The way Attention Deficit Hyperactivity Disorder, or ADHD, is diagnosed has changed a number of times and the next change is expected in 2013. This article explains the changes over the years and why the new change is necessary.
How Attention Deficit Hyperactivity Disorder is diagnosed continues to change
The understanding and diagnosis of ADHD has changed over the years in accordance with the development and changes within the Diagnostic and Statistical Manual of Mental Disorders. ADHD was first referred to in the DSM-II in 1968 where the condition was described as “hyperkinectic reaction of childhood,” emphasising on inattention, impulsivity and motor activity (APA, 1968). In the second edition, the disorder was referred to as Attention Deficit Disorder (ADD), consisting of two subtypes; with hyperactivity and without hyperactivity (APA, 1980). In 1987, the DSM-III was revised and the condition was renamed from ADD to Attention Deficit Hyperactivity Disorder (ADHD) with a single diagnostic checklist (APA, 1987). In 1994, the current DSM-IV was released, consisting of the three subtypes of ADHD; predominately inattentive, predominantly hyperactive-impulsive, and combined subtype (APA, 1994).
The disadvantages of the current method of diagnosing ADHD
However, there are several disadvantages with the current DSM criteria. One disadvantage includes unreliable recall of age of onset, before the age of seven, which is particularly difficult to account for in adults. Age of onset, is not justifiable and not based on any empirical evidence and the duration of only 6 months of experiencing difficulties is too short, and does not reflect that ADHD is a developmental disability rather than a difficulty based solely on the context (Barkley, 2003). The current criteria is primarily constructed for a child population and does not reflect the growing understanding and acceptance of adult ADHD (Bresnahan & Barry, 2002). Another disadvantage is that the symptoms are not adjusted for genders. For example, males typically exhibit more symptoms and to a more severe degree than females, but this is not considered in the DSM-IV.
When and how will diagnosing change?
The next edition of the DSM, DSM-V is planned to be published in May 2013. A draft version of the DSM-V has already been released and is currently being revised. Diagnosis of ADHD will be altered in the following ways; the age of onset will be raised from seven years of age to twelve years of age, whereby symptoms of inattention or hyperactivity-impulsiveness must be noticeable by this time. Furthermore, the current DSM states that at least six symptoms must be met where as it is being proposed that this will be lowered to four symptoms for individuals aged seventeen or over. This therefore means that adults will need to meet fewer symptoms for a diagnosis of ADHD and consequently reflects that ADHD is understood to be a child but also an adult condition.