A man must be strong enough to mold the peculiarity of his imperfections into the perfection of his peculiarities.

 

- Walter Rathenau

 

Chapter 4

DIAGNOSING MY ADD SYMPTOMS

 

My adult ADD symptoms were identified with the aid of the following guides:

 

§        Adult ADD Quiz

§        DSM-IV ADHD criteria

§        Suggested Diagnostic Criteria for ADHD in Adults

 

Adult ADD Quiz

 

Hallowell and Ratey's Adult ADD Quiz (1994a, pp. 209-214) is an excellent initial screening tool to de­termine whether a full ADD evaluation is war­ranted.  In my case, I identified with 68 out of 100 ADD char­acteristics listed on the quiz.

 

DSM-IV ADHD Criteria

 

As an adult, I possess seven of nine DSM-IV ADHD inatten­tive symptoms.  (My symptom raters are listed in pa­rentheses.)  I often have difficulty with:

 

1.    Maintaining attention when doing tasks (self, wife).

Tasks that are routine and boring to me, espe­cially household chores, hold my attention the least.

2.    Following through with instructions and assign­ments (self, wife).

Again, this symptom relates to boredom.  If a task is novel and interesting to me, I am better able to follow it through to completion.

3.    Organizing life and work (self, wife).

I have problems physically organizing work mate­rials and personal papers (they are left in piles or put into paper bags and boxes); I also have great difficulty mentally organizing for­mal oral presentations in a logical, coher­ent manner.

4.    Participating in tasks that require mental exer­tion (self).

I have trouble exerting myself mentally if I am en­gaged in an activity that is not personally stimu­lating for me (e.g., playing card games, reading techni­cal reports, etc.).

5.    Losing things required for task completion (self, wife).

Things tend to get lost because of my poor or­ganiza­tional ability and disin­clination to put them away in their proper places.

6.    Being distracted by stimuli in the environment (self).

Anything will distract me if I am doing a task I do not enjoy.

7.    Forgetting things (self).

Remembering names and schedules is hard for me.

 

 

Currently, I also exhibit two DSM-IV ADHD hy­peractive-impulsive symp­toms.  I often,

 

1.     Feel restless (self).

Restlessness is a problem when I do not have an inter­esting task to occupy my mind.  However, even when I sit down to read a good book I am often able to read only for brief stretches. 

2.    Interrupt others (self, peers, work supervisor).

This problem occurs when I get impatient to make a point in a conversation, especially when I am excited about the topic.

 

Suggested Diagnostic Criteria for ADHD in Adults

 

Eighteen of Hallowell and Ratey's twenty Sug­gested Diag­nostic Criteria for At­tention-Deficit Hyper­activity Disorder in Adults (ibid., pp. 201-202) de­scribe me (15 are required for a possible diagnosis).   The ones that apply to me in­clude the following:

 

§        A sense of underachievement (self, wife)

§        Disorganization (self, wife)

§        Chronic procrastination (self, wife)

§        Trouble following through (self, wife)

§        Speaking one's mind (self)

§        Frequent boredom (self)

§        Easily distracted (self)

§        Creative and intelligent (a local judge, Louis Sauter)[1]

§        Impatient (wife, daughters)

§        Impulsive, verbally or otherwise (self, peers)

§        Prone to worry (self, wife, daughters)

§        Insecure (self)

§        Labile moods (self, wife)

§        Restless (self)

§        Addictive behavior [overeating] (self, wife)

§        Self-esteem problems (self)

§        Poor self-observation (wife)

§        A probable family history of ADD (paternal side of the family)

             

Two of the suggested criteria do not apply to me:  an on­going search for high stimulation (I seek stimula­tion, but not "high-stim," risky behaviors); and trou­ble going through proper channels (a minor problem when I first started my ca­reer in social work).

 

My Scores on Rating Scales

 

Behavior rating instruments are administered to as­sess ADHD traits and be­haviors more objectively.  The ones used to evaluate me included those listed below (see de­scriptions in the previous chapter, My Apprenticeship with an ADHD Clinic):

             

§        Copeland Symptom Checklist for Adult ADHD

§        ADHD Behavior Checklist for Adults

§        Wender Utah Rating Scale

§        Boredom Proneness Rating Scale

§        Buchsbaum Continuous Performance Test

§        Amen's ADD Subtype Test

 

* * *

             

My wife and I completed the Copeland Symptom Checklist. The results in Table 1 below are signifi­cant as follows:

            

 

Table 1

 

 

 

Table 2 below shows my self-rating of current ADD symptoms on the ADHD Behavior Checklist for Adults—including scale scores, and whether the scores are clinically significant (+1.5 standard devia­tions or greater):

 

 

 

Table 2

 

The results of the other rating scales I completed were as follows:

 

§        I achieved a total retrospective symptom score on the Wender Utah Rating Scale that is greater than +1.5 stan­dard deviations (SD) above the mean score for adult men with ADHD, indicating the probability of ADD.

§        My score on the Boredom Proneness Rating Scale is more than +2.5 SD greater than the male mean, suggest­ing that I am highly prone to boredom.

§        My errors of omission are within normal limits on the Buchsbaum Continuous Performance Test, but I had 16 errors of commission, compared to a norm for normal adults of 3.9 (+/-2.2).  This indi­cates im­pul­siveness in re­sponding.

§        Amen's 58-item ADD Subtype Test[2], which I took on-line, suggests that I have an inattentive-type of ADD caused by an overactive limbic system.

 

Taken together, my ratings on the objective scales point to a diagnosis of ADHD, Predominantly Inat­tentive Type.  This conclusion is supported by a re­view of my physical and mental developmental his­tory, health history, child­hood school records, aca­demic scores and a study of my family history that follows in later chapters.

 

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