Can I Trust Myself?
by Ari Tuckman, PsyD, MBA

When you make a commitment to yourself or others to do something, can you rely on yourself to do it? Will it get done in the way that was promised? And on time? For too many ADHD adults, the answer to these questions is, "I would like to think so, but I just don't know." Despite great intentions, many adults with ADHD have learned to doubt themselves. This happens in two ways:

• Looking backwards-When they complete something or look back on their day, they may wonder whether they've done everything that they should have. They may say to themselves, "I'm pretty sure I did everything, but I've been burned before when it turned out later that I had forgotten some important things." So it's hard to ever feel really confident that there isn't a ticking time bomb out there somewhere.
• Looking forwards-When they make a commitment to do something, either to themselves or someone else, a voice in the back of their heads may say, "I hope you can do this. These sorts of things tend to not work out so well. Your batting average should be higher." The lessons of the past carry forward to cause doubt for the future.

So how do you find that middle ground? How do you learn to trust yourself more? A few different ways:

• Treat your ADHD-Find providers who really know what they're doing with ADHD in adults-and find new ones if you have to. A full treatment program involves education about ADHD, medication, coaching, and therapy, depending upon your needs.
• Really work on incorporating to-do lists and a planner-I know, I know, you hate these things and they never worked in the past. So find a system that works for you, rather than one that works for your OCD friend. You're more likely to stick with a system that fits your way of thinking and is easier to use. However, you still need to push yourself to stick with it rather than give in to the temptation of, "I'll remember this without writing it down." You won't
• Don't over-commit yourself-Be honest with yourself about what you can realistically handle. Most people prefer to hear a no early, when they still have time to plan accordingly, rather than later when it puts them in a bind.
• Accept that sometimes you'll blow it-Everybody makes mistakes, so don't go over-board with the guilt, since it only makes you less likely to use effective strategies to fix the situation.

This month's teleconference features psychologist, Ari Tuckman, PsyD. MBA who will be speaking on Coping Mechanisms That Work for Adults with ADHD.

Sign up for this important teleconference by going to myADHD.com. Join this teleconference on Wednesday, January 9, 2008 from 8:30 - 9:30 pm Call: (646) 519-5883 Pin: 2648 at 8:30 pm EST to join the teleconference.

The following ADHD research abstracts were provided by Dr. Sam Goldstein, editor of the Journal of Attention Disorders

Kayoma, T., Tachimori, H., Osada, H., & Kurita, H. (2006). Cognitive and symptom profiles in high functioning Pervasive Developmental Disorder - Not Otherwise Specified and ADHD. Journal of Autism and Developmental Disorders, 36, 373-380.

Two samples of youth, one with Pervasive Developmental Disorder and normal intelligence and the other with ADHD were compared on measures of intelligence and autism. Compared to those with ADHD, children with Pervasive Developmental Disorders scored significantly lower on Verbal Comprehension, Vocabulary and General Comprehension. However, they scored higher on a non-verbal reasoning measure, the Block Design task. After controlling for total score, those with Pervasive Developmental Disorder were significantly more abnormal on relationships with people, non-verbal communication and general impressions but less abnormal on activity level. The authors suggest that these differences in cognitive and autistic symptom profiles may help professionals in the future distinguish clinically between the two conditions.

Kessler, R.C., Adler, L., Barkley, R., Biederman, J., Conners, C.K., Demler, O., et al. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry, 163, 716-723.

A screen for adult ADHD was included in a probability sub-sample of over 3,000 18 to 44 year-old respondents in the national comorbidity survey replication, a nationally representative household survey using a lay administered diagnostic interview to assess a wide range of DSM-IV disorders. Blinded clinical follow-up interviews of adult ADHD were carried out with 154 respondents, over-sampling those with positive screen results. The estimated prevalence of current adult ADHD was 4.4%. Significant correlates included being male, previously married, unemployed and non-Hispanic white. Adult ADHD was highly comorbid with many other DSM-IV disorders assessed in the survey and was associated with substantial impairment. The majority of cases were untreated although many individuals had obtained treatment for other comorbid mental and substance related disorders. The authors suggest that additional research needed to determine whether effective treatment would reduce the onset, persistence and severity of disorders that co-occur with ADHD.

Leibson, C., Barbaresi, W.J., Ransom, J., Colligan, R.C., Kemner, J., Weaver, A.L., & Katusic, S.K. (2006). Emergency department use and costs for youth with ADHD: Associations with stimulant treatment.

This study investigated whether stimulant treatment is associated with reduced emergency department use and medical costs. Detailed school and medical records for individuals born 1976-1982 in Rochester, Minnesota were reviewed to identify those who met criteria for ADHD between five years and emigration from the area. The study followed birth cohort members with ADHD and provided a link to billing data from 1987 to age 18 for outcomes of emergency room visits, emergency room costs and medical costs. Of 313 youth with ADHD, 74% received any stimulant treatment with duration range from 14 days to 11 years. Treated and untreated youth were similar with respect to median annual emergency department visits and medical costs. However, increasing proportion of follow-up on stimulants was associated with fewer emergency department visits.

Mill, J., Caspy, A., Williams, B.S., Craig, I., Taylor, A., & Polo-Thomas, M. (2006). Prediction of heterogeneity and intelligence and adult prognosis by genetic polymorphisms in the dopamine system among children with ADHD. Archives of General Psychiatry, 63, 462-469.

This study sought to test the hypothesis that the DRD4 7 repeat allel and the DAT1 10 repeat allel would prove useful in identifying a subset of children with ADHD who have compromised intellectual functions. Two birth cohorts were investigated. The first cohort was born in Britain in 1994-1995 and included over 2,000 children. The second was born in New Zealand in 1972-1973 and included over 1,000 children. Evaluation of ADHD, I.Q. and adult psychosocial adjustment was made. Polymorphisms in the DRD4 and DAT1 genes were associated with variation in intellectual functioning among children diagnosed as having ADHD apart from severity of their symptoms. The authors suggest their findings indicate that genetic information may be useful for etiology based psychiatric nosologies.

Below are some Treatment Tools developed by Wilma Fellman, M.Ed., LPC in her book, Finding a Career That Works for You. These myADHD.com tools can help those making career decisions and applying for new jobs in 2008.

• #9002 Matching Your Interests and Your Career Choice: Part I
• #9003 Matching Your Interests and Your Career Choice: Job Activities
• #9004Matching Your Career Interests and Your Career Choice: Occupations
• #9006 Preparing Your Resume