UK Essay
Writing Service - We accept all subjects. Just send us your instructions.
Only £10 per page. www.mywritingassistant.com
Hong Kong Essay Writing Service - We accept all subjects. Just send us your instructions. Only HK$117 per page. www.mywritingassistant.com
Singapore Essay Writing Service - We accept all subjects. Just send us your instruction. Only SG$19.32 per page. www.mywritingassistant.com.
Hong Kong Essay Writing Service - We accept all subjects. Just send us your instructions. Only HK$117 per page. www.mywritingassistant.com
Singapore Essay Writing Service - We accept all subjects. Just send us your instruction. Only SG$19.32 per page. www.mywritingassistant.com.
Working Memory of Adults
with Attention-Deficit Hyperactivity Syndrome (ADHD)
This
proposal will discuss a study that will specifically test if adults with attention-deficit
hyperactivity syndrome (ADHD) will score lower on working memory tasks than
adults who do not have ADHD characteristics. In this study, the main aim is to
know the difference in terms of working memory tasks among adults with ADHD
symptoms and those who do not. In order to test the hypothesis, the researcher
will resort to quantitative research method. Several subjects will be chosen
(i.e. mathematics, grammar, and science) for college classes to set for
observing both adults with and without ADHD symptoms, specifically how they
fair with remembering the lessons. Those with symptoms of ADHD will be
determined through an ADHD behavior checklist. Then working memory difference
will be measured with the help of some working tasks such as working span and
number span. The purpose of the tasks is to compare those adults who score
higher on the ADHD behavior checklist with those who do not exhibit ADHD
symptoms. This topic is chosen to contribute in determining the reasons why
adults with symptoms of ADHD are always associated with negative status such
as: high incidence of psychiatric problems; lower employment status;
relationship problems; poor frustration tolerance and anger dysregulation; low
self-esteem; and a high incidence of drug and alcohol abuse. The study will be
important in a sense that it will confirm the memory problems of people with
ADHD, which in turn, would inspire experts to create better interventions and
to research more regarding the problem. Thus, the study can contribute in this
field by creating more awareness about the problem.
Background
of the Study
Attention-Deficit/Hyperactivity
Disorder (ADHD) is one of the most prevalent developmental disorders diagnosed
in childhood, characterized by excessive activity, short attention span, and
impulsivity (APA, 2000). It is a neurobiological disorder that interferes with
an individual’s capacity to regulate activity level (hyperactivity), inhibit
behaviour (impulsivity) and attend to tasks (inattention) in developmentally
appropriate ways. The cause of the disorder is found in the functioning of the
brain. Attention Deficit Disorder ADD ADHD is a limiting metabolic dysfunction
of the brain. When neural building materials are lacking, neurological demands
cannot be fulfilled easily. This interferes with the efficient processing of
information (APA, 2000). The core symptoms of ADHD include an inability to
maintain attention and concentration (APA, 2000). Other symptoms include:
squirming excessively; has difficulty remaining seated; easily distracted;
often loses things; has difficulty following instructions; often talks excessively;
has difficulty sustaining attention; often interrupts; shifts from one activity
to another; and often doesn’t listen to what is said (APA, 2000).
In
adults, those who have the symptoms experience a broad range of psychological
problems. As mentioned in the introduction, these include a high incidence of
psychiatric problems (Biederman et al, 1993), lower employment status (Mannuzza
et al, 1993), relationship problems (Barkley, 1990), poor frustration tolerance
and anger dysregulation (Woods, 1986), low self-esteem (Weiss and Hechtman,
1986) and a high incidence of drug and alcohol abuse (Mannuzza et al, 1993). However,
its prevalence is less in the adult population, with only between 2 and 6% who
have the symptoms.
The
American Psychiatric Association (APA) criteria of the characteristics of ADHD
is said to be developed only for children. However, their criteria can persist
to adults. Similar to the APA criteria, the ‘Utah’ operational criteria for adult ADHD,
which include a childhood history consistent with ADHD, involve a broader range
of features, i.e. hyperactivity, inattention, mood liability, short-fuse
temper, disorganization, stress sensitivity and impulsivity (Wender et al,
2001). But often, ADHD symptoms in adults is associated with other behavior
disorders such as mood disorders, borderline personality disorder (BPD),
antisocial personality disorder (APD) and mania (Evenden, 1999, Moeller et al,
2001). Furthermore, adult ADHD have been associated with other disorders such
as depression, bipolar disorder, schizophrenia and BPD (Walker et al, 2000;
Elliot et al, 1998). It co-occurs with ‘cluster B’ personality disorder of the
APA criteria. Also, there are several reports of neurocognitive impairments in
patients with BPD involving attention, verbal and visual memory, planning and
information processing, as well as problems with cognitive inflexibility, poor
self-monitoring and perseveration (Van Reekum, 1993; Stein et al, 1994).
The
reports show that adults with ADHD can have poor memory. Specifically at work,
the study conducted by Dowson et al (2004) in response to spatial working
memory performance of adults with ADHD, the results support their claim that
aspects of working memory performance are particularly impaired in adult ADHD. With
the use of ANOVA, they found that the ADHD group, contrary to the BPD group,
was the only patient group to show SWM impairment relative to the non-clinical
controls.
On the
other hand, Karatekin (2004) state that children with ADHD have deficits in divided
attention (i.e., the central executive component but there was no evidence for
gross deficits in the buffers or rehearsal processes. Thus, these results
suggest that the impairments observed in complex tasks of working memory in
ADHD may be attributable to a dysfunction in the central executive component
rather than in the verbal or spatial buffers or rehearsal processes. The
findings here can be a great support like that of Mariani and Barkley (1997),
who found deficits in spatial working memory in unmedicated preschool boys with
ADHD on a task that required the children to remember the spatial location of
pictures; and who also found that there were no deficits among adolescent boys.
Also, the result in Karatekin’s study supports the suggestions that that
individuals with ADHD perform poorly on complex tasks that rely heavily on
central executive (e.g., Barnett et al., 2001; Kuntsi, Oosterlaan, and
Stevenson, 2001; Pennington and Ozonoff, 1996; Schweitzer et al., 2000).
However, it also disproves the other result of the same studies – which it also
relies heavily on buffers. It deviates from its framework – the Baddeley and
Hitch’s (1974) model – which means that working memory, involves buffers for
holding information for 2–3 s at a time, rehearsal mechanisms to refresh this
information over a longer period, and a central executive component that
coordinates the activities of these buffers and controls attention.
Statement
of the Problem
The problem in the study is to
determine the difference between the verbal written and spatial memory tasks
capability of adults who have ADHD symptoms and those who haven’t. This can be
answered with less difficulty by addressing the following queries:
1.
How
do adults with ADHD perform with working memory tasks?
2.
Do
they perform in a satisfactory level?
3.
Does
their achievement in spatial memory tasks have any difference with the
achievement of those who don’t have the symptoms?
4.
Does
their achievement in verbal memory tasks have any difference with the
achievements of those who don’t have the symptoms?
5.
Does
their achievement with written memory tasks have any difference with those who
don’t have the symptoms?
6.
Does
the difference, if there’s any, considerably high?
7.
Which
type of memory task do the ADHD adults have more difficulty with?
Hypothesis
The hypothesis of the study is that
adults with ADHD will score lower on working memory tasks than adults who do
not have ADHD characteristics. This is because of the observed and studied
facts that such condition can affect one’s capability to memorize.
Significance
of the Study
This study is significant to the
field of ADHD research because it would support previous studies that find ADHD
to be related with the difficulty in memorizing visual and verbal contexts.
Furthermore, this can help fill the lack of specificity on the behavioral
features of adult ADHD and can help in identifying it clearly, particularly in
terms of their behavioral features when being engaged with a spatial, written
or verbal memory task. In addition, perhaps the most promising importance of
this study is that it will help in creating awareness regarding the problem of
ADHD in engaging with working memory tasks. Such problems can affect their
academic performance and their social status. Professionals should realize the
need for an effective intervention that would ADHD adults. This study can also
contribute to future studies that will tackle the same issue. The results that
would be found here can serve as a valuable references, and further, can open
up new issues that are worthy of being investigated. The study will benefit
those in the academe, in psychiatry, in psychology, and people who are
concerned with ADHD adult issues.
Objectives of the Study
The main objective of the study is
to be able to differentiate the performance of adults with ADHD symptoms from
the performance of adults who do not have the symptoms. Through this main
objective, come the sub-objectives such as researching literatures related to
the topic for better understanding of issues, conducting quantitative working
memory tasks such as digit span, word span, and visual span. Finally, another
objective of the study is to be able to create awareness regarding the problem
of ADHD adult in engaging with working memory span.
Scope
and Limitation
The study will only cover adults
with ADHD and will not cover any other disorders that would comparable with the
main topic. The areas to be investigated are limited only to spatial working
memory, verbal working memory, and written working memory. On the other hand,
the study will only be limited to quantitative research method, using the
working tasks to test the hypothesis statistically. The researcher will only
resort to the ANOVA method. Furthermore, college classes will be the venue of
the research, and from there, the respondents will be acquired.
Methodology
Primary
and secondary research will be used in the study. Primary research will be
conducted through an experiment with selected college students. First, an ADHD
behavior checklist will be distributed to the students to determine who among
them have the symptoms of the disorder. Then, the researcher will conduct
several working tasks that will include visual span, digit span, letter span
and verbal span. Then from that, the researcher will compare the performance of
those who score higher on the ADHD behavior checklist with those who do not
exhibit ADHD symptoms. Although some may not be confirmed they actually have
ADHD, the symptoms will categorize the class.
On the
other hand, secondary research will be conducted by acquiring data from related
literatures i.e. from books, journal articles, research and studies, news
features, medical releases, etc.
The study will use quantitative
research because it involves counting and measuring the events and performing
the statistical analysis of a body of numerical data (Smith, 1988). It is
compatible with the study because it allows the research problem to be
conducted in a very specific and set terms (Frankfort-Nachmias & Nachmias,
1992). Furthermore, quantitative research clearly and precisely specifies both
the independent and the dependent variables under investigation (Matveev,
2002). It also follows firmly the original set of research goals, arriving at
more objective conclusions, testing hypothesis, determining the issues of
causality and eliminates or minimises
subjectivity of judgment (Kealey & Protheroe, 1996). In addition, this
method allows for longitudinal measures of subsequent performance of research
subjects (Matveev, 2002). Finally, it provides achieving high levels of
reliability of gathered data due to controlled observations, laboratory
experiments, mass surveys, or other form of research manipulations (Balsley,
1970).
Data
Collection
The
behavior check list to be used in the study will be adopted from Dr. Daniel
Amen of Irvine College of Medicine in California.
The checklist (see Appendix), is not a tool for self-diagnosis, but merely to
help determining whether ADHD may be a factor in the behavior of the person being
assessed. He explained that an actual diagnosis can be made only by an
experienced professional (Amen, 2004). Nonetheless, the checklist can help
categorize the students and can help considerably in the development of the
study. In the checklist, more than 20 items with a score of three or more
indicates a strong tendency toward ADHD. The behavior or symptoms checklist
includes asking the respondent’s past history, short-attention span or
distractibility, restlessness, impulsivity, poor organization, problems getting
started and following through, negative internal feelings, relational
difficulties, short fuse, frequent search for high stimulation, tendency to get
stuck, switches things around, writing fine/motor coordinating difficulties,
sleep/wake difficulties, low energy, or sensitive to noise or touch.
The
checklist will be based on sort of a five-point Likert Scale where 0 is
equivalent to never, 1= rarely, 2 = occasionally, 3 = frequently , and 4 = very
frequently.
On the
other hand, digit span, letter span, and verbal span will be constructed by the
researcher to test and compare the performance of the respondents toward
working memory tasks.
Data Analysis
The SPSS 3 software will be used in
the data analysis of the study. The performance of the respondents will be
tested with the one-way analysis of variance. This is to test the means of the
performance of the respondents on each of the working memory tasks. On the
other hand, the checklist will be analyzed with the use of percentage and
weighted mean computation. To interpret, this is how the formulae should look
like:
1. Percentage – to determine the magnitude of the
responses to the questionnaire.
n
% = -------- x
100 ; n – number of responses
N N
– total number of respondents
2. Weighted Mean
f1x1 + f2x2
+ f3x3 + f4x4
+ f5x5
x =
---------------------------------------------
;
xt
where: f – weight given to each response
x – number of responses
xt
– total number of responses
References:
Amen, D.G. (2004). Adult ADHD Symptoms
Checklist (online). Available at: http://www.addresources.org/article_checklist_amen.php
[Accessed: 11/04/04].
American Psychiatric Association
(2000). Diagnostic and statistical manual of mental
disorders: DSM-IVTR (4th edn: Text
revision). Washington: American Psychiatric Association.
Baddeley, A.D., and Hitch, G.J.
(1974). Working memory. In G.A. Bower (Ed.), The psychology of learning and motivation (pp.
47–89). New York:
Academic Press.
Balsley,
H.L. (1970). Quantitative research methods for business
and economics. New York: Random House.
Barkley R. (1990). Attention deficit hyperactivity
disorder. A handbook for diagnosis and treatment. New York: Guilford
Press.
Barnett, R., Maruff, P., Vance, A.,
Luk, E.S.L., Costin, J., Wood, C., and Pantelis, C. (2001). Abnormal
executive function in attention deficit and hyperactivity disorder: The effect
of stimulant medication and age on spatial working memory. Psychological Medicine, Vol.31; pp.
1107–1115.
Biederman J, Faraone S, Spencer T et al.(1993).Patterns of psychiatric
comorbidity, cognition, and psychosocial functioning in adults with attention
deficit hyperactivity disorder. American
Journal of Psychiatry,
Vol.150; pp.1792-1798.
Dowson, JH, McLeam, A., Bazanisi, E.,
Toone, B., Young, S., Robbins, C.W. and Sahakian, B.J. (2004). Impaired
spatial working memory in adults with attention-deficit/hyperactivity disorder:
comparisons with performance in adults with borderline personality disorder and
in control subjects. Acta Psychiatr
Scand Vol.2, No.10: pp.45–54.
Elliott R, Sahakian BJ, Michael A, and
Paykel ES (1998). Abnormal neural response to feedback on
planning and guessing tasks in patients with unipolar depression. Psychol Med, Vol.28; pp.559–571.
Evenden J. (1999).
Impulsivity: a discussion of
clinical and experimental findings. J
Psychopharmacol, No13; pp.180-192.
Frankfort-Nachmias, C., & Nachmias, D. (1992). Research
methods in the social sciences
(4th ed.). New York:
St. Martin's Press.
Karatekin, C. (2004). A
test of the integrity of the components of Baddeley’s model of working memory
in attention-deficit/hyperactivity disorder (ADHD). Journal of Child Psychology and Psychiatry, Vol.45, No.5; pp 912–926
Kealey,
D.J., & Protheroe, D.R. (1996).
The effectiveness of cross-cultural training for expatriates: An assessment of
the literature on the issue. In
International Journal of Intercultural
Relations, Vol. 20 No. 2, pp. 141- 165.
Kuntsi, J., Oosterlaan, J., &
Stevenson, J. (2001).
Psychological mechanisms in
hyperactivity: I. Response inhibition deficit,
working memory impairment, delay aversion, or something else? Journal of Child Psychology and Psychiatry,
Vol.42; pp.199–210.
Mannuzza S, Klein R, Bessler A, Malloy
P, LaPadula M. (1993).
Adult outcomes of hyperactive boys.
Educational achievement, occupational rank, and psychiatric status. Archives
of General Psychiatry; Vol.50;
pp.565–576.
Mariani, M.A., & Barkley, R.A.
(1997). Neuropsychological and academic functioning in
preschool boys with Attention Deficit Hyperactivity Disorder. Developmental Neuropsychology, Vol.13; pp.
111–129.
Matveev,
A.V. (2002). The
Advantages Of Employing Quantitative And Qualitative
Methods In Intercultural Research: Practical Implications From The Study Of The Perceptions Of
Intercultural Communication Competence
By American And Russian Managers. New York: Russian Communication Association.
Moeller FG, Barratt ES, Dougherty DM,
Schmitz JM, Swan AC (2001).
Psychiatric Aspects of Impulsivity. Am J Psychiatry, Vol.158: pp.1783–1793.
Pennington, B.F., & Ozonoff, S.
(1996). Executive functions and developmental
psychopathology. Journal of Child
Psychology and Psychiatry, Vol.37; pp.51–87.
Schweitzer, J.B., Faber, T.L.,
Grafton, S.T., Tune, L.E., Hoffman, J.M., & Kilts, C.D. (2000). Alterations
in the functional anatomy of working memory in adult Attention Deficit
Hyperactivity Disorder. American Journal of Psychiatry,
Vol.157; pp. 278–280.
Stein DJ, Hollander E, Cohen L et al.
(1994). Neuropsychiatric impairment in impulsive
personality disorders. Psychiatry
Res, Vol.48: pp.257–266.
Van Reekum R. (1993). Acquired
and developmental brain dysfunction in borderline personality disorder. Canadian Journal of Psychiatry Vol.38
(Suppl. 1): pp.S4–S10.
Walker AJ, Shores EA, Trollor JN, Lee
T, and Sachdev PS (2000).
Neuropsychological functioning of adults
with attention de.cit hyperactivity disorder. J Clin Exp Neuropsychology, Vol.22:115–124.
Weiss G, Hechtman LT. (1986). Hyperactive children grown up.
New
York: Guilford.
Wender PH, Wolf LE, Wasserstein J.
(2000). Adults with ADHD. An Overview. Ann NY Acad Sci, No.931; pp.1–16.
Woods, D. (1986). The diagnosis and
treatment of attention deficit disorder, residual type. Psychiatric
Annals, Vol. 6; pp.23–28.
Appendix
Past History
1.__*History of ADHD symptoms in childhood, such as distractibility, short attention span, impulsivity or restlessness. ADHD doesn't start at age 30.2.__History of not living up to potential in school or work (report cards with comments such as "not living up to potential")
3.__History of frequent behavior problems in school (mostly for males)
4.__History of bedwetting past age 5
5.__Family history of ADHD , learning problems, mood disorders or substance abuse problems
Short Attention Span/Distractibility
6.__*Short attention span, unless very interested in something7.__*Easily distracted, tendency to drift away (although at times can be hyperfocused)
8.__Lacks attention to detail, due to distractibility
9.__Trouble listening carefully to directions
10.__Frequently misplaces things
11.__Skips around while reading, or goes to the end first, trouble staying on track
12.__Difficulty learning new games, because it is hard to stay on track during directions
13.__Easily distracted during sex, causing frequent breaks or turn-offs during lovemaking
14.__Poor listening skills
15.__Tendency to be easily bored (tunes out)
Restlessness
16.__Restlessness, constant motion, legs moving, fidgeting17.__Has to be moving in order to think
18.__Trouble sitting still, such as trouble sitting in one place for too long, sitting at a desk job for long periods, sitting through a movie
19.__An internal sense of anxiety or nervousness
Impulsivity
20.__Impulsive, in words and/or actions (spending)21.__Say just what comes to mind without considering its impact (tactless)
22.__Trouble going through established channels, trouble following proper procedure, an attitude of "read the directions when all else fails"
23.__Impatient, low frustration tolerance
24.__A prisoner of the moment
25.__Frequent traffic violations
26.__Frequent, impulsive job changes
27.__Tendency to embarrass others
28.__Lying or stealing on impulse
Poor Organization
29.__Poor organization and planning, trouble maintaining an organized work/living area30.__Chronically late or chronically in a hurry
31.__Often have piles of stuff
32.__Easily overwhelmed by tasks of daily living
33.__Poor financial management (late bills, check book a mess, spending unnecessary money on late fees)
Problems Getting Started and Following Through
34.__Chronic procrastination or trouble getting started35.__Starting projects but not finishing them, poor follow through
36.__Enthusiastic beginnings but poor endings
37.__Spends excessive time at work because of inefficiencies
38.__Inconsistent work performance
Negative Internal Feelings
39.__Chronic sense of under achievement, feeling you should be much further along in your life than you are40.__Chronic problems with self-esteem
41.__Sense of impending doom
42.__Mood swings
43.__Negativity
44.__Frequent feeling of demoralization or that things won't work out for you
Relational Difficulties
45.__Trouble sustaining friendships or intimate relationships, promiscuity46.__Trouble with intimacy
47.__Tendency to be immature
48.__Self-centered; immature interests
49.__Failure to see others' needs or activities as important
50.__Lack of talking in a relationship
51.__Verbally abusive to others
52.__Prone to hysterical outburst
53.__Avoids group activities
54.__Trouble with authority
Short Fuse
55.__Quick responses to slights that are real or imagined56.__Rage outbursts, short fuse
Frequent Search For High Stimulation
57.__Frequent search for high stimulation (bungee jumping, gambling, race track, high stress jobs, ER doctors, doing many things at once, etc.)58.__Tendency to seek conflict, be argumentative or to start disagreements for the fun of it
Tendency To Get Stuck (thoughts or behaviors)
59.__Tendency to worry needlessly and endlessly60.__Tendency toward ADHD ictions (food, alcohol, drugs, work)
Switches Things Around
61.__Switches around numbers, letters or words62.__Turn words around in conversations
Writing/Fine Motor Coordination Difficulties
63.__Poor writing skills (hard to get information from brain to pen)64.__Poor handwriting, often prints
65.__Coordination difficulties
The Harder I Try The Worse It Gets
66.__Performance becomes worse under pressure.67.__Test anxiety, or during tests your mind tends to go blank
68.__The harder you try, the worse it gets
69.__Work or schoolwork deteriorates under pressure
70.__Tendency to turn off or become stuck when asked questions in social situations
71.__Falls asleep or becomes tired while reading
Sleep/Wake Difficulties
72.__Difficulty falling asleep, may be due to too many thoughts at night73.__Difficulty coming awake (may need coffee or other stimulant or activity before feeling fully awake)
Low Energy
74.__Periods of low energy, especially early in the morning and in the afternoon75.__Frequently feeling tired
Sensitive To Noise Or Touch
76.__Startles easily77.__Sensitive to touch, clothes, noise and light
Total Number of Items with a score of three (3) or more: _______
Score for Item #1: _______
Score for Item #6: _______
Score for Item #7: _______
