Types of ADHD
July 16, 2011 by admin
Filed under Adult ADHD, All Articles, Dr Amens Types of ADHD, Treatment of Adult ADHD, Types of ADHD
Types of ADHD
Based on these criteria, the DSM-IV identifies three subtypes of ADHD:
1. ADHD, Combined Type: Both inattention and hyperactivity-impulsivity symptoms.
2.ADHD, Predominantly Inattentive Type: Inattention but not hyperactivity-impulsivity symptoms.
3. ADHD, Predominantly Hyperactive-Impulsive Type: Hyperactivity-impulsivity but not inattention symptoms.
Dr. Amens Types of ADHD
Dr. Amen who is a child, adolescent, and adult psychiatrist, and medical director of the Amen Clinics in California, Washington, and Virginia, has used a combination of symptoms and brain scans to come up with his own types of ADHD.
Amen considers these to be the hallmark symptoms of ADHD:
- Short attention span
- Distractibility
- Disorganization
- Procrastination
- Poor internal supervision
Based on these symptoms, and the use of SPECT brain scans to highlight activity in the parts of the brain related to attention, short-term memory, and forethought, Amen described these six types of ADHD:
- Type 1 — Classic ADHD. All of the hallmark symptoms of ADHD, plus hyperactivity and impulsivity. Responds well to stimulant medications.
- Type 2 — Inattentive ADHD. All of the hallmark features of ADHD, but instead of hyperactivity, there is low energy. Also responds well to stimulant medications.
- Type 3 — Overfocused ADHD. All of the hallmark features of ADHD, in addition to negative thoughts and behaviors, such as opposition and arguing. Tends to respond better to an antidepressant (such as Prozac) combined with a stimulant.
- Type 4 — Temporal Lobe ADHD. The hallmark features of ADHD, plus irritability, aggressiveness, and memory and learning problems. Responds better to antiseizure medications (like Neurontin) than to stimulants.
- Type 5 — Limbic ADHD. Combines ADHD with depression and low energy and decreased motivation. Responds better to stimulating antidepressants than to stimulants.
- Type 6 — The Ring of Fire. Cross between ADHD and bipolar disorder. Characterized by moodiness, aggressiveness, and anger. Anticonvulsants or newer antipsychotic medications tend to work better than stimulants.
How Did Amen Come Up With His Types of ADHD?
Amen has performed and analyzed thousands of single photon emission computed tomography (SPECT) brain scans on people with psychological problems. SPECT uses a radioactive dye to create a three-dimensional image of the blood flow and activity in the brain. It is typically used to diagnose medical conditions such as Alzheimer’s disease, Parkinson’s disease, and head injury. Amen says this type of scan also can provide doctors with more thorough information about ADHD and other psychological conditions.
SPECT scans don’t themselves diagnose ADHD, but they can help fine-tune the diagnosis when considered together with the patient’s medical history and psychiatric evaluation, according to Amen. He says these scans measure whether areas of the brain are working correctly, too hard, or not enough. Knowing which areas of the brain are problematic in children with ADHD can help doctors focus treatments on those areas. SPECT also can identify how well a child’s medication is working, according to Amen.
Criticism of Amen’s Types of ADHD
Although some psychologists and psychiatrists hail Amen as a pioneering ADHD researcher, others are vocally opposed to his methods. Critics argue that his tests are very expensive (scans can cost upwards of $3,000), and have not been proven to be helpful by scientific studies in peer-reviewed medical journals.
In 2005, the American Psychological Association (APA) Council on Children, Adolescents and Their Families released a position paper stating that brain imaging for the purpose of diagnosing psychiatric disorders in children and adults is still experimental, and there isn’t enough evidence to support its general use. The report also raised concerns about the long-term effects on children who are exposed to the radiation used in SPECT and other brain scans.
Although he claims to have had great success with his patients, currently Amen’s techniques for diagnosing ADHD are not widely accepted in the medical community. However, the APA Council did acknowledge that refinements in brain imaging techniques might make these scans more useful in the future.
