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by Russell A. Barkley, Kevin R. Murphy and Mariellen Fischer
Guilford, 2008
Review by Stephanie Moulton Sarkis, Ph.D. on Jul 1st 2008

ADHD in Adults

The book details the results of the UMASS Study, which examined the impact of ADHD on clinic-referred adults, and the results of the Milwaukee Study, one of the largest longitudinal studies on the impact of ADHD from childhood through adulthood.  The authors also review other published studies of ADHD and its impact on the life cycle.  It should be disclosed that while I was reading this book for the review, I found that my book was listed in the references. 

The book consists of 14 chapters: Introduction, History and Prevalence of ADHD in Adults; Diagnostic Criteria for ADHD in Adults; Defining ADHD in Adults; Making the Diagnosis in the UMASS and Milwaukee Studies; DSM Symptom Utility and the Issue of Age of Onset, Impairment in Major Life Activities; Identifying New Symptoms of ADHD in Adulthood; Comorbid Psychiatric Disorders and Psychological Maladjustment; Educational and Occupational Functioning; Drug Use and Antisocial Behavior; Health, Lifestyle, Money Management and Driving; Sex, Dating, Marriage, Parenting, and Psychological Adjustment of Offspring; Neuropsychological Functioning; and Summary, Conclusions, and Treatment Implications. 

Each chapter ends with "Conclusions & Clinical Implications", a bulleted list that not only summarizes the chapter, but also provides the author's suggestions regarding such issues as the upcoming DSM-V classification of ADHD, implications for clinical practice, and suggestions for more accurate assessment of ADHD symptoms in adults. 

The authors balance information from both studies in an easy-to-follow manner.  For each subheading, for example, "Comorbid Psychiatric Disorders", the results of the UMASS Study are presented, followed by the results of the Milwaukee Study.  The authors then discuss the similarities and differences between the two studies, and also detail other research that has been done in that particular area. 

The book contains 106 tables.  Each table is well organized and placed in the appropriate location in the chapter.  The bar graphs are clearly labeled and it is easy to differentiate the variables.  The book also includes highlighted sections such as on page 43, where eight assessment scales are described, including information on norms.  It may have been helpful to provide a separate index of tables, but this may have been beyond the authors' control. 

The book contains up-to-date research, with the most recent article published in 2007.  This inclusion of current research is especially important due to the rapidly changing data on ADHD.  The authors cite from several prominent journals, including the Journal of the American Medical Association, Journal of Attention Disorders, and Neuropsychology.

Chapter 7, "Identifying New Symptoms of ADHD in Adulthood", the authors present a new list of adult ADHD symptoms.  This is especially important considering that ADHD symptoms change over the course of the lifespan, and the DSM-IV-TR (American Psychiatric Association, 2000) does not include a specific list of these symptoms in adulthood.  The authors present the statistical analysis of the original 91 symptoms and then present the pared down list.  

Chapter 12, "Sex, Dating/Marriage, Parenting, and Adjustment" may be of particular interest to psychotherapists who work with ADHD children and parents.  This chapter presents and discusses data showing that parents of ADHD children have a higher total Parenting Stress Index score than controls.  In addition, the UMASS study found that both parental depression and the child's oppositional defiant disorder symptoms are predictors of parental stress. 

In chapter 13, "Neuropsychological Functioning", the authors detail Barkley's definition of executive functions (EF), and also discuss how the definition differs from other widely held assumptions about EFs.  The chapter also gives synopses for nine tests of executive function, including the commercially available Simon game, with data supporting its use. 

This book will greatly enhance the practice of any clinician, regardless of the age of the patient/client ADHD population. The book provides details of a fascinating longitudinal study, and it is beneficial reading for any practitioner. 

American Psychiatric Association (2000).  Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington DC: Author.

© 2008 Stephanie Moulton Sarkis

Stephanie Moulton Sarkis PhD is the author of the books "10 Simple Solutions to Adult ADD: How to Overcome Chronic Distraction and Accomplish Your Goals"  and "Making the Grade with ADD: A Student's Guide to Succeeding in College with Attention Deficit Disorder". Dr. Sarkis is a national certified counselor and licensed mental health counselor in Gainesville, Florida who specializes in ADD counseling and coaching.  She is also the director of assessments and evaluations at Sarkis Family Psychiatry and Sarkis Clinical Trials and an assistant adjust professor at the University of Florida.  She has been featured on national and regional TV and radio, including CNN, Fox News, and ABC News.  She can be found at www.stephaniesarkis.com or stephanie@stephaniesarkis.com.