Characteristics of ADHD and ADD

ADHD (Attention Deficit Hyperactivity Disorder) and ADD (Attention Deficit Disorder) are a neurodevelopmental condition (i.e. difference in the brain) characterised by an inability to plan, organise, and focus on tasks. This stems from a persistent inability to suppress stimuli-induced responses, self-soothe, and emotionally regulate. It affects affect both children and adults from all backgrounds.

Is there a difference between ADD and ADHD?

It is important to understand that there is effectively no difference between ADD and ADHD. The American Psychiatric Association officially changed the name of ADD to ADHD in 1987 and so ADD is no longer widely recognised as a diagnosable condition. The term ADHD is now preferred throughout scientific literature today. ADHD is now classified predominately either as inattentive, hyperactive, or combined. These descriptions serve to capture the symptom profile of the disorder and/or what is presented as the biggest impairment for the individual.

Characteristics of ADHD

ADHD is a chronic neurodevelopmental disability. This means that children with ADHD experience a delay in how quickly their traits develop in comparison to a child that does not have ADHD. This delay will typically persist throughout childhood. Children with ADHD do not necessarily “catch up” with others during their teens or when they reach adulthood. By the time they reach complete brain maturity they will typically remain developmentally behind the general population.

Is ADHD a Learned Behaviour?

ADHD is not a psychopathology. This means that ADHD is not characterised by children learning maladaptive (or inappropriate) behaviours as they grow. It is instead characterised by traits not developing on time, and therefore the expression of age-inappropriate behaviours.

At its core, ADHD is a disorder of self-regulation, not inattention. Children with ADHD are generally able to perceive and pay attention to things just fine. What they typically cannot do easily is self-regulate their responses to stimuli. What we can observe in children with ADHD is a failure to develop on schedule. This is not an attention deficit. As such, the term ADHD is itself somewhat inaccurate or mislabelled. The disorder itself might potentially be more accurately called SRDD (Self-Regulatory Developmental Disorder.)

ADHD inattentiveness is distinct from other disorders. This is because it is essentially a failure of persistence rather than an inability to perceive. People with ADHD may have a lack of behavioural or motivational goals. They may also lack a good degree of hindsight and/or foresight.

Is ADHD More Common in Males?

ADHD is more common in males than females. There are many theories as to why. Most feature a balance between a genetic predisposition for males to develop the necessary neurological differences, increased social development and skill acquisition in females with ADHD (which can help to mask symptoms), high levels of underdiagnosis in females (likely because of the former) and overdiagnosis of ADHD in males (seeing unrelated disorders as ADHD.)

Characteristics of ADHD and ODD/CD

It has been argued that the main diagnostic classifications of ADHD should be ADHD with ODD (Oppositional Defiant Disorder) and/or CD (Conduct Disorder), and ADHD without either. ADHD children with these classifications can differ significantly from each other in their behaviours and outcomes:

ODD is typically defined by aggressiveness and a tendency to purposefully bother and irritate others. Children with ODD are often uncooperative on purpose, do not follow rules, argue about small or unimportant things, and possess an irritable or negative attitude.
CD behaviours appear similar to ODD, but taken to extremes. Children expressing CD may appear to have no inherent respect for other people’s rights or feelings and enjoy causing harm or hurting people. Children with CD may be observed stealing or destroying things, conducting threatening behaviour towards others (fighting, bullying, emotional abuse), and lying without feeling bad about their actions.
The distinction between ADHD and ODD / CD largely has to do with intention. Children with ODD and CD are considered to deliberately misbehave, whereas a child with ADHD misbehaves more out of reflex or impulse.
ADHD is inherently not a disruptive behaviour disorder, but more of an inhibition disorder. Children with disruptive behaviour disorders may lack the ability to feel guilt or remorse about their behaviour (especially with CD), whereas children with ADHD may impulsively misbehave in similar ways but feel remorse afterwards.

Will Children with ADHD Develop ODD or CD?

Children with ADHD are more likely to develop ODD / CD. A large number of children with ADD have ODD or CD. The inability to self-regulate emotions may help to explain this. Being unable to manage frustration and impatience inevitably leads to confrontation with friends and authority figures. Eventually it may become so hard to interact to others in a non-confrontational manner that children give up on the alternatives, thereby developing ODD or CD.

Anti-social Characteristics of ADHD and ADD

ADHD with ODD/ CD is a strong predictor of anti-social behaviour into adulthood (particularly in the case of CD.) ADHD alone does not contribute to anti-social behaviours. Early intervention for ODD / CD in childhood is the key to help prevent future mental health issues:

ADHD with ODD/ CD is a strong predictor of anti-social behaviour into adulthood.
It carries a high risk of psychopathy, wherein individuals lacks guilt, conscience, empathy and remorse. ADHD alone does NOT contribute to psychopathy, but ADHD with Conduct Disorder is a very significant predictor of psychopathy.
Adults with ODD can look very different from children with ODD as they are more likely to develop anxiety and depression and may grow to be antisocial or bipolar.