Review of ADHD Comorbidities: Handbook for ADHD Complications in Children and Adults
ADHD COMORBIDITIES: Handbook for ADHD Complications in Children and Adults
Edited by Thomas E. Brown, Ph.D.
Published by American Psychiatric Publishing, Inc, 2009, Arlington, VA: 458 pp.
Reviewed By Merri Rosenberg
Given the prevalence of attention deficit disorder/hyperactivity disorder (ADHD) among the nation’s school age population, and beyond, it’s hard to find a classroom or family that hasn’t been affected.
And while this volume isn’t designed for the lay reader, it’s an invaluable addition to the school psychologist’s or special education team’s bookshelf. It probably wouldn’t be a bad idea for pediatricians and adolescent medicine specialists to have a copy, too. Since the previous edition appeared nine years ago, advances in the field make this update a compelling resource.
As the editor writes, “ADHD is no longer understood as a simple disorder of disruptive behavior characterized simply by impaired inhibitory control. It is now recognized as a complex disorder of the brain’s executive functions…it is quite clear that, for most affected individuals, ADHD is complicated not only in itself. More often than not, ADHD is further complicated by comorbidity with one or more additional psychiatric disorders.”
Further, he explains, “I propose that the high rate of comorbidity between ADD or ADHD and other psychiatric disorders occurs because this syndrome of impairments in executive functions is not just one among many other psychiatric disorders but is a foundational disorder that tends to expose affected individuals to impairments that may at some point constitute additional disorders of learning, emotion, and/or behavior. From that perspective, ADD is not so much like a defective software program that interferes with running tasks in just one limited package of software. It is more like impairment in a computer’s operating system that can affect a wide variety of functions.”
Particularly significant is the recognition that not everyone suffering from ADHD exhibits behavioral problems—and that “the most significant impairments of this syndrome often occur in adolescence and adulthood, those times in life when individuals face increased demands for self-management.”
Chapters not only show how ADHD presents itself in children, adolescents and adults, but also identify and discuss what ADHD looks like when it is associated with such conditions as anxiety disorders, obsessive-compulsive disorders, autism spectrum disorders, and substance abuses.
It is a comprehensive and exhaustive volume, with ample references, suggestions for further readings, and even useful web sites. While the information can be overwhelming, the variety of therapeutic responses to the syndrome—from cognitive and behavioral therapy to appropriate medication—offer a glimmer of hope for concerned teachers and beleaguered family members.#