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Why ADD is Outdated



Many people say they have ADD (Attention Deficit Disorder)- let’s not even get started on those who self-diagnose because they saw a few “relatable” posts on social media- but the term is actually outdated, and it has been for a while, now.


Let’s throw it all the way back to the Diagnostic and Statistical Manual of Mental Disorders, specifically the DSM-II, to see how the terms defining what is now attention-deficit/hyperactivity disorder (ADHD) have changed. “In DSM-II, the disorder was termed Hyperkinetic Reaction of Childhood, which as the name implies focused primarily on symptoms of excessive motor activity” [1]. When reading this term, it seems to only capture a diagnosis of hyperactivity, but the American Psychiatric Association updated the term in the next edition of the DSM. “With the publication of the DSM-III in 1980, the disorder was markedly re-conceptualized with a focus on problems with attention, impulsivity, and hyperactivity, and was renamed Attention Deficit Disorder (with and without Hyperactivity)” [1].


So the term “Attention Deficit Disorder” didn’t come into use until 1980, but it was updated, again, just seven years later. “The term Attention Deficit/Hyperactivity Disorder (ADHD) was introduced in DSM-III-R, with the controversial elimination of ADD without Hyperactivity” [1]. So, 1987 is officially the year when the APA dropped ADD as a diagnosis. “With the publication of the DSM- IV, the term ADHD was retained along with the introduction of three specific subtypes (predominantly Inattentive, predominantly Hyperactive-Impulsive, and Combined), defined by the presence of excessive symptoms of inattention and/or hyperactivity-impulsivity” [1]. In the fourth edition of the DSM, the APA expanded upon what a diagnosis of ADHD was and included the three subtypes listed above. So, ADHD encompassed a diagnosis for those who had inattentive symptoms, those who had hyperactive/impulsive symptoms, and those who had a combination of both.


Now that we’ve had that little history lesson, let’s get back to the present day. There have been two more publications of the DSM- the DSM-5 and the DSM-5-TR. The DSM-5 was published in 2013, and the DSM-5-TR was published most recently in 2022, and both just provided updated descriptions of what an ADHD diagnosis looks like, but ADD has not been added back into any DSM since its elimination in 1987.


So, why do people still use the term “ADD” when it hasn’t been a diagnosis since the late 1980s? Well, “a lot of people still use the old term ADD, either out of habit or because it’s a more familiar term than ADHD. Some people use it to refer to inattentive type ADHD — without the hyperactivity” [2]. So, what it really boils down to is people just not having the right knowledge or the updated knowledge. This is why it is important to spread education and knowledge to those who don’t have the resources so we can end the confusion that comes with outdated medical terms.



References:

1. Epstein, J. N., & Loren, R. E. (2013). Changes in the Definition of ADHD in DSM-5: Subtle but Important. Neuropsychiatry, 3(5), 455–458. https://doi.org/10.2217/npy.13.59



 

Contributors:

Author: Lauryn Agron

Editor: Chadwick Huynh

Health scientist: Raven Montallana


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