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ADHD in Adults: Diagnosis, Impairments, and Long-Term Management - Test
by Russell A. Barkley, Ph.D., ABPP

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1. The first suggestion that ADHD might persist from childhood into adulthood was provided by:	Help
Melchior Adam Weikard. Sigmund Freud. John B. Watson. B. F. Skinner.

2. Wender (1976) was the first to:	Help
Describe ADHD in the child and adult population. Study the efficacy of stimulants in adults with MBD (ADHD). Describe the effectiveness of cognitive therapy for adult ADHD. None of the above

3. The first new nonstimulant drug developed for ADHD in adults was:	Help
Amphetamine. Methylphenidate. Daytrana Atomoxetine.

4. The prevalence of ADHD in U.S. adults is approximately:	Help
1-2%. 4-5%. 8-10%. None of the above

5. Adult ADHD is considered a neurodevelopmental disorder comprised of which of the following sets of symptoms:	Help
Anxiety and depression symptoms Social communication and restricted interests Inattention and hyperactive-impulsive symptoms Obsessional thoughts and compulsions

6. The symptoms of adult ADHD are:	Help
Dimensional, falling along a continuum of typical or normal behavior. Categorical, reflecting an all or none type of disorder. Pathognomonic, indicating the presence of a psychopathology whenever any symptom is present. Disguised within those of another disorder, like depression.

7. Which of the following are part of the DSM-5 diagnostic criteria for adult ADHD:	Help
The presence of at least 5 symptoms on either symptom list The onset of symptoms by age 12 years Symptoms must lead to impairment in major life activities. All of the above

8. DSM-5 changed the term for the three forms of ADHD from "subtypes" to "presentations" because:	Help
The different forms can change and evolve over time such that their differences are not stable or qualitatively different from each other. The terms mean the same thing. The three forms of ADHD are uniquely different disorders from each other. None of the above

9. The new clarifications of symptoms added in parentheses after many symptoms are:

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Based on sound scientific evidence that they relate well to the root symptom they are intended to clarify.
Much more accurate in diagnosing adolescents and adults with ADHD than are the root symptoms they are intended to clarify.
Only weakly related to the root symptom they are intended to clarify, behaving much more like new or additional symptoms and thus should be ignored for now in diagnosis.
The best symptoms for identifying impairment in teens and adults with ADHD instead of the root symptoms they are intended to clarify.

10. The inattention of people with ADHD can best be characterized as:	Help
Rumination. Mind wandering. Behavior that is being poorly governed by mental representations about the tasks they have to do or the future they are planning. Behavior that is being overly governed by mental representations about time and the future.

11. In Barkley's theory of ADHD, he identifies:	Help
ADHD interferes with thoughts, emotions, actions, words and motivations aimed at organizing behavior across time. The deficits in the cognitive components of executive functioning disrupt the adult's EF in daily life activities. The result in the adult with ADHD being blind to time. All of the above

12. Barkley has argued that the age of onset of symptoms producing impairment for a diagnosis of ADHD should be:	Help
Left at age 7-years-old as in DSM-IV because it works as well for adults as for children. Eliminated completely or else raised to adolescence (12 to 16-years-old). Raised to age 30-years-old to eliminate developmental difficulties. Lowered to age 5-years-old to expand the range for diagnosing.

13. Barkley asserts that the determination of "impairment" in the diagnostic criteria be relative to the:	Help
Individual's IQ score. Average or normal person in the population. Individual's specialized current peer group. None of the above

14. One reason that ADHD is considered to be a disorder of executive functioning is because:	Help
The disorder differentially interferes with a career in business organization. The neuroanatomy of ADHD consistently finds deficits in the four EF networks in the brain. The genes involved in ADHD are essential for the execution of balance, coordination, and locomotion. None of the above

15. The "hot" network of the brain implicated in ADHD is responsible for the:	Help
Top-down regulation of emotion in the service of goals and longer-term welfare. Regulation of body temperature. Capacity to generate aggressive behavior from experiences of anger and frustration. Detection of ambient temperature in the surrounding context

16. Adopting the view that ADHD must be EFDD means clinically that:	Help
ADHD comprises a far broader array of cognitive and behavioral deficiencies than is reflected in the DSM-5. One needs to listen for the deficits in the various executive functions as they interview the patient about the EF domains, going beyond the DSM-5 symptoms. It is the broader array of EF deficits that accounts for the range of impairments in adults with ADHD. All of the above

17. The two dimensions of ADHD symptoms represent subsets of the two major EF dimensions of:	Help
Inhibition and Meta-cognition. Inhibition and Motor Control. Meta-cognition and Sensory Processing. None of the above

18. Based on the view that ADHD is actually a form of EFDD, then:

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Neuropsychological tests of EF are incredibly useful in accurately diagnosing ADHD.
Neuropsychological tests of EF are far better at detecting the presence of ADHD than are rating scales of EF or ADHD symptoms.
Rating scales of EF, surprisingly, are actually better at detecting the presence of the EF deficits in adult ADHD than are the neuropsychological tests of EF.
Disappointingly, neither EF tests nor EF rating scales have proven at all useful in the diagnosis of adult ADHD

19. Given the involvement of EF in ADHD and the problems with current DSM-5 criteria, Barkley recommends:	Help
When assessing adolescents and adults, clinicians not place so much emphasis on hyperactive symptoms. Clinicians look for additional symptoms of impulsivity besides verbal ones in DSM-5. Understand that "inattention" symptoms in DSM-5 reflect problems with metacognitive and other executive function deficits in daily life. All of the above

20. In view of ADHD being EFDD and a largely chronic disorder of self-regulation, one can think of – and explain – ADHD as being:	Help
The most benign of outpatient mental disorders in terms of its limited impairments. A disorder that can be readily cured by contemporary evidence-based therapies. The diabetes of mental health. None of the above

21. Clinical judgment is necessary in rendering the diagnosis of ADHD because:	Help
Self-reported ADHD-like symptoms may be better accounted for by the presence of another disorder. The symptoms patients endorse may not rise to the level of being clinically significant or developmentally inappropriate. There must be compelling evidence that the onset of symptoms occurred sometime during childhood or adolescence and have been chronic and pervasive. All of the above

22. Barkley and colleagues (2008) identified a new list of symptoms for adults with ADHD. Which statement describes this list of symptoms?	Help
They are the same symptoms as in DSM-IV and 5 for children. All 14 symptoms are compiled from other disorders. Three are from the DSM and six from evaluating executive functioning. None of the above

23. The concept of "impairment" can be distinguished from the concept of "symptoms" as follows:

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The symptoms of ADHD are its behavioral expressions, while impairments are the consequences of those symptoms.
The symptoms of ADHD are manifestations of underlying intrapsychic conflicts, while impairments are the psychological pain and suffering the person may experience from such conflicts.
The symptoms of ADHD arise from defects in the hippocampus that result in cognitive distortions while impairments are the reactions of others to these distortions.
None of the above

24. Which of the following domains of major life activities is likely to be the most adversely affected in the histories of adults having ADHD:	Help
Sexual behavior Criminal activity School or education Substance abuse

25. Adult ADHD may also lead to adverse outcomes in which of the following areas of major life activities:	Help
Money management Driving Dating, marriage, or cohabiting All of the above

26. Which of the following are among the health and medical problems associated with adult ADHD:	Help
Risk for arthritis Risk for kidney disease Risk for sleeping problems Risk for irritable bowel syndrome

27. Which of the following health risks are associated with adult ADHD:	Help
Excess Internet use and addiction Increased use of tobacco, alcohol, and marijuana Accidental injuries All of the above

28. In view of all of the different domains of impairment associated with ADHD by adulthood, especially in the medical and health domains, ADHD should be viewed as not just a mental health problem, but a:	Help
Public health problem. Educational system problem. Criminal justice problem. Family dynamics problem

29. ADHD increases the liability for having other psychiatric disorders. At least what percent of cases of ADHD have another disorder?	Help
20 percent 40 percent 80 percent None of the above

30. A crucial step in preparing an adult with ADHD for treatment is:	Help
Helping the adult to understand and accept or "own" their disorder. Understanding their insurance reimbursements. Obtaining signed releases of information. None of the above.

31. Which of the following are considered to be among the evidence-based therapies for adult ADHD:	Help
Cognitive behavioral therapy focused on EF deficits Coaching Medication All of the above

32. CBT programs for adult ADHD have been developed by:	Help
Freud and Jung Stuart and Gottman Solanto and Safren Meichenbaum and Kendall

33. The two basic types or categories of FDA approved medications for ADHD are:	Help
Anti-anxiety and anti-psychotics. Stimulants and nonstimulants. Narcoleptics and tranquilizers. Anti-depressants and MAO inhibitors.

34. Specific FDA medications for use in managing adult ADHD are:	Help
Methylphenidate and amphetamine. Atomoxetine. Anti-hypertensive drugs (alpha-2 agonists). All of the above.

35. ADHD medications approved by the FDA:	Help
Only come in immediate release preparations at this time. Come in a variety of stimulant delivery systems such as liquids, pills, time release pellets, osmotic pumps, skin patches, and pro-drug formulations. Require weeks to months of titration before benefits are evident. Benefit only 25-35% of all adults with ADHD.

36. Which of the following medications have been used "off-label" in the management of adult ADHD:	Help
Thorazine and chlorpromazine Bupropion and modafinil Fluoxetine and fluvoxamine Ibuprofen and acetaminaphen

37. Which of the following is not considered to be a promising but under-investigated therapy for ADHD in adults:	Help
Routine physical exercise Marital/couples counseling Insight oriented psychotherapy Mindfulness meditation

38. A general strategy or guiding principle for managing ADHD in adults is:	Help
Understanding that ADHD is a disorder of performance, not one of knowledge. Ensuring that the patient understands the psychosocial origins of the disorder. Learning that ADHD can be an effective excuse for irresponsible behavior. Focusing on the reduction of stress and anxiety.

39. "Point of performance", an important factor in planning treatment, refers to:	Help
Using a behavioral chart with points earned for compliance. Assisting the client in the natural environment for a particular behavior. Making sure the client understands the reasoning for the treatment plan. Scoring one's performance over time like a report card.

40. When it comes to self-motivation, adults with ADHD:	Help
Have no problems with this domain of executive functioning. Do not benefit from making arrangements to be more accountable to others. Can benefit from arranging for frequent external types of motivation to help them get through the job. Should arrange extravagantly large rewards at the end of long quotas of work to be done.

41. It can be very helpful to the management of adult ADHD if the patient views the condition as:	Help
Easily treated through physical exercise and healthy diet. The diabetes of psychiatry - a chronic disorder that can be effectively managed. An adjustment reaction to situational distress. An episodic disorder requiring periodic psychotherapy.

42. Rules alone don't guide behavior very well in adult ADHD. What can clinicians do to help?	Help
Make rules into physical lists. Have the adult talk out loud or in a low voice to themself and state the rules aloud. Digitally record reminders on a recorder and then play then back again as needed. All of the above

43. Which of the following are specific strategies that can be recommended for addressing problems in work and school settings that are due to adult ADHD:	Help
Find a coach or "mentor" to which the adult can be held accountable several times each day for their work. Encourage the adult to use a daily assignment calendar and a journal. Digitally record important lectures or meetings. All of the above

44. Requesting extra time on timed tests in college or work is:	Help
Especially helpful and specifically benefits the adult with ADHD while being of no benefit to others with ADHD. Beneficial for everyone, disabled or not. Of no help to anyone. Only helpful on graduate school admissions tests.

45. The SQ4R system for improving reading comprehension does not include which of the following:	Help
Survey the material to be read. Draft some questions that need to be answered. Use large print versions of textbooks. Read, recite, write, and review.

46. Suggestions for managing the excessive Internet use of adults with ADHD might include:	Help
At home, placing the computer with Internet access in a space set aside for working. Setting up two computers: one for work and the other for play. Installing Internet time management software on the home and workplace computers. All of the above.

47. Managing the health risks posed by adult ADHD often includes advising clients to:	Help
Reduce humidity within their work settings. Eliminate sugar in their diet. Develop regular weekly exercise patterns. Reduce consumption of gluten containing products.

48. Driving performance risks posed by adult ADHD can be reduced by:	Help
Using ADHD medications while driving. Precluding the use of alcohol when planning to operate a motor vehicle. Asking a spouse or partner who does not have ADHD to drive children to their various activities. All of the above.

ADHD in Adults: Diagnosis, Impairments, and Long-Term Management - Test by Russell A. Barkley, Ph.D., ABPP

ADHD in Adults: Diagnosis, Impairments, and Long-Term Management - Test
by Russell A. Barkley, Ph.D., ABPP