Attention-Deficit/Hyperactivity Disorder: Causes, Symptoms, Treatment DSM-5

According to the Diagnostic and Statistical Manual of Mental Disorders, attention-deficit/hyperactivity disorder (ADHD) is characterized by a pattern of inattention and hyperactivity-impulsivity, which gets in the way of normal functioning and development. This inattention includes difficulty staying focused and on task, being disorganized, and is not attributed to misunderstanding or disobedience. The hyperactivity denotes excessive motor activity at inappropriate times—such as running around—or excessive fidgeting, talking, and moving around. Lastly, the impulsiveness that characterizes ADHD refers to sporadic actions that weren’t thought out and could potentially harm the individual (e.g., running into traffic), as well as socially intrusive ones (e.g., interrupting others).

Diagnostic Criteria for Attention-Deficit/Hyperactivity Disorder DSM-5

The following are criteria determined by the DSM-5 that should be met in order for a correct attention-deficit/hyperactivity disorder diagnosis to be completed:

The individual shows persistent displays of inattention and/or hyperactivity-impulsivity that interferes with functioning and/or development as described by 1 and/or 2:

• Inattention: At least six of the following symptoms have lasted for 6 months or more, to a degree that is inconsistent with developmental levels and that negatively impacts social and academic/occupational activities:
• The individual often fails to pay close attention to detail and/or makes careless mistakes. For example, he or she overlooks important details.
• The individual typically has trouble staying focused on given tasks (e.g., he or she finds it difficult to focus during lectures or conversations.).
• He or she appears distracted when spoken to directly—their mind seems elsewhere.
• The individual often fails to follow instructions and finish schoolwork or other duties.
• He or she has trouble organizing tasks and activities. For example, the individual has poor time management and difficulty keeping materials in order.
• The individual avoids or dislikes engaging in tasks that require serious mental effort; this may include school work or, for adults, completing reports or forms.
• He or she regularly loses important things necessary to completing tasks, such as school materials, pencils, and glasses.
• He or she is easily distracted by irrelevant, unimportant thoughts or objects.
• The individual is forgetful in everyday activities (e.g., paying bills, completing chores, making/keeping appointments).
• Hyperactivity and impulsivity: At least six of the following symptoms have lasted for 6 months or more to a degree that is inconsistent with developmental levels and that negatively affects social and academic/occupational activities:
• The individual often fidgets or squirms.
• He or she often fails to stay seated when expected to.
• The individual runs and climbs around inappropriately. (In adults, they may instead just feel restless).
• He or she is unable to engage in leisure activity quietly.
• He or she is often “on the go” at all times.
• The individual talks excessively.
• He or she blurts out answers prematurely.
• The individual has a hard time waiting for his or her turn.
• He or she interrupts and/or intrudes on others. For example, the individual enters conversations not meant for him or her, takes other’s things, or takes over what someone else is doing.
• Several of the aforementioned inattentive or hyperactive-impulsive symptoms were present before the age of 12.
• Several of the aforementioned inattentive or hyperactive-impulsive symptoms are present in two or more settings, such as at home, at school, at work; with friends or relatives; etc.
• The symptoms clearly interfere with everyday functioning.
• The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and cannot be better explained by another mental disorder.

A few specifications are important when it comes to making an ADHD diagnosis. The severity—whether it be mild, moderate, or severe (based on the amount of symptoms and level of their impairment)—should be specified as well as the subtype:

314.01 (F90.2) Combined presentation: In this case, both criterion for inattention and hyperactivity-impulsivity are met for the past 6 months.

314.00 (F90.0) Predominantly inattentive presentation: Criterion for inattention is met, but criterion for hyperactivity-impulsivity is not for the past 6 months.

314.01 (F90.1) Predominantly hyperactive/impulsive presentation: This is where an individual meets the criterion for hyperactivity-impulsivity, but not criterion for inattention over the past 6 months.

And if…

in partial remission: This is when full criteria were met previously, but now fewer than the full criteria have been met for the past 6 months, and the symptoms still impair the individual’s everyday functioning.

Who is at Risk of Developing Attention-Deficit/Hyperactivity Disorder DSM-5?

According to population surveys, around 5% of children and 2.5% of adults have ADHD. While ADHD appears to mostly affect individuals at random and research is still being done, there are a few individuals who may be at greater risk: those with a very low birth weight, individuals with a history of child abuse or neglect, those with close relatives who have ADHD, and individuals with a history of infections or alcohol exposure in utero.

Treatment for Attention-Deficit/Hyperactivity Disorder

There are two important treatment components for attention-deficit/hyperactivity disorder. These include:

1. Psychotherapy: This form of therapy will help the individual learn the skills they need in order to live better and more successfully with the disorder.
2. Medication: Stimulant drugs are often used to calm hyperactivity and impulsivity, and, therefore, helps individuals focus better, work more productively, and learn without distraction. Some effective and popular stimulants include Adderall and Focalin. Other drugs, such as antidepressants, are also used to treat those with ADHD.

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