Jul 28th 2023
Attention-deficit disorder (ADD) is a term that was previously used to refer to what is now known as inattentive ADHD. It is a neurodevelopmental disorder that emerges in childhood and can cause impairments in social, academic, and professional functioning. Treatment for inattentive ADHD typically includes medication and behavioral therapy.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that presents with symptoms of inattention, hyperactivity, and impulsivity. Attention deficit disorder (ADD) is a term previously used to refer to ADHD that presents primarily with symptoms of inattention, with an absence of hyperactive and impulsive behaviors .
Recent adaptations to diagnostic criteria have changed to include different subtypes or presentations of ADHD. As such, ADD is now referred to as ADHD with predominantly inattentive presentation, or inattentive ADHD .
Currently, it is believed that inattentive ADHD and hyperactive-impulsive ADHD are caused by a combination of different factors. The different presentations of ADHD can co-occur and change throughout the lifetime and each presentation may share contributing factors. However, new research is constantly investigating the causes to develop a better understanding .
ADHD has a highly genetic disorder and often runs in families. As such, there is a significantly high likelihood that a person with ADHD will have a child with ADHD. Additionally, subtypes of ADHD do not alter the possibility of heritability. Inattentive, hyperactive-impulsive, and combined ADHD presentations can occur within the same family .
Studies have found differences in the brains of people with ADHD compared to those without. This includes differences in the volume and activity of specific brain areas and the levels and activity of certain neurotransmitters, such as dopamine and norepinephrine .
Research suggests that complications during pregnancy and childbirth can contribute to the risk of ADHD. For example, low birth weight, preterm delivery, and exposure to tobacco and substances during pregnancy are all thought to increase the likelihood of the child having ADHD. However, this link may also be related to other factors .
Diagnosing inattentive type ADHD is considered to be more challenging than diagnosing hyperactive-impulsive ADHD. This is because inattentive ADHD causes internalized symptoms that may go unnoticed for some time. As such, many cases of inattentive ADHD are not diagnosed until later in life when the impact of symptoms becomes more evident .
For a child or adult to seek a diagnosis of inattentive ADHD, it is necessary to be assessed by a specialized professional, such as a pediatrician, psychiatrist, or other trained mental health professional .
The professional will assess the individual using structured interviews and questionnaires that help to ascertain information about the presenting symptoms. Assessing children will also involve gathering information from parents, including development, functioning, and behavior at home .
Similarly, gathering information from the child’s school and teachers about academic functioning and behavior in the classroom and with peers can be helpful . The mental health professional will also gather information about individual and family mental and physical health history.
It is common for ADHD to co-occur with other conditions, such as learning disorders, anxiety, depression, autism spectrum disorder, and obsessive-compulsive disorder (OCD). As such, questions relating to the presence of these conditions will also be asked .
The clinician will utilize the diagnostic criteria for ADHD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to formulate their diagnosis. Criteria for ADHD with predominantly inattentive presentation state that six or more of the following symptoms must be present for at least six months :
Additionally, the following must be true:
The severity of these symptoms can also be determined as mild, moderate, or severe .
The individual will also be assessed for symptoms of hyperactivity and impulsivity using DSM-5 criteria. They can then be diagnosed with ADHD with a predominantly inattentive presentation, ADHD with a predominantly hyperactive and impulsive presentation, or combined ADHD if the criteria for both presentations are met .
Inattentive ADHD is often treated with medication and therapeutic interventions.
Current research and evidence suggest that people with different ADHD presentations respond similarly to medications. As such, there is no difference in the medications prescribed to individuals with inattentive ADHD and hyperactive-impulsive ADHD, although lower doses may be required to treat inattentive ADHD effectively .
Behavioral interventions can help manage symptoms of ADHD and may differ depending on the individual’s age.
For example, cognitive behavioral therapy (CBT) and occupational therapy (OT) can effectively treat adults with ADHD. These interventions can help adults learn to adapt behaviors to improve their daily, social, and professional functioning .
For children with ADHD, treatments often involve input from parents and educators to help manage their behaviors in a supportive manner. This may also include approaches used in CBT, such as techniques to improve social skills, organization, and self-management .
Treatment for ADHD will depend on the individual’s symptoms, areas of impaired functioning, and age. Medicinal and therapeutic interventions are commonly combined to provide the most effective treatment option .
Other potentially helpful interventions include meditation and mindfulness, dietary changes, and exercise. Although there is limited research on these interventions, some have found them effective .
ADHD can be diagnosed as a predominantly inattentive presentation, predominantly hyperactive-impulsive presentation, or a combined presentation. Inattentive ADHD was previously referred to as ADD, while ADHD referred to a hyperactive-impulsive presentation .
As such, the difference between ADD and ADHD is the presenting symptoms. ADD, or now known as inattentive ADHD, involves more internalized symptoms, such as :
In contrast, ADHD, or hyperactive-impulsive ADHD, involves more externalized symptoms, such as :
Therefore, symptoms of the hyperactive-impulsive presentation are often more noticeable, as they are externalized and may be more likely to cause disruption to the surrounding people or environment. Symptoms of inattentive ADHD may be more hidden or unrecognized as they are less outwardly expressed .
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