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Attention Deficit Hyperactivity Disorder: Concepts, Controversies, New Directions PDF

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A ttention D eficit H yperActivity D isorDer Medical Psychiatry Series Editor Emeritus William A. Frosch, M.D. Weill Medical College of Cornell University New York, New York, U.S.A. Advisory Board Jonathan E. Alpert, M.D., Ph.D. Siegfried Kasper, M.D. MassachusettsGeneralHospitalandHarvard MedicalUniversityofVienna UniversitySchoolofMedicine Vienna,Austria Boston,Massachusetts,U.S.A. Mark H. Rapaport, M.D. Bennett Leventhal, M.D. Cedars-SinaiMedicalCenter UniversityofChicagoSchoolofMedicine LosAngeles,California,U.S.A. Chicago,Illinois,U.S.A. 1. Handbookof DepressionandAnxiety: ABiological Approach, editedby JohanA.den Boerand J.M.Ad Sitsen 2. AnticonvulsantsinMoodDisorders,editedbyRussellT.JoffeandJoseph R. Calabrese 3. Serotoninin AntipsychoticTreatment:Mechanismsand ClinicalPractice, editedbyJohn M.Kane,H.-J.Mo¨ller, andFransAwouters 4. Handbookof Functional Gastrointestinal Disorders,editedby KevinW.Olden 5. ClinicalManagement of Anxiety,editedbyJohanA. denBoer 6. 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AttentionDeficit Hyperactivity Disorder:Concepts,Controversies, NewDirections, editedbyKeithMcBurnett and LindaPfiffner A ttention D eficit H yperActivity D isorDer Concepts, Controversies, New Directions Edited by Keith McBurnett University of California, San Francisco, USA Linda Pfiffner University of California, San Francisco, USA InformaHealthcareUSA,Inc. 52VanderbiltAvenue NewYork,NY10017 2008byInformaHealthcareUSA,Inc. InformaHealthcareisanInformabusiness NoclaimtooriginalU.S.Governmentworks PrintedintheUnitedStatesofAmericaonacid-freepaper 10 9 8 7 6 5 4 3 2 1 InternationalStandardBookNumber-10:0-8247-2927-7(Hardcover) InternationalStandardBookNumber-13:978-0-8247-2927-1(Hardcover) This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reliable data and information,buttheauthorandthepublishercannotassumeresponsibilityforthevalidityofall materialsorfortheconsequenceoftheiruse. Nopartofthisbookmaybereprinted,reproduced,transmitted,orutilizedinanyformbyany electronic, mechanical, or other means, now known or hereafter invented, including photocopying,microfilming,andrecording,orinanyinformationstorageorretrievalsystem, withoutwrittenpermissionfromthepublishers. Forpermissiontophotocopyorusematerialelectronicallyfromthiswork,pleaseaccesswww. copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC)222RosewoodDrive,Danvers,MA01923,978-750-8400.CCCisanot-for-profitorgani- zationthatprovideslicensesandregistrationforavarietyofusers.Fororganizationsthathave beengrantedaphotocopylicensebytheCCC,aseparatesystemofpaymenthasbeenarranged. TrademarkNotice:Productorcorporatenamesmaybetrademarksorregisteredtrademarks, andareusedonlyforidentificationandexplanationwithoutintenttoinfringe. LibraryofCongressCataloging-in-PublicationData Attentiondeficithyperactivitydisorders:concepts,controversies,newdirections/ editedbyKeithMcBurnett,LindaPfiffner. p.;cm.– (Medicalpsychiatry;37) Includesbibliographicalreferencesandindex. ISBN-13:978-0-8247-2927-1(hb:alk.paper) ISBN-10:0-8247-2927-7(hb:alk.paper) 1. Attention-deficithyperactivitydisorder. I.McBurnett,Keith.II.Pfiffner,LindaJo. III.Series. [DNLM:1. AttentionDeficitDisorderwithHyperactivity. W1ME421SM v.372008/WS350.8.A8A883072008] RJ506.H9A9362008 618.9208589–dc22 2007043380 ForCorporateSalesandReprintPermissionscall212-520-2700orwriteto: SalesDepartment,52VanderbiltAve.,16thfloor,NewYork,NY10017. VisittheInformawebsiteat www.informa.com andtheInformaHealthcareWebsiteat www.informahealthcare.com Preface This book bridges the gap between the several existing introductory works on attention deficit hyperactivity disorder and those more advanced texts thatfocusonanarrowissueorsubpopulation.Ittargetsreadersintraining (medicalandnursingstudents,residents,graduatestudents,etc.)ratherthan a lay audience, and thus it is a natural companion to the attention deficit hyperactivity disorder section in the Diagnostic and Statistical Manual of MentalDisorders-IV-TR.Althoughitcanbeusedasanintroductorytext,it also covers specialized topics that will be of interest to seasoned clinicians and to anyone affected by attention deficit hyperactivity disorder who wishes to broaden their understanding of the disorder. We asked experts around the world to contribute chapters, with the guideline that they be brief and concise. We granted significant “wiggle room” when contributors needed more length. Some topics received extra emphasis,inordertopresentreaderswithmoreofwhattheymightneedto know rather than what they already know about attention deficit hyper- activity disorder. For example, because most of what is known about the disorder comes from research with school-age boys, we thought it essential to include chapters spanning ages and genders. We also overweighted psychosocial approaches to treatment, because the sub-modalities of evidence-based psychosocial treatment are rarely presented. Coverage of medication was limited to the essentials, because pharmacotherapy of attentiondeficithyperactivitydisorderisalreadywidelydisseminatedonline and in book form and because continuing medical education and pharmaceutical-medical liaisons are sources of continual updates for the prescribing community. This book also asks readers to challenge their assumptions about attention deficit hyperactivity disorder. The chapter by Pelham is an iconoclastic manifesto on the primary importance of psychosocial treat- ment.ItstemsfromthefactthatthefirstreportedresultoftheMultimodal Treatment of ADHD Study—that well-managed pharmacotherapy is more effective than psychosocial treatment, and that little is gained from adding psychosocialtreatmenttopharmacotherapyalone—isoftenover-interpreted. Byconsideringabroadercontext,Pelham’schapterstimulatesthereaderinto becoming more sophisticated about medication versus psychosocial issues. Diller’s chapter reminds the reader that, even with the amount of research iii iv Preface currently available on the disorder, much work remains to be done before some fundamental questions can be put to rest. Regardless of the reader’s viewpoint, the chapters in the “Controversies” section will leave the reader betterabletodefendtheirviews. Our choice of emphases should not be misconstrued. Our personal views are that attention deficit hyperactivity disorder is a valid and under- treated disorder, that multimodal treatment (medication and psychosocial) is often the best treatment, that federal funding of research on this and relateddisordersshouldbequadrupled,andthatmajorrevisionsareneeded to how treatment is provided and reimbursed. Everyone is affected by attention deficit hyperactivity disorder, whether they have it or not. Given the worldwide estimated prevalence of 5.29%, chances are that one out of every 20 people one encounters (including drivers of other cars) has the disorder. Untreated and under-treated, it closes off many paths to better education, better jobs, better health, and better social relationships. It is a costly disorder for everyone. We know a great deal about identifying and helping individuals with attention deficit hyperactivity disorder, but we mustn’t allow ourselves to smugly think we know enough. If our book stimulates readers to consider new views on it and to develop their own insights, it will have done its job. Weoweadebtofgratitudeforthescholarlyeffortsofthecontributors to this book. Special thanks are due to Russell Schachar, Joel Nigg, and Glen Elliott, who helped in the conceptualization and early planning. Keith McBurnett Linda Pfiffner Contents Preface iii Contributors ix SECTION I: ASSESSMENT 1. The Diagnosis and How We Got There 1 Keith McBurnett 2. Differential Diagnosis of Attention and Auditory Processing Disorders 9 Laurent Demanez SECTION II: CLINICAL CONCEPTUALIZATIONS 3. Clinical Testing of Intelligence, Achievement, and Neuropsychological Performance in ADHD 21 Leah Ellenberg and Joel Kramer 4. Self-Esteem and Self-Perceptions in ADHD 29 Nina M. Kaiser and Betsy Hoza 5. The Family Context of ADHD 41 Charlotte Johnston and Douglas Scoular 6. Comorbidity as an Organizing Principle 51 Linda J. Pfiffner 7. DysfunctionsofAttention,Learning,andCentralAuditoryProcessing: What’s the Difference? 63 Juliana Sanchez Bloom and George W. Hynd SECTION III: CLINICAL NEUROSCIENCE 8. Neuroanatomy of ADHD 71 F. Xavier Castellanos and Eleanor Ainslie v

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