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DSM-IV-TR

Today I get to know a new terminology related to ADHD, DSM-IV-TR. It is an acronym that stands for Diagnostic and Statistical Manual of Mental Disorders (DSM) a common language and criteria to standardized classification of mental disorder, developed by American Psychology Association. Yup, categorizing people is the main paid occupation of professionals.

This DSM professionals classify ADHD into three main clusters, symptoms of either inattention (type A) and hyperactivity (type B) and a combination of both (Type C). Symptoms of inattention (Type A symptoms) include an inability to remain focused on any type of task, difficulty organizing behavior and planning action, as well as ease of distraction. Hyperactivity-impulsivity symptoms or Type B symptoms include an inability to control voluntary motor activity and spontaneous generation of socially-inappropriate behaviors. Type C symptoms is a combination of Type A and B. Research indicated that ADHD occurs mostly to male rather than female. The symptoms may continue to manifest into adulthood but the symptoms lessen and remain only 15% at the age 25.

Literature mentioned two main causes of ADHD, genetic and brain lesion. My son seems to suffer from perinatal brain lesion because of Hypoxic-Ischemia. Hypoxia refers to a lack of oxygen in the blood while ischemia refers to a reduction in blood supply to a particular tissue. HI can occur during perinatal phase, including the childbirth. I have a vague recollection of what the doctor told me once. He had mentioned something about birth trauma which didn't make any sense at all to me at that time. Aparently it is the Hypoxic-Ischemia. The absence of oxygen and blood impacted the death of the brain cells and caused ADHD.

One of the impacted area is the Prefrontal Cortex (PFC). The functions carried out by the prefrontal cortex area is executive functions. Executive function relates to abilities to differentiate among conflicting thoughts, determine good and bad, better and best, same and different, future consequences of current activities, working toward a defined goal, prediction of outcomes, expectation based on actions, and social "control" Other impact affected the sttriatum, the major input station of the Basal Ganglia System. The basal ganglia are associated with a variety of functions, including voluntary motor control, procedural learning relating to routine behaviors or "habits" such as eye movements, and cognitive emotional functions. Experimental studies show that the basal ganglia exert an inhibitory influence on a number of motor systems, and that a release of this inhibition ‘s permits a motor system to become active. The "behavior switching" that takes place within the basal ganglia is influenced by signals from many parts of the brain, including the prefrontal cortex which plays a key role in executive functions.

Hah... it took me a couple of days before I could gather all the information. The above case is my understanding on my son’s case and the above information need to be confirmed by the neurologist It shed light into my perspective on my son’s behavioral issues. He’s seeing the therapist tomorrow. Therapist deals with his inability to stay focus. We’ll see what happen.

Image taken from http://www.empowher.com/media/reference/conduct-disorder