Attention-Deficit Hyperactivity Disorder (ADHD)

Adults with attention-deficit hyperactivity disorder (ADHD) often have difficulty beginning or completing tasks that are routine and uninteresting. They may also have difficulty following instructions, being on time, and making deadlines.

Adults with attention-deficit hyperactivity disorder (ADHD) often have difficulty beginning or completing tasks that are routine and uninteresting. They may also have difficulty following instructions, being on time, and making deadlines. They may be disorganized and prone to losing things: offices may be cluttered with unfiled papers and homes with clothes and unpacked boxes. Those with ADHD also have a harder time tolerating the delay between thought and action as well as refraining from acting on impulses. Difficulty controlling impulses may be apparent in problems involving greater amounts of risk-taking behavior as well as excess consumption of food, or sex. Individuals with ADHD may talk excessively, blurt out answers to questions, or interrupt others. Hyperactivity may also be seen in physical restlessness, fidgeting, and difficulty staying seated. In terms of thinking, impulsivity may lead the individual to jump to conclusions and make decisions without adequate consideration of the consequences.

According to Diagnostic and Statistical Manual of Mental Disorders, individuals must meet 5 of 9 criteria from 2 clusters of symptoms: inattention and hyperactivity. Several of these symptoms must have been present prior to age 12 and present in two or more settings. There is evidence that the symptoms interfere with social, academic, and occupational functioning.

The appropriate diagnosis of ADHD is made after a thorough evaluation to determine 1) that symptoms are of the scope, severity and frequency that satisfy the DSM-5 diagnostic criteria; 2) whether symptoms were present in childhood; and 3) what other conditions may be present that could account for inattention and hyperactivity. Such conditions include depression, anxiety, learning disabilities, and bipolar disorder. In addition to a thorough clinical interview, the assessment of ADHD may also involve the use of structured assessments such as the Conner’s Adult ADHD Diagnostic Interview. Often, a neuropsychological evaluation is needed to definitively diagnose ADHD and rule out other conditions that cause problems of attention and hyperactivity.

CBT [in individual or group formats, with or without medication] has been demonstrated to decrease inattention as well as improve time management, organization, and planning (Safran, Sprich, Mimiaga, Surman, Knouse, et al., 2010; Solanto, Marks, Wasserstein, Mitchell, Abikoff, Alvir, et al., 2010). Treatment for ADHD also targets failure to complete tasks, forgetfulness, indecisiveness, and procrastination. Treatment for ADHD is multifaceted and involves skills training, the development of compensatory strategies, and the use of reinforcement to strengthen new behaviors. The length of treatment is generally 8 to 12 sessions.

Cognitive Behavioral Therapy for ADHD

In treatment, clients will learn to identify and modify beliefs about worry using cognitive restructuring strategies like questioning evidence and validity of worry, challenging appraisals about the uncontrollability of worry, and normalizing.

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