Family Members Report on Symptoms of Adult ADHD

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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  • Brailey

    July 19th, 2012 at 3:37 PM

    For me, I grew up with ADHD, and now as an adult I am not sure that the symptoms have gone away, it’s just that I have learned how to have a little better control over those things that once would have thrown me way off course.

    I am lucky that my parents pursued a diagnosis and treatment for me from a very young age, so even by the time I was in elementary school we had practiced ways for me to keep the behavior in check so that I could focus on what I was in school actually to do.

    It was not always easy but I felt like I always had guidance through my family and my counselors and teachers. I think that this is what has made all the difference in the world to me as I have gotten older.

  • evie

    July 19th, 2012 at 5:35 PM

    Often times it is the family who has to live with the individual with ADHD who have a much better grasp about the ways that the illness affects the one with the disorder than those who actually live with ADHD. I think that many times the individual with any illness or disorder becomes immune to the ways that it affects their lives, it is just what they live with on a daily basis. But the family members who see it from an objective outside view have a better vision about the ways that it changes them, even though many times their observations fall on deaf ears.

  • miley

    July 19th, 2012 at 7:10 PM

    so do we need a re-look at the criteria specified in the DSM-IV?

    I think even if it is modified there will always be cases of individuals who do not meet the criteria but still have trouble functioning. there is always going to be a difference between the theoretical criteria and real world cases. how do things proceed in such a case?

  • Pete

    July 20th, 2012 at 4:16 AM

    How hard is it to diagnose an adult ADHD case when it has gone unnoticed when the individual was a child?
    Do you think that there are a lot of doctors who would pick up on this is what it could be if this adult patient had never mentioned a pst issue with ADHD?
    Just like with children, adults lives can be so marred by having to deal with all of the ramifications that having ADHD can pose to someone.

  • solomon

    July 20th, 2012 at 11:27 AM

    To think how far we have come in the world of mental health but could still be missing the boat when diagnosing and treating something like ADHD which is so prevalent in society really does concern me. There are obviously adults who have to live with this just like children; however where some doctors seem to be over eager to treat and medicate the children with ADHD symptoms, adults often have a difficult time finding a professional who will diagnose them correctly and help them get the care that they need.

  • marilynJ

    July 21st, 2012 at 10:41 AM

    I can definitely see the benfits of soliciting opinions from family members versus always taking the patient’s word for something. It is often hard to see objectively things that are going on with us because, well, we like to put a positive spin on things. Whereas with family, you know that they will generally be a little more forthright and honest, most of the time more so than we want them to be! But they have a clear vision about the things that they have noticed that might be odd to them. So asking for their input could help a therapist go a log way toward creating a better treatment plan for the patient, one which will specifically address the issues that the patient has to deal with.

  • Jean Nystrom

    July 21st, 2012 at 12:43 PM

    I have done a lot of homework on this topic. I found no quantitative statistics that convinced me that medication is the way to go. I feel that parents with children and persons suffering from ADHD/ADD should seek alternatives to the current medications available. I have a child with ADHD. I tried the Ritalin with little to no success. I found the drug made my child lethargic and once it wore off she would either crash or become even more hyper-active. Believe me, I tried it for a period of time to see if it would build up in her system and alleviate not only the behavior but the side effects. It did not. After doing much research I found a program that is working for my child and my family. I use Play Attention. Play Attention is a program that builds behavioral shaping. Since investing my child’s mental health into this platform I have now learned that they are using this program at nuclear power plants, nascar mechanics use it, why? To focus and reach their maximum potential. Personally, I just want my child to live a normal, loving life and enjoy life to the maximum. Jnystrom

  • jnystrom

    July 22nd, 2012 at 11:50 AM

    I realize this article is about ADHD and adults but I just have to share some thoughts. I totally agree with marilynJ especially when it comes to children with ADD/ADHD. I only started noticing there was a problem when I got called from the school and was having problems doing homework with my daughter. I had to be her advocate and desperately wanted to be. Being recently divorced I did not know what was happening between the two households and was not getting the information that I needed. I incorporated the play attention and adhd nanny so that she was not only learning to focus but was kept on task because both households began to use the second program I mentioned. She was too young to know and I (at the time) was too sick to notice-breast cancer. Great observation marilynJ family input is a must.

  • Polly Hall

    July 23rd, 2012 at 11:25 AM

    if only we could get the patients to be as honest as the family members being surveyed then that could lead to a whole lot of improvement in the way that adults with ADHD are treated
    but most of the time i think that you will find that they always tend to think that they’ve got it all under control but we know that’s not always true
    it almost seems like they are afriad of being stigmatized if they admit that they have problems focusing stc without ever thinking about how much more success they could see in life if they were to actually seek help for their issue


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