Attention-Deficit/Hyperactivity Disorder: A Neuropsychological Perspective Towards DSM-V

Abstract

Neuropsychological methods and techniques have much to offer in the evaluation of the individual suspected as having Attention-Deficit/Hyperactivity Disorder (ADHD). After a review of the historical evolution of the ADHD concept, incidence and prevalence, and DSM-IV criteria for diagnosis, especially as regards omission related to gender differences, and other associated cultural, familial, socioenvironmental, and subject influences, this paper describes a number of dilemmas and obstacles encountered in clinical practice. Included are the confounds associated with the wide range of possible comorbidities, the insufficiency of current DSM-IV criteria, the emergence of subtype differentiation and its impact on diagnosis and treatment. The complex relationship between neuropsychological constructs and ADHD, and obstacles to valid assessment are also addressed. The complexities associated with a thorough ADHD evaluation are viewed within an impressive and expansive existing scientific framework and recommendations are made for future directions.

Cognitive Profile for Children with ADHD by Using WISC-IV: Subtype Differences? // Detección de perfiles cognitivos mediante WISC-IV en niños diagnosticados de TDAH: ¿Existen diferencias entre subtipos?

“…La concepción y definición del TDAH ha ido variando gradualmente a lo largo del tiempo (Stefanatos y Baron, 2007). Tal y como afirmaron Tillman, Eninger, Forssman y Bohlin (2011): «(el TDAH) conviene estudiarlo en un marco dimensional y de desarrollo en el que tanto los síntomas como sus bases neuropsicológicas, en lugar de ser estáticos se encuentren situados en el extremo de un continuo de normalidad y varíen según el nivel de desarrollo» (p. 181).…”

What have birth cohort studies asked about genetic, pre- and perinatal exposures and child and adolescent onset mental health outcomes? A systematic review

“…We lack a detailed knowledge of the aetiology, risk factors, correlates, onset, early symptoms, course and prevalence of child psychiatric conditions including conduct disorder (CD) (Moffitt et al, 2008), oppositional defiant disorder (ODD) (Karnik, McMullin, & Steiner, 2006), tic disorders, bipolar disorder, attention-deficit hyperactivity disorder (ADHD) (Stefanotis & Baron, 2007) schizophrenia (Read, van Os, Morrison, & Ross, 2005) and autism spectrum conditions (ASC) (Rapin & Tuchman, 2008). Some of these conditions will be discussed in more detail to provide specific examples of the issues that need to be addressed.…”

Comorbidity in ADHD: A Neuropsychological Perspective

“…In ADHD, attention is only one of these consequences; and for an important number of cases is not the most important. Diverse clinicians and researches in this field began to underline the need for systematic neuropsychological evaluation in order to objectify attention disorders , interpretations on these results should be made within valid scientific models (Drake & Wallach, 2007;Stefanatos & Baron, 2007). Professionals should understand basic neuropsychological and psychological mechanism causing ADHD: attention is ONLY one of the cognitive processes involved, due to inadequate development in executive function control; in most cases comorbidity is ALSO explained by the same psychophysiological and/or neuropsychological mechanisms; based on this comprehension intervention programs will be more specific, and above all: more scientifically oriented.…”

“…Instead of comorbidity summation, basics and common neuropsychological mechanism are proposed in order to explain from wider perspective attentional, behavioral and psychological profiles (Barkley, 1997(Barkley, , 2009Stefanatos & Baron, 2007).…”

“…(Drake & Wallach, 2007;Stefanatos & Baron;, Taurines et al 2010. And although a neuropsychological approximation to understand the basic mechanisms of "psychological" disorders is continuously increasing, the neuropsychological profile for each disorder hasn't yet acquired a central role in diagnosis and treatment (Beblo, Sinnamon & Baune, 2011: Neuropsychology Review).…”