ADDitude for Professionals

ADDitude’s Top 25 Reads for Professionals

For a quarter of a century, ADDitude has shared research, insights, and calls to action with our professional readers on critical topics from adolescent ADHD neurocircuitry to hormonal symptom interactions during menopause, and everything in between. Here are our top 25 reads for experts, from experts.

1. ADHD in Older Adults: Distinct Diagnostic and Treatment Considerations

by David W. Goodman, M.D., LFAPA

“ADHD is widely studied and recognized — except when it occurs in older adults. For a variety of reasons, research on ADHD in older age has historically lagged, resulting in a dearth of relevant diagnostic and treatment tools. Regardless of research deficits, it is abundantly clear that older adults with ADHD have unique needs and characteristics – including age-related cognitive changes, co-existing psychiatric and medical conditions, and more – that influence evaluation and treatment for the disorder.”

2. What Is Inattentive ADHD? Symptoms, Characteristics, Diagnostic Considerations

by Mary V. Solanto, Ph.D.

“Individuals with inattentive type ADHD do not exhibit the stereotypical symptoms of ADHD — namely physical hyperactivity and impulsivity. Their executive dysfunction is easily blamed on carelessness or laziness, and their social struggles may be attributed to growing pains or character idiosyncrasies. All of this contributes to a chronic problem of underdiagnosis and inadequate treatment for inattentive type ADHD, particularly in girls and women.”

3. Why We Must Achieve Equitable ADHD Care for African American and Latinx Children

by Tumaini Rucker Coker, M.D., MBA

“As rates for ADHD diagnosis increase across the population, a growing body of literature highlights barriers to ADHD diagnosis and treatment – from the clinical level to systemic factors – that disproportionately impact children and adolescents of color. These inequities have created and deepened societal divides that put Black and Latinx children at greater risk of poor educational outcomes. Sufficiently addressing disparities in care starts with an understanding of why racial and ethnic imbalances matter, the roots of these inequities, and their consequences for overall health and well-being.”

4. Traumatic Stress Alongside ADHD: 5 Reasons Clinicians Need to Consider Trauma

by Michelle Frank, Psy.D.

“Traumatic stress and ADHD share significant associations, according to a growing body of research. Studies show that people with ADHD score higher than their neurotypical peers on the Adverse Childhood Experiences (ACEs) questionnaire, which measures the impact of negative, stressful, or traumatic events on well-being. This means that they are likely to report troubling events like domestic violence, caregiver substance abuse, physical or sexual abuse, neglect, mental illness, poverty, and community violence. Experiences of racism, discrimination, and oppression can also lead to trauma. So, what is the connection between trauma and ADHD? How do we tease apart the diagnoses? What do their similarities mean for symptoms, diagnosis, and treatment?”

5. ADHD in Women and Girls: Why Female Symptoms Slip Through Diagnostic Cracks

by Stephen Hinshaw, Ph.D.; Ellen Littman, Ph.D.; and Andrea Chronis-Tuscano, Ph.D.

“Empirical evidence on female manifestations of ADHD – including findings on self-harm, peer relationships, trauma, and more – reveal crucial aspects of the condition that are as devastating as they are under-appreciated. Along with a recognition of general sex and gender differences, these factors must inform future research practices and clinical approaches for this group. The bottom line: Our approach to ADHD in women and girls has been broken for too long. To fix it, we must challenge everything we know about the assessment, diagnosis, and treatment of ADHD today.”

6. ADHD in Teens: How Symptoms Manifest as Unique Challenges for Adolescents and Young Adults

by Timothy Wilens, M.D.

“The delayed frontal lobe development associated with ADHD in the teenage years makes regulating the limbic system – the circuitry associated with emotion, anxiety, reward, and risky behavior – more difficult. This differential brain development may explain some observable dysregulation and instability in adolescents with ADHD, and it builds a case for why families still need to remain involved and vigilant through the teen’s development in this period.”

7. Menopause, Hormones & ADHD: What We Know, What Research is Needed

by Jeanette Wasserstein, Ph.D.

“How do the hormonal changes of menopause uniquely affect women who have ADHD? Unfortunately, despite increased and hugely warranted interest, there are no studies that specifically examine menopause in females with ADHD, and that is a serious medical problem. But what we do know – about menopause in general, the role of estrogen, and the effects of hormonal fluctuations on ‘ADHD-like’ symptoms – may help us understand the menopausal transition for women with ADHD, and how clinicians can approach treatment and care for this group.”

8. Treatment for Depression and ADHD: Treating Comorbid Mood Disorders Safely

by Roberto Olivardia, Ph.D.

“Comorbid depression and ADHD present a unique set of risks and challenges. For people with mood disorders, having comorbid ADHD is associated with an earlier onset of depression, more frequent hospitalizations due to depression, more recurrent episodes, and higher risk of suicide, among other markers. Proper management and treatment of both ADHD and depression is, therefore, crucial.”

9. The ADHD-Anger Connection: New Insights into Emotional Dysregulation and Treatment Considerations

by Joel Nigg, Ph.D.

“Even when controlling for related comorbid conditions, individuals with ADHD experience disproportionate problems with anger, irritability, and managing other emotions. These problems walk in lock step with the general difficulties in self-regulation that characterize ADHD. Recent findings, however, suggest that problems with emotional regulation, including anger and negative emotions, are genetically linked to ADHD, too. Ultimately, emotional dysregulation is one major reason that ADHD is subjectively difficult to manage, and why it also poses such a high risk for other problems like depression, anxiety, or negative self-medication.”

10. A Clinician’s Guide to Tic Disorders in Children: Symptoms, Comorbidities & Treatments

by John Piacentini, Ph.D., ABPP

“Persistent tic disorders, including Tourette’s disorder, affect about one in fifty children in the U.S. according to the latest research. What’s more, tic disorders are highly comorbid. More than 80% of children with Tourette’s disorder have a co-occurring mental, behavioral, or developmental disorder, with ADHD and anxiety topping the list of commonly diagnosed conditions. These facts and figures suggest that clinicians are more likely than not to encounter tic disorders when caring for pediatric patients.”

11. The Choice to Medicate for ADHD: A Clinician’s Guide to Navigating Parental Concerns

by Roberto Olivardia, Ph.D.

“The issue of medication for children with ADHD — more than with any other condition that I treat — is controversial and murky. For parents, the question of adding medication to their child’s treatment plan is one that weighs heavily. They research the pros and cons of ADHD medication, but their findings are colored by feelings of guilt and fear of judgment from others. While it’s important to educate parents on how medications work and why they might be used, it’s equally critical for clinicians to support parents by being mindful of the concerns that are often present, though not always overtly stated, as they navigate the decision-making process.”

12. We Need to Talk About ADHD Stigma in BIPOC Communities

by Evelyn Polk Green, M.S.Ed.

“Stigma in Black and other marginalized communities spurs resistance to ADHD diagnoses and treatment. Parents believe an ADHD diagnosis implies their child has an intellectual disability. They also fear an ADHD diagnosis will relegate their child to special education. Black and Latinx children are assigned disproportionately to these programs, often with poor outcomes. Historical and institutional medical maltreatment also informs decisions about treatment. These fears are not without justification, but they bring devastating results. They often lead to parents refusing medication in an ADHD treatment plan.”

13. A Critical Need Ignored: Inadequate Diagnosis and Treatment of ADHD After Age 60

by Kathleen Nadeau, Ph.D.

“ADHD doesn’t diminish — like your hairline or stamina — with age. In fact, symptoms of ADHD may flare and grow after midlife — especially when mixed with normal age-related cognitive decline, worsening physical health, and the lack of structure that often comes with retirement. Why then, do the unique needs of this large (and growing) population of adults with ADHD remain largely ignored in diagnostic tests, accepted treatment practices, and peer-reviewed research?”

14. Sleep and ADHD Medication Use: A Clinician’s Guide to Mitigating Side Effects in Children

by Mark A. Stein, Ph.D.

“Research confirms the increased prevalence of sleep problems among children with ADHD, and clinical experience shows us that ADHD symptoms and characteristics – difficulty ‘shutting down’ the mind, for instance – plus comorbid psychiatric disorders like anxiety and oppositional defiant disorder can cause or aggravate sleep problems as well. In addition, sleep problems, such as insomnia, are a common side effect associated with ADHD medications. In other words, ADHD symptoms and the first-line interventions to treat those symptoms both elevate an individual’s risk for poor sleep.”

15. The Science of Fear: Probing the Brain Circuits That Link ADHD and PTSD

by Joseph Biederman, M.D.; Mohammed R. Milad, Ph.D.; and Andrea Spencer, M.D.

“Our systematic review and meta-analysis of several studies examining the relationship between ADHD and PTSD reveals a bidirectional association between the two disorders. The relative risk for PTSD in individuals with ADHD is four times greater compared to normal controls; it is close to 2 against psychiatric controls, and 1.6 against traumatized controls. The risk for ADHD in individuals with PTSD is twice that observed in normal controls.”

16. Professional Guidelines for Diagnosing Autism Spectrum Disorder

by Theresa Regan, Ph.D.

“While ‘autism awareness’ is growing, what we’re really lacking is holistic ‘autism recognition.’ Few medical professionals and mental health care professionals can confidently say: ‘I know what autism looks like in the classroom, in the medical clinic, in families, and in neighborhoods.’ Since ASD presents with multiple behavioral characteristics, professionals often miss the big picture of autism and, instead, diagnose small pieces of the picture separately — for example, obsessive compulsive disorder (OCD), social anxiety, eating disorder, bipolar disorder, or ADHD.”

17. How a Physician Treats ADHD with Combination Therapy

by Oren Mason, M.D.

“I discovered ‘combination therapy’ by accident. The term refers to using a stimulant and a non-stimulant to reduce ADHD symptoms. There were no lectures in medical school on this therapy and no studies of it yet, in 2000, when I started my ADHD practice. I learned about it from my patients, who noticed that it did a very effective job of helping them manage symptoms.”

18. When a Mood Disorder Looks Like ADHD — and Vice Versa: Differentiating Signs of Emotional Dysregulation

by Thomas E. Brown, Ph.D., and Ryan J. Kennedy

“Emotional dysregulation and moodiness are not included in the diagnostic criteria for ADHD – a detrimental omission, according to many researchers and clinicians. The reality is that children and adults with ADHD commonly experience irritability, low frustration tolerance, and mood lability. However, emotional dysregulation is not exclusive to ADHD. Chronic moodiness is also a central component of mood disorders like bipolar disorder, which may complicate the evaluation, diagnosis, and treatment process. Differentiating moodiness as it appears in ADHD, bipolar disorder, and similar disorders is critically important — and not always straightforward.”

19. ADHD in Adults Looks Different. Most Diagnostic Criteria Ignores This Fact.

by Russell Barkley, Ph.D.

“The ADHD symptoms listed in the DSM were developed for children. We can see this in the phrasing of certain symptoms, such as ‘can’t play quietly’ or ‘driven by a motor’ in the hyperactive/impulsive items. These phrasings don’t translate well to the adult experience. Few adults with ADHD would use these terms to describe their daily experience with the condition, leaving clinicians to extrapolate these items into clinical practice with adults.”

20. The Clinicians’ Guide to Serving and Protecting LGBTQIA+ Youth

by Elena Man, M.D.; Amy Dryer, M.D.; and Rachel Sayer, LCPC, PCIT-C

“LGBTQIA+ youth face an elevated risk for experiencing serious mental health issues.1 Depression and anxiety impact more than half of all youth who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, or asexual, according to a 2022 survey by the Trevor Project. In addition, 45% of LGBTQIA+ adolescents and young adults say they have seriously considered attempting suicide in the past year, according to the same survey. To end this devastating trend and save lives, LGBTQIA+ youth need many things — primary among them is support.”

21. 11 Steps to Prescribing and Using ADHD Medication Effectively

by William Dodson, M.D., LF-APA

“The most recent Practice Parameters update on ADHD from the American Academy of Child and Adolescent Psychiatry recommends medication as a primary therapy for ADHD because it shows detectable, lasting benefit over multi-modal treatment. In other words, ADHD medication works. Yet, 93% of psychiatry residencies don’t mention ADHD in four years of training, and a full 50% of pediatric residencies don’t mention ADHD. So how is a physician supposed to understand and adjust treatment plans without a rich background in ADHD?”

22. The Physician’s Guide for Distinguishing Bipolar Disorder and ADHD

by Roberto Olivardia, Ph.D.; Jannice Rodden, and ADDitude Editors

“Bipolar disorder (BD) often co-occurs with ADHD, with comorbidity figures as high as 20% Recent research also suggests that about 1 in 13 patients with ADHD has comorbid BD, and up to 1 in 6 patients with BD has comorbid ADHD. This comorbidity rate is significant enough to justify dual evaluations for virtually every patient, yet bipolar disorder is often missed or misdiagnosed, in part because several depressive and manic symptoms of bipolar disorder and ADHD symptoms closely resemble each other.”

23. Beyond the Core Symptoms of ADHD in Children: Comorbid Screening and Treatment Guidance

by Adelaide S. Robb, M.D.

“ADHD rarely exists in isolation. As treating clinicians, we must properly screen for and address ADHD and its comorbidities at the same time. ADHD and its common comorbid conditions are best diagnosed through a comprehensive psychological evaluation. These fuller evaluations — in contrast to the lone rating scales many pediatricians use — extract a wealth of information about a patient’s ADHD symptoms and any present comorbidities, like learning and language disabilities, early in the evaluation process.”

24. Migraines and ADHD: The Overlooked Connection to Headaches

by Sarah Cheyette, M.D.

“Children with ADHD may be twice as likely to experience headaches as are children without ADHD. Children with ADHD are also at greater risk for migraines than are children without ADHD, and frequency of migraine headaches may be directly linked to risk of ADHD. The issue extends into adulthood as well. One study estimates that migraines occur with ADHD about 35% of the time in adult patients. Headaches, including migraine headaches, do seem to be triggered by ADHD.”

25. 4 Reasons Adults Give Up on ADHD Medication: Solving Nonadherence and Treatment Inconsistency

by William Dodson, M.D., LF-APA

“ADHD medications work dramatically well. Still, medication nonadherence is a serious – and often unnoticed – problem among adult patients, regardless of age or prescription. According to a recent study, fewer than half of adult patients could be considered ‘consistently medicated’ for ADHD, based on prescription renewal records. Prescribers must understand and address the barriers to ADHD medication adherence to provide the best care possible for patients and improve long-term outcomes.”

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