Hey I was wondering what the difference is between ADD and ADHD. I believe I was diagnosed with ADD but I am on concerta and isnt that for ADHD. Every time I take my meds I feel really restless. It does help me kind of concentrate. Are there any other meds that people can recomend for me. I have tried Focalin, Concerta, Adderall, and Ritalin. Thanks

ADD is the old term, Attention Deficit Disorder, whereas ADHD is a newer term (the newest is AD/HD), Attention Deficit Hyperactivity Disorder. These days, the term ADD is often used to mean the ADHD Predominantly Inattentive subtype (ADHD w/o hyperactivity). Stimulants are used to treat all of the subtypes, even the Inattentive type.

by Sam Goldstein, Ph.D.

Salt Lake City, UT

Although the labels used to describe this cluster of childhood problems has changed numerous times over the past 100 years, the term Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder is most familiar to educators, medical and mental health professionals. However, there continues to be a degree of disagreement in what defines this set of childhood problems and the best diagnostic label. Researchers have argued that this might be best be referred to as a reward system dysfunction, a learning disability or a self-regulatory disorder to name but a few. It is increasingly recognized that ADHD in fact does not represent a problem with faulty attention but rather represents a problem of faulty modulation and self-regulation. Individuals with ADHD when interested are sufficiently motivated to pay attention as well or nearly as well as others. It is when tasks are repetitive, effortful, uninteresting or not of their choosing that they experience greater difficulty staying focused and remaining on task.

It is when consequences, either rewards or punishments, are delayed, infrequent, unpredictable or inconsistent that they experience greater difficulties than their peers. Problems with self-regulation cause difficulty managing emotions. Small events are responded to with excessive behavior and emotion. Self- regulatory problems make it difficult to develop habitual behaviors. More practice trials are needed over longer periods of time for individuals with ADHD to progress from behaviors that are governed by the outside world to behaviors that are self-governed or habitual. Negotiating the demands of every day life requires efficient self-regulation to develop the habits necessary for success.

The current Diagnostic and Statistical Manual of the American Psychiatric Association is in it's fourth edition. Categorically ADHD contains three primary and one related diagnosis. The first contains symptoms of the inattentive type, the second, the hyperactive-impulsive type, the third a combination of the previous two and the fourth or related type, symptoms of either type one or two but of insufficient number to warrant a full syndrome diagnosis but clear impairment present. This latter diagnosis is referred to as Attention Deficit Hyperactivity Disorder - Not Otherwise Specified. It is now increasingly recognized that given these criteria, approximately 2% to 3% of the childhood and for that matter adult population meets the combined type criteria, nearly the same percentage meeting the inattentive type criteria, less than half a percent meeting the hyperactive- impulsive type criteria and no data available concerning the not otherwise specified type. (emphasis mine)Thought you might like to see an excerpt of what Goldstein had to say about ADD/ADHD. The whole article is available at www.schwablearning.com (http://www.schwablearning.com).


Scattered

I almost forgot -- welcome to the forums!:) Here's some more information on the difference between ADD inattention) and ADHD (hyperactivity/impulsivity) by Barkley from a CEU class.



Inattention.

Attention represents a multidimensional construct (Bate, Mathias, & Crawford, 2001; Mirsky, 1996; Strauss, Thompson, Adams, Redline, & Burant, 2000) implying that several qualitatively distinct problems with attention may be evident in children (Barkley, 2001a). The dimension impaired in ADHD reflects an inability to sustain attention or persist at tasks or play activities, remember and follow through on rules and instructions, and resist distractions while doing so. I have elsewhere argued that this dimension more likely reflects problems with the executive function of working memory than poor attention, per se (Barkley, 1997b) and evidence is becoming available to support this contention (Oosterlan, Sheres, & Sergeant, in press; Seguin, Boulerice, Harden, Tremblay, & Pihl, 1999; Wiers, Gunning, & Sergeant, 1998). Parents and teachers frequently complain that these children do not seem to listen as well as they should for their age, cannot concentrate, are easily distracted, fail to finish assignments, are forgetful, and change activities more often than others (DuPaul, Powers, Anastopolous, & Reid, 1999). Research employing objective measures corroborates these complaints through observations of more “off-task” behavior, less work productivity, greater looking away from assigned tasks (including television), less persistence at tedious tasks, such as continuous performance tasks, being slower and less likely to return to an activity once interrupted, less attentive to changes in the rules governing a task, and less capable of shifting attention across tasks flexibly (Borger & van der Meere, 2000; Hoza, Pelham, Waschbusch, Kipp, & Owens, 2001; Lorch et al., 2000; Luk, 1985; Newcorn et al., 2001; Seidman, Biederman, Faraone, Weber, & Ouellette, 1997; Shelton et al., , 1998). This inattentive behavior distinguishes these children from those with learning disabilities (Barkley, DuPaul, & McMurray, 1990) or other psychiatric disorders (Chang et al., 1999; Swaab-Barneveld et al., 2000) and does not appear to be a function of other disorders often comorbid with ADHD (anxiety, depression, or oppositional and conduct problems) (Murphy, Barkley, & Bush, 2001; Klorman et al., 1999; Newcorn et al., 2001; Nigg, 1999; Seidman et al., 1997).

Hyperactive–Impulsive Behavior (Disinhibition).

As with attention, inhibition is a multidimensional construct (Nigg, 2000; Olson, Schilling, & Bates, 1999) and thus various, qualitatively distinct forms of inhibitory impairments may eventually be found in children. The problems with inhibition seen in ADHD are thought to involve voluntary or executive inhibition of prepotent responses rather than impulsiveness that may be more motivationally controlled, as in a heightened sensitivity to available reward (reward seeking) or to excessive fear (Nigg, 2001). Some evidence suggests that an excess sensitivity to reward or to sensation seeking may be more associated with severity of conduct disorder or psychopathy than with severity of ADHD (Beauchaine, Katkin, Strassberg, & Snarr, 2001; Dougherty & Quay, 1991; Fischer, Barkley, Smallish, & Fletcher, in press; Matthys, van Goozen, de Vries, Cohen-Kettenis, & van Engeland, 1998). Evidence is less clear about deficits in automatic or involuntary inhibition, as in eyeblinking or negative priming, being associated with ADHD (Nigg, 2001).

More specifically, ADHD children manifest difficulties with excessive activity level and fidgetiness, less ability to stay seated when required, greater touching of objects, moving about, running, and climbing than other children, playing noisily, talking excessively, acting impulsively, interrupting others’ activities, and being less able than others to wait in line or take turns in games (American Psychiatric Association, 1994). Parents and teachers describe them as acting as if driven by a motor, incessantly in motion, always on the go, and unable to wait for events to occur. Research objectively documents them to be more active than other children (Barkley & Cunningham, 1979a; Dane, Schachar, & Tannock, 2000; Luk, 1985; Porrino et al., 1983; Shelton et al., 1998), to have considerable difficulties with stopping an ongoing behavior (Schachar, Tannock, & Logan, 1993; Milich, Hartung, & Haigler, 1994; Nigg, 1999, 2001; Oosterlaan, Logan, & Sergeant, 1998), to talk more than others (Barkley, Cunningham, & Karlsson, 1983), to interrupt others’ conversations (Malone & Swanson, 1993), to be less able to resist immediate temptations and delay gratification (Anderson, Hinshaw, & Simmel, 1994; Barkley, Edwards, Laneiri, & Metevia, 2001; Olson et al., 1999; Rapport, Tucker, DuPaul, Merlo, & Stoner, 1986; Solanto et al., 2001), and to respond too quickly and too often when they are required to wait and watch for events to happen, as is often seen in impulsive errors on continuous performance tests (Losier, McGrath, & Klein, 1996; Newcorn et al., 2001). Although less frequently examined, the differences in activity and impulsiveness have been found between children with ADHD and those with learning disabilities (Barkley, DuPaul, & McMurray, 1990; Bayliss & Roodenrys, 2000; Klorman et al., 1999; Willcutt et al., 2001). Mounting evidence further shows that these inhibitory deficits are not a function of other psychiatric disorders that may overlap with ADHD (Barkley, Edwards, Laneiri, & Metevia, 2001; Halperin, Matier, Bedi, Sharpin, & Newcorn, 1992; Fischer et al., in press; Murphy, Barkley, & Bush, 2001; Nigg, 1999; Oosterlaan et al., 1998; Seidman et al., 1997).

Interestingly, recent research shows that the problems with inhibition arise first (at age 3–4 years) ahead of those related to inattention (at age 5–7 years), or than the sluggish cognitive tempo that characterizes the predominantly inattentive subtype that may arise even later (ages 8-10) (Hart et al., 1995; Loeber, Green, Lahey, Christ, & Frick, 1992; Milich et al., 2001). Whereas the symptoms of disinhibition in the DSM item lists seem to decline with age, perhaps owing to their heavier weighting with hyperactive than impulsive behavior, those of inattention remain relatively stable during the elementary grades (Hart et al., 1995). But eventually decline by adolescence (Fischer, Barkley, Fletcher, & Smallish, 1993a), though not to normal levels. Why the inattention arises later than the disinhibitory symptoms and does not decline when the latter do over development remains an enigma. As noted above, it may simply reflect the different weightings of symptoms in the DSM. Those of hyperactivity may be more typical of preschool to early school-age children and are over-represented in the DSM list while those reflecting inattention may be more characteristic of school-age children. Another explanation comes from the theoretical model described below (Barkley, 1997b) in which inhibition and the two types of working memory (nonverbal and verbal) emerge at separate times in development.


Inhibition and Stimulant Medications

This theory suggests a more specific implication for the management of ADHD. Only a treatment that can result in improvement or normalization of the underlying neuropsychological deficit in behavioral inhibition is likely to result in an improvement or normalization of the executive functions dependent on such inhibition. To date, the only treatment that exists that has any hope of achieving this end is stimulant medication or other psychopharmacological agents that improve or normalize the neural substrates in the prefrontal regions that likely underlie this disorder. Evidence to date suggests that this improvement or normalization in inhibition and some of the executive functions may occur as a temporary consequence of active treatment with stimulant medication, yet only during the time course the medication remains within the brain. Research shows that clinical improvement in behavior occurs in as many as 75–92% of those with the hyperactive–impulsive form of ADHD and results in normalization of behavior in approximately 50–60% of these cases, on average. The model of ADHD developed here, then, implies that stimulant medication is not only a useful treatment approach for the management of ADHD but the predominant treatment approach among those treatments currently available because it is the only treatment known to date to produce such improvement/normalization rates.

Society may view medication treatment of ADHD children as anathema largely as a result of a misunderstanding of both the nature of ADHD specifically and the nature of self-control more generally. In both instances, many in society wrongly believe the causes of both ADHD and poor self-control to be chiefly social in nature, with poor upbringing and child management by the parents of the poorly self-controlled child seen as the most likely culprit. The present model states that not only is this view of ADHD incorrect but so is this view of self-regulation. And this model also implies that using stimulant medication to help to temporarily improve or alleviate the underlying neuropsychological dysfunction is a commendable, ethically and professionally responsible, and humane way of proceeding with treatment for those with ADHD.

I'm too tired to look up the reference, but if memory serves, Barkley states that 90% of hyperactive/impulsive ADHD individuals respond to stimulent medication. I don't remember the exact figure, but it is much lower for those with purely inattentive ADD (in the 50 - 70% range -- I think -- and not as much improvement frequently as seen for combined types).

I'm diagnosed as inattentive (although according to Barkley's criteria I would be combination type because I was hyperactive as a kid). My Concerta helps but it doesn't fully normalize my organization, motivation, procrastination and the like. But I'll take what I can get and learn all I can about adaptations I need to make. I hope you find a solution that works well for you.

Scattered

1)ADD (plain-no whip cream or sprinkles maybe a few nuts)

Brain wanders off...zones out....goes to commercial without directors permission...MIA attention span! Brain director reading magazine during production!

also called ADD-inattentive

2)ADHD- "H" factor = very active (lots of sprinkles, whip cream, sporadic nuts scattered through out)

brain zones into every thing, takes body with it (here a bounce, there a bounce, every where a bounce bounce)...... brain AWOL attention span.

director running around in circles wishing for a commercial break!

Also called ADD-impulsive


3)ADD-combined (whip cream and sprinkles every where but on top)

uneven, unexpected, individual diversities of both impulsive…AND inattentive…. commercial breaks plus moments of hyper active circle running!

Director calls in sick a lot, especially on Mondays and Fridays!


Hope this helps!

1)ADD (plain-no whip cream or sprinkles maybe a few nuts)

Brain wanders off...zones out....goes to commercial without directors permission...MIA attention span! Brain director reading magazine during production!

also called ADD-inattentive

2)ADHD- "H" factor = very active (lots of sprinkles, whip cream, sporadic nuts scattered through out)

brain zones into every thing, takes body with it (here a bounce, there a bounce, every where a bounce bounce)...... brain AWOL attention span.

director running around in circles wishing for a commercial break!

Also called ADD-impulsive


3)ADD-combined (whip cream and sprinkles every where but on top)

uneven, unexpected, individual diversities of both impulsive…AND inattentive…. commercial breaks plus moments of hyper active circle running!

Director calls in sick a lot, especially on Mondays and Fridays!


Hope this helps!
This is one of the best explainations I have see yet. Printing it now for future reference. Still laughing...:D

A.D.D. is the term used in an older version of the D.S.M. (Diagnostic and Statistical Manual) for mental health professionals. A.D.H.D. is the term used in the most recent version, the D.S.M. IV. There is no difference between the two. ADD is simply an outdated phrase.

1)ADD (plain-no whip cream or sprinkles maybe a few nuts)

Brain wanders off...zones out....goes to commercial without directors permission...MIA attention span! Brain director reading magazine during production!

also called ADD-inattentive

2)ADHD- "H" factor = very active (lots of sprinkles, whip cream, sporadic nuts scattered through out)

brain zones into every thing, takes body with it (here a bounce, there a bounce, every where a bounce bounce)...... brain AWOL attention span.

director running around in circles wishing for a commercial break!

Also called ADD-impulsive


3)ADD-combined (whip cream and sprinkles every where but on top)

uneven, unexpected, individual diversities of both impulsive…AND inattentive…. commercial breaks plus moments of hyper active circle running!

Director calls in sick a lot, especially on Mondays and Fridays!


Hope this helps!

I love this explaination too! Tammy, is it okay if we use this?

There is no difference between the two. ADD is simply an outdated phrase.


WARNING:

This member is also out dated.......

I wear under garments under my garments, I prefer my hair to remain with in the realm of colors peoples hair naturally come in, and address older people by proper names until told I can do otherwise!

My bank, credit card company, and several other financial establishments changing names so often I forget who I bank with, where to mail my credit payment, ect.....yet I am the one with the “disorder”

We have attention deficit disorder=which means no matter where your sprinkles, whip cream (I almost said nuts) are located we are always viewing short attention span theater due to working memory, frontal lobe, dopamine, snaphoo........

Okay

ADD-I (impulsive)

ADD-C (combined)

ADD=inattentive!

or


ADD=every thing but pure impulsive....

ADD=every thing including impulsive

ADD=late for breakfast, lunch and supper ......remember to eat when hungry not according to clock!

I personally prefer to describe my "condition" as ADD with "H" factor!

.....................or ADHD

Take you pick because if any one has any questions few will have problems asking for clarification!


I love this explanation too! Tammy, is it okay if we use this?

Sure.....feel free to do so. Glad I could help!