News: ADHD Can Cause Lifelong Problems, Study Finds - US News and World Report

ADHD Can Cause Lifelong Problems, Study Finds

Attention-deficit/hyperactivity disorder that persists into adulthood may affect physical and mental health

If children with attention-deficit/hyperactivity disorder, or ADHD, continue to have the condition in adulthood, a new study suggests that they may face an array of physical and mental health issues.

The study, which spanned more than 30 years, found that people who had ADHD as teens and adults face a greater risk of stress, work problems, financial troubles, physical health issues and additional mental health issues, such as depression or antisocial personality disorder.  

They also had difficulty in terms of work and experienced a great deal of financial stress.  82 percent higher odds of having impaired physical health. They were also more than twice as likely to have another mental health problem

 The study included 551 children. Seventy-two of those children were diagnosed with ADHD in 1975 when they were between the ages of 14 and 16. The researchers followed up with the children as they grew, and the final of five outcome surveys was given at an average age of 37.

ADHD Study - US News and World Report 

License Exam: Assessment and Diagnosis - Treatment Planning (11%)

Assessment and Diagnosis, Treatment Planning (11%)

Diagnosis Can Miss ADHD in Girls

 http://bpd.about.com/od/glossary/g/DSM.htm
http://bipolar.about.com/cs/faqs/f/faq_dsm.htm

MULTIAXIAL DIAGNOSIS

In the DSM-IV-TR system, an individual is diagnosed on five different domains, or "axes."  The multi-axial system in DSM-IV-TR was developed in part in order to capture more of the complexity surrounding psychiatric conditions.
Axis I: Clinical Disorders: Major psychiatric disorders are diagnosed on Axis I. For example, major depressive disorder and posttraumatic stress disorder disorders of learning, and developmental disabilities.   Axis I tends to be reserved for major disorders that are thought to be somewhat episodic
Axis II: Personality Disorders or Mental Retardation: these are thought to be longer-standing conditions of thinking and behavior that are typically present before age 18.  For example, personality disorders and Mental retardation (or MR).  These are chronic conditions separated from Axis I conditions in order to allow them to be highlighted
Axis III: Medical or Physical Conditions: Axis III is reserved for medical or physical conditions that may affect or be affected by mental health issues.  For example, if someone has cancer, and their illness and treatment are affecting their mental health, that would be important information to be conveyed in the diagnosis.
Axis IV: Contributing Environmental or Psychosocial Factors: Often, a psychiatric diagnosis happens in the context of major environmental or social stressors. For example, job loss, divorce, financial problems, or homelessness.
Axis V: Global Assessment of Functioning: The GAF is a number between 0 and 100 which is meant to indicate level of functioning, or a person's ability to engage in adaptive daily living.  Lower scores indicate lower functioning. 

Click here for the Expanded text on Multiaxial Diagnosis

 Axis I is reserved for clinical disorders and developmental and learning disorders. Disorders that may be present on Axis I include:

• Panic Disorder
• Generalized Anxiety Disorder
• Social Phobia
• Obsessive-Compulsive Disorder
• Posttraumatic Stress Disorder
• Specific Phobia

Axis II is for personality disorders or mental retardation. Disorders that may appear on Axis II include:

• Borderline Personality Disorder
• Histrionic Personality Disorder
• Dependent Personality Disorder
• Obsessive-Compulsive Personality Disorder

Axis III is for medical and/or physical conditions or disorders. For example:

• Hyperthyroidism
• Mitral Valve Prolapse (MVP)

Axis IV indicates factors contributing to, or affecting, the current psychiatric disorder and treatment outcomes. These include:

• Lack of an adequate support system
• Social issues
• Educational problems
• Problems with work
• Financial difficulties
• Legal problems
• Other psychosocial and environmental problems

Axis V is for the GAF or global assessment functioning. This is a 100-point scale that the mental health professional uses to describe the patient’s overall level of performance in usual daily activities and social, occupational, academic and interpersonal functioning.

_Source:

American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: Author.  

DSM Decision Trees for Differential Diagnosis

The purpose of these decision trees is to aid the clinician in understanding the organization and hierarchical structure of the DSM-IV Classification. Each decision tree starts with a set of clinical features. When one of these features is a prominent part of the presenting clinical picture, the clinician can follow the series of questions to rule in or rule out various disorders.
I. Differential Diagnosis of Mental Disorders Due to a General Medical Condition
II. Differential Diagnosis of Substance-Induced Disorders
III. Differential Diagnosis of Psychotic Disorders
IV. Differential Diagnosis of Mood Disorders
V. Differential Diagnosis of Anxiety Disorders
VI. Differential Diagnosis of Somatoform Disorders
Click here for expanded text on Differential Diagnosis

Mental/Behavioral Health DISORDERS

Mood and Anxiety Disorders

 http://ptsd.about.com/od/ptsdbasics/a/PTSDoverview.htm

http://depression.about.com/od/whatisdepression/tp/facts.htm

Personality Disorders

http://bpd.about.com/od/relatedconditions/a/Personality-Disorders.htm

The DSM-IV-TR states that Borderline Personality Disorder (BPD) is an Axis II disorder characterized by a pervasive pattern of instability of interpersonal relationships, self-image, and emotions/affects. The diagnostic criteria for BPD is that it is manifested by 5 or more symptoms, such as inappropriate, intense anger, fear of abandonment, impulsive self-damaging behaviors, suicidal threats and gestures, and chronic feelings of emptiness. People with BPD may have a tendency to themselves and others as all good or all bad, with no grey areas; this is termed “splitting.”

http://bpd.about.com/od/relatedconditions/a/Narcissistic-Personality-Disorder.htm


AUTISM
http://autism.about.com/od/whatisautism/a/symptoms.htm

Variables Predicting Happiness

From CGH Systems Book:

•  Overall Ideas:  Positive Mental State: contentment, joy, overall satisfaction, positive mood, absence of negative mood, living according to true self (inner daemon).   Bliss, power, knowledge, optimism.  Feelings: self-esteem, hopefulness, capability, resilience/hardiness, decision-making ability, intrinsic motivation.   NOT: sex, age, having children, location, race, income (these can be controlled for). Except for when there is extreme financial hardship.
• Predictors of Happiness: self-esteem, social support, efficacy, relatedness (feeling socially included), loving relationship with a spouse, personality traits such as extroversion and openness, community involvement, optimism, ack of neuroticism, spiritual or religious, autonomy, competence having goals and values, ability to adapt (change has a short impact), making progress, using effort, pursuing goals, lack of rumination, adequate resources, (Myers, 1992; Costa & McCrae, 1980; Heady & Wearing, 1992; Diener, Suh, Lucas, & Smith, 1999). Hardiness & Resiliency (Siebert, 1996)
• Positive Mental Health: ego strength, intrnisic motivation, optimism (Antonovsky, 1993; Maddi, 1999a, 1996b).  Mental Health: feelings of vitality, subjective well-being, problem solving abilities, excercising control over environment and self, self-understanding and insight.  Jung variables: psychic ingeration, wholess, or sense of self.  Also, personality types. NF, SF, ST, NT types.  Maslow: Self-actualization.

Defining Variables

Brainstorming a list of variables, and possible research questions...

TOPIC 4: IDENTIFYING AND COMBINING VARIABLES

Broad Problem Area:
PERSONALITY + CULTURE = HAPPINESS
people may not "fit" in culture they were born, they live in
is "mis-fit" based on personality of culture vs. individual personality
Do people know that there is a personality of a culture?
would it help? Would people move?
Knowledge variables (do people know?)
know what cultural personality is?
know own personality?
would it make a difference?
Opinions or feelings variables (attitudes, how feel, prefer, favor, depressed)?
are people happy in their culture?
do they feel as if they fit in?
are people happy? how happy, on 1-5 scale?
are people depressed if their personality is a mis-match for their culture?
Overt behavior or action variables (people move, they spend time, use of clinics, donations)
do people move from a region? what are the statistics on different states/regions?
population of certain regions is on the rise, and others are down
have you lived elsewhere? when? how long?
visit clinics (more mental illness)?
donations to charity?
spend time with loved ones?
Fact variables
indiv. personality
cultural personality
region
state
mental health status

More Literature Review

Yuan, Anastasia S. Vogt, RACIAL COMPOSITION OF NEIGHBORHOOD AND EMOTIONAL WELL-BEING. Sociological Spectrum; Jan/Feb2008, Vol. 28 Issue 1, p105-129.

Living in a higher percentage same-race neighborhood improves the emotional well-being of Blacks and Hispanics; although, it is related to different aspects of emotional well-being. Social support explains part of this relationship for Blacks.

Singh, M. Predicting General Well-Being From Emotional Intelligence and Three Broad Personality Traits. Journal of Applied Social Psychology; Mar2008, Vol. 38 Issue 3, p635-646.

EI was related but distinct from the 3 personality variables. Trait-EI demonstrated the strongest correlation with job satisfaction, but predicted general well-being no better than Neuroticism. In regression analyses, trait-EI predicted l variance in the well-being criteria, beyond the 3 personality traits. It was concluded that trait-EI may be useful in examining dispositional influences on psychological well-being.

Ryan, R. ON HAPPINESS AND HUMAN POTENTIALS: A Review of Research on Hedonic and Eudaimonic Well-Being. Annual Review of Psychology; 2001, Vol. 52 Issue 1, p141, 26pgs.

Lit. review of well-being. Social class and wealth as predictors of well-being; Physical health and its relations to well-being; Research on differences in well-being across time and place.

Sorting Through the Literature

Smith, Timothy B., Cultural values and happiness. American Psychologist, Vol. 55(10). From PsycARTICLES

refers to Csikszentmihalyi's research correlating happiness, not with money or wealth, but with the experience of FLOW. Csikszentmihalyi, M. (1999). If we are so rich, why aren't we happy? American Psychologist, 54, 821–827. Thinks M. C. made a mistake in claiming it is causation. Hypothesizes that losing oneself is the basis for happiness, as other cultures emphasize this (and connecting with others) and find happiness. "If losing oneself in a project, relationship, or dream is followed by a very positive condition, it does not mean that the experience itself caused happiness. It is equally likely that losing oneself is the causative factor... research supports the tenet that the less people focus on themselves, the happier they are (e.g., Nolen-Hoeksema & Davis, 1999). Moreover, the quality of a person's connection with others is often the best predictor of therapy outcome and mental health (Hubble, Duncan, & Miller, 1999). "

Lyubomirsky, Sonja.

Why are some people happier than others? The role of cognitive and motivational processes in well-being. American Psychologist, Vol. 56(3). From PsycARTICLES.

Why and how is happiness important??

One of the most salient and significant dimensions of human experience and emotional life is happines. Aristotle's (trans. 1974) two millennia-old argument that happiness is the whole aim and end of human existence. Why some people are happier than others is important for both theoretical and practical reasons, and the pursuit of its answer should be a central goal of a positive psychology (Seligman & Csikszentmihalyi, 2000). people rank the pursuit of happiness as one of their most cherished goals in life (Diener & Oishi, 2000; Diener, Suh, Smith, & Shao, 1995; Freedman, 1978; Triandis, Bontempo, Leung, & Hui, 1990; for an exception, see Lyubomirsky, 2000). Furthermore, happiness appears to have a number of positive by-products, which may benefit not only individuals, but families, communities, and societies (see Myers, 1992; Veenhoven, 1988, for reviews). a great deal of research has addressed this question. the general conclusion from almost a century of research on the determinants of well-being is that objective circumstances, demographic variables, and life events are correlated with happiness less strongly than intuition and everyday experience tell us they ought to be (cf. Diener et al., 1999; Lyubomirsky & Ross, 1999). By several estimates, all of these variables put together account for no more than 8% to 15% of the variance in happiness (e.g., Andrews & Withey, 1976; Argyle, 1999; Diener, 1984;Diener et al., 1999).

Not wealth

remarkably small associations between happiness and wealth, such as Myers's (2000) observation that as Americans' personal income has nearly tripled in the last half century, their happiness levels have remained the same, and Diener and colleagues' finding that the wealthiest Americans—those earning more than $10 million annually—report levels of personal happiness only trivially greater than their less affluent peers (Diener, Horwitz, & Emmons, 1985).

Furnham, A. & Petrides, K. V. TRAIT EMOTIONAL INTELLIGENCE AND HAPPINESS. Social Behavior & Personality: An International Journal; 2003, Vol. 31 Issue 8, p815-823.

measures of trait emotional intelligence (trait EI), happiness, personality, and cognitive ability. Neuroticism was negatively related to happiness, whereas Extraversion and Openness to Experience were positively related to it. The positive relationship between trail EI (not cognitive ability) and happiness persisted in the presence of the Big Five. In contrast, the Big Five did not account for a significant amount of happiness variance when trait EI was partialled out.

Refining the Research Area

I'm using the steps included in Mildred Patten's Proposing Empirical Research. It is set up with instruction on different topics and walks you through the whole research process, from choosing a topic of study on into conducting the study and drawing conclusions.

TOPIC 1: What is empirical research?

1. What will you observe? personality, culture, and happiness.
2. The main variable is : answers to questions regarding happiness, and Big Five personality tests.
3. Other variables: secondary data.
4. Whom might you observe? general representation of people in different states & regions.
5. How can you observe this variable? Surveys and personality testing.
6. When might you make the observations? Using secondary data, observations already made.

TOPIC 2: Identifying Broad Problem Areas

1. Problem Area: personality, happiness, and culture
2. Description of interest: I question how personality and happiness is passed on through culture. I also question whether a "good fit" between culture and personality makes people happier. By moving can we make a better fit? I believe so, because I did it myself, moving from the Deep South to New England, based on my personality traits.

TOPIC 3: Identifying and Combining Variables

1. Topic area: personality + culture = happiness?
2. Is the area in the mainstream of social work? Culture is, and we are learning more about personality through the Big Five theories, happiness (well-being) is one of our core concerns.
3. Is there a substantial body of literature on the problem area? Yes, I think so. Prof. Hudson has directed to me some references he used in his paper on the geography of mental health, dealing with happiness and personality, and region. He assures me there is lots of new research on connections between personality and happiness. I also know that Refrow has done much study on culture/place and personality.
4. Is the problem area timely? Oh, yes! This is an emerging area that is getting a lot of attention right now. And, also needs further study, which I want to do.