Attention Problems in Adults

Identifying Attention Problems

James J. De Santis, Ph.D.
138 North Brand Boulevard, Suite 300
Glendale, California 91203-4618
TEL (818) 551-1714

Identifying Attention Problems
by James J. De Santis, Ph.D.

What is Attention-Deficit/Hyperactivity Disorder?

Attention-Deficit/Hyperactivity Disorder, or "ADHD," is a condition composed of one or both of two main elements--inattention and disinhibition.

1. Inattention

While people with ADHD can pay attention, they have difficulty sustaining attention. They have difficulty focusing, holding attention continuously, and selectively shifting the focus of attention. Often such individuals have difficulty concentrating for long periods of time. They are easily distracted, especially when engaged in tasks that require persistence or vigilance. It's hard to just stay "tuned in."

Occasionally, people with ADHD actually may find that they sometimes "hyperfocus," or get too absorbed in an activity, because they cannot easily or flexibly control their attention.

2. Disinhibition

Inhibition is the ability to restrain our inner impulses. Conversely, behavioral disinhibition is an "inability to stop." Disinhibition can appear in either or both of two ways--hyperactivity and impulsivity.

Hyperactivity involves motor restlessness. Individuals with ADHD can experience this as constantly being "on the go." They may have difficulty sitting still in meetings, often fidgeting or talking excessively, or leaving their seat frequently. They may have difficulty engaging in quiet activities.

Impulsivity involves an inability to stop and think before taking action. Such an individual may frequently speak before editing their thoughts, even interrupting sometimes. They may also experience impulsivity around planning, spending, or other behaviors.

What Causes ADHD?

Not much is yet known about the cause of ADHD. The disorder may in part be genetic and may have a neurological or biochemical basis. We do know that it tends to run in families. It may also be influenced by environmental factors, like stress.

ADHD always begins in childhood. ADHD occurs in about 3-5% of elementary school children. It occurs in 3-5 times as many males as females.

While it can sometimes be identified as early as age 3, ADHD may not always be identified early. The disorder may be overlooked, especially when the primary symptom is inattention.

In the past, ADHD was first thought of as a disorder only of childhood. More recently ADHD has been recognized as frequently continuing into adolescence and adulthood for many sufferers.

The course of ADHD may vary. Some people will experience more inattention than hyperactivity or vice versa. For 15-30% of children with ADHD, their symptoms may disappear as they grow up.

However, as many as 50-65% of children with ADHD will continue to exhibit some symptoms into adolescence or adulthood. Frequently, adults with ADHD may find their childhood symptoms of disinhibition have decreased while their symptoms of inattention continue to cause them problems.

Some Signs of ADHD

Whether in children or adults, ADHD can have an adverse impact on effectiveness in school, work, or interpersonal relationships. We all may experience some inattention, restlessness, or impulsivity at times; however, people with ADHD experience these in excess of what most people the same age do. Some signs of ADHD are the following:

People with ADHD report a kind of mental "fuzziness." They may experience inconsistency in their ability to recall facts, which makes them seem forgetful. For example, they may have to read a paragraph several times to understand it.

Individuals with ADHD may have trouble staying organized. They may have trouble forming plans on their own. They may have trouble adhering to established procedures or rules.

Such individuals can have trouble getting from point A to point B. They may struggle with starting new tasks and may appear to procrastinate. They may start too many projects, get swamped, and have difficulty following through on everything they started, so they end up completing very little. They may inaccurately be labeled as "lazy."

They may tend to get bored easily or seem chronically impatient. They may have little tolerance for frustration and find their attention drifting from tasks that are familiar, repetitive, tedious, or uninteresting, instead functioning better on tasks that are highly stimulating, exciting, or novel.

Even though they may possess high potential for success, their actual school or work performance may be inconsistent--they may do well some days and poorly other days. Overall, they may be underachieving in life as a result.

When To Seek Help

Evaluation for ADHD is warranted when prominent symptoms of inattention, hyperactivity, or impulsivity are interfering with effectiveness with school, work, or interpersonal relationships.

ADHD should be diagnosed only by a qualified professional. An in-depth investigation is generally necessary to diagnose ADHD; no single interview or test will conclusively diagnose ADHD.

A thorough evaluation usually will include a clinical interview, a review of personal history, consultation with your physician or therapist, and completion of a short set of structured questionnaires and objective psychological tests.

Evaluation should rule out other difficulties that can mimic the symptoms of ADHD, such as clinical depression, anxiety disorders, learning disabilities, memory impairment, understimulating or chaotic environments, addiction-related disorders, or medical causes.

Although no permanent "cure" has yet been found, ADHD is definitely a condition that can be treated effectively. A comprehensive plan of treatment may include a number of recommendations, such as:

Education about ADHD
Training in self-control methods
Organization and time-management techniques
Classroom or workplace modifications
ADHD coaching
EEG neurofeedback
Medication
Exercise
Psychological or family counseling
Communication with loved ones
ADHD support groups