Adult ADHD More Inattention or More Hyperactivity?

Adult ADHD More Inattention or More Hyperactivity?

As people with ADHD age into adulthood, do they all become predominantly inattentive?

This is what psychiatrists have said for years. They have reported that hyperactivity symptoms diminish and all that remains is inattention. Russell Barkley has, in the past, proposed that folks with the Inattentive type of ADHD are hyperactive too. They are just less hyperactive than the folks with Combined type ADHD or Hyperactive type ADHD. People with the Inattentive type are predominantly inattentive and that is the main feature of their condition and their primary disability but more hyperactivity is there too.

A results of a small study published in the Journal BMC this month may be the proof that Dr. Barkley is right. The study looked at the question of adult ADHD and hyperactivity and inattention symptoms and found that the conventional wisdom has been wrong. The answer to the question was no. People with ADHD remain more active than people without ADHD even in adulthood.

Most importantly were the findings that not only do people with the Combined type and Hyperactive type of ADHD remain more hyperactive than people without this condition but people with the Inattentive type of ADHD are also more active. Even MORE interesting was the fact that it was the activity levels (as measured by a motion detection machine) and not the attention levels (as measured by a number of tests) that were a better indicator of persistent ADHD in adulthood.  The results held true for both males and females.  attention scores were not great either but the activity scores were the best marker of ADHD for ALL the types.

I believe these study  results are accurate.  Granted this was a very small study and generalizing from this small a sample is always risky. The reason that I believe the results is that I know that when I am “on task” and when my son is “on task”, we tend to both be a bit more hyperactive than average (perhaps because we are compensating or because of the effort it requires from us). Russell Barkley has been right about an awful lot that he has reported about ADHD and I think this study moves us in the direction of his thinking regarding the continuum of symptoms of the three ADHD subtypes.

I do not think that there is any argument that ADHD presents differently in different people.  I have posted about the differences between Inattentive ADHD or ADD and the other types of ADHD.  I also believe that the people with Predominantly Inattentive ADHD probably have a different biological, genetic and neurological profile than people with the other subtypes but what this study may prove is that those of us with ADHD are more alike than we are different.



BMC Psychiatry. 2012 Nov 7;12(1):190. [Epub ahead of print]
Hyperactivity persists in male and female adults with ADHD and remains a highly discriminative feature of thedisorder: a case-control study.
Teicher MH, Polcari A, Fourligas N, Vitaliano G, Navalta CP.