Curious to hear what others think, as this definitely aligns with my own experiences.
The original study is behind a paywall, but I’m trying to see if I can get a hold of the full text somehow. For now, here’s the abstract.
Abstract
Objectives: Recent studies report a fluctuating course of attention-deficit/ hyperactivity disorder (ADHD) across development characterized by intermittent periods of remission and recurrence. In the Multimodal Treatment of ADHD (MTA) study, we investigated fluctuating ADHD including clinical expression over time, childhood predictors, and between- and within-person associations with factors hypothesized as relevant to remission and recurrence.
Methods: Children with DSM-5 ADHD, combined type (N = 483), participating in the MTA adult follow-up were assessed 9 times from baseline (mean age = 8.46) to 16-year follow-up (mean age = 25.12). The fluctuating subgroup (63.8% of sample) was compared to other MTA subgroups on variables of interest over time.
Results: The fluctuating subgroup experienced multiple fluctuations over 16 years (mean = 3.58, SD = 1.36) with a 6- to 7-symptom within-person difference between peaks and troughs. Remission periods typically first occurred in adolescence and were associated with higher environmental demands (both between- and within-person), particularly at younger ages. Compared to other groups, the fluctuating subgroup demonstrated moderate clinical severity. In contrast, the stable persistent group (10.8%) was specifically associated with early and lasting risk for mood disorders, substance use problems in adolescence/ young adulthood, low medication utilization, and poorer response to childhood treatment. Protective factors were detected in the recovery group (9.1%; very low parental psychopathology) and the partial remission group (15.6%; higher rates of comorbid anxiety).
Conclusions: In the absence of specific risk or protective factors, individuals with ADHD demonstrated meaningful within-individual fluctuations across development. Clinicians should communicate this expectation and monitor fluctuations to trigger as-needed return to care. During remission periods, individuals with ADHD successfully manage increased demands and responsibilities.
It makes sense on the surface. ADHD is a deficiency of self -regulation. External pressures remove the “self” part of the equation. The scary part is the recurrence/remission cycle that makes it seem, to you and to everyone else, like you finally have your shit together.
Anyone who knows how good we function in a crisis is able to extrapolate from there that this would be a thing.
As others have said it’s the burnout and the subsequent time it takes to recover that makes this basically unsustainable. Even when finding a balance there will still be burnout.
Hi. You have broken the community rules by posting paywalled content. Since there was a lot of engagement I am giving you the opportunity to edit your post and copy the text here that is available and then remove the link.
Is the psypost.org link paywalled for others? Or just the link to the original study?
The problem is with the original study. We don’t allow advertising or other ways that a person could extract money from our community. Some people are desperate for answers and it takes advantage of them. Sorry to be a pain!
