Adult ADHD Diagnostic Assessment and Treatment
Many adults suffering from ADHD have a hard time getting diagnosed. Doctors must determine whether symptoms are present today and if they have been previously present (technically prior to the age of 12).
Usually, a thorough evaluation involves more than one person. It is helpful to include family members, co-workers and teachers.
Self-Assessment Tools
The Adult ADHD Symptom Self Report Scale is the most popular instrument for self-assessment for adults suffering from ADHD. It is available online and can be completed by adults at home. This tool asks a series of questions about symptoms that are commonly experienced by those with ADHD. It is a good first step in determining whether or not to seek an additional assessment from a medical professional.
Other symptoms inventories for adults include the BADDS42 and the AD/HD Symptom Inventory for Adults (AD/HD-IS) and the CAARS44. The BADDS, a 40-item assessment that provides context for ADHD symptoms in real-life situations, is a 40 item measure. It can be administered by self-report or as an instrument rated by an observer. It includes a number of important supplementary factors, separate from the DSM-5 subscales, and also provides norms that are based on age.
These symptom inventories can be helpful in the process of diagnosing ADHD because they provide a wider range of data points than a single clinical interview, but they are limited by their low positive predictive value. This means that they considerably over-diagnose cases of possible ADHD. This is because many of the symptoms that these tools evaluate are present in healthy individuals and aren't exclusive to ADHD.
Another issue is that the diagnosis of ADHD must be based on the presence of symptoms over time and in a variety of settings. This requires a thorough evaluation of functioning under different perspectives, as well as the consideration of comorbidities, such as addiction disorders or depression. These comorbidities are frequently present in ADHD and can have a an adverse effect on the quality of life for those suffering from these disorders.
Despite their limitations, self-assessment tools are still useful as screening tools that inform a person of the possibility that may be suffering from an elevated level of ADHD symptoms. It is recommended to consider a medical evaluation. This can be particularly important for a person with concerns that their symptoms may be affecting their daily life at the workplace, at school or in their family.
Contrary to self-assessment tools, clinical interviews with a specialist in the field of ADHD can provide a complete picture and greater confidence in the diagnosis. They can draw from an array of data that can include the results of neuropsychological tests and other measures based on performance, as also anecdotal evidence from the daily activities of a patient.
Diagnosis
A diagnosis of adult ADHD can only be made by an authorized mental health professional trained in conducting these tests. Self-tests online, such as self-tests and rating scales could determine if your symptoms are caused by ADHD but they cannot provide a definitive diagnosis.
A professional ADHD assessment requires a thorough assessment, information from sources independent like the spouse or a family member, and standard psychometric tests. A thorough assessment is made to determine if the person's symptoms have a significant enough impact that they cause impairment in two or more aspects of their lives. It could be that you are fired from a job, enduring financial difficulties because of not paying bills on time or having conflict and distress in relationships.
It is important that patients discuss their symptoms honestly and openly during the interview. Adults with ADHD often hide their symptoms because they're embarrassed or fearful that others will judge them. It may be difficult but it's important that an expert to have a complete picture of the individual's life and their symptoms.
Diagnostic interviews that are structured can be used to evaluate adult ADHD. These types of interviews can help reduce the dependence on the DSM-based inventory of symptoms that was designed for children but does not always translate well for adults. Adult ADHD inventories, executive function inventories, and impairment/quality-of-life ratings are all beneficial tools in the evaluation process. They permit the clinicians to track the progress of the patient throughout treatment.
Ask your primary care physician for an appointment with a local specialist who is trained in the diagnosis of adult ADHD. You can also request a referral from your insurer, contact a university-based hospital or check with your local psychology group or support group to find a qualified professional. If you're having trouble finding someone near you, you can also call a national company that offers consultations via video or phone to connect you with an expert. These services are a reasonable method of getting the assistance that you require right now.
Treatment
Adults suffering from ADHD might have issues at work, home and in their relationships. Inattention, disorganization, and the symptoms of impulsivity can affect self-esteem and social functioning which can lead to frustration and the feeling that things will never be the same again. It's crucial to find a professional who understands the challenges of diagnosing and treating adults with ADHD.
In contrast to children, adults have to be able to demonstrate higher levels of symptoms in order to be diagnosed. Adults have to exhibit more severe, long-term problems across multiple areas of their life. It is crucial to gather the complete medical history because certain illnesses can exhibit similar symptoms as ADHD including thyroid disorders and hearing or vision issues as well as seizures. Some drugs and medications may also cause ADHD-like symptoms and signs.
Structured diagnostic interviews help clinicians verify that the symptoms being observed are indeed related to ADHD and not other neurodevelopmental or psychiatric disorders. This can include asking about the patient's education, work experience and family background. The physician can also inquire about the use of alcohol and drugs as well as the current and past use, and any other health problems such as sleep disorder or hearing or vision disorders.
In addition to the structured interview, other tests could be used. These include IQ tests and achievement tests as in addition to various tests of neuropsychology or psychological. These tests do not diagnose ADHD but can provide important information on how it affects the person.
Once a correct diagnosis has been made, psychosocial and pharmacological treatments are often employed to treat the symptoms. These treatments can be employed individually or in combination. For instance, a patient might be treated with cognitive behavior therapy to identify and modify "thought distortions" and improve his ability to prioritize tasks and organize. ADHD medication is a way to reduce impulsiveness, which makes it hard for patients to finish their school work or work assignments.
All adults with a newly diagnosed ADHD or uncontrolled symptoms are advised to consult their healthcare provider in the next 30 days. Then, regular follow-ups will be suggested until symptoms and functioning have improved. It is crucial that the health professional monitors comorbid conditions such as mood disorders and anxiety when treating.
Support
Adults with ADHD might find help in a variety of ways. Some are at ease in online forums and virtual peer support groups like those offered by ADDitude magazine. Participating in local support groups as well as camps for children, teens and adults with ADHD can help them connect with others. These groups can provide assistance, resources, and guest speakers to assist with learning and coping skills.
Adults are more difficult to diagnose than children, and a majority of the self-assessment tools cannot give a definitive diagnosis. The symptom guidelines in the DSM-V are specifically designed to help diagnose children, while an adult ADHD diagnosis is only made after an extensive clinical evaluation that includes structured diagnostic interviews as well as a variety of objective tests. Neuropsychological tests and performance-based assessments are particularly useful in assessing executive function deficits. They allow a clinician to observe symptoms in action and can provide a better picture of the severity of impairment than self-report instruments.
It is crucial to speak with other significant people in the life of the patient including spouse or spouse, parents or siblings and even employers. Although assessing adhd in adults may be difficult for the person being evaluated however, it is essential that they open up and discuss their problems honestly. Many times, people suffering from ADHD are unaware of how their actions affect the people around them. They may also be reluctant to discuss negative consequences of their behavior.
A complete assessment includes a thorough examination of the patient's past to determine if there are any psychiatric or other conditions that could be causing the symptoms. It is not uncommon for people suffering from ADHD to be diagnosed with more than one disorder.
It is important for people who suffer from ADHD to have a third party complete questionnaires that evaluate their symptoms and impact on quality of life. This is because symptom evaluations are based on subjective. The person who is chosen must be a close family member or parent who is familiar with the individual and can attest to their observations. Some doctors request that a trusted friend or employer complete a similar form to obtain additional information that is not provided in the clinical interview.