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By Sam Goldstein, Ph.D.
Teenagers with AD/HD exhibit considerably higher frequencies of psychiatric conditions than found in the general population. These conditions fall into two broad categories: externalizing and internalizing.
Externalizing conditions cause disruption to others interacting with the child. The externalizing conditions related to AD/HD include:
Although ODD and CD are not caused by AD/HD, they can be "fueled" by the condition. The combination of AD/HD and ODD or CD places these teens at risk to develop a number of adverse personality styles, including antisocial, dependent, and borderline traits into their adult years. CD is also a strong predictor of experimentation with substances such as tobacco and alcohol, and is strongly associated with later substance dependence and abuse.
Internalizing problems cause discomfort for the affected child but not for others. The internalizing disorders related to AD/HD include:
Compared to unaffected teens, teenagers with AD/HD have been reported to perform poorly on a variety of neuropsychological measures assessing executive functioning - the skills necessary to negotiate everyday life. Though still not well-defined, executive functions include:
It's easy to understand how failure to develop efficient self-discipline leads to vulnerability in developing the functional skills listed above. It is not just that "biology is destiny," but rather it increases the risk of problems, making life - and ultimately transition into adulthood - more complex and difficult for youth with AD/HD.
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