The Endlessness Diagnosis of ADHA

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Jan 9, 2024

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Jimmy Lama Grand Canyon University ENG-105: English Composition 1 Professor Kevin 9/8/23 2
The Endlessness Diagnosis of ADHD Should a rise in ADHD diagnosis raise questions? The CDC, Center for Disease Control and Prevention, (2020), a well-known government entity, defines ADHD as one of the most common neurodevelopmental disorders that are initially diagnosed in childhood (para. 1). Over- diagnosis of ADHD can occur when clinicians rely solely on subjective measures, leading to misdiagnosis. The similarity of symptoms between other conditions can also lead to misdiagnosis, and gender influences diagnosis. Boys are more likely to be diagnosed due to externalizing behaviors, while girls tend to show internalizing behaviors, leading to a gender discrepancy. It is essential for clinicians to consider alternative explanations, rule out other conditions, and consider gender differences when assessing ADHD symptoms to ensure valid and reliable diagnoses. The recent spike in ADHD diagnosis has raised concerns about over-diagnosis and misdiagnosis. Government data reports a significant increase of almost 22% in children diagnosed with ADHD in the past four years. Research has shown that clinicians rely on subjective measures and over-diagnose the disorder, leading to inappropriate treatment and harm. One study conducted by Merten et al. (2017) found significant evidence of over-diagnosis of ADHD disorder in clinical practices. The researchers discovered that children who did not fulfill ADHD criteria were being diagnosed with ADHD with an increased rate of 20%. The study also found that 16.7% of 473 cases examined were diagnosed with ADHD disorder although the criteria were not fulfilled. Another alarming finding was that 7% of cases that fulfilled the criteria for ADHD were given no diagnosis. These results provide evidence that there is an issue with over-diagnosis of ADHD disorder, leading to misdiagnosis and potentially inappropriate treatment. Moreover, in a study conducted by Bruchmuller, 473 children's medical documents 3
were examined by psychotherapists to determine their diagnosis. The outcome showed that 16.7% of the cases were diagnosed with ADHD disorder despite not fulfilling the criteria. This suggests that clinicians may be relying too heavily on subjective measures and failing to fully assess other possible conditions that may better explain a child's symptoms. The over-diagnosis of ADHD disorder can be attributed to the high academic demands and expectations placed on children. Clinicians may attribute symptoms of ADHD to academic struggles rather than considering other possible causes. Additionally, gender differences can contribute to over- diagnosis of ADHD as boys tend to exhibit externalizing behaviors while girls exhibit more internalizing behaviors. This can lead to under diagnosis of ADHD in girls, resulting in a gender discrepancy in the diagnosis and treatment of ADHD. Misdiagnosis of ADHD is a significant issue that can cause harm to individuals who may have been faultily diagnosed. Research conducted by Mullet and Rinn (2015) indicates that 75% of children diagnosed with ADHD also meet the criteria for another psychiatric diagnosis. Misdiagnosis can occur due to the lack of specialized training in educators or mental health professionals who may rely on rating scales to determine if an individual shows signs and symptoms of ADHD. This can place educators in a position to make diagnostic decisions without conducting a comprehensive assessment, leading to potential misdiagnosis. Medical professionals, such as psychologists, physicians, psychiatrists, or therapists, may also contribute to the misdiagnosis of ADHD. Studies have found that medical professionals often diagnose ADHD without conducting a comprehensive assessment, which can lead to misdiagnosis when other mental health symptoms relate to a different disorder such as giftedness, bipolar, or obsessive-compulsive disorder. The Diagnostic and Statistical Manual (DSM) is a diagnostic assessment tool that professionals can use to reduce the amount of misdiagnosis in ADHD. The 4
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DSM must be properly utilized to ensure a valid and reliable diagnosis of ADHD. Over the last decade, giftedness was misdiagnosed as ADHD due to the overlap of symptoms, which highlights the importance of using a standardized and comprehensive assessment tool to diagnose ADHD accurately. The rise of ADHD misdiagnosis is also a significant factor contributing to the gender discrepancy in diagnosis and treatment of ADHD. Girls tend to exhibit more internalizing behaviors such as anxiety and depression, leading to underdiagnosis of ADHD in girls. In addition, Gender influence diagnosing is a phenomenon where mental health professionals diagnose ADHD based on the gender of the patient. Studies show that boys are more likely to be diagnosed with ADHD than girls, as they exhibit more hyperactive and impulsive behavior, which leads to overdiagnosis of the disorder. Conversely, girls display inattention deficit symptoms, such as procrastination, hesitation, and forgetfulness, which can be overlooked as they do not conform to traditional perceptions of how boys behave. The media also plays a role in portraying ADHD as a disorder that commonly affects boys, leading to stereotypes and biases when diagnosing ADHD in girls. Mental health professionals may not adhere to the criteria of the DSM diagnostic tool when assessing a child for ADHD due to assumptions made based on their gender and behavior. This can result in the omission of certain criteria and potentially lead to misdiagnosis or underdiagnosis of ADHD in girls. It is crucial for mental health professionals to evaluate patients based on the DSM diagnostic tool's criteria and avoid gender bias when diagnosing ADHD. It is also essential to consider individual differences and how ADHD symptoms may manifest differently in boys and girls, ensuring a valid and reliable diagnosis to provide appropriate treatment. 5
As a result, there has been an increase in ADHD diagnoses due to uncontrolled overdiagnosis, misdiagnosis, and gender bias. Clinical professionals are diagnosing children who do not meet the criteria for ADHD, leading to an unnecessary increase in diagnoses. Untrained educators are also conducting diagnostic assessments, which can lead to misdiagnosis. Gender bias is also contributing to the increase in ADHD diagnoses, with boys being diagnosed more frequently due to traditional perceptions of them being dominant and aggressive. These perceptions can lead to assessments being conducted based on assumptions and stereotypes, rather than using validated diagnostic tools. To decrease the rise in ADHD diagnoses, policies and procedures should be put in place to mandate continued education for diagnosticians working with children and adolescents affected by the disorder. Continued education would allow professionals to use validated diagnostic tools without gender bias, resulting in earlier and more accurate diagnoses, and appropriate treatment. Furthermore, educating parents and the public about ADHD and its symptoms will help to address misconceptions and stereotypes associated with the disorder. References Banaschewski, T., Becker, K., Döpfner, M., Holtmann, M., Rösler, M., & Romanos, M. (2017). Attention-Deficit/Hyperactivity Disorder. Deutsches Aerzteblatt International, 114(9), 149– 159. https://doi-org.lopes.idm.oclc.org/10.3238/arztebl.2017.0149 Bruchmüller, K., Margraf, J., & Schneider, S. (2012). Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis. Journal 6
of Consulting and Clinical Psychology, 80(1), 128–138. https://doiorg.lopes.idm.oclc.org/10.1037/a0026582.supp (Supplemental) Davidovitch, M., Koren, G., Fund, N., Shrem, M., & Porath, A. (2017). Challenges in defining the rates of ADHD diagnosis and treatment: trends over the last decade. BMC Pediatrics, 1. https://doi-org.lopes.idm.oclc.org/10.1186/s12887-017-0971-0 Fresson, M., Meulemans, T., Dardenne, B., & Geurten, M. (2018). Overdiagnosis of ADHD in boys: Stereotype impact on neuropsychological assessment. Applied Neuropsychology: Child, 1–15. https://doi- org.lopes.idm.oclc.org/10.1080/21622965.2018.1430576 Merten, E. C., Cwik, J. C., Margraf, J., & Schneider, S. (2017). Overdiagnosis of mental disorders in children and adolescents (in developed countries). Child and Adolescent Psychiatry and Mental Health, 1. https://doi-org.lopes.idm.oclc.org/10.1186/s13034-016- 0140-5 Mullet, D. R., & Rinn, A. N. (2015). Giftedness and ADHD: Identification, Misdiagnosis, and Dual Diagnosis. Roeper Review, 37(4), 195–207. https://doiorg.lopes.idm.oclc.org/10.1080/02783193.2015.1077910 New CDC data on ADHD shows an increase in diagnosis, raises questions. (2013). Brown University Child & Adolescent Psychopharmacology Update, 15(5), 1–7. 7
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