Attention-Deficit Hyperactivity Disorder (ADHD) Essay
ADHD in adults Problem: 6.2 million adults in USA have ADHD but approximately 75% are undiagnosed. Data does not exist to specify local rates of ADHD in adults in Cypress, TX. Background: undiagnosed and untreated ADHD is associated with increased risk of poor school performance, job performance, relationship problems, & increased risk for motor vehicle accidents, specifically collisions. Data collection: standardized validated diagnostic screening forms Adult ADHD Self-Report Scale Symptom Checklist (ASRS) will be administered to a convenience sample of persons 18 y/o or older in the town of Cypress, TX. Diagnosis: screening results will be tabulated and compared against national statistics Implementation: persons screening positive on ASRS will be referred to psychiatry clinic in the community for further evaluation to determine if diagnosis of ADHD is present. Group education classes will be conducted and all persons screening positive will be offered this education class. Evaluation: Data collected, including number of persons screening positive for ADHD with ASRS, and number of persons receiving diagnosis of ADHD will be compared against national statistics to identify if local rates are greater than, equal to, or less than national statistics. Data can be further broken down and analyzed to evaluate trends based on individual demographics. Attention-Deficit Hyperactivity Disorder (ADHD) Essay.
Attention-Deficit Hyperactivity Disorder (ADHD): Undiagnosed Adult in Cypress, Texas
Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric/ neurodevelopmental mental disorder that typically commences in childhood. It usually subsides with treatment as the child approaches adulthood in most cases. However, in some cases, the condition progresses to adulthood with quite a negative impact on the social and occupational life of the victim. Because of this profile, the disorder affects children more, but it equally affects adolescents and adults too (NIH, 2017). Diminished sustained attention or inattention and hyperactivity/ excessive impulsivity are the hallmarks of this neurodevelopmental disorder. There is a quick loss of concentration when doing a task. This is also accompanied by forgetfulness. In children, there is marked academic impairment. But adult ADHD victims also experience problems forming lasting interpersonal relationships as well as integrating socially in the society. A combination of these factors therefore ends up affecting the work life of the adult with ADHD. The condition can present in three forms referred to as specifiers: predominantly inattentive presentation, predominantly hyperactive/ impulsive presentation, or combined presentation. According to Sadock et al. (2015), 85% of children who have ADHD continue to have it through adolescence and 60% continue having the condition as adults (Sadock et al., 2015; APA, 2013). This shows that a significant number of adults actually suffer from ADHD, yet the condition remains largely underdiagnosed in the adult population. Attention-Deficit Hyperactivity Disorder (ADHD) Essay. This paper discusses the behavioral disorder that is ADHD in adults (taking the city of Cypress in Texas as a microcosm), advanced public health nursing assessment and prevention, as well as scope of standard of practice on adult mental health by the advanced public health nurse.
Data on Adult ADHD in Cypress, Texas
There is a glaring paucity of literature on the data for adult ADHD in the city of Cypress in the state of Texas. For this reason, national data and data from the Centers for Disease Prevention and Control (CDC) will be used to extrapolate the likely scenario prevailing in the city of Cypress. Despite this lack of easily available data, however, the city of Cypress appears to be well resourced with psychiatrists, psychologists, and psychiatric-mental health nurse practitioners (PMHNPs), and therapists who offer treatment ad therapy for adult ADHD (Psychology Today, 2020a; Psychology Today, 2020b). By extrapolation, this abundance of supply in Cypress can be interpreted to mean that there is considerable demand for the services. What this means is that prevalence of adult ADHD in Cypress could be nearing the national average.
According to the National Institute of Mental Health (NIH), in the US adult population aged between 18 years and 44 years the lifetime prevalence of ADHD is about 8.1%. The current adult prevalence is however 4.4% with males being more affected (5.4%) compared to females (3.2%). An important observation to note in these statistics by NIH is that compared to all other racial or ethnic populations, non-Hispanic whites have a higher prevalence of adult ADHD. These statistics are based on data obtained from the National Comorbidity Survey Replication or NCS-R (NIH, 2017). By extrapolating these figures to Cypress, therefore, it can be surmised that the prevalence of adult ADHD in the city is 4.4%.
About 2.5% to 5% of all adults suffer from ADHD. Surprisingly, approximately 75% of these remain undiagnosed. This scenario applies to the city of Cypress in Texas as it does to the rest of the United States. One reason for this situation is that ADHD is often comorbid with other conditions in adults, thereby masking its presentation. Data rom national statistics shows that between 17% and 22% of adults who are seen in psychiatric outpatient clinics for other mental health conditions also suffer from this behavioral disorder. The ADHD symptoms for these adult patients are however usually mistaken for those of the comorbidities they suffer from (Grinsberg et al., 2014). According to Leahy (2018), some of these comorbidities with adult ADHD include anxiety disorders, sleep disorders, and mood disorders. Underdiagnosis of adult ADHD has been found to be very rampant, contrary to the earlier belief that the condition subsided as a child grew into an adult. This has led to many adults having problems and obstacles in their lives without knowing or realizing that the cause is actually undiagnosed ADHD. It is not only their self-esteem that is affected but also their interpersonal relationships as well as their emotional wellbeing. Examples of the characteristics that may give away an adult suffering from undiagnosed ADHD are emotional marital problems and a lack of empathy while relating to others. The person may also suffer financial ruin as a result of impulsivity as in buying things without planning for the same. Additionally, the adult with undiagnosed ADHD may also find that they cannot concentrate in one job or keep it for long (Fast Braiin, 2018). Attention-Deficit Hyperactivity Disorder (ADHD) Essay.
DSM-5 Diagnostic Criteria for ADHD
There has been some criticism that one of the reasons for the underdiagnosis of ADHD in adults is that its diagnostic criteria in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) favor children. The DSM-5 diagnostic criteria are as follows:
Advanced Public Health Nursing Assessment, Prevention Programs and Interventions for Adult ADHD
The Advanced Public Health Nurse (APHN-BC) is a healthcare professional that analyzes trends in disease in the general population and then comes up with measures and interventions aimed at preventing the occurrence of the disease or condition. The advanced public health nurse is therefore primarily concerned with primary prevention of disease through education and health promotion. But in order to come up with educational and prevention strategies for a particular condition such as adult ADHD, the APHN-BC must first perform an assessment that will precede the implementation of interventions. This assessment by the APHN-BC is what will support the decision making on interventions for the population/ public. It generates information about the community/ population for which the public health nurse wants to come up with prevention strategies. To accomplish this assessment task with regard to adult ADHD, the APHN-BC uses the public health nursing assessment tool or PHNAT in which she will (Truglio-Londrigan, & Lewenson, 2016):
Prevention Programs and Interventions for Adult ADHD in Cypress, Texas
It is not possible to completely prevent the emergence or manifestation of ADHD in adults. However, the preventive measures and interventions implemented by the APHN-BC can result in a reduction of the incidence of the condition in the general population, including that of Cypress. Some of the prevention programs and interventions the APHN-BC can implement in the case of Cypress include:
Advanced Public Health Nursing: Scope and Standards of Practice for Adult Mental Health
Like all advanced practice nurses, the APHN-BC is expected to be able to practice to the fullest extent of their education and training. Their unit of care is the entire population as opposed to individual patients. Their scope of practice includes:
The prevalence of adult ADHD is quite high despite the fact that the condition is grossly underdiagnosed in adults. Part of the reason is that ADHD is mostly comorbid with other similarly presenting conditions such as mood disorders and anxiety disorders. The role of the APHN-BC in preventing ADHD (lowering the incidence) is important because they are concerned with primary prevention of disease in entire populations, including mental health conditions.
American Nurses Association [ANA] (2013). Public health nursing: Scope and standards of practice, 2nd ed. Author.
American Psychological Association [APA] (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th ed. Author.
Fast Braiin (March 31, 2018). Understanding how to recognize underdiagnosed ADHD in adults. https://fastbraiin.com/undiagnosed-adhd-in-adults/
Grinsberg, Y., Quintero, J., Anand, E., Casillas, M., & Upadhyaya, H.P. (2014). Underdiagnosis of attention-deficit/ hyperactivity disorder in adult patients: A review of the literature. The Primary Care Companion for CNS Disorders, 16(3). https://doi.org/10.4088/PCC.13r01600
Leahy, L.G. (2018). Diagnosis and treatment of ADHD in children vs adults: What nurses should know. Archives of Psychiatric Nursing, 1-6. https://doi.org/10.1016/j.apnu.2018.06.013
National Institute of Mental Health [NIH] (2017). Attention-deficit hyperactivity disorder (ADHD). https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd.shtml
Psychology Today (2020a). ADHD psychiatrists in Cypress, TX. https://www.psychologytoday.com/us/psychiatrists/adhd/tx/cypress
Psychology Today (2020b). ADHD therapists in Cypress, TX. https://www.psychologytoday.com/us/therapists/adhd/tx/cypress
Sadock, B.J., Sadock, V.A., & Ruiz, P. (2015). Synopsis of psychiatry: Behavioral sciences/ clinical psychiatry, 11th ed. Wolters Kluwer.
Truglio-Londrigan, M., & Lewenson, S.B. (2016). Assessment: Using the public health nursing assessment tool. Nurse Key – Fastest Nurse Insight Engine. https://nursekey.com/assessment-using-the-public-health-nursing-assessment-tool/
Washington State Nurses Association (2011). Public health and public health nursing. http://www.quadcouncilphn.org/wp-content/uploads/2016/03/2011_WSNA-Public-Health-and-PHN.pdf . Attention-Deficit Hyperactivity Disorder (ADHD) Essay.
ADHD in adults
Problem: 6.2 million adults in USA have ADHD but approximately 75% are undiagnosed. Data does not exist to specify local rates of ADHD in adults in Cypress, TX.
Background: undiagnosed and untreated ADHD is associated with increased risk of poor school performance, job performance, relationship problems, & increased risk for motor vehicle accidents, specifically collisions.
Data collection: standardized validated diagnostic screening forms Adult ADHD Self-Report Scale Symptom Checklist (ASRS) will be administered to a convenience sample of persons 18 y/o or older in the town of Cypress, TX.
Diagnosis: screening results will be tabulated and compared against national statistics
Implementation: persons screening positive on ASRS will be referred to psychiatry clinic in the community for further evaluation to determine if diagnosis of ADHD is present. Group education classes will be conducted and all persons screening positive will be offered this education class.
Evaluation: Data collected, including number of persons screening positive for ADHD with ASRS, and number of persons receiving diagnosis of ADHD will be compared against national statistics to identify if local rates are greater than, equal to, or less than national statistics. Data can be further broken down and analyzed to evaluate trends based on individual demographics.
Project on Undiagnosed adult with ADHD.
1.Look for data in Cypress Texas. U. S.A.
2.Add Advanced Public Health Nursing assessment, implementation of prevention programs in term of intervention for adult with ADHA.
3.Add Advanced Public Health Nursing scope of standard of practice on mental health in adult. Attention-Deficit Hyperactivity Disorder (ADHD) Essay.