There is a growing consensus that the central feature of ADHD is disinhibition. Patients are unable to stop themselves from immediately responding, and they have deficits in their capacity for monitoring their own behavior. Hyperactivity, while a common feature among children, is likely to be less overt in adults. Utah criteria may be called the imperative criteria for this. For adults, it is used like this: What is the childhood history consistent with ADHD? What are the adult symptoms? Does the adult have hyperactivity and poor concentration? Is there any affective lability or hot temper? Is there the inability to complete tasks and disorganization? Is there any stress intolerance, or impulsivity? (Wender, 1998)

Wender developed these ADHD criteria, known as the Utah criteria, which reflect the distinct features of the disorder in adults. The diagnosis of ADHD in an adult requires a longstanding history of ADHD symptoms, dating back to at least age seven. In the absence of treatment, such symptoms should have been consistently present without remission. In addition, hyperactivity and poor concentration should be present in adulthood, along with two of the five additional symptoms: affective lability; hot temper; inability to complete tasks and disorganization; stress intolerance; and impulsivity.

The Utah criteria include the emotional aspects of the syndrome. Affective lability is characterized by brief, intense affective outbursts ranging from euphoria to despair to anger, and is experienced by the ADHD adult as being out of control. Under conditions of increased emotional arousal from external demands, the patient becomes more disorganized and distractible.

Treatment of Adult ADHD

Some treatments for ADHD in adults are as follows:

Stimulants: Stimulants work by increasing both blood flow and the levels of Dopamine in the brain, especially the frontal lobes where the brain’s Executive Functions take place. Stimulants will increase the brain’s ability to inhibit itself. This allows the brain to focus on the right thing at the right time, and to be less distracted, and less impulsive. Stimulants increase the “signal to noise ratio” in the brain.

Antidepressants: Antidepressants are considered a second choice for treatment of adults with ADHD. The older antidepressants, the tricyclics, are sometimes used because they, like the stimulants, affect norepinephrine and dopamine.

Other Medications: Sympatholytics have also been used in the management of ADHD as well as the non-stimulant ADHD medication, Strattera.

Self-Management Strategies: Adults with ADHD benefit considerably from direct education about the disorder. They can use information about their deficits to develop compensatory strategies. Planning and organization can be improved by encouraging patients to make lists and use methodically written schedules.

more: A Life Skills Program for ADHD Adults

next: A List of Great ADHD Books

References

Wender, Paul (1998). Attention-Deficit Hyperactivity Disorder in Adults . Oxford University Press.

Weiss, Margaret (2001). Adhd in Adulthood: A Guide to Current Theory, Diagnosis, and Treatment . Johns Hopkins University Press.

Goldstein, Sam; Ellison, Anne (2002). Clinicians' Guide to Adult ADHD: Assessment and Intervention. Academic Press.