A Cognitive Therapy Approach for Adult Attention Deficit/Hyperactivity Disorder

Ramsay, J. Russell; Rostain, Anthony L.

doi:10.1891/jcop.17.4.319.52537

Cited by 35 publications

(35 citation statements)

References 23 publications

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“…The underlying neurobiology Psychotherapy for Adults With ADHD and neuropsychology of ADHD are important threads affecting the case conceptualization insofar that they have affected the patient's developmental experiences of and interactions with the environment. In fact, the symptoms of ADHD have such a profound and pervasive effect on development that it has been described as an "Axis I.5" disorder (Ramsay & Rostain, 2003). The conceptualization provides an understanding of a patient's experience and a blueprint for interventions at a number of different levels.…”

Section: Case Conceptualizationmentioning

confidence: 99%

Adapting Psychotherapy to Meet the Needs of Adults With Attention-Deficit/Hyperactivity Disorder.

Ramsay¹,

Rostain²

2005

Psychotherapy: Theory, Research, Practice, Training

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Requests for the assessment and treatment of attention-deficit/hyperactivity disorder (ADHD) among adult patients are on the rise. The findings from longitudinal research indicate that clinically significant symptoms persist into adulthood for many children diagnosed with ADHD. Many other patients' symptoms are not identified until they are in active treatment for other complaints in adulthood. Thus, psychotherapists are increasingly likely to encounter adult patients with ADHD-related issues. However, the same core symptoms of inattention, impulsivity, and hyperactivity that create functional problems in patients' lives also interfere with the effectiveness of psychotherapy. The aim of this article is to summarize the accumulated clinical and empirical wisdom about how to effectively adapt psychotherapy to meet the needs of adult patients with ADHD. Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder of childhood that has wide-ranging effects on behavior, learning and cognition, and emotional functioning (Barkley, 1998; Brown, 2000; Wender, 2000). It is estimated that ADHD affects about 3-5% of school-age children in the United States (American Psychiatric Association [APA], 2000). Barkley (1998) summarized prevalence studies of ADHD that used established diagnostic criteria for children and adolescents. The prevalence rates ranged from 2% to 9.5% (M ϭ 4.9%) of children and adolescents when using DSM-III criteria (APA, 1980) and 1.4% to 13.3% (M ϭ 5.9%) when using adults' ratings of DSM-III-R criteria (APA, 1987). Reviews of international samples show similar prevalence rates of ADHD in children in other countries, indicating that ADHD is not simply an American disorder (Barkley, 1998; Faraone, Sergeant, Gillberg, & Biederman, 2003), though diversity issues remain understudied (Gingerich, Turnock, Litfin, & Rosén, 1998). The prevalence of ADHD in adults falls between 4 and 5%, on the basis of surveys of nonclinical samples of college students and of adults applying for their driver's licenses (Bark

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Section: Case Conceptualizationmentioning

confidence: 99%

Adapting Psychotherapy to Meet the Needs of Adults With Attention-Deficit/Hyperactivity Disorder.

Ramsay¹,

Rostain²

2005

Psychotherapy: Theory, Research, Practice, Training

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“…Already more than a decade ago, Ramsay & Rostain discussed the importance of internalized core beliefs, also known as schemas, in relation to adult ADHD and ADHD-specific psychotherapy 15 and suggested the targeting of a patient's "compensatory strategies", linked to his schemas, by CBT. The same authors created the concept of ADHD as an "Axis 1.5 disorder", emphasizing the fundamental influence of ADHD traits on a patient's personal development 16 .…”

Section: Existence Of Maladaptive Schemas In Adhd: Results From Recenmentioning

confidence: 99%

New psychotherapeutic approaches in adult ADHD - acknowledging biographical factors

Lücke¹

2017

J Neurol Neuromedicine

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Cognitive behavioral therapy (CBT) is the standard form of psychotherapy currently used in adult attention deficit hyperactivity disorder (ADHD). However, biographical factors, such as chronic negative feedback in childhood, which may likely play a role in ADHD as a developmental disorder, are usually not substantially addressed by CBT. In recent years, schema therapy has received increasing attention as an effective therapy approach for chronic psychiatric disorders. A core feature of schema therapy is the identification and targeting of early maladaptive schemas, which are dysfunctional patterns and beliefs resulting from childhood experiences. Recently, two studies have demonstrated an increased prevalence of maladaptive schemas in adult ADHD. Thus, schema therapy might constitute a potentially promising approach in the treatment of ADHD, especially with regard to secondary problems such as poor coping strategies or impaired self-perception. However, randomized controlled clinical studies are needed to support that theory. Here, we provide an overview on the topic of biography-oriented therapy approaches in relation to adult ADHD, summarize current literature and discuss implications for future research.

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“…Typical maladaptive schemas (see Ramsay and Rostain 2003) in adults with ADHD are above all defectiveness (''I'm basically inadequate''), failure (''I've not fulfilled my potential''), and insufficient self-control (''I cannot rely on myself to do what I need to'') (Ramsay and Rostain 2003). Moreover, the affected individuals are prone to cognitive distortion (Beck 1963) such as overgeneralization or comparative thinking.…”

Section: Definitionmentioning

confidence: 99%

“…As a result of their longstanding neuropsychological impairments, such as distractibility, disorganization, emotional instability, or disinhibition, they have not adopted effective coping skills (see Fig. 1) (Ramsay and Rostain 2003;Bramham et al 2009). Thus, patients with ADHD typically are familiar with many negative life outcomes and underachievement.…”

Section: Definitionmentioning

confidence: 99%

“…To foster resilience Ramsay and Rostain (2003), consider it to be important to keep the focus on relevant goals in one's life, without capitulating when confronted with setbacks. Likewise, in relapse prevention, it is useful to anticipate the interference or ambivalence the patient could encounter and to develop anticipatory responses.…”

Section: Specific Therapeutic Interventions and Their Significancementioning

confidence: 99%

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Therapy-relevant factors in adult ADHD from a cognitive behavioural perspective

Newark

Stieglitz

2010

ADHD Atten Def Hyp Disord

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Adult individuals with attention-deficit hyperactivity disorder (ADHD) have been suffering from this neurobiological and highly heritable disorder chronically since childhood. Resulting from their longstanding neuropsychological impairments, such as attentional problems, emotional instability, and disinhibition, they are familiar to a multiplicity of negative life outcomes and underachievement. Furthermore, a large part of this population suffers from psychiatric comorbidity. This accumulation of negative experiences has an impact on therapy-relevant factors such as the individual's self-esteem, self-efficacy, development of core beliefs/schemas, and coping strategies. Based on negative beliefs about the self, individuals confronted with difficult situations develop maladaptive coping strategies, for instance avoidance and procrastination. These strategies lead to maintenance and reinforcement of maladaptive beliefs, and as such they acquit themselves as schema-confirming. Captured in this vicious cycle, the individual sees her negative view of the self confirmed. The purpose of this paper is to illuminate these interactive factors that influence the aforementioned cycle in order to emphasize the cognitive behavioural interventions tailored to those factors on the basis of latest research. Furthermore, the authors want to attract notice to the resources people with ADHD are said to have, namely creativity and resilience. These postulated resources could be therapy-relevant by creating positive beliefs about the self, hence improving coping skills and breaking the vicious circle of negative appraisal. Taking into account personal resources and their fostering may be an important fundament for the treatment plan of adult ADHD. Information on the current state of research and theoretical approaches concerning the below-mentioned key words was gathered through MEDLINE, PsycINFO, PSYNDEXplus, and PubMed databases.

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A Cognitive Therapy Approach for Adult Attention Deficit/Hyperactivity Disorder

Cited by 35 publications

References 23 publications

Adapting Psychotherapy to Meet the Needs of Adults With Attention-Deficit/Hyperactivity Disorder.

Adapting Psychotherapy to Meet the Needs of Adults With Attention-Deficit/Hyperactivity Disorder.

New psychotherapeutic approaches in adult ADHD - acknowledging biographical factors

Therapy-relevant factors in adult ADHD from a cognitive behavioural perspective

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