adhd: is it as simple as that? - adhdfoundation.org.uk · •adhd is a neurodevelopmental condition...
TRANSCRIPT
ADHD: Is it as simple as that?
Kalum Bodfield, Dr Philip Carey, Professor David Putwain & Dr Avril Rowley
Liverpool John Moores University
1
ADHD: What is it?
• ADHD is a neurodevelopmental condition characterised
by the cardinal symptoms of inattention, hyperactivity and
impulsivity.
• It is categorised in the DSM-V (diagnostic and statistical
manual of mental health disorders (American
Psychological Association, 2013) as either:
– ADHD of the inattentive type.
– ADHD of the hyperactive-impulse type.
– ADHD of the combined type.
2
ADHD: The Complexities
3
• ADHD rarely appears alone, it usually manifests with one
or multiple comorbidities.
• These include (but aren’t limited to): • Oppositional defiant disorder (ODD) (Jensen et al., 2001)
• Depression (Wilens et al., 2002)
• Anxiety (Schatz & Rostain, 2006)
• Autism (Simonoff et al., 2008)
• Attachment related issues (Jensen & Steinhausen, 2015)
4
ADHD: The
Complexities
Image taken from MyHealthyFeeling (http://www.myhealthyfeeling.com/adhd-and-add-difference-adhd-types/)
But how complex is ADHD and the complexities?
• Consider, individuals can show traits of ADHD without having ADHD. For
example, impulsivity (Hart & Dempster, 1997).
• Individuals can show symptoms of depression without having depression,
consider dysthymia (Weissman, Leaf, Bruce & Florio, 1988), bereavement
etc.
• Autism is already considered a spectrum model (Volkmar, State & Klin,
2009).
• Anxiety is experienced by all but only becomes pathological when chronic
without a reasonable trigger (American Psychological Association, 2013) –
also consider defensive pessimism (Norem & Cantor, 1986).
5
What Complex ADHD looks like in the classroom?
Consider an individual
with traits of ADHD,
but then also consider
them to have
comorbid traits of
depression, or autism,
or even anxiety. How
will this impact the
manifestation of traits
on behaviours?
• Figure taken from http://newideas.net/different-types-
adhd/three-adhd-disorders
6
How do you manage this?
7
The Proposed Model
• ADHD and many conditions can be explored as
spectrums, with traits manifesting in individuals.
• At some level these traits become pathological.
• This research will look at whether traits exist in an
adolescent population and to what extent the culmination
of them leads to a greater experienced deficit in academic
functioning.
8
A Constellation of Deficit
9
Anxious Traits Depressive Traits
Educational Attainment
Deficit Autistic Traits
ADHD Traits
Maladaptive Attachment
Patterns
The Research Project
• Research questions:
– To what extent do multiple, adverse mental health traits impact academic
attainment?
– At what level of severity do these traits begin to impact educational attainment?
• Hypothesis:
• The presence of multiple adverse mental health traits will have a greater
effect on educational attainment than the presence of singular traits.
• The initial phase of the study will comprise of three construct validations on
measures of attachment, ADHD traits and autistic traits.
• The final phase will comprise of a multiple regression analysis on a questionnaire
given to GCSE students and their GCSE results collected in August 2019.
10
Possible Outcomes?
• There are multiple outcomes possible, presented are a few of the possible
outcomes:
– The greater amount of traits present the greater the deficit in educational
attainment. Traits do become pathological at a level.
– Only certain traits negatively impact academic attainment. Only certain
traits become pathological.
– There is not a significant impact on academic attainment by any of the
mental health traits explored and none of the traits are pathological by
nature.
11
Next Steps?
• To begin the research project;
• To explore the relationship between comorbid traits and
their impact on attainment and the severity of this impact.
12
How you can be involved!
• We’re currently looking for schools to participate in the
project!
• Initially this is taking part in the construct validations – we
need pupils to complete an interview and then a cohort to
complete a survey
• Following the completion of this we can collect data to
explore the relationship, which is again a questionnaire.
13
Questions?
14
References • American Psychological Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Washington, DC.
• Hart, S. D., & Dempster, R. J. (1997). Impulsivity and psychopathy. Impulsivity: Theory, assessment, and treatment, 212-232.
• Jensen, P. S., Hinshaw, S. P., Kraemer, H. C., Lenora, N., Newcorn, J. H., Abikoff, H. B., ... & Elliott, G. R. (2001). ADHD comorbidity
findings from the MTA study: comparing comorbid subgroups. Journal of the American Academy of Child & Adolescent
Psychiatry, 40(2), 147-158.
• Jensen, C. M., & Steinhausen, H. C. (2015). Comorbid mental disorders in children and adolescents with attention-
deficit/hyperactivity disorder in a large nationwide study. ADHD Attention Deficit and Hyperactivity Disorders, 7(1), 27-38.
• Kim, M. J., Park, I., Lim, M. H., Paik, K. C., Cho, S., Kwon, H. J., ... & Ha, M. (2017). Prevalence of attention-deficit/hyperactivity
disorder and its comorbidity among Korean children in a community population. Journal of Korean medical science, 32(3), 401-406.
• Norem, J. K., & Cantor, N. (1986). Defensive pessimism: Harnessing anxiety as motivation. Journal of personality and social
psychology, 51(6), 1208.
• Schatz, D. B., & Rostain, A. L. (2006). ADHD with comorbid anxiety: a review of the current literature. Journal of Attention
disorders, 10(2), 141-149.
15
References • Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism
spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American
Academy of Child & Adolescent Psychiatry, 47(8), 921-929.
• Volkmar, F. R., State, M., & Klin, A. (2009). Autism and autism spectrum disorders: diagnostic issues for the coming decade. Journal
of Child Psychology and Psychiatry, 50(1‐2), 108-115.
• Weissman, M. M., Leaf, P. J., Bruce, M. L., & Florio, L. (1988). The epidemiology of dysthymia in five communities: rates, risks,
comorbidity, and treatment. The American Journal of Psychiatry, 145(7), 815.
• Wilens, T. E., Biederman, J., Brown, S., Tanguay, S., Monuteaux, M. C., Blake, C., & Spencer, T. J. (2002). Psychiatric comorbidity
and functioning in clinically referred preschool children and school-age youths with ADHD. Journal of the American Academy of Child
& Adolescent Psychiatry, 41(3), 262-268.
16