This mid-level to advanced pre-conference session will focus on the understanding and evaluation of executive functioning within the context of ADHD across the lifespan. The presentation will include strategies for assessment and treatment.
College students with ADHD represent a population that is particularly vulnerable to problematic alcohol use, given the developmentally inappropriate levels of inattention, hyperactivity and impulsivity characteristic of the disorder, combined with the college lifestyle. Despite the clear indication from emerging research of the need for interventions for this population, there are few published randomized controlled studies of psychosocial interventions for college students with ADHD, and none specifically targeting problematic alcohol use in those with ADHD at any age. Moreover, brief motivation-based alcohol interventions that generally have been successful for college students show limited benefits among individuals with elevated impulsivity and poor self-regulation, both hallmarks of ADHD, calling for the need to modify BMIs for this vulnerable group. Toward the goal of developing targeted interventions for college students with ADHD, it is crucial to determine treatment approaches that target problematic alcohol use and that are developmentally appropriate for this high-risk group. Although originally developed to treat depression, behavioral activation has been shown to be efficacious for a range of clinically relevant presentations including college students with problematic drinking patterns. Based on its core components that focus on planning and accountability, BA has clear relevance for addressing ADHD-related executive functioning deficits, which may increase the propensity for engagement in risky behavior. With funding from NIH, we modified brief BA to increase relevance to college students with ADHD who are engaging in problematic alcohol use, and integrated this approach with BMI. We call this program SUCCEEDS (Students Understanding College Choices: Encouraging and Executing Decisions for Success).
There has been more empirical and clinical interest in the relationship between ADHD and Cluster B (borderline, narcissistic, antisocial, and histrionic) and Cluster C (avoidant, dependent, and obsessive-compulsive) personality disorders. Since both ADHD and personality disorders are widely misunderstood, there is much room for diagnostic confusion. This session will explore each of the Cluster B and C personality disorders and execute proper differential diagnosis with various case examples. Clinical anecdotes will include ADHD patients misdiagnosed with a personality disorder, patients with personality disorders misdiagnosed as ADHD, and cases where patients have both, but only one diagnosis or neither is diagnosed. ADHD can serve as a risk factor for the development of a personality disorder. Treatment implications will also be reviewed, especially focusing on patients with a combined presentation, as they are often at higher risk for dangerous, parasuicidal, or suicidal behaviors, less treatment compliant, and more clinically challenging.
From sleep and nutrition to cognitive behavioral therapy and emotion, from parent training to navigating medication, mindfulness can be used directly to augment almost all of the rest of ADHD care. Beginning mindfulness practice often starts with attention, to sounds or breathing—but that barely scratches the surface of the larger intentions of mindfulness. Like ADHD itself, mindfulness impacts far more than attention, impacting executive function and also setting an intention of greater awareness and wisdom around anything we do in life. A concept called the “foundations of mindfulness” reflects the larger psychology of why it works, and can be integrated with research around the benefits of bringing awareness to habitual patterns around physical sensations, emotion, thought, self-perception, and showing how that all relates to resilience. Complex and comorbid ADHD never responds to only one intervention—and for someone living with ADHD, navigating and sustaining a plan is undermined by ADHD itself. The intention of this session is to expand the common view of mindfulness, integrating it into traditional, evidence-based care while providing practical tools around both mindfulness and ADHD to take into everyday life.
ADHD occurs with other mental health and medical conditions with other mental health conditions (bipolar disorder, substance use disorders, depression, anxiety disorders, etc.) and medical conditions (pregnancy, cardiovascular disease, migraines, sleep disorders, etc.) in more than 70% of cases. This advanced course presents options for the medication management of ADHD when it co-occurs with other common ailments and explores the causes of medication treatment failures. Time will be reserved for participants to present their own case reports for group discussion.
As coaches, we are passionate about helping our clients break through old limiting patterns to live healthy, energized lives. This session offers you an introduction to an approach that facilitates sustainable shifts in your clients’ personal, interpersonal, and work lives. The Enneagram framework is a highly effective tool that uses specific processes and strategies to assist and support changes in your clients. The Enneagram is rooted in universal elements from most major spiritual traditions without specific dogma. Cross-cultural and demonstrated to be effective, the Enneagram is the sound tool for helping your clients at a basic level, such as communicating clearly, identifying strengths, identifying opportunities for growth, and taking personal responsibility. With a deeper understanding of the Enneagram framework, you can go even beyond identifying nine dominant personality traits and patterns in your clients to help them stimulate real transformation as they identify the beliefs, behaviors and thoughts that are no longer useful.
The diagnostic criteria were written by and for researchers. The DSM criteria concern only visible behaviors that can be counted in studies and subjected to statistical analysis. They ignore the major areas of impairment that concern patients and clinicians such as emotional control and expression, cognitive and learning styles, sleep disturbances, relationships, and how ADHD changes through the life cycle. Indeed, the current DSM criteria have never once been research validated in person over the age of 16. The ICD-10 criteria used in the rest of the world match the DSM set from the 1980’s that still require hyperactivity. Perhaps the most significant deficiency of our current definition of ADHD is that it has never led to a therapy that has been able to demonstrate “detectable, lasting benefits for the core symptoms of ADHD. To many people this means that we have been missing something both huge and fundamental about the very nature of ADHD. This presentation explains why everything that we expected to work has not and what might work instead.
This presentation will begin with an overview of ADHD neurobiology, emphasizing our current understanding of gender-based differences in brain structure and function. Then, we’ll explore the unique developmental trajectory of females with ADHD, and how it differs from that of males with ADHD. For a holistic view, we’ll examine how the manifestations of symptoms are influenced by a complex interplay of neurology, genetics, hormones, sociocultural expectations, environmental conditions, and comorbidities. This longitudinal perspective will highlight the risk factors for potentially dire outcomes, and underscore the necessity for earlier identification, more accurate diagnoses, and treatment alliances providing ongoing support.
On one end of a self-control and attention dysregulation spectrum, ADHD can be thought of as a disorder of under-inhibition and distractibility. On the other end of this spectrum, autism and anxiety can be viewed as disorders of over-inhibition and perseveration. When these conditions coexist, effective treatment depends upon finding the right balance between opposing tendencies. Dr. Shapiro will present very specific strategies, using medication and cognitive-behavioral therapy, to find this golden mean for children with coexisting ADHD, autism, and anxiety.
This presentation will review the developing concept of ADHD in older adults. I will discuss the identification and diagnosis highlighted by brief patient cases. These cases will illuminate consideration of other causes for cognitive complaints in older adults, including medical illnesses, medications, and age-related decline. Effective treatment options such as medication and psychotherapies will be discussed.
The session is designed to introduce professionals to Supporting Teens' Autonomy Daily (STAND), an empirically supported intervention for executive functioning and motivation deficits in teens with ADHD. This treatment engages parents and teens in treatment and utilizes a skills-based approach blended with motivational interviewing to help family members set realistic expectations and long-term goals, practice new skills at home, and figure out their best-case scenario for navigating the challenges of adolescence.
Individuals diagnosed with ADHD often have experienced a lifetime of shame messages after dealing with undiagnosed ADHD. Even when the ADHD is diagnosed earlier in life, it is misunderstood. Many individuals, family members, teachers, supervisors, etc., see ADHD as a character disorder rather than a neurological disorder. By the time clients seek help from mental health professionals or coaches, they've absorbed unintended, hurtful messages and are often shackled by shame and the desire to override it by perfectionism. This presentation will introduce participants to the relationship between executive function deficits and shame messages. Participants will be introduced to user-friendly methods to coach clients to develop shame resilience and embrace their vulnerability, as they offer strategies that are part of traditional ADHD coaching. Participants will be offered tools that lead clients to practice mindful self-compassion and understand when shame is leading to suffering, as well as specific coaching techniques and powerful questions to inspire clients to develop shame resilience. The presentation is based on the research of Dr. Brene Brown and Dr. Kristin Neff.