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The history of ADHD

  • stephaniemeier2
  • Jan 26
  • 3 min read

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that has a rich and evolving history dating back to the late 19th and early 20th centuries. The disorder, which is characterized by inattention, hyperactivity, and impulsivity, has undergone numerous changes in understanding, diagnosis, and treatment over the years.





The earliest recorded descriptions of symptoms resembling ADHD can be traced to 1887 when a German physician, Dr. Heinrich Hoffmann, wrote about children with high levels of hyperactive behavior in his book "Die Verwahrlosung der Sinnesorgane" (The Degeneration of the Sense Organs). In 1902, Sir George Still, a British pediatrician, presented a series of lectures at the Royal College of Physicians in London, where he described a group of children who had difficulty sustaining attention, controlling impulses, and exhibiting overactive behavior. He referred to this condition as "moral defect of habit" and suggested that it stemmed from a genetic or biological origin rather than poor upbringing.


The term "minimal brain dysfunction" began to be used in the 1950s and 1960s to describe children with learning and behavioral issues, including those that would later be recognized as ADHD. During this time, Dr. Leon Eisenberg and Dr. Keith Conners conducted extensive research and started using the term "hyperkinetic reaction of childhood" to categorize children with hyperactive and impulsive behaviors. The use of stimulant medication to treat these children also emerged, with the first studies showing positive effects from amphetamines in the late 1930s and the more well-known Ritalin (methylphenidate) becoming commonly prescribed in the 1960s.


In 1968, the American Psychological Association (APA) included "Hyperkinetic Reaction of Childhood" in the second edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-II), which was a significant step in the formal recognition of the condition. The term "Attention Deficit Disorder" (ADD) appeared for the first time in the DSM-III in 1980, focusing on the inattentive symptoms of the disorder.


The concept of ADHD as we know it today took shape in the 1980s and 1990s. In 1980, the term "Attention Deficit Hyperactivity Disorder" (ADHD) was introduced in the DSM-III, combining the concepts of inattention and hyperactivity. This marked a shift in understanding the condition as a persistent behavioral pattern rather than a temporary phase of development. The DSM-III-R in 1987 introduced the subcategories of ADHD: Predominantly Inattentive, Predominantly Hyperactive-Impulsive, and Combined Type. The DSM-IV in 1994 further refined the criteria for diagnosis, emphasizing the persistence of symptoms across various settings and their impact on social and academic functioning.


Research into the biological underpinnings of ADHD grew significantly in the late 20th century, with studies indicating differences in brain structure and function in individuals with the disorder, such as lower levels of dopamine and norepinephrine in certain brain regions. These neurotransmitters are crucial for regulating attention and behavior. Genetic studies also began to emerge, revealing that ADHD has a strong hereditary component.


Throughout the 1990s and early 2000s, there was an increase in the number of children diagnosed with ADHD, which led to concerns about overdiagnosis and overmedication. This era also saw a rise in the use of behavioral therapies and the development of new medications, such as the non-stimulant drug Strattera (atomoxetine), which was approved by the FDA in 2002.


The most recent edition of the DSM, the DSM-5, published in 2013, made further modifications to the diagnostic criteria for ADHD, including the recognition that the condition can persist into adulthood and the introduction of specifiers to better define the presentation of the disorder, such as "with or without hyperactivity" and "with or without impulsivity."


Today, ADHD is understood as a complex and multifaceted disorder influenced by a combination of genetic, environmental, and developmental factors. It is diagnosed using a comprehensive assessment that considers symptoms, impairments, and the rule-out of other conditions. Treatment typically involves a combination of medication, behavioral therapy, and educational accommodations, with ongoing research aiming to improve interventions and outcomes for individuals with ADHD. The history of ADHD is a testament to the evolving nature of medical and psychological knowledge, as well as the continuous effort to improve the lives of those affected by the disorder.

 
 
 

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