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ADULT ADD/ADHD.
Term Paper ID:28946
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Essay Subject:
Assesses extent to which Attention Deficit Disorder & Attention Deficit/Hyperactivity Disorder affects adult's self-esteem. Discusses need for education of problem. Intervention strategies.... More...
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13 Pages / 2925 Words
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Paper Abstract:
Assesses extent to which Attention Deficit Disorder & Attention Deficit/Hyperactivity Disorder affects adult's self-esteem. Discusses need for education of problem. Intervention strategies.
Paper Introduction:
Table of Contents
Title Page
Chapter One: Introduction 2
Background 2
Objectives & Statement of the Problem 2
Research Question 3
Hypotheses 3
Chapter Two: Review of Related Literature 4
Chapter Three: Research Methodology
Experimental Design 11
Subjects 11
Apparatus/Tools 12
Analysis 14
Interpretation 14
Text of the Paper:
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The WesternJournal of Medicine, 3(2), 259. You have had those close to you helping you to remember your commitments6. The scoring for some items willbe reversed. [On-Line].Available:http://www.chadd.org/facts/add_facts.htm (1992). & Ratey J. C. Adult outcome of hyperactive boys: Educational adjustment,occupational rank, and psychiatric status. Dunne, J. They will also receive a test at the beginning of the year and againtowards the end of the year to measure their level of self-esteem. Higgins, E. You have eliminated all negative self statements4. Self-esteem can be defined as the judgments we make about our worthand the feelings that are associated with those judgments (Rosenberg,1979). Chapter Three Research MethodologyExperimental Design This study will be a pre-test, post-test, experimental design. The most important step in the beginning of treating adults with ADD is toinstill a sense of hope once more. First, they said that agood therapist will work hard to get rid of the negativity that adults haveafter living many years without knowing they had ADD. I take a positive attitude toward myself.Analysis A one-way analysis of variance (ANOVA) will be conducted to evaluatethe relationships between whether the subjects receive psychotherapy,pharmacotherapy, or both, and the improvement in post-test measures of self-esteem. Table of ContentsTitle PageChapter One: Introduction 2 Background 2 Objectives & Statement of the Problem 2 Research Question 3 Hypotheses 3Chapter Two: Review of Related Literature 4Chapter Three: Research Methodology Experimental Design 11 Subjects 11 Apparatus/Tools 12 Analysis 14 Interpretation 14 Chapter One IntroductionBackground Limited research has been conducted in the area of attention deficitdisorder (ADD) in adults. (1999). Monographs of the Society for Research in ChildDevelopment, 57, 226. The subjects will also fill out a questionnaire at theend of the year to display which intervention strategies they receivedduring their treatment. 5. However, this does not teach them how to develop asense of self-control that is vital in restraining against aggressiveimpulses. (1999). On the whole, I am satisfied with myself. Journal of FamilyPractice, 48(1), 15. Research has documented that individualswith ADHD have shown improvements in self-esteem, cognition, and social andfamily function when treated with stimulants (Spencer, Biederman, Wilens,Harding, O'Donnel, & Griffin, 1996). You have developed good management of your time8. The questionnaire will also consist of questionsabout time management, and if they have shown improvements in their problemsolving skills. The adults alsoneed to understand that it cannot be cured simply by willing it to healitself, by being punished, by sacrifice, or by experiencing self-inflictedpain. Subjects receiving both psychotherapy and pharmacotherapy will show higher post-test measures on self-esteem than those adults receiving only one mode of therapy.2. I feel that I am a person of worth, at least on an equal plane with others. and Watkins, C. You have developed good problem solving skills The scale is an eight-item scale, with items answered on a four-pointscale from strongly agree to strongly disagree. The use of psychostimulantsalone has been used to decrease the impulsivity and aggression that is seenin people with ADHD. E., Arnold, V., Benson, S., Bernet, W., Bukstein, O.,Kinlan, J., McClellan, J., Sloan, E. S. (1997). (199 ). All in all, I am inclined to feel that I am a failure. Family therapy is considered to be helpful in resolving the chaoticrelationships that usually occur as a result of ADHD. Psychological Review, 92(4), 548-573. He has suggested that persons who attribute failure toability view failure as an internal, stable, uncontrollable event. Sylwester (1997) stated that psychotherapy should include the teachingof time management, family systems approaches, problem solving, andcommunication training. Summary of the practiceparameters for the assessment and treatment of children, adolescents, andadults with ADHD. (1999). New York: Basic Books. Weiner (1985) has indicated that beliefs about the causes of successand failure vary along three dimensions: locus (internal or external),stability (stable or unstable), and control (controllable oruncontrollable). Research found regardingaffects of ADD/ADHD on adult's self-esteem is lacking.Objectives & Statement of the Problem The purpose of this study is to assess the extent to which ADD/ADHDaffects adult's self-esteem. Rosenberg, M., (1979). Involvement of theadult's family during the treatment process can be helpful by providingfeedback about the efficacy of the treatments and in ameliorating theadult's cooperation with the treatment. Researchers have found that adults with ADHD experience lower levelsof occupational achievement than those studied without ADHD (Mannuzza etal., 1993; Slomkowski, Klein, & Mannuzza, 1995). The comparative analysis of antidepresentsand stimulants for the treatment of adults with ADHD. You have reduced or eliminated alcohol and/or drug use5. The most common side effects of the drugwere dry mouth, constipation, lightheadedness, and insomnia. Mannuzza, S., Klein, R. The following questionswill be asked: During the past year,(1 You have been on a regular schedule for physical exercise(2 You have maintained a sense of humor3. Additional characteristics include difficulty inmaintaining an organized living or work place, inconsistent workperformance, inattention to detail, making decisions without anticipatingconsequences, difficulty delaying gratification, stimulation seeking,restlessness, low frustration tolerance, and impatience (Krener, 1996). Itwas also mentioned that without adequate medication, cognitive therapiesare likely to be ineffective and the use of psychoanalysis therapy can beharmful. Slomkowski C., Klein, R. ED 42 942) Hallowell M. Thesubjects will be given a pre-test at the beginning of the year to measuretheir level of self-esteem, followed by a post-test measurement towards theend of the year. Research has shown that antidepressants (desipramine) and stimulants(methylphenidate) are equally effective for treating adults with ADHD(Higgins, 1999). Available: http://www.chadd.org/facts/add_facts.htm. Rosenberg, M. Afterthey have been given a proper diagnosis, they are usually relieved to findout that their difficulties are due to ADHD, and not due to personal flaws. A 55-year-old man with attention-deficit/hyperactivity disorder. 8. This most likely isattributed to their behavioral problems, academic failure, and low self-esteem (Weiss & Hechtman, 1993). [On-Line]. (1997). Byrnes and Watkins also stated that adults who have been properlydiagnosed with ADHD should receive treatment that teaches them ways tostructure their lives, while allowing for some spontaneity. (1995). (1996). Subjects receiving both psychopharmacology and psychotherapy as treatmentApparatus/Tools CHADD (1999) discussed some intervention strategies that will be usedin the questionnaire which included: scheduling regular physical exercise,maintaining a sense of humor, eliminating negative self statements,reducing or eliminating alcohol or drug use, having those close to themhelp with remembering commitments, and providing feedback. They said that by the time a diagnosisis made, many of those with ADD have already lost a majority of theconfidence they have in themselves. Apgar's research also revealed that the group who wasadministered desipramine showed significant reductions in hyperactivity,impulsivity, and inattentiveness. J. It is also expected that there will be a strong positive correlationbetween the intervention strategies and overall self-esteem. 2. (1965). T. Use of desipramine for treatment of adult ADHD.American Family Physician, 55(1), 3 6. Barkley, R. Weiner, B. Archives of General Psychiatry,5 , 565-576. Biederman, J. (1998). Dunne, Arnold, Benson, Bernet, Bukstein, Kinlan, McClellan, and Sloan(1997) stated that psychotherapy alone is unlikely to be successful intreating ADHD in adults unless pharmacotherapy is also administered. 6. The following items make up the scale: 1. Self-esteem is considered the most important aspect of self-development (Stipek, Recchia, & McClintic, 1992). Mannuzza, S., Klein, R. Health and Wellness, 37,11. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) (1999) stated that ADD in adults hasnot been thoroughly researched and only recently has been recognized as anadult disability. NIH Consensus Statement, 16(2) 1-37. The subjects will be placed into three differentgroups depending on the type of therapy they will be receiving. (1998). Research has shown that 66% of children diagnosed withADD or ADHD continue to experience one or more symptoms into adulthood(Dunning, 1998). (ERIC Document Reproduction Service No. Chapter Two Review of Related Literature Evidence has lead to the belief that attention-deficit/hyperactivitydisorder (ADHD) is caused by abnormal catecholamine metabolism in the brain(Biederman, 1998). ADHD has an enormous impact in terms of financial cost, the stress tofamilies, the impact on academic and vocational activities, and alsonegative effects on self-esteem. New York: Guilford. Thiswill be measured using the Rosenberg Self-esteem Scale (Rosenberg, 1965).The scale is a ten-item scale, with items answered on a four-point scalefrom strongly agree to strongly disagree. CHADD (1999) stated thatadults with ADD often experience career difficulties and may lose theirjobs, which may be attributed to poor job performance, attention andorganizational problems, or relationship problems. Stipek, D. Educational Leadership, 54(5), 75. The impact of attention disorders duringadulthood: A review of the current literature. I feel I do not have much to be proud of. The experimenter will give the subjects theself-esteem assessment test and the questionnaire, and the therapist willcollect the completed forms.Subjects The subjects will consist of adults (18 years and older) who havebeen diagnosed with either ADD or ADHD and are receiving treatment at alocal psychiatric clinic. At times I think I am no good at all. Thesegroups will include the following:(1 Subjects receiving psychopharmacology as treatment 2. Second, theyexpressed that those with ADD need to give themselves permission to bethemselves. CHADD. Is self-esteem animportant outcome in hyperactive children? Available:http:/www.baltimorepsych.com/adultadd.htm. Adult attention-deficit disorder. Third, they suggested that those with ADD give up trying tobecome the person they always thought they should be (e.g., model studentor organized executive) and instead focus on who they are. It will also look at the effectspsychotherapy and/or psychopharmacology have on the improvements of self-esteem.Research Question The following research question will be focused on in this study: 1 Which intervention strategies are the most effective in improving self- esteem in adults with ADHD?Hypotheses The following hypotheses will be tested in this study: 1. Weis, G., & Hechtman, L. J., Recchia, S., & McClintic, S., (1992). They stressed that the adults need to understand they do not have adisease of will, or one caused by a weakness of character. CHADD reported that this might be attributed to theprevious belief that the symptoms of ADD were resolved in adolescence dueto brain development, hormonal change, or other developmental changes.Mannuzza, Klein, Bessler, Malloy, and LaPadula (1997) also expressed theconcern that very little is known about the adult outcome of ADD. Thisdiscovery shows the importance of self-esteem at its early stages, and ifchildren or adults who show signs of ADHD are not properly diagnosed, itcan lead to a feeling of poor self-worth (Brynes & Watkins, 1999). Attention deficit hyperactivity disorder.New York: Guilford Press. It was also stated that ADD in adults is often eithermisdiagnosed, or not diagnosed at all. Desipramine treatment has been shown to be clinically andstatistically more effective in treating patients with ADHD than a placebo(Apgar, 1997). I feel that I have a number of good qualities. Journal of the American Academy of Child and AdolescentPsychiatry, 36(9), 1311. Hyperactive children grown up,second edition. These criteria includes: either inattention orhyperactivity persisting from childhood and three of the following:inability to complete tasks, impaired interpersonal relationships orinability to sustain relationships over time, hot or explosive temper, andstress intolerance. (1985). Spencer, T., Biederman, J., Wilens, T., Harding, M., O'Donnell, D.,Griffin, S. Attention deficit hyperactivity disorder inadults: Guidelines for evaluation and treatment. (1996). The neurobiology of self-esteem and aggression. Sylwester (1997) stated that psychotherapy should include the teachingof time management, family systems approaches, problem solving, andcommunication training. Society and the adolescent self-image.Princeton University Press. G., Bessler, A., Malloy, P., & LaPadula, M.(1997). In adults as with children and adolescents, education about ADHD isthe most important feature of the treatment plan (Dunne et al., 1997).CHADD (1999) also discussed the importance of education as being the firststrategy to use during intervention. Journal of the American Academy of Childand Adolescent Psychiatry, 35(4), 4 9. Subjects receiving psychotherapy as treatment 3. 3. Hallowell and Ratey (1992) stated that the treatment of ADD could bebroken into five simple areas. Theyemphasized that time management and planning are important skills that mustbe taught to allow those with ADHD to live more structured and productivelives. 9. Subjects receiving only psychotherapy will show the lowest post-test measures on self-esteem. Pharmacotherapy of attention-deficit hyperactivitydisorder across the life cycle. Krener, P. (1998). ADD adults need lots of encouragement. Fact Sheet 7: Adults With Attention Deficit Disorder.[On-Line]. This is attributed to the evaluations we make about our owncompetencies and the impact these evaluations have on our emotionalexperiences, future behavior, and long-term psychological adjustment(Stipek, Recchia, & McClintic, 1992). I wish I could have more respect for myself. The impulsivity and aggression of individuals with ADHD brings about alower level of self-esteem (Sylwester, 1997). CHADD also mentioned that most of theadults with ADD have very little understanding of the disability. JAMA, The Journal of the American MedicalAssociation, 12(1), 1 86. Conceiving the self. 7. When this occurs, it can lead tolow self-esteem, increased frustration, and educational or vocationalfailure. Self-evaluationin young children. CHADD also discussed some intervention strategies which include:scheduling regular physical exercise, maintaining a sense of humor,eliminating negative self statements, reducing or eliminating alcohol ordrug use, having those close to them help with remembering commitments, andproviding feedback. Brynes, G. References Apgar, B. Correlation coefficients will be computed between the interventionstrategies scale and the self-esteem scale to determine if there are anysignificant associations between them.Interpretation This experiment will most likely show that the subjects with ADD/ADHDwho receive both psychotherapy and pharmacotherapy will display the highestself-esteem in post-test measures. Educational and occupational outcomes of hyperactive boys grownup. Self-esteem is considered the most important aspect of self-development. 5 Tips on the Management ofAdult Attention Deficit Disorder (Enhanced Version). Research has found that hyperactive children do not remain in schoolas long as other children who are not hyperactive. It is also expected that those adultswho only receive psychotherapy will have the lowest post-test self-esteem,because they will be unable to control the impulsivity and hyperactivitywithout the use of medication. 1 . Hallowell and Ratey also discussed some tips on what type ofprocedures should take place during psychotherapy. An attributional theory of achievement motivationand emotion. H. Research has shown that the use of psychopharmacology alone intreating ADHD has displayed little improvement in the academic and socialskills of children (National Institute of Health [NIH] Consensus Statement,1998). Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder(1998). Dunning, S. Failureis seen as beyond their control and they have little incentive to persistin similar tasks in the future. The original sample for which this scale consisted of 5, 24high school juniors and seniors from ten randomly selected schools in NewYork. Intervention strategies used in psychotherapywill be evaluated to determine which approaches prove to be the mostbeneficial in improving self-esteem. Those who are close to you have been providing feedback about your behavior7. Sylwester, R. Journal of Abnormal ChildPsychology, 23, 3 3-315. Young adults who have been diagnosed with ADHD in childhood have shownthat conduct problems, arrest records, poor academic histories and acontinuation of ADHD into later adulthood is very common (Apgar, 1998).Khouzam (1997) stated that adults with ADHD require long-term treatment fortheir lifelong disorder. (1997). E. Apgar, B. I am able to do things as well as most other people. This treatment consists of psychotherapy andpsychopharmacology. Each subject will be assigned a number that only the therapist knowsto maintain confidentiality. I certainly feel useless at times. (1992). A. G., & Mannuzza, S. Each of the subjects will fill out the following questionnaire to helpdetermine what type of intervention they received. (Doctoral dissertation,Biola University, 1998). 4. Adult Attention Deficit Disorder:Diagnosis, Coping and Mastery. (1993). They also emphasized that the adults need to remember that they havea neuropsychiatric condition caused by an abnormality in the biology of thebrain. Adult psychiatric status of hyperactive boys.American Family Physician, 58(2), 528. (1997). An adult needs to meet several criteria in order to bediagnosed with ADD. As early as pre-school, children who have been diagnosed with ADHDtypically develop consistent patterns of inattention, behavioraldisinhibition, conduct problems, and low self-esteem, that can lead todepression by the time they are in the second grade (Barkley, 199 ). These areas included (1) diagnosis; (2)education; (3) structure, support, and coaching; (4) various forms ofpsychotherapy; and (5) medication. G., Bessler, A., Malloy, P., & LaPadula, M.(1993). These children beginfind school settings aversive from a young age. Khouzam, R. Journal of the American AcademyOf Child and Adolescent Psychiatry, 36(6), 1222.
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