Attention-deficit hyperactivity disorder (ADHD) is a mental health condition that is usually first diagnosed in childhood. Symptoms of ADHD include difficulty focusing, inability to follow through, challenges with staying on task, emotional dysregulation, and volatile and aggressive behavior. It was once theorized that the symptoms of ADHD diminish as a child ages and by the time of adulthood are all but gone. However, in recent years, research has suggested that these symptoms may persist into adulthood. Individuals who enter young adulthood with ADHD can often have poor adjustment outcomes. They tend to have difficulty maintaining gainful employment and housing and are more likely than their non-ADHD peers to be incarcerated or have problems with drugs and alcohol. Many adults with ADHD may have never received a diagnosis and therefore are unaware that help may be available. In order to receive a diagnosis of ADHD, a client must meet certain criteria as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). However, many adults who cannot function well as a result of their symptoms fall below that threshold.
Margaret H. Sibley of the Center for Children and Families at Florida International University has studied adult and childhood ADHD for years and believes that adult symptoms are not as clear cut as those outlined in the DSM-IV. In a recent study, Sibley evaluated the current diagnostic criteria by assessing 121 young adults without ADHD and 200 young adults with ADHD. She used self-reports and family generated reports to make her assessments. She found that of those who had been diagnosed with ADHD in their youth, 75% still experienced symptoms and more than half had impairments within the clinical range. Despite this, less than 20% of these young adults met the diagnostic criteria for a diagnosis of ADHD in adulthood. When she compared the self-reports to family reports, Sibley found that the participants reported fewer symptoms of ADHD than their family members reported. This suggests that informants, people close to the individual with ADHD, are integral in obtaining an accurate assessment. Sibley said, “Despite the potential inconvenience of contacting informants, they are far more likely than the target individual to provide valid information about current and childhood functioning.” She also believes that more comprehensive assessments and lower diagnostic thresholds could help accurately identify individuals who have symptoms of adult ADHD.
Sibley, M. H., Pelham, W. E., Jr., Molina, B. S. G., Gnagy, E. M., Waxmonsky, J. G., Waschbusch, D. A., et al. (2012). When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0029098
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