Classifying ADHD Inattentive (ADHD I) and Sluggish Cognitive Tempo has proved difficult. A new study performed in China and published in the April edition of the BMC Psychiatry Journal aimed to determine if the classification system used to identify ADHD subtypes influenced treatment outcome. They added a new twist to the classification system. They added the symptom of Aggression.
Instead of classifying the people in this study as simply ADHD I, ADHD C or ADHD H (Inattentive, Combined or Hyperactive), the researchers sub-grouped the participants into two categories that they labeled "Aggressive" and "Non-Aggressive".
People with Inattentive ADHD (ADHD I) do not score high on aggression scales as you probably know but people with Combined type and Hyperactive type ADHD can have huge problems with aggression.
All the subjects were treated with either medication or with some other interventions that the attending medical provider deemed appropriate. What they found was that the participants that were in the "Non-Aggressive" group improved more than the aggressive group at 6 month follow-up regardless of if they were ADHD I vs ADHD C or whatever ADHD subtype they were in.
I wrote a post a long time ago about ADHD impulsive behavior being where the rubber meets the road in a diagnosis of ADHD. People with ADHD I tend to be less impulsive and this is obviously a good thing but what I meant to say in that post is that people with Impulsive behavior tend to do a lot less well when they have ADHD than people without impulsive symptoms and ADHD.
People with ADHD I can sometimes be quite docile which is also a good thing according to this latest study. According to this study we could make the argument that it is not so much the impulsive behavior that is the problem in ADHD but it is the aggression with the impulsive behavior that is so destructive.
Aggression results when there is a loss of emotional control and Russell Barkley, PhD, an ADHD authority claims that ADHD is actually best categorized by a lack of emotional control. Barkley is not speaking about ADHD I and is referring to our ADHD C cousins who tend to be aggressive and impulsive.
Dr. Barkley has pretty much decided that those of us with ADHD I do not have ADHD at all and, as far as I can tell from his most recent lectures, what we do have is anyone's guess.