ADHD: The Most Common Behavioral Disorder

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This essay intends to give a brief overview of the controversy surrounding the diagnosis of Attention

Deficit Hyperactivity Disorder. I will start looking at the diagnostic criteria for Attention Deficit Hyperactivity

Disorder. For the purpose of this essay I will just refer to children even though I am aware of the disorder in


Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavioural disorder amongst

school aged children. In the Centres for disease and prevention publication (2002), it is estimated that there

are among 1.6253 million children diagnosed with ADHD. With prevalence rates much higher for the US

compared to other European countries. ( The main characteristics

of ADHD are Inattention, Hyperactivity and Impulsivity. For instance:- children will show problems such as

falling to follow instructions to complete a task, always on the go and interrupting conversations etc. Children

with ADHD will experience academic difficulties, social difficulties and difficulties with self-concept.

Professionals’ who diagnose ADHD are to follow the criteria set out in the DSM-IV (American Psychiatric

Association in their Diagnostic and Statistical Manual of Mental Disorders) or the ICD-10. (International

Statistical Classification of Diseases and Related Health Problems. Hyperkinetic disorders) It is worth noting

that the US/Canada use the DSM-IV whereas other European countries tend to use the ICD-10. Both

diagnostics criteria’s are very similar in the way of symptoms, however the ICD-10 rules out co-morbidity and

pervasiveness. With the ICD-10 symptoms have to be present before the age of 7 and children must show

symptoms which are from 3 categories:- Inattention (6 out of 9), Overactivity(3 out of 5) and Impulsivity (1

out of 4). The DSM-IV on the other hand only has two domains as they combined the last two shown in the

ICD-10 into one:- Inattention (6 out of 9) and Hyperactivity/Impulsivity (6 out of 9). The DSM-IV allows for

subtypes of ADHD, if all criteria’s are met from both domains they than are then classified as the combined

type, if only Inattention is met (6/9) they are then classified as predominantly Inattentive and if only

Hyperactivity/Impulsivity is met (6/9) they are diagnosed predominantly hyperactive/impulsive. The

difference in criteria and especially the subtypes which the DSM-IV allows for, could be one explanation on

why the prevalence rates are higher in the US than other countries which do not use the DSM-IV. Skounti,

Philialithis, Galanakis (2006) This is also supported by Moffitt and Melchior (2007) who reviewed meta-

regression carried out by Polanczyk and colleagues and found that different prevalence rates between North

America and Europe could be explained by the different methodologies. According to Moffitt and Melchior

(2007) the DSM-IV is far more lenient, in that the child only has to fall in one of the two domains

compared to the ICD-10 where each domain criteria needs to be met.

As outlined above, validity of the diagnostic criteria is cause for concern and has shown in these

Studies and many others to play a role in the prevalence of ADHD. Another area I am now going to look at is

the subjectivity of the rating scales used to identify whether an individual meets the criteria or not. In looking

at this area I will also bring into the debate the role cultural differences might play on the prevalence rates of


Symptoms of ADHD has to be predominant in two situations. This is manly the home and school of

the child. Therefore both teachers and parents play a vital role in whether the child receives a diagnosis or not.

Information is normally collected by using behavioural rating scales, check lists and interviews. Most

frequently used...
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