Jacqueline Corcoran, Ph.D.
from: Corcoran, J., & Walsh, J. (2012 2nd ed.). Mental Health in Social Work: A Casebook on Diagnosis and Strengths-Based Assessment. Boston: Allyn & Bacon and updated with DSM-5.
DSM-5Classified as a neurodevelopmental disorder
Persistent pattern of impulsive, hyperactive and/or inattentive behavior
6 mos.
Before 12 years
Can be hyperactive, combined presentation or inattentive only
Conceptualizationcognitive or neuro-
psychological impairment that
is manifested in terms of self-
regulation, behavior inhibition,
and self-control
Prevalence7.8% among children aged 4-17
The lifetime prevalence rate in adults is 8.1%
more prominent among boys by a 2.5:1 ratio
Multi-Modal Treatment Study of
Children with Attention Deficit
Hyperactivity Disorder - only
31.8% of the participants had a
diagnosis of ADHD alone
Co-morbidity
CourseAbout a third (36%) of childhood cases continue into adulthood
70-90%
Genetic influence
Behavioral TherapyChildren learn pro-social behavior through positive reinforcement
Parents are taught to respond to children’s negative behaviors by ignoring or punishing
Parents are taught through didactic instruction, behavioral rehearsal, modeling, and role plays.
12 sessions in either individual or group
Psychoeducation
Primary psychostimulant drugs
are methylphenidate, the
amphetamines, and pemoline
majority of children (71%) with
ADHD take methylphenidate
(Ritalin)
Medication
AlternativesBupropion (Wellbutrin)
Atomoxetine (Strattera), a selective norepinephrine reuptake inhibitor
Concerns with medication
Benefit not diagnostic
Young children’s prefrontal cortex not developed
does not appear to alter the adolescent or adult outcome of ADHD
a majority of participants (64%) experienced any side effect, and a proportion (14%) suffered moderate-to-severe side effects
negative effect of stimulant treatment on growth
for non-stimulant medications, short-term safety data are lacking
lack of long-term evidence that medication is safe when taken over a number of years.
Criteria’s relevance to girls
GPs often involved with diagnosis
Drug company involvement
Prevalence rates higher in US than other developed countries
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