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ADHD etc DSM-5 workgroup report


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http://www.psych.org/MainMenu/Research/DSMIV/DSMV/DSMRevisionActivities/DSM-V-Work-Group-Reports/ADHD-and-Disruptive-Behavior-Disorders-Work-Group-Report.aspx

Not final, just an ongoing report.

Stuff I thought was interesting:

They're talking over the the ADHD/ADD (hyperactive vs inattentive) distinction. Apparently evidence doesn't really support the subtype distinction doesn't hold up well empirically. I couldn't figure out what they were concluding there.

They think three major dimensions - hyperactivity, inattention, and impulsivity - should be assessed separately, and that impulsivity may have been underconsidered as a factor

They want to change the criteria for adults to reflect different manifestations of similar problems over time. (For example, you have different options for impulsive behavior as an adult than as a kid.)

They're considering revising the symptoms-present-before-age-7 criterion, but want to keep it earlier than when people tend to abuse drugs and develop mood and psychotic disorders. (I'm assuming because that would make it easier to differentially diagnose it? Although I read in the review I mentioned above that there's not much justification for setting it before the mid-teens.)

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  • 1 month later...

it's interesting to me that the 'pros" have not reached consensus on subjective Ad/Hd diagnises. I believe that defiance and other aggressive/passive agressive can be subsumed under the manic phase of adhd. When under streatem I am inattentive and cannot hold a thought. I am simultaneous guily of having a hair trigger and I have a real defiance

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it's interesting to me that the 'pros" have not reached consensus on subjective Ad/Hd diagnises. I believe that defiance and other aggressive/passive agressive can be subsumed under the manic phase of adhd. When under streatem I am inattentive and cannot hold a thought. I am simultaneous guily of having a hair trigger and I have a real defiance

Bipolar Disorder has a manic phase, not ADHD.

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They think three major dimensions - hyperactivity, inattention, and impulsivity - should be assessed separately, and that impulsivity may have been underconsidered as a factor

I listened to Barkley address this in a lecture that was up on the UC Berkeley's Mind Dept. website. It made a lot of sense to me at the time. It seemed more consistent with my own experience of the whole ADD thing--particularly my life prior to dx.
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it's interesting to me that the 'pros" have not reached consensus on subjective Ad/Hd diagnises. I believe that defiance and other aggressive/passive agressive can be subsumed under the manic phase of adhd. When under streatem I am inattentive and cannot hold a thought. I am simultaneous guily of having a hair trigger and I have a real defiance

Bipolar Disorder has a manic phase, not ADHD.

Dear moderater. Please realize that I suffer from an ilness on concentration and order following. I cannot figure out how to manipulate the god damn boards and was recently kicked out because of it. Where's your humanity. I'm challenged in learning and following directions. My brain is like a seive. Aby chance you guys can lighten up on me?

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They think three major dimensions - hyperactivity, inattention, and impulsivity - should be assessed separately, and that impulsivity may have been underconsidered as a factor

I listened to Barkley address this in a lecture that was up on the UC Berkeley's Mind Dept. website. It made a lot of sense to me at the time. It seemed more consistent with my own experience of the whole ADD thing--particularly my life prior to dx.

The part where you tell your friends about the diagnosis, and they're appalled that you're just finding this out NOW, after some of the boneheaded maneuvers you've made in the past several years ... and oh shit, they not only have a list, but some of the pictures are still on the Internet ...

Or, maybe that's just me.

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it's interesting to me that the 'pros" have not reached consensus on subjective Ad/Hd diagnises. I believe that defiance and other aggressive/passive agressive can be subsumed under the manic phase of adhd. When under streatem I am inattentive and cannot hold a thought. I am simultaneous guily of having a hair trigger and I have a real defiance

Bipolar Disorder has a manic phase, not ADHD.

Dear moderater. Please realize that I suffer from an ilness on concentration and order following. I cannot figure out how to manipulate the god damn boards and was recently kicked out because of it. Where's your humanity. I'm challenged in learning and following directions. My brain is like a seive. Aby chance you guys can lighten up on me?

And..you missed my point entirely.

are you sure you're up for the job?

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Where's your humanity.

It's in a little box under the bed, where I occasionally feed it dust bunnies and the odd piece of lettuce.

And..you missed my point entirely.

are you sure you're up for the job?

Now that you've followed up your plea for understanding with an implied insult,

I don't really care what your point was. In fact, the likelihood of "going easy" on you,

has gone down considerably.

For now, I would suggest you reread the site rules.

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it's interesting to me that the 'pros" have not reached consensus on subjective Ad/Hd diagnises. I believe that defiance and other aggressive/passive agressive can be subsumed under the manic phase of adhd. When under streatem I am inattentive and cannot hold a thought. I am simultaneous guily of having a hair trigger and I have a real defiance

Bipolar Disorder has a manic phase, not ADHD.

Dear moderater. Please realize that I suffer from an ilness on concentration and order following. I cannot figure out how to manipulate the god damn boards and was recently kicked out because of it. Where's your humanity. I'm challenged in learning and following directions. My brain is like a seive. Aby chance you guys can lighten up on me?

At what point were you kicked out?

Your inability to navigate the site has nothing to do with the fact that ADHD has no manic phase. Bipolar disorder does. It is your responsibility to sound like a coherent human being if you want to communicate with others.

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The part where you tell your friends about the diagnosis, and they're appalled that you're just finding this out NOW, after some of the boneheaded maneuvers you've made in the past several years ... and oh shit, they not only have a list, but some of the pictures are still on the Internet ...

It's not just you. Seriously tho, friends and family still don't get that you can have ADHD and not be hyperactive. The impulsiveness is attributed to a weak moral character.
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its a new day. hopefully a new moderator as well. I propose we explore the wide range of symptoms both real and symbolic related to add-innatentive and ad/hd, I submit that specially for adult women, hyper symptoms are sublimated by our culture and so bleed out in different ways. Manic depression my eye

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New moderator here. I don't know what you mean by real symptoms versus "symbolic" symptoms, or what you mean by symptoms "bleeding out". If you're saying that cultural gender roles affect how symptoms are expressed and how other people react to them, sure. I think that's important in ADHD, and it's something people talk about and write books about and do research on.

Having a disorder related to inattention sucks, but it doesn't mean other people have to pretend you're right when you're not. ADHD does not have a "manic phase"; bipolar I does.

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its a new day. hopefully a new moderator as well. I propose we explore the wide range of symptoms both real and symbolic related to add-innatentive and ad/hd, I submit that specially for adult women, hyper symptoms are sublimated by our culture and so bleed out in different ways. Manic depression my eye

I'm not sure whether another voice helps or complicates things. What it seems like happened was

--an original post spoke about adhd symptoms, but also used the phrase "manic" or "mania." Manic/mania has a specific set of symptoms and is associated with a specific disorder - bipolar disorder a.k.a manic depression. Hence, there was lots of confusion.

--to try to sort out the confusion, someone pointed out that mania is a symptom of bipolar disorder, not adhd. someone could have both--but if the person is demonstrating mania (as opposed to, say, hyperactivity plus impulsivity), the disorder is bipolar.

--If the point was that people get misdiagnosed as manic when in fact it's adhd symptoms of hyperactivity and impulsivity, you could make that argument (though probably on a separate post by now). I'm skeptical, just because mania has fairly high standards. But you may not mean "manic" clinically speaking.

I may have missed something, but that's my guess at where things were and where they are. If you want to try to take a stab at the issue, it might not hurt to start over and just clarify the original point.

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  • 11 months later...

The current proposed criteria make the following major changes:

  • There is much greater recognition that the symptoms of ADHD affect adults just as much as children.
  • Adolescents and adults only need to meet 4 or more criteria for either inattentiveness or hyperactivity. This reflects the changing presentation.
  • The age threshold has been raised to 12 years old. The workgroup acknowledges that the DSM-IV threshold of 7 years was chosen arbitrarily, and a higher threshold is more accurate.
  • A predominantly inattentive (restrictive) subtype has been added to better represent inattentive patients who do not show any symptoms of hyperactivity. Someone presenting with 3 or more hyperactive symptoms would be classified as PI, while someone with fewer hyperactive symptoms would be classified as PI-R. It doesn't seem that these subtypes are supposed be coded separately.
  • Pervasive developmental disorders are not exclusions to the ADHD diagnosis. The proposed criteria fully allows for comorbid diagnosis of ASD and ADHD. (The DSM-IV specifically excludes the diagnosis of ADHD in someone with a pervasive developmental disorder.)

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The current proposed criteria make the following major changes:

  • There is much greater recognition that the symptoms of ADHD affect adults just as much as children.
  • Adolescents and adults only need to meet 4 or more criteria for either inattentiveness or hyperactivity. This reflects the changing presentation.
  • The age threshold has been raised to 12 years old. The workgroup acknowledges that the DSM-IV threshold of 7 years was chosen arbitrarily, and a higher threshold is more accurate.
  • A predominantly inattentive (restrictive) subtype has been added to better represent inattentive patients who do not show any symptoms of hyperactivity. Someone presenting with 3 or more hyperactive symptoms would be classified as PI, while someone with fewer hyperactive symptoms would be classified as PI-R. It doesn't seem that these subtypes are supposed be coded separately.
  • Pervasive developmental disorders are not exclusions to the ADHD diagnosis. The proposed criteria fully allows for comorbid diagnosis of ASD and ADHD. (The DSM-IV specifically excludes the diagnosis of ADHD in someone with a pervasive developmental disorder.)

Do you have an updated link?

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  • 1 year later...
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