November 3, 2009
ADD Research Paper
Attention deficit hyperactivity disorder has traditionally been seen as a behavior disorder characterized by inattention, distractibility, impulsivity, and hyperactivity. These traits are generally the criteria that are used in diagnosing the disorder and many doctors prescribing medications do not truly understand how much more complicated the diagnosis is for ADHD. Thomas E. Brown, PhD, writes in his latest book, Attention-Deficit Disorder: The Unfocused Mind, that an overly simplistic understanding of ADHD still persists among many medical professionals and the general public. He believes attention is an incredibly complicated, multifaceted function of the human mind and it plays the most important role in how we perceive, remember, think and feel. His research has challenged the older ideas and myths concerning ADHD syndrome and brought to light how complex the disorder is to diagnose and treat. Dr. Brown believes “the myths and misconceptions about ADHD make it even more difficult for the people who suffer from it to be understood and to get adequate treatment.” He has outlined the key elements in his latest book to support the “new paradigm” to better describe ADHD. (Brown, 2008) New research, utilizing brain scan (SPECT) technology is also giving doctors new tools to better diagnose and treat the illness. Daniel G. Amen, M.D. has pioneered the use of brain scan technology with clinical practice to give patients a more specific diagnosis by showing the areas of dysfunction in the brain. The hope is that with a better model for doctors and psychiatrists to follow, better treatment plans can be developed to help people of all ages better handle the symptoms and be educated about behavior modifications which will help them be more successful.
Dr. Brown’s first element describes ADD as essentially a complex disorder of the unconscious self-management system of the brain. The new description focuses less on the hyperactivity and behavior problems and instead describes the real issue, which is the self-management system of the brain itself. Brown has discovered, through his treatment of attention related disorders, the powerful link between attention and multiple aspects of the brains management system. He states that attention is really the name for the integrated operation of the executive functions of brain activity. To understand ADD and its effects, Dr. Brown has created a model with six clusters representing each important aspect of the brain’s executive function – activation, focus, effort, emotion, memory and action. He describes each cluster as an important piece of the brain’s executive function and he emphasizes, “They depend upon and interact continuously with each other in ever-shifting ways.” Studies done by Russell Barkley, where he interviewed hundreds of patients, support the same basic model describing ADD as a disorder of the control center of the brain. Brown sees the six clusters as important functions an individual must use to manage the multiple aspects of everyday life. He concludes that all ADHD persons, regardless of subtype, are suffering from impairments of executive function and it is the essence of their disorder.
The second key element emphasized in Dr. Brown’s study was the chronic difficulties with self-regulation of emotion resulting from ADHD. Even though the current criteria for ADD does not list emotional regulation as one of the symptoms, many rating scales (Connors Adult ADHD Rating Scales) describe multiple emotional problems like a “hot temper” and “overreaction”. The people suffering report inappropriate emotional reactions to frustrations and a low threshold for irritability. The ADD sufferers describe the feeling of emotions flood their minds and take up all the space so that they are so preoccupied with the thoughts that they lose rational perspective about a situation. The immediacy of the emotion can then have too...
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