HYPERACTIVITY DISORDER (ADHD)

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IN COLLEGE
STUDENTS
Sources
 Wenar, C. & Kerig, P. (2006). Developmental
Psychopathology from Infancy through Adolescence, 5th
ed., Boston: McGraw-Hill.
 Brown, T. E. (1999). Inattention and Executive Functions:
New Understandings of ADD Syndrome. APA
presentation.
 American Psychiatric Association (2000). Diagnostic and
Statistical Manual of Mental Disorders, 4th ed., Text
Revision. Washington, D.C.: APA.
 Weyandt, L. L., & DuPaul, G. (2006). ADHD in college
students. Journal of Attention Disorders, 10(1), 9-19.
1
A quick self-assessment
 Please take out a piece of paper.
 Following are 6 statements describing
behaviors or difficulties that people sometimes
have. For each one, please write down the
number that indicates how often you have
noticed that behavior or difficulty in
yourself IN THE LAST SIX MONTHS.
(based on ASRS WHO screener, from Kessler et al.,
2005)
2
NEVER
0
RARELY
1
SOMETIMES
2
OFTEN
3
VERY OFTEN
4
1) How often do you have trouble wrapping up the
fine details of a project, once the challenging
parts have been done?
2) How often do you have difficulty getting things in
order when you have to do a task that requires
organization?
3) When you have a task that requires a lot of
thought, how often do you avoid or delay getting
started?
3
NEVER
0
RARELY
1
SOMETIMES
2
OFTEN
3
VERY OFTEN
4
4) How often do you have problems
remembering appointments or obligations?
5) How often do you fidget or squirm with your
hands or your feet when you have to sit
down for a long time?
6) 6) How often do you feel overly active and
compelled to do things, like you were
driven by a motor?
4
Scoring the ASRS
 A total of 11 or higher MAY BE
consistent with adult ADHD
 NOTE: There is much more to
diagnosis than this – many
things can affect the scores
5
Diagnosing ATTENTION-DEFICIT/
HYPERACTIVITY DISORDER (ADHD)
DSM-IV-TR (the Diagnostic and
Statistical Manual of Mental
Disorders)
delineates 3 types of ADHD
1. hyperactive-impulsive type
2. inattentive type
3. combined type
6
DSM-IV-TR criteria for inattentive type
(6 or more of these for at least 6 mos. to a degree that is
maladaptive and inconsistent with developmental level)
difficulty sustaining attention
careless mistakes on schoolwork
failure to complete tasks
does not seem to listen when spoken to directly
difficulty organizing
reluctance to do things that require
sustained mental effort
forgetfulness
loses things
7
easily distracted
DSM-IV-TR criteria for hyperactivity/impulsivity
(6 or more for at least 6 mos. to a degree that is
maladaptive and inconsistent with developmental level)
hyperactivity



often fidgets and squirms
leaves seat frequently
runs or climbs excessively and
inappropriately
difficulty playing quietly
excessive activity, as if “driven by a motor”
excessive talking



often blurts out answers
has difficulty awaiting turn
frequently interrupts others



impulsivity
8
9
BUT there’s more to the story:
the day-to-day realities of living with ADHD
Features associated with ADHD
(often, though not always, present)
DIFFICULT BEHAVIOR
temper outbursts
bossy
demanding
stubborn
10
More associated features
NEGATIVE FEELINGS
changeable moods
angry, frustrated
sad, demoralized
poor self-esteem
resentful
11
More associated features
SOCIAL
rejection by
others
seen as lazy,
irresponsible,
difficult,
disobedient
12
More associated features
ACHIEVEMENT/
OCCUPATIONAL
poor achievement/
don’t apply self
finish fewer years of
school
poor vocational
adjustment
lower IQ scores
13
The Development of ADHD
Tends to emerge in preschool and early school
years, as children’s
natural curiosity is
channeled into learning
specific subjects in a
structured academic
setting
Prevalence for school-age children: 3 to 7 %
Prevalence for college students:
not well understood
estimates range from 2% to 8%
14
Significant COMORBIDITY
Disruptive behavior
(oppositional defiant disorder, conduct disorder)
Strong association -maybe 50%!
When CD and ADHD coexist, more
serious disturbance, more
depression, more substance abuse
& adult criminal activity
15
Comorbidity (continued)
ANXIETY in 10-40% of
clinical population with ADHD
More likely with inattentive-type.
BUT anxiety tends to diminish intensity of
ADHD symptoms!
Also, IMPORTANT to assess for presence of
trauma (PTSD symptoms can resemble
ADHD, but treatment interventions very
16
different)
COMORBIDITY (continued)
Mood disorders
20-30%
(depression, bipolar disorder)
BUT this may be related more to CD
ALSO symptoms of ADHD overlap to
some extent with bipolar disorder
Learning Disorders 19-26%
BUT maybe 80% have significant
learning problems
Also, an array of developmental problems – motor,
cognitive, emotional, and social.
These complicate the picture and increase the
risk of other psychopathology
17
ADHD in adults
Less well researched, and less understood
 Persists for about 50% of individuals
 Significant impairment, yet often not
recognized as ADHD
 ADHD is more difficult to detect in adults,
18
FROM http://adderallxronline.com/adult_adhd/undiagnosed_adhd/might_have_adhd.asp
20
ADHD in college students
Again, not well researched
or well understood
 Between 2 and 8% of college students
report clinically significant symptoms
 Greater risk of academic difficulties
 May be greater risk of psychological
problems as well
21
ADHD in college students
 Increasingly, requesting accommodations
 Most often, extra time on tests and separate testing
rooms
 Often comorbid with other difficulties,
esp. learning
disorders
22
Problems of college students with ADHD
Preliminary studies suggest:
 Lower GPA, more academic
problems
 Impaired organizational skills
 Procrastination
 Study skill deficits
23
Problems of college students with ADHD
(continued)
 Deficits in self-control and selfmanagement
 Inner restlessness, intrusive and
off-task thoughts
 Psychological distress
 Interpersonal difficulties
24
Resources at Shepherd University
 Shepherd University Disability Support
Services
-- Christana Johnson: (304) 876-5453
 TRIO Student Support Services
-- Cynthia Copney: (304) 876- 5779
 Counseling Services (304) 876-5276
 Academic Support Center (304) 876-5221
 Dr. Anne Murtagh, Psychology
(304) 876-5257
25
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