Etiology of Disorder
Your Demographic InformationMy name is Rojin Baghbaninogourani and I am 22 years and single and female.
- Your Family history
I have a family history of depression and one that is also riddled with anxiety disorders. The family relationships are cordial and good however members of the family are not very social. I have only one close friend and not involved with anyone in any romantic relationship. Furthermore, I am living with parents and my support system is my family.
- Description of Disorder (approved)
Attention deficit hyperactivity disorder (ADHD) is a mental health disorder that can lead to more than normal instances of hyperactive and impulsive actions. Individuals that suffer from ADHD can also be noted to have issues limiting their attention to one activity or even sitting in an area for a lengthened period of time (Thapar et al., 2013). It is a disorder that affects both grown-ups and children and it is a scientifically recognized diagnosis. There are a number of ADHDs based on the grouping offered by the American Psychological Association. These three types are predominantly inattentive disorder, predominantly hyperactivity-impulsive disorder or even both. Predominantly inattentive people have a hard time focusing on tasks carried out daily and adhering to instructions. Predominantly hyperactivity-impulsive persons on the other hand show major hyperactive and impulsive habits that are expressed with actions such as fidgeting, the interruption of others during a conversation and the lack of patience to wait one’s own turn. People that suffer from both conditions display both inattention and hyperactivity. They may fail to pay attention, be very impulsive and have more than average levels of energy. Based on a research study carried out by Kolar et al. (2008), more than 60 percent of kids with ADHD still present such symptoms when they are mature. However, a good number of them are likely to have these symptoms fade away as they mature. It is thus important that treatment is offered to those that are affected by the disorder.
- Description of symptoms
The symptoms of ADHD are associated with habits and behaviors such as the lack of focus or the concentration on activities. It also involves having memory slips about very critical tasks while also being quickly distracted, having a hard time being still while sitting. Finally, the interruption of people while they are still talking is another common symptom. The symptoms of ADHS in kids and young adults are well-defined. The can be clearly notice by the age of six and tend to happen in more than one place both and home and places of learning. Inattentiveness are such as having a limited attention span and being easily distracted, the carrying out of careless errors for instance, cooking with the wrong ingredients, the appearance of forgetfulness and the loss of material and also not being able to adhere to tasks that take up lot of time or are hard (Felt et al., 2014). It also presents itself as appearing to have the inability to listen or also taking up instructions and the constant changing of tasks and having an issue in organizing the activities one does. Hyperactivity then presents itself as having the inability to stay calm in an area, incessant fidgeting, the inability to focus on tasks, countless talking and impatience and also interrupting conversations and a poor sense of danger. The symptoms are also are presented in other conditions such as anxiety disorder that causes the child to be anxious and nervous during most of the time, oppositional defiant disorder (ODD) where there is the presentation of poor
and disruptive habits (Harvey et al.,2016). Conduct disorder is present and there are antisocial habits that are highly present in the individual, depression, sleep issues, epilepsy, Tourette’s syndrome where the nervous system is ailed, presenting itself as joint involuntary noises and tics, dyslexia and even autistic spectrum disorder that influences social communication, interests and habits.
- Etiology of Disorder
ADHD as a disorder shows multiple etiologies because of the joint effect of genetics, neurological and environmental elements that enable the pathogenesis and the heterogeneous phenotype. Based on studies of families, twins and adoptions evidence shows that there is a strong correlation between ADHD and hereditary polygenic issues (Sciberras et al., 2017). Gene changes are critical in the prediction of risk for ADHD especially on brain growth, cell migration and the encoding for catecholamine receptors and transporter genes. The finding of gene sets that influence the neurotransmitter pathways in the brain has offered an explanation that there are uncommon copy number variants and the build-up of bigger deletions and the repetitions that affect gene transcription are more frequently located in individuals that experience ADHD. Moreover the non-inherited neurological factors that influence brain injury have been suggested to have an effect on ADHD pathogenesis. Birth and pregnancy issues have been shown to have a greater risk of instigating ADHD risk based in utero-exposure to liquor and tobacco and even reduced birth-weight (Bendiksen, 2016). Epilepsy, adverse brain injury, hypoxic-anoxic brain injury, has also been seen to add to ADHD risk. The contact with environmental toxins has been associated with ADHD symptoms. Evidence has suggested that ADHD is a disorder that comes in place during early brain development. Referencing different MRI studies there have been variations found in the structural growth and functional establishment of the pre-frontal cortex, the basal ganglia, anterior cingulate cortex and cerebellum (Qiu et al., 2011). Furthermore a setback in cortical growth combined with pike cortical thickness that is present in the cerebellum at around 7 years has been seen to be present in growing children and at the age of 10 years kids suffering from ADHD.
- Type of assessment tools in diagnosing approved disorder
Kyle is 14 year old teenager from Missouri, whose behavior has become a worrying issue for his mother, Hanna. She notes these habits were present for a couple of years but since she was busy with work and supporting her other three kids but recently during her stay at home, she noticed that Kyle was very distracted in his schoolwork, he was always inattentive to tasks and appeared forgetful and was extremely active during outdoor activities being unable relax. The mother however became concerned when Kyle began getting nervous when reporting to school, and began coming back with notes with teachers for class disruption. She also found a notebook in his room where he had written that “I have been sad for a long time”. She thus decided to bring him in for assessment and diagnosis after reading various sources from the internet.
Kyle’s diagnosis could be carried out through the following three tests:
One will be ADHD rating scales that will include questionnaires that can be used to identify specific symptoms of ADHD, which may not be seen during the clinical evaluation. In this case an adolescent evaluation test using rating scales will be utilized. Intelligence test may be also used in the evaluation of Kyle as they are a standard element in most ADHD evaluations as they tend to measure the IQ of the person and also look for learning disabilities that are mostly seen in people with ADHD (Cordeiro et al., 2011). Another final scale that could be used for diagnosis are Broad Spectrum Scales that are used to monitor for social, emotional and even psychotic issues and they often can be ordered when the doctor is sure that there may be issues with mood, OCDs and other conditions that relate to ADHD.
- Recommendations and treatment plan.
Based on the diagnosis and the utilization of the mentioned screening and assessment tools it is clear that Kyle exhibits the symptoms that are consistent with ADHD. It should be made aware for Kyle and his mother that there is no cure for ADHD; however the focus will be on the management of the presented symptoms. It is also critical to inform them that these symptoms are bound to vary or even reduce as Kyle transitions into adulthood. The necessity of education in the symptom management plan will offer the family the needed assets in order to comprehend the disorder and the course of treatment. The education will be centered on Kyle’s mother and himself, because Kyle has the ability to understand his diagnosis and this aspect will be able to grow over time and thus he should be made aware that his re-education may be required and it will be able to address the possible adverse attitudes towards the disease and its treatment.
This education will be used in tandem with ADHD medication which should be effective in addressing the co-occurring conditions that may need changes in the regimen of the treatment (Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management, 2011). Kyle will also be subjected to long-acting medications to offer more symptom management all during the day because many of the tasks that adolescents are doing during the day have ended and there is the transition to resting hours. Kyle and his mother should be made aware that the medication utilization does not in any way increase the risk of substance abuse and instead they reduce the risk of substance abuse.
Behavioral intervention will also be used a part of the treatment plan especially when the person involved is a teenager just like Kyle. For instance, one proven method that has been seen to work with teens is parent-teen training in the solving of problems. Furthermore, other psychosocial treatments that could be recommended could be parent training in behavioral management methods and teacher training in classroom control as Kyle has become disruptive and anti-authority in classroom settings (Schoenfelder & Sasser, 2016). Thus, Kyle’s teachers as part of the treatment plan may be required to understand such methods.
Psychosocial methods are a critical part of treatment of ADHD in both children and adolescents. Based on scientific literature such as those posted by Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management (2011) dictate that behaviorally based psychosocial treatments known as behavioral modification are effective in the treatment of ADHD. The treatment of ADHD through such behavioral modification is combined with their medical and education interventions as explained above. This is a multimodal treatment and is part of the treatment pan offered to Kyle. This approach is made up of parent and child emancipation, medication and school programming and support systems. The level of ADHD may be a determining factor of the components needed in the treatment and management phase and it should also be tailored to meet the needs of the family and teen.
This approach will be very important for Kyle as it will offer Kyle a chance to address the issues that are present in his daily life that are more than the symptoms such as inattentiveness, hyperactivity and also problems at school and the disregard for adult authority. These problems will be able to enable the prediction of how Kyle as a teen will carry out himself in the long run.
After deciding on the best approaches to incorporate in the treatment plan, which is a multimodal treatment approach as discussed and the identification of the individual needs of the plan , the initial phase of the treatment will have been put in place (Hinshaw et al., 2015). The key with this phase will be defining the treatment goals and clarifying this issue with the family and Kyle. In this case a realistic approach will be reducing conflict in school with teachers and then setting other moving targets such as increasing his socialization skills in order to make him feel less sad. This approach will enable Kyle to tackle each problem slowly and realistically focusing on improving every problematic behavior.
After the initialization of this treatment plan and the appropriation of needed medication and prescription there needs to be the institution of follow-up clinic visits by Kyle in order to examine the observance, safety and the permissibility of the medication and how the symptoms that are being targeted are responding to the treatment. There thus will be the monitoring, reexamination and evaluation of the response when the treatment objectives are reached there may be the inclusion of changes in doses of medicine accorded to Kyle (Hinshaw et al., 2015). Psycho education will be emphasized during this period as they will need to be an adherence by the child and the parent in their understanding of their ADHD. Finally, there is a need to be redesigning of the plan especially if there is there is a lack of strict follow-up of the medication or the support needed and also if there is any sign of substance use in the patient or even the close family members involves. Also, especially in Kyle’s case developmental factors ought to be examined as there is a sense of autonomy with growth and even if there are novel demands by the patient as they transition.