What is Attention Deficit Disorder?

Attention deficit disorder (ADD) is the most common neuropsychiatric disorder of childhood. Studies have found that the majority of individuals diagnosed with ADD have symptoms that persist well into adulthood. Many who are affected by ADD evade diagnosis as children, and come to The Midtown Practice with complaints of focusing difficulties that date back to school age. Together, with your clinician, we will work to diagnose the reason for your difficulties with attention, and identify any comorbid psychological disorders such as anxiety, depression, or substance abuse. Once we have a clear picture of your symptoms and condition, we will work collaboratively to design a treatment that addresses your focusing issues. Our goal will be to see tangible improvements in your relationships and educational and/or occupational functioning. If you or a loved one is struggling with ADD we can help. We work with children, adolescents, and adults to manage ADD.

Causes of ADD

The cause of ADD is not completely known. Certain biological risk factors have been identified. These include first degree relatives with a diagnosis, exposure to environmental toxins such as lead paint, prenatal exposure to drugs, alcohol, or smoking, and premature birth.

Although there is no one imaging study that is FDA approved to diagnose ADD, imaging studies have found some structural brain abnormalities in individuals with ADD. These include smaller brain volumes in the frontal cortex, cerebellum, and other subcortical structures. These structural changes might lead to dysfunction in the neural circuitry underlying executive function, inhibition of behavior, and reward pathways.

Clinical Symptoms of Attentional Deficit Disorder

There are three subtypes of ADD: predominantly inattentive type, predominantly hyperactive/impulsive presentation, and combined presentation. In children and adolescents symptoms of hyperactivity and impulsivity are common. While in adults, these symptoms may be less overt, as maturity and socialization diminish these aspects. Inattention is most often prominent, and impulsivity might be seen more in verbalizations such as frequently — putting your foot in your mouth — rather than physical behavior such as inability to sit quietly in school.

Diagnosis

During your assessment at The Midtown Practice, your clinician will do a thorough history to identify symptoms consistent with a DSM 5 diagnosis of ADD. We will also rule out other disorders that might interfere with attention such as a depression, anxiety disorder, or a nonpsychiatric medical issue. In those individuals not diagnosed in childhood, we will do a careful evaluation to see if your symptoms date back to school age. When appropriate, we might ask you to obtain collateral history from your parents or other family members with familiarity of your academic and peer development. This history is especially important, because ADD is not something that you acquire as an adult, but rather something that can be traced back to early childhood. History is therefore central to obtaining a proper diagnosis.

A diagnosis of ADD is based on the number and severity of symptoms, the duration of symptoms, and the degree to which these symptoms cause impairment in life. In order to meet the criteria for ADD, we look for significant negative impact in at least two major settings in a person’s life. Examples of the severity of impairment include failure to pay bills in a timely manner, being put on academic or occupational probation due to failing performance, or repeated driving offenses due to distraction and impulsivity.