Answers to Quiz

Quiz Questions

Section A.  The Nitty Gritty -medical conceptualisation and treatment of ADHD

1)    C

2)    ICD (ICD-10 or ICD-11 also acceptable)

3)    Hyperactivity, impulsiveness and inattention

4) All except A

Note on answer A: although there is evidence that men and women who were diagnosed with ADHD are at ‘increased risk of police contact’, the existing evidence suggests crimes of violence are less frequent for ADHD without a comorbid conduct disorder.  See e.g. (Young, 2007)

5) A and f are wrong. Thus: a=-1, b=1, c=1, d=1, e=1, f=-1, g=1, F=1

Note: increased Self-Transcendence is supported by 2 Studies (Lynn DE, 2005) (Smilley, Loo, Hale, & Shresha, 2009)

6) Thom Hartnell

7) B

Section B. History of ADHD

1) 1 point for any of the following up to a maximum of three points: Minimal brain dysfunction, minimal brain damage, post-encephalitic behaviour disorder, defect of moral control, hyperkinetic disorder of childhood, attention deficit disorder, attention deficit hyperactivity disorder.

2) C. By Dr Charles Bradley in 1937

3) D.  Link to   newspaper report (in Dutch)

<http://www.nieuwsblad.be/article/detail.aspx?articleid=8H1B9D68

4) 1 point for any of the underlined points to a maximum of three points  -18-year-old American sentenced to 6 strokes (later commuted to 4) of the cane for vandalism in Singapore. Caused international debate over ADHD and responsibility for actions

5) J. Ritalin came on the market for hyperactive children in 1956

6) The parliamentary assembly in Strasbourg published a report on  Controlling the Diagnosis and Treatment of Hyperactive Children in 2002 partially based on a meeting in 1999. Subsequently, criticised by a reply from the Committee of Ministers

‘Some of the points raised in the Recommendation are at variance with the views held by the vast majority of the scientific community and that they are dangerously close to certain well-known theories which the “Church of Scientology” has promoted for some time but which do not stand up to serious scientific scrutiny.’

Section C. ADHD and Culture

1) Falstaff  (portrait by Eduard von Grützner above) in Henry IV PART 2

2) Bart Simpson. All the children in Southpark. If you know others email me –

3) Percy Jackson in The lightning thief by Riordan-.

 Notes:  Symptoms are well described by Riordan and superpowers (sort of!) plausibly extrapolated from them. Other examples of superpower / ADHD symptom confusion appear to trivialise ADHD e.g. True blood’s Sookie Stackhouse   revealed she was thought to have ADHD as a child   when her ability to read peoples minds interfered with her ability to concentrate-

1)   Films -Charlie Bartlett becomes manic on Ritalin. In Pecker, Pecker’s sister is diagnosed with ADHD and becomes zombie is on Ritalin – consuming too much sugar caused her ADHD

TV: South Park –every kid in town prescribed Ritalin. Side effect extreme dullness. Bart Simpson; medication made him insanely paranoid

4) Connolly, Kieboom, Cassidy -1 point each

Some of the others possibly had ADHD but diagnosis not confirmed.

Two worth noting are -

 Doyle has said that she had brain damage at birth, but people diagnosed with MBD (a precursor of ADHD) were told at diagnosis that they likely had brain damage at birth retrospectively.  Two adults in this group were formerly diagnosed with MBD, in one the brain damage at birth ran in the family, should have changed midwife, I guess! So it is possible that Boyle was diagnosed with MBD and nowadays would have been diagnosed with ADHD.

 Some celebrities mention childhood hyperactivity, even a medical consultation without making it clear if they were diagnosed or even formally assessed for ADHD.

E.g. Usain Bolt the’ fastest man in the world’ told the Guardian (28th August 2010) that his Grocer parents took him to the doctor: "I was all over the place, climbing things. My mum goes, 'There must be something wrong with this kid', and the doctor goes, 'Nooooo, he's just hyperactive. ‘His Mum has commented that the doctor added that she should be careful with him by the roadside. Perhaps this was the limit of available treatment when Bolt was growing up in rural Jamaica? 

  Niels Albert the Belgian Cyclist tells a similar story. In  2009 he gave an interview on lunchtime Flemish news (Een, 10^th January 2011). When he was around five years old, his mum thought he was hyperkinetic (another old name for ADHD) and consulted a pediatrician who advised her to find her son’s’ ‘thing’. Great advice but did all parents so advised find their kids  ‘thing’? Luckily, Albert found his ‘thing ‘nine years later, taking up cycle racing at 14.   Again it is neither clear if Albert was assessed nor, if assessed, diagnosed, and if the advice was supplementary to a treatment regime or in lieu of treatment.

I have avoided postmortem diagnosis e.g. Einstein and making my own diagnosis e.g. Schindler screams ADHD to me!

Some on the list are rumoured to have a diagnosis, but it is hard to establish that there is not a formal diagnosis (Although Bart Peeters recently denied having ADHD).  So if you know of a link, which seems to settle the question of diagnosis for any of the others, do let me know.

6) Love thought Ritalin prescribed in childhood fostered Cobain’s addiction

7) Wrong- scientific evidence suggests that children with ADHD are less likely to develop addictions as adults then their unmedicated peers.

 Based on this, since Cobain took Ritalin for only three months when he was seven years old, had he been treated longer in childhood or received treatment in adulthood he would have been less likely to develop an addiction to heroin.   Furthermore, other factors, which likely to have contributed to an increased susceptibility to addiction include a Rock, star lifestyle and a disturbed childhood.

8) a) Indigo

Stephanie Clark, Adult Anglophone ADHD group, 24.12.2012

References

Lynn DE, L. G. (2005). Temperament and Character Profiles and the Dopamine D4 receptor gene in ADHD. American Journal of Pyschiatry , 906-913.

Smilley, S., SK, L., TS, H., & Shresha, A. (2009). Mindfulness and Ateention Deficit Hyperactivity Disorder. Journal of Clinical Psychology , 1087-1098.

Young, S. (2007). Forensic Aspects of ADHD. In M. Fitzgerald, M. Bellgrove, & M. Gill, Handbook of attention defecit hyperactivity disorder (pp. 90-105). Chichester: Wiley.

Sleep and ADHD

the problems
1) Going to bed
• Getting a second wind, i.e. feeling drowsy than waking up again, when everyone else is going to bed
• Feeling you need time to unwind / do own thing after everyone else has gone to bed
• Difficulty stopping doing something in order to go to bed: watching TV, reading book, computer etc
2) Getting to sleep
• Resisting sleep. Some adults with ADHD report resenting sleep / fighting it
• Often can’t shut mind off and relax
3) Sleeping
• Restless sleep- may disturb partner, may not feel refreshed
• Scary/ anxious dreams
• Staying asleep frequently waking up during the night and staying awake.
4) Getting up and daytime
• Often eventually fall deeply asleep (about 4pm) and have difficulty waking
• Feeling sleepy or falling asleep in the daytime
• Generally, lack of structure and regular bedtimes / wake times
5) Finally sleep problems may worsen as you get older both because older people (ADHD or not) generally have more sleep problems than younger people but that does not mean you need put up with insufficient sleep especially as it becomes harder to manage on insufficient sleep
Problem solving hints
People with ADHD often feel that standard solutions don’t address their problem- so I have tried to list as many as possible below- find what speaks to you or use a sleep diary to problem solve,
In general –
• Sleep problems can be caused by common health problems; acid reflux, asthma, B12 deficiency (a lot of people have problems absorbing this, especially as they get older).For severe sleep problems whatever the cause -do consult a doctor.
• Beware of high short term expectation. this is the ADHD Achilles heel in achieving change . Don’t try to change too much immediately. Credit yourself for your progress, do not berate yourself for your difficulties Don’t give up when you backslide.. If you have ADHD you will backslide, but that does not mean you are not progressing. You can achieve anything slowly!
The tips-
• Ambient temperature affects sleep - bedroom should not be too warm.
• Problems with circadian rhythm - Light and dark affect sleep rhythms .Get some sunlight / use light box in daytime
• Dim lights in the later part of evening, Avoid TV, computer screens, reading from a backlit device such as an iPad . Here is a link to a free program that moderates computer screen brightness with the time of day
• Meal times affect sleep rhythms. So establish regular meal times and avoid eating a large meal late in the evening (also because digestion process may disturb sleep in addition to circadian rhythm,). NB There is a theory that protein should be eaten in the morning and lunchtime and carbohydrates at evening meal (which supports serotonin production for sleep but mixed scientific evidence that this improves sleep quality). Protein also positively affects alertness levels, so may be useful if you wish to be alerter in daytime.
• Establish a winding down pre sleep routine- what works for you bath, read a book, meditation.
• All of the following can negatively affect sleep if taken in the evening alcohol (may help you fall asleep, but subsequent sleep is broken), caffeine, chocolate, exercise (good to improve sleep, but not the last few hours before bed), heavy meal. (Also as you get older metabolism slows, so foodstuffs and drugs and eating late may begin to impact sleep even if it did not do so previously). Caffeine may affect sleet in some individuals taken as early as 3 pm.
• If you are sleepy go to bed before you get a second wind.
• If that fails and you get a second wind- some find that reading something light, comforting, dry, or technical helps clear their mind and induce sleep. In my case trying to learn something by heart, vocabulary or a presentation for example exhausts me again quickly, but not doing something that demands deep thought such as writing the presentation.
• Relax, if you can’t sleep, it can be better to make relaxation the aim .Accept that some nights you won’t sleep
• Scary dreams-- some good evidence that rethinking the dream story and reframing it as more pleasant can diminish anxiety caused by nightmares over time. E.g. my ADHD grandson was having nightmares about a second big bang accompanied by a sense of loneliness and devastation, a solution is to think of him in a safe and returnable space witnessing one possible, incredible, fantastic, infinitely distant astrophysical event.
• Anxiety and worrying about sleep- keep a notebook by the bed- if you’re awake worrying about something make a note of it so you can deal with it in the morning. (Also useful for writing any good ideas you have going to sleep.)
• Difficulty getting up at your planned time, especially for those working from home. It really helps if you are getting up for something you want to do- an exercise session in the gym, time to watch a breakfast show, a run with a friend.
• Sometimes sleep problems are triggered by stress or illness and continue after the original trigger. Often this is because you have built negative associations with being in bed i.e. with lying awake, tired and worrying. Break the association using sleep restriction, get up as soon as you wake and can’t sleep- aiming to gradually extend the time you spend asleep.
• Needing a little relaxation time after everyone else has gone to bed more than you need sleep? - try to cut the time down spent relaxing- often you stay up after you have successfully wound down, or stay up on nights when you feel you could go to sleep immediately because this alone time has become a habit. Be aware of the minimum unwind time you need. Alternately or additionally , Try exploring the possibility of unwinding earlier (if you have family, partner you need to negotiate this and offer something attractive in return)
• Finally, don’t know where to start? Keep a sleep diary how much you slept, and anything that may have affected sleep: stress. Wine, caffeine, stimulants, dark chocolate, bed time, getting up time, illness.

How to turn ideas into reality

December 14th 8pm
Discussion topic How to Turn Ideas into Reality: being creative with ADHD

People with ADHD are often good at generating ideas
it could be something mundane like-
if I swap my sock drawer with my bigger underwear drawer - my socks will not leap across the floor every time I open the drawer.
Or a world changing invention: Such as a way to make cars that input atmospheric carbon dioxide and output fixed carbon

Execution of those ideas is another thing!


A couple of links to get you into the mind set-

http://anmolmehta.com/blog/2008/10/01/10-keys-for-turning-ideas-into-reality/

A general New Age sort of approach

http://www.addbusinessowner.com/2010/02/turning-ideas-into-reality-whos-your-opposite.html

Argues that working with someone with opposite strengths can be useful for someone with ADHD