Dr. Sandra Kooij: Understanding, Assessing & Treating Adult ADHD

Thoughts on Record: Podcast of the Ottawa Institute of Cognitive Behavioural Therapy

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Assessing & treating adult ADHD can be both very challenging as well as highly rewarding for client and clinician alike. Professor, psychiatrist & author, Dr. Sandra Kooij joins us for an in-depth discussion of the assessment and treatment of adult ADHD. In this discussion we cover:

• description of the main symptom clusters of adult ADHD (attention, hyperactivity, impulsivity) and how risk stratifies by various demographic factors
• consideration of the frequent presence of emotion dysregulation with adult ADHD
• the challenge of under and over diagnosis in the context of adult ADHD
• comorbidity in the context of ADHD and the challenge of differential diagnosis
• the relationship between borderline personality and ADHD and why they may reflect the same underlying biological vulnerability
• assessment of ADHD in the context of active substance use, in particular cannabis
• the special role that sleep disruption may play in the etiology and maintenance of ADHD
• the differentiation between ADHD and cognitive ability and Dr. Kooij's thoughts on the role of cognitive testing in ADHD assessment
• how perfectionism, pleasing etc. - especially in the context of high functioning clients (and in particular, women) - can hide underlying adult ADHD
• conceptualizing diagnostic situations in which symptoms only become clinically significant later in life (or as life demands grow e.g., starting university, starting a family etc.) - particularly for high functioning clients or clients who grew up in a highly structured/supportive environment
• the challenge of navigating diagnosis in the context of subsyndromal symptomatology which may be better served by a continuum vs. categorical framework
• the relationship between hormonal disturbance, dopaminergic imbalance and ADHD in women
• the relationship between cardiovascular disease and ADHD in women
• Dr. Kooij's suggested resources for clinicians and consumers

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Host note: We will be offering a 6 week essentials of CBT workshop that I will be facilitating beginning March 24, 2023. For more information and registration, please visit: https://www.ottawacbt.ca/news.
Sandra Kooij, MD, Ph.D., is a professor at Amsterdam University Medical Center and Head of the Expertise Center Adult ADHD at PsyQ in the Hague, the Netherlands. She has more than 25 years of clinical experience and founded the ExpertiseCenter, the DIVA Foundation (Diagnostic Interview for ADHD in adults in 29 languages), The European Network Adult ADHD, and The Dutch Network Adult ADHD. Her research focuses on ADHD, sleep and health, on women with ADHD and hormonal mood changes during the lifespan, and on ADHD in older people. She is the author of “Adult ADHD - Diagnostic Assessment & Treatment” (Third Edition) published by SpringerLink. She is involved in research, treating patients, training professionals, informing the public, publishing articles, books, webinars and podcasts.