DSM 5 Guided ADHD Series

ADHD Combined Presentation A-1

Greg is a college student who is requesting a Dexedrine prescription for his ADHD. He reports he was prescribed Dexedrine as a child and believes he was five or six years old when he began the medication. He has been without the medication for about a year and feels the result is that his grades are lower and that he is struggling with studying. He describes symptoms of restlessness, distraction, poor concentration, forgetfulness and hyperactivity. When he was asked for permission to release his prior medical records to confirm his story, he was hesitant to agree.

ADHD Combined Presentation A-2

Scenario 21D

Sarah is a young girl who is accompanied by her mother, Mrs. Higgins. They brought completed questionnaires regarding Sarah’s symptoms of ADHD, endorsing: forgetfulness, fidgeting, losing items, and daydreaming in class. During the interview Sarah occasionally loses interest, glancing off into the distance and becoming distracted. Mrs. Higgins describes early-child hyperactivity with uncontrollable behaviors such as jumping into a pool before she could swim and sticking her hand into cages at the zoo.

ADHD Combined Presentation A-3

Scenario 22A

Harold spends the interview fidgeting. His supervisor at his architectural firm recently complained that Harold made frequent mistakes and does not listen during important meetings. Harold feels these problems are connected to the increasing stresses at work of having greater workloads and quicker deadlines. When asked if he experienced similar difficulties in the past, Harold describes that he had similar issues when he was in college and was unable to cram for exams. He reports that at home and at the office, he is completely disorganized, often loses items, and forgets to pay bills.

Rule/Out ADHD Combined Presentation

Scenario 22C

Ms. Rumstat is a junior high teacher who has noticed changes in herself, and wonders if she developed some form of ADD or ADHD. Ms. Rumstat believes that her symptoms may come from the increasing prevalence of ADHD among her students with her “picking up on the mood” of her class. She reports that when she is conducting a lesson in front of her class, she often loses her place and describes the sensation of her mind “going blank.” She reports those symptoms lead to her breaking out in a sweat with her trying to conceal her difficulties. She reports that other problems include: making mistakes when she is recording grades, becoming lost in conversations without recollection of what other people said, and losing items. Family and friends say that her misplacing items and her becoming distracted is nothing new but she feels these problems have exacerbated. She reports that she has always been: “a squirmer,” a trait in her childhood that drove her mother crazy. She denies any personal life stresses, denies being depressed, and reports she is the happiest she’s ever been, noting that she recently became engaged. Ms. Rumstat reports she has an older brother who was diagnosed with ADHD and who currently takes ADHD medications.

Rule/Out ADHD Combined Presentation; Rule/Out Alcohol Use Disorder, Moderate

Scenario 21C

Meg is a college student who describes suffering from symptoms of ADHD. She reports difficulty concentrating on her studies and difficulty focusing on conversations. She also reports that she forgets details, squirms in seats, is late, and is completely disorganized. Meg’s roommate, Katie, suffers from ADHD and diagnosed Meg as having ADHD. Meg feels guilty admitting that she tried Katie’s 10 mg Dexedrine pills, taking one pill while studying and another pill before an exam. She thought that the pills were immensely helpful. Meg occasionally drinks during social events, but denies she drinks to excess. She denies that she uses drugs or has ever abused prescription medications.