Nov 13, 2017 | Research Updates
J. Russell Ramsay, Ph.D.
Associate Professor of Clinical Psychology
University of Pennsylvania, Perelman School of Medicine
A recent, online ahead of print article in the Journal of Attention Disorders addresses the social media language and use in a sample of 1399 adults self-identified as being diagnosed with ADHD compared with matched controls. In addition to linguistic analysis of public Twitter posts regarding themes (including how these themes mapped onto the 5-factor model of personality), adults with ADHD were significantly more likely than controls to post between 12 midnight and 6 a.m. The study represents a novel use of social media to gain relevant information about the experiences and expressions of adults with ADHD not typically captured in other venues.
A benefit of your APSARD membership is free access to articles published in the Journal of Attention Disorders.
Oct 24, 2017 | Research Updates
J.J. Sandra Kooij, M.D., Ph.D.
Here is a video blog from Dr. Sandra Kooij, an APSARD Board-member, describing her research during the recent European College of Neuropsychopharmacology Congress in Paris.
Click here to access the video.
Oct 5, 2017 | Research Updates
J. Russell Ramsay, Ph.D.
Associate Professor of Clinical Psychology
University of Pennsylvania, Perelman School of Medicine
The HBO series, In Treatment (2008-2010) centered on the life and practice of a psychotherapist, Paul Weston (as portrayed by Gabriel Byrne). Each nightly episode focused on a session with a different patient, with the course of therapy with each patient followed week-by-week. In a scene from a Season 1 episode (with a patient named Alex, if you want to track it down), Dr. Weston jokingly retorted, “In my profession we say that the customer is always wrong.”
Although some may argue that there is some truth in that line, clinicians and researchers who treat and study adults with ADHD seek objective measures of treatment response and improvements in symptoms and functional outcomes. Blinded assessments and other objective measures are employed toward this end, as there may be many biases in patient self-report.
However, what about patients’ subjective sense of what works for them? What do the “customers” have to say?
This question was asked as part of a separate analysis of follow up impressions gathered during a randomized controlled multi-center trial that compared the results between a specialized group psychotherapy for adult ADHD and supportive community care while either on stimulant medication or placebo (Philipsen et al., 2015). The results of this original study indicated that there were no significant differences between the specialized group treatment and community care (in either medication or placebo conditions) on blinded ratings of ADHD symptoms.
However, the study also employed a participant-rated therapy evaluation form to get their perspectives on what was most effective in the treatments they received (Groß et al., 2017). Participants rated their psychosocial treatment experience on a 5-point Likert scale (“How do you judge the effectiveness of the whole treatment in respect to your ADHD symptoms?” [with the added phrase “…until today’s date” for 18-month post-treatment follow-up].
At the end of the one-year treatment study and at 18-month follow-up, significantly (though moderately) more participants in the specialized group psychotherapy found this treatment to be more helpful when compared with those in community care. At 18 months, this difference was only found among participants receiving psychological treatment in the placebo condition of the medication arm; there was no difference between specialized group therapy with placebo and community care with stimulant. The group therapist was rated as the most helpful component of psychosocial treatment for ADHD. The presence of other group members and the information provided in sessions were viewed as next most helpful to an equal degree. The correlations with observer and blind-ratings were strong enough to support the use of this additional self-report item.
The take away message from the article is that there is potentially fruitful additional source of outcome data on the benefit of psychosocial treatments for adult ADHD, namely, “customer” feedback.
Highlighted Article
Groß, V., …. Philipsen, A. (2017). Effectiveness of psychotherapy in adult ADHD: What do patients think? Results of the COMPAS study. Journal of Attention Disorders. online ahead of print. doi: 10.1177/1087054717720718
Other reference
Philipsen, A., et al. (2015). Effects of group psychotherapy, individual counseling, methylphenidate, and placebo in the treatment of adult attention-deficit/hyperactivity disorder: A randomized clinical trial. JAMA Psychiatry, 72, 1199-1210.
Aug 31, 2017 | Research Updates
J. Russell Ramsay, Ph.D.
Associate Professor of Clinical Psychology
University of Pennsylvania, Perelman School of Medicine
The October issue of the Journal of Attentions Disorders includes an article on the effects of maternal smoking during pregnancy on the risk for smoking in ADHD children grown up. The findings are based on a controlled longitudinal study of children with ADHD in adulthood. The extended effects of smoking continue to be a relevant issue in behavioral health, particularly for individuals with ADHD.
Biederman, J., Martelon, M. K., Woodworth, K. Y., Spencer, T. J., & Faraone, S. V. (2017). Is maternal smoking during pregnancy a risk factor for cigarette smoking in offspring?: A longitudinal controlled study of ADHD children grown up. Journal of Attention Disorders, 21, 975-985.
All APSARD members have access to the Journal of Attention Disorders as a benefit of their membership. The article above can be accessed at:
http://journals.sagepub.com/home/jad
Jul 25, 2017 | Research Updates
David Giwerc, MCAC, MCC
ADD Coach Academy
In this second blog, I will discuss what the research Entrepreneurship and Psychological Disorders: How ADHD can be productively harnessed revealed about the importance of hyper focus and how some of the world’s leading Entrepreneurs use the strength of hyper focus. I will also propose a few practical recommendations to expand the research I believe are critical to the success of an Entrepreneur with ADHD.
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Hyper focus, the Strength of ADHD Entrepreneurs to Catalyze Successful Outcomes and Recommendations for Expanding “Positive Approaches” Research
Wiklund et al. (2016). Entrepreneurship and psychological disorders: How ADHD can be productively harnessed. Journal of Business Venturing Insights, 6, 14-20. doi.org/10.1016/j.jbvi.2016.07.001
The final important element revealed in the research on the impact of ADHD on entrepreneurs (Wiklund et al., 2016) is that hyper focus was identified as among the greatest attributes for the ADHD entrepreneur. Hyper focus is the ability to focus intensely on a task at hand to the exclusion of all else – including forsaking eating and sleeping. This is often observed with ADHD entrepreneurs who are pursuing a business venture about which they are passionately enthused. David Neeleman revealed that he could not pay attention in the classroom, yet was able to hyper focus tirelessly on important issues within the airline industry, which eventually led to the founding of JetBlue.
Paul Orfalea was referred to as his company’s “chief wanderer,” spending 3 weeks on the road hyper focusing on how his own stores were operating and what his competitors were doing. He said it was his ADHD that compelled him to wander because he could never bear staying in one place too long. He also discovered that leaving headquarters removed him from the boring, mundane, daily routine of work that left little room for insight, inspiration and innovation, qualities that drove him to differentiate his product from that of his competitors, which helped placed Kinkos in the forefront of consumers’ minds, making it the world’s leading retailer for document copying and business services; Orfalea sold Kinkos to Federal Express for $2.4 billion in 2014.
This study reinforced what I have observed in coaching Entrepreneurs with ADHD for over 20 years. Every successful entrepreneur is involved with a business they love. The business enterprise is not derived from pressure to work in a business or workplace environment not suited to their ADHD and unique strengths.
These and other examples represent the restless, impatient nature of the entrepreneur with ADHD who experiences boredom while attending to the daily mundane grind of tasks, which impedes the ability to think creatively and innovate. Without sufficient mental stimulation, the entrepreneur with ADHD will seek out opportunities to explore new and interesting ideas, which may induce a state of hyper focus. This type of intense, intellectual attentiveness and vigor will lead to the attainment of a wider scope of knowledge, in a specific domain, often expanding their perspective, abilities and confidence, in a chosen field, thus increasing the chance for success when an intuitive decision needs to be made, which is a conjecture of Wiklund et al. (2016).
Future Research Recommendations:
Existing research on adult ADHD has not supported evidence for any positive effects of the diverse qualities inherent in ADHD. However, some anecdotal evidence suggests that some features ADHD may have positive implications in some settings, such as entrepreneurship.
The Wiklund et al. (2016) study is an important first step towards understanding how ADHD impacts entrepreneurship, albeit based on case study. It transcends the symptoms of ADHD and opens a new pathway for more formal academic/scientific study to investigate positive ways to approach ADHD and entrepreneurship.
There are at least three areas for future research: 1) the role of physical exercise in managing an entrepreneur’s ADHD symptoms and how a consistent exercise regimen may be a source of time-limited symptom management the promotes creativity; 2) identification and integration of unique information processing styles for improved communication of information, presenting business proposals, and assigning and managing tasks, which may inform strategic use of assistive technology in business settings; and 3) the use of the VIA character strengths survey (Peterson & Seligman, 2004) to identity self-endorsed character traits that may be associated with entrepreneurship. I can only conjecture that “creativity” would emerge as one of the core signature strengths in entrepreneurs with ADHD.
Many of the ADHD entrepreneurs in the study knew intuitively that they were different and stood out from peers in ways that might not have been perceived in positive terms. One of the most important messages of this research is that ADHD is not only a diagnosis; it is also, potentially, a unique difference that may bring with it unconventional strengths. When understood by entrepreneurs with ADHD in this way, it can be the catalyst for identifying who they are, including envisioning unconventional ways of doing things in order to create and build innovative and successful businesses.
References
Csikszentmihalyi, M. (1997). Flow and the Psychology of Discovery and Invention. HarperPerennial, New York.
Orfalea, P., & Marsh A. (2005). Copy This!: Lessons from a hyperactive dyslexic who turned a bright idea into one of America’s best companies. Workman Publishing Company, Inc.: New York
Logan, J. (2009). Dyslexic entrepreneurs: the incidence; their coping strategies and their business skills. Dyslexia 15 (4), 328–346.
Peterson,C., & Seligman,M. (2004). Character Strengths and Virtues: A Handbook and Classification. Oxford University Press: New York
Wiklund et al. (2016). Entrepreneurship and psychological disorders: How ADHD can be productively harnessed. Journal of Business Venturing Insights, 6, 14-20. doi.org/10.1016/j.jbvi.2016.07.001
