ADHD: Symptoms of the Disease

ADHD symptoms and the related diagnosis, have had a long and controversial history concerning the boundary between this disorder and age-appropriate distractibility and over-activity. There has been a large amount of different opinions as to whether ADHD symptoms should be focused on the categories of “inattention” or “hyperactivity”. This change in emphasis has also resulted in a changing definition of the constitution of ADHD symptoms over the past couple of decades. The DSM-IV, which is the manual used to diagnose mental health concerns, has gone through several revisions of this disorder, beginning with the DSM II diagnosis of Hyperkinetic Reaction of Childhood and which has now evolved into the current diagnosis of Attention Deficit Hyperactivity Disorder (ADHD), with subtypes such as (1) combined type, (2) predominantly inattentive type and (3) predominantly hyperactive-impulsive type. This helps to indicate that there are variable degrees of inattention and hyperactivity-impulsivity which occur in the presentation of this disorder.

ADHD symptom assessment should always consider the patient’s age and developmental level. The presentation may evolve from one subtype to another over time, such as when the child becomes an adult, the hyperactivity component may be less prominent, making the combined type no longer applicable. Some of the basic ADHD symptoms of the predominantly inattentive type include: difficulty paying close attention to details and making careless mistakes, difficulty sustaining attention during tasks, problems with listening when spoken to directly, lack of follow-through on instructions and finishing school-work, chores or duties in the workplace, difficulty organizing tasks and activities, avoidance or reluctance to engaging in tasks which require sustained mental effort, losing things necessary for tasks or activities, easily distracted by extraneous stimuli, and forgetful in daily activities.

ADHD symptoms of the hyperactive type involve such behaviors as fidgeting with hands or feet and constantly squirming, difficulty remaining seated in a classroom or other situation where remaining seated is expected, running about and climbing excessively in situations in which it is inappropriate, difficulty playing or engaging in leisure activities quietly, talking excessively, and seeming to be “on the go” or often appearing as “driven by a motor“. Symptoms of impulsivity include blurting out answers before questions have been completed, difficulty awaiting turn, and often interrupting or intruding on others.

Other Considerations in addition to the basic ADHD symptoms: Other considerations for making an assessment of ADHD  are that some of these symptoms must have persisted for at least six months and have caused significant impairment prior to the age of seven years old. The impairment usually must be present in two or more settings, such as work, school, or at home, and there must be clear evidence of significant impairment in these settings. Finally, in providing a diagnosis of ADHD, a mental health clinician must rule out other symptoms and disorders such as pervasive developmental disorders, schizophrenia or other psychotic disorders, mood disorders, anxiety disorders and personality disorders. Only properly trained mental health clinicians such as psychologists, psychiatrists and neurologists should make a diagnosis of ADHD.