined. ADHD is not considered just a problem with poor attention but is additionally a problem with moderating emotions and effective self-regulation, particularly of activity level and impulse control. Dealing with the demands of everyday life requires self-regulation to develop successful life skills. For people with ADHD, problems with self-regulation often cause difficulty managing emotions, so they might respond to small events with excessive behavior and emotion while not noticing more important events. Also, problems with self-control make it difficult to develop good habits. Compared with other people, those with ADHD
often require more practice over longer periods of time to develop effective behavior that is self-regulated or habitual. These issues can result in difficulties in many aspects of life, including school or job achievement, performance in athletic activities, driving, as well as success in
relationships, specifically friendships, dating, and marriage.
Again, the root problem in ADHD is not a simple problem of not paying
attention. When people with ADHD are involved in an area that naturally holds
their interest, they can pay attention as well as, or nearly as well as, others.
However, when tasks are repetitive or hold no interest for that person, these
individuals often experience greater difficulty maintaining focus and remaining
on task. Therefore, they may be prone to procrastination and immaturity.
ADHD is
a well-recognized diagnosis in children that has been formally identified in
adults for about the past 20 years. As children with ADHD grow up, their overtly
hyperactive-impulsive qualities often diminish, while the inattentive and
disorganized patterns of behavior remain constant. Their hyperactive-impulsive
problems may also become more internal and overtly subtle. Adults with ADHD
often fit this pattern: inattention, disorganization, and low tolerance of
frustration or boredom, combined with the childhood history of inattention, as
well as overt hyperactivity, and/or impulsivity. The level of impulsiveness in
childhood seems to be the best predictor of symptoms later in life. High levels
of childhood impulsivity seem to predict more serious adult dysfunction.
Recognizing that ADHD can continue from childhood into adulthood has taken a
significant amount of time. One to 6% of adults are estimated to have ADHD. In
adults, women are thought to suffer from ADHD at a rate that is much closer to
equal compared to men.
Current estimates are that 85% of children receiving the diagnosis of ADHD are
at risk for having the disorder as an adult. About one-third of those children
may outgrow many symptoms; however, not all symptoms are outgrown. The remaining
two-thirds of children with ADHD continue to have most symptoms but those
symptoms may be different in adulthood than in childhood. For example, the child
who has trouble sitting still may grow up into an adult who gets bored easily.
Adults with ADHD may also experience significant co-occurring psychiatric and
life problems, such as impulse and borderline personality problems, substance
abuse, and a significant risk for depression and anxiety disorders.
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Job performance. Their work performance may be inconsistent because they
have problems organizing their work, managing their time, and concentrating on
one task at a time. They may be forgetful and misplace or lose things. They may
quit their jobs out of boredom.
Attention deficit hyperactivity disorder (ADHD) is a developmental condition of inattention and distractibility, with or without accompanying hyperactivity.