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“Rigorous, comprehensive, informative, and impressive are words that come to mind after reading this book. This effort rewarded me with a clear understanding of the issues involved in identification of patients with adult attention-deficit hyperactivity disorder (ADHD), the serious implications of the disorder in regard to life's functional domains, and a conceptualization of the core cognitive issues underlying the condition....I appreciated the authoritative tone throughout the work. These authors' extensive involvement in the relatively under researched field of adult ADHD was apparent. The literature reviews in each chapter were extensive and informative. The study data presentations provided information that often addressed noted gaps in the literature. The writing is clear and the data presentation well organized....I would strongly recommend this work to those routinely involved in the assessment and treatment of patients with adult ADHD, as well as to those actively involved in or planning research activities with this patient population. For the clinician who encounters these patients less frequently, the concluding chapter and the conclusions of chapters of interest would provide excellent information and guidance. The authors succeed splendidly in their effort to communicate the severity of adult ADHD and to advance concepts about its nature and ideas of addressing its related impairments.”

—Psychiatric Services


“In impressive and straightforward style, reviews a wealth of data on comorbid conditions and treatment considerations. For the first time ever, readers are able to gain an empirically derived, comprehensive contrast of how ADHD is uniquely exhibited, categorized, and treated in adulthood versus childhood....An invaluable synthesis of data and treatment implications. As an added bonus, the authors have graciously decided to provide access to the data to any scientist who purchases the text....The integrative, rigorous focus on research and clinical practice that defines ADHD in Adults: What the Science Says makes it a foundational addition to the literature. The writing style is clear, concise, and compelling, and the layout of the text effectively integrates chapter summaries and continuity of a variety of topic areas. Clinicians in particular may appreciate the focus on treatment strategies....The quality and magnitude of ADHD in Adults: What the Science Says can uniquely inform future nosology and research on ADHD in adulthood. Clinicians, researchers, graduate students, and the educated lay public will feel that they have at once found both an authoritative reference on ADHD in adulthood and a text that actually addresses the common experiences of many adults with ADHD.”

—PsycCRITIQUES


“Remarkable....[It] will be an enormous resource for years to come. In an area still fraught with so much misunderstanding and lack of awareness, not just among the general public but also among medical and mental health professionals, the authors have done all of us a great service—clinicians, researchers, and consumers alike....This volume should set the standard for what we know for the foreseeable future.”

—Journal of Attention Disorders


“Echoes and expands on the findings of several prior investigations, further establishing clear evidence that ADHD has wide-ranging implications for health and well-being. Strengths and novel aspects of the studies presented include employment of a broad range of assessments, comparison of two ADHD populations, use of community and clinical control subjects, and use of multiple informants. The text is enriched by introduction to prior related work, discussion of nosological issues, clear explanation of findings, and recapitulations of these findings in chapter highlights. The publication of this work and its implications for identification of ADHD in adulthood are timely given DSM-V criteria are under consideration. Clinicians and researchers wishing to understand the adult extension of this childhood-defined disorder and explore means of optimally identifying it in adulthood will benefit greatly from studying this rich and remarkable volume.”

—Journal of Nervous and Mental Disease


“This book is extraordinarily comprehensive....A good resource for all those interested in the complexities of diagnosing and treating ADHD.”

—Bulletin of the Menninger Clinic


“The authors...are leading experts in the field of attention-deficit hyperactivity disorder (ADHD) in children, teenagers, and adults. The authors are all psychologists....This book provides an excellent summary of the adult outcomes of ADHD including documented impairments in major life activities, educational and occupational functioning, and drug use and antisocial behaviour. There are also important chapters on the effects of ADHD on health, lifestyle, money management, driving, marriage, and parenting. For clinicians who are skeptical about the serious impairments associated with ADHD in adults, this is a very compelling book. By far the most interesting part of the book are the authors' hypotheses and suggestions for adult-specific criteria....For readers interested in anticipating new diagnostic criteria that will likely appear in DSM-V, this book is a must read....For those interested in the evidence-base for the diagnosis and impairments of ADHD in adults, and for those interested in the development of adult specific diagnostic criteria, this book is essential.”

—Canadian Journal of Psychiatry


“This text demonstrates the significant ongoing disadvantage of ADHD to adults, as well as to children. Yet, it also provides a useful discussion of treatment and management options. Comprising fourteen chapters, an excellent index and eighteen pages of references, it is a worthy contender for placement in academic collections related to education, psychology, and psychiatry.”

—Australian Journal of Dyslexia and Specific Learning Difficulties


“Although some topics are quite technical, the narrative is accessible, and statistical analyses are generally relegated to tables so as not to interrupt the flow....This book will be the definitive work on the subject for some time....Highly recommended. Upper-division undergraduates through professionals.”

—Choice


“This book will greatly enhance the practice of any children, regardless of the age of the patient/client ADHD population. The book provides details of a fascinating longitudinal study, and it is beneficial reading for any practitioner.”

—Metapsychology Online Reviews


“This energetic and informative book tackles head-on the knotty issue of what ADHD in adults really means. It includes helpful answers to such vital problems as what modifications to diagnostic criteria are appropriate, and what are the inferential biases to which clinicians are prone when seeing self-referred cases in their offices. This is the most definitive work to date on the difficult task of generalizing from children with ADHD to adults with ADHD. The authors break new ground in addressing these issues with comprehensive data from their own well-regarded samples. This timely book thus provides a fresh and needed perspective to help resolve longstanding difficulties in understanding ADHD in adults. It will be helpful to DSM-V committee deliberations and to those planning future scientific studies, as well as to clinicians needing a clearer picture of what to expect in adults with ADHD.”

—Joel T. Nigg, PhD, Professor of Psychiatry and Behavioral Neuroscience, Oregon Health and Science University


“A veritable tour de force. This work will be equally useful to researchers seeking innovative hypotheses about ADHD, to clinicians seeking to understand the course of ADHD into adulthood, and to students at all levels of training. Readers have access to a unified and systematic view of the results from two notable, methodologically rigorous research studies. The book addresses a wide range of clinically urgent issues, such as psychiatric comorbidity, drug use, life impairments, educational attainment, and neuropsychological impairment. The discussions of diagnostic criteria not only provide clinically useful information for adult assessment, but also should strongly influence the evolution of the DSM-V.”

—Stephen V. Faraone, PhD, Distinguished Professor and Vice Chair for Research, Department of Psychiatry, State University of New York Upstate Medical University


“The single best source of scientific information on adult ADHD available to date. The results of two major research investigations are thoroughly reviewed to explicate important similarities and differences between children with ADHD followed into adulthood and individuals first referred for ADHD symptoms as adults. This is the first text to make this important and clinically relevant distinction. It is sure to be an indispensable resource for both clinicians and researchers. In addition, graduate students in clinical psychology, counseling, social work, and school psychology will find this text helpful both for the data it provides about adult ADHD and for its insights into how to establish a coherent research agenda.”

—George J. DuPaul, PhD, Department of Education and Human Services, Lehigh University

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Table of Contents

1. Introduction

2. History and Prevalence of ADHD in Adults

3. Diagnostic Criteria for ADHD in Adults

4. Defining ADHD in Adults: Making the Diagnosis in the UMASS and Milwaukee Studies

5. DSM Symptom Utility and the Issue of Age of Onset

6. Impairment in Major Life Activities

7. Identifying New Symptoms of ADHD in Adulthood

8. Comorbid Psychiatric Disorders and Psychological Maladjustment

9. Educational and Occupational Functioning

10. Drug Use and Antisocial Behavior

11. Health, Lifestyle, Money Management, and Driving

12. Sex, Dating and Marriage, Parenting, and Psychological Adjustment of Offspring

13. Neuropsychological Functioning

14. Summary, Conclusions, and Treatment Implications

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About the Authors

Russell A. Barkley, PhD, ABPP, ABCN, before retiring in 2021, served on the faculties of the University of Massachusetts Medical Center, the Medical University of South Carolina, and Virginia Commonwealth University. Dr. Barkley has worked with children, adolescents, and families since the 1970s and is the author of numerous bestselling books for both professionals and the public, including Taking Charge of ADHD and Your Defiant Child. He has also published six assessment scales and more than 300 scientific articles and book chapters on attention-deficit/hyperactivity disorder, executive functioning, and childhood defiance. A frequent conference presenter and speaker who is widely cited in the national media, Dr. Barkley is past president of the Section on Clinical Child Psychology (the former Division 12) of the American Psychological Association (APA), and of the International Society for Research in Child and Adolescent Psychopathology. He is a recipient of awards from the American Academy of Pediatrics and the APA, among other honors. His website is www.russellbarkley.org.​

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Kevin R. Murphy, PhD, is founder and Director of the Adult ADHD Clinic of Central Massachusetts in Northborough and is also Research Associate Professor of Psychiatry, State University of New York Upstate Medical University in Syracuse. He was previously Director of the Adult ADHD Clinic and an Associate Professor of Psychiatry at the University of Massachusetts Medical School. He has published extensively on adults with ADHD and consults widely on the clinical diagnosis and management of ADHD in adults. Dr. Murphy served as the coinvestigator on the research study of clinic-referred adults with ADHD reported in this volume and conducted the clinical evaluations of all of the adults in that project.

Mariellen Fischer, PhD, is currently in private practice and was previously a pediatric neuropsychologist and Professor in the Division of Neuropsychology, Department of Neurology, Medical College of Wisconsin. Dr. Fischer has published numerous articles on ADHD, developmental psychopathology, and neuropsychology. She and Dr. Barkley have reported the earlier results of the Milwaukee longitudinal study of hyperactive children, the adult outcome of which is presented in this book. Dr. Fischer served as coinvestigator and the Milwaukee site principal investigator on the longitudinal study reported in this volume.

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Audience

Researchers and advanced students in clinical psychology, psychiatry, and related fields; also of interest to mental health practitioners working with both adults and children.

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Course Use

May serve as a supplemental text in graduate-level courses on adult psychopathology and ADHD.