DEFINITION:
The phrase “attention deficit hyperactivity disorder (ADHD)” refers to a mental disorder characterized by the inability to focus attention for any substantial length of time, excessive physical activity, impulsivity, and deficits in emotional regulation and behavioral self-control.
For an individual to be diagnosed with ADHD, the foregoing symptoms must be severe, pervasive, and present in multiple contexts in ways that are not age-appropriate.
The last criterion flows from the fact that ADHD is viewed almost exclusively as a childhood developmental disorder—basically, the inability of children, especially boys, to adjust to the requirements of the modern educational system.
For this reason, ADHD is controversial among some psychologists (see below).
ETYMOLOGY:
Discussion of the symptoms associated with the diagnostic category of ADHD was inaugurated by the English pediatrician George Frederic Still (1868–1941) in three public lectures he delivered in 1902. These lectures, entitled Some Abnormal Psychical Conditions in Children, were published in the premier British medical journal, The Lancet, and also in book form later that same year.
Over the following decades, this constellation of symptoms began to be referred to by several different terms, notably, “hyperactivity” and “learning disability.”
The phrase ADHD itself was initially introduced into the medical literature as a subcategory of “attention deficit disorder (ADD)” in the third edition of the Diagnostic and Statistical Manual of Mental Illnesses (DSM-III), published in 1980. ADHD replaced ADD as the primary diagnostic category in the revised version of the third edition (DSM-III-R), published in 1987.
The English noun “attention” is attested from the fourteenth century. It derives, via the Middle English word attencioun, from the Classical Latin noun attentio, attentiōnis, meaning “attention,” which, in turn, is linked to the past participle attentus from the verb attendo, attendere, meaning “to stretch to” or “to attend to.”
The English noun “deficit” is attested from the eighteenth century. It derives, via the French déficit, from the Classical Latin word deficit, meaning “it is wanting.” Deficit is the third-person, present indicative form of the verb dēficio, deficere, meaning “to do less than one might” or “to fail.”
The English noun “hyperactivity” and the associated adjective “hyperactive” are attested from the mid-nineteenth century. The words are compounded from the following two elements:
(1) The English prefix “hyper-“ derives, via Middle English and Latin, from the Greek preposition huper, meaning “over,” “above,” or “beyond.”
(2) The English noun “activity” is attested from the fifteenth century, while the associated adjective “active” is a century older. “Active” derives, via Middle English and Middle French, from the Classical Latin adjective activus, which is connected to the noun actus, actūs, meaning “driving,” “movement,” “doing,” or “action.” The noun actus, in turn, is connected to the past participle actus of the verb ago, agere, meaning “to set in motion.”
For the etymology of the term “disorder,” see the Glossary entry, borderline personality disorder.
DISCUSSION:
In contemporary usage, three sub-categories of ADHD are frequently distinguished:
- predominantly inattentive
- predominantly hyperactive-impulsive
- combined presentation
Statistically, ADHD manifests differently in boys and in girls, with the majority of girls falling into the first sub-category above—namely, mainly exhibiting symptoms of inattention and distraction—while the majority of boys fall into the second category—manifesting hyperactivity, impulsivity, and lack of self-control.
There are several distinct controversies surrounding the diagnosis and treatment of ADHD.
- One has to do with the widespread used of powerful drugs, notably, Ritalin (Methylphenidate), in young children to render them docile.
- Another controversy surrounds what has been called the “medicalization” of normal behavior that happens to be inconvenient for parents and schoolteachers.
- A third controversy involves the effort of contemporary American society to efface the natural differences between boys and girls: the children who are most-often assigned the label of ADHD are boys, because boys have a greater natural need for physical activity and so more difficulty in sitting still for long hours at a desk.
- While ADHD may be a lifelong illness, its symptoms tend to decline in severity as the individual ages, making it of most concern in children and adolescents—but this may simply show that younger people ought not to be expected to conform to the same standards of attention and inactivity as older individuals.