Professionally successful adults with attention-deficit/hyperactivity disorder (ADHD): Compensation strategies and subjective effects of pharmacological treatment

Abstract

Although as a group, adult patients with ADHD have difficulties in social functioning due to inattention and executive dysfunction, some strive and succeed in living a productive, independent life.PurposeTo report on professionally successful adults with ADHD and analyze their main symptoms, compensation strategies and the subjective effect of methylphenidate on their functioning.MethodsThe main symptoms of five patients with ADHD who are University educated and financially independent are reported. These patients were selected from a personally followed cohort of adults with ADHD. All were diagnosed according to DSM-IV adapted criteria (K-SADS E, version 6.0) and completed the Portuguese translated version of the ADHD adult self-reporting scale (ASRS).ResultsMain reported symptoms included difficulties with attention, tendency to procrastinate and to ‘shuffle’ priorities, excessive daytime somnolence, memory difficulties and impulsiveness. Compensation strategies revolve around conscious, ‘energy demanding’ and time consuming efforts to control and circumvent symptomatic behavioral tendencies. They feel methylphenidate helps by alleviating the need to constantly apply compensation strategies for socially disabling symptoms. In sum, they achieve the same results in a more natural, less effortful fashion.ConclusionsAdults with ADHD may succeed professionally despite significant symptoms of inattention and executive dysfunction. They do so by appropriately using effortful strategies of compensation, the need for which is alleviated by the use of methylphenidate. These subjective reports require confirmation in prospective studies on larger series of patients.

College Adjustment as a Mediator Between Attention Deficit/Hyperactivity Disorder Symptoms and Work Self-Efficacy

“…Satisfaction with their undergraduate studies, the perception of the competence to perform professional tasks, and career planning perspectives appear to be similar between students with and without frequent ADHD symptoms. Inattention/hyperactivity may not influence career perspectives and the perception of competences due to the strategies that students use to overcome the obstacles of these symptoms, such as taking notes, using alarm clocks, and obtaining assistance from friends and family to remember commitments (Palmini, 2008). New investigations should still address the implications of this particular finding.…”

“…These findings disagree with results of a study performed with ADHD-afflicted college students, in which no differences were observed between students with or without ADHD with regard to the number of hours of study per week, the quality of the notes taken during classes, and the performance of assignments ahead of time (Advokat et al, 2011). Nevertheless, ADHD students need to be constantly vigilant to control inappropriate behavioral tendencies (Palmini, 2008) and restrain energy outbursts to finish assignments (Conners, 2009).…”

“…With respect to cognitive functioning, students who report ADHD symptoms have poor planning and study skills (Rabiner, Anastopoulos, Costello, Hoyle, & Swartzwelder, 2008); they have greater difficulty concentrating and avoiding distractions (Palmini, 2008;Rohde, Knapp, Lykowski, & Carim, 2004); and they tend to have lower Grade Point Averages (GPA) compared to other students (Advokat, Lane, & Luo, 2011). Interpersonally, college students with ADHD symptoms are more prone to become involved in arguments with professors and classmates (Souza, Mattos, Pina, & Fortes, 2008), possess fewer social skills and social adjustment strategies (ShawZirt, Popali-Lehane, Chaplin, & Berman, 2005), and receive less support from friends (Wilmshurst, Peele, & Wilmshurst, 2011).…”

Repercussões do Transtorno de Déficit de Atenção/Hiperatividade (TDAH) na Experiência Universitária

“…Os sintomas podem ser mais evidentes em situações que demandam atenção constante ou que não apresentam novidades ou atrativos para o indivíduo. Todavia, os sinais do transtorno podem ser minimizados pelo controle rígido do sujeito, quando este se encontra em um ambiente novo ou quando está envolvido em atividades que despertam seu interesse (APA, 1994;Palmini, 2008). Por exemplo, no que se refere ao trabalho, indivíduos com TDAH preferem empregos ou tarefas variadas e ativas em vez das estáveis e calmas.…”

“…As estratégias adotadas para controlar os sintomas do TDAH, muitas vezes, permitem que muitos indivíduos com o transtorno consigam ingressar no ensino superior, ser bem sucedidos e levar uma vida produtiva e independente, apesar das dificuldades escolares e de atenção (Palmini, 2008). De fato, há evidências de indivíduos com TDAH que sentiram menos dificuldades no ensino superior, seja porque já descobriram como superar os problemas decorrentes da desatenção, impulsividade e/ou hiperatividade, ou pela pouca exigência dos docentes em relação aos alunos no contexto universitário (Reis & Camargo, 2008).…”