Time Blindness of Attention Deficit Hyperactivity Disorder (ADHD)
The prevalence of attention deficit hyperactivity disorder (ADHD) is about 7.2% worldwide for children and 2.5% for adults (Thomas et al. 2015, DSM-V-TR). In Australia, this figure is reaching 8.2% for children and between 2-5% for adults (Australian Institute of Health and Welfare, 2022, Deloitte, 2019). With the increasing prevalence of ADHD in our modern society, researchers are seeking to understand the root causes of this neurodevelopmental disorder. This will be further explored in this article, but first, let’s consider what the most common symptoms of ADHD are.
According to Diagnostic and Statistical Manual of Mental Disorders 5th edition, text revision (DSM-V-TR) the characteristics of ADHD are:
Inattention
- Poor attention to detail, work is inaccurate
- Difficulty remaining focused during conversations, lectures, reading
- Absentminded even when there is no obvious distraction
- Disorganised work, poor time management, unable to meet deadlines
- Avoids paperwork such as writing or reviewing reports, completing forms
- Loses necessary items such as mobile phone, wallet, school materials, keys
- Easily distractible with external stimuli or unrelated thoughts
- Forgetful in daily activities, such as chores, paying bills, keeping appointments (DMS-V-TR)
Impulsivity
- Often talks excessively
- Cannot wait for turn in conversation
- Difficulty waiting in line
- Interrupts or intrudes on others (DMS-V-TR)
Over-activity
- Fidgets, taps, squirms
- Leaves seat when remaining seated is expected
- Feeling restless, runs or climbs when it is inappropriate
- Difficulty engaging in leisure activity quietly
- Difficulty being still for extended time (DMS-V-TR)
Difficulties with time management as noted above is a well-established deficit in ADHD (Ptacek et al. 2019). Time management is under the control of the executive function, which also controls self-motivation, working memory, planning, problem-solving, as well as emotive and behavioural inhibition (Ptacek et al. 2019). The increasing evidence of executive dysfunction in ADHD led to the assumption that these difficulties are related to deficits in the perception, recording and estimation of time (Ptacek et al. 2019).
This so-called time blindness has been investigated and consistently found to be severely impaired in people with ADHD (Toplak & Tannock, 2005). Interestingly, ADHD medication such as methylphenidate (i.e. Ritalin, Concerta) was found to have a positive impact not only on overall functioning, but more specifically on ADHD individuals’ perception of time (Barkley et al. 2001).
However, such positive impact on time perception was also found when financial rewards were offered (Luman et al. 2015). One explanation offered to this phenomenon is the dopamine deficiency found in people with ADHD (Luman et al. 2015). Dopamine in the human body plays a crucial role in experiencing motivation and pleasure, and both Methylphenidate, such as Ritalin and Concerta as well as the prospect of a monetary reward increase the dopamine levels to such an extent that the individual is able to sustain interest in a task (Gottlieb 2001).
Time processing issues have been found to be consistent across all sub-types of ADHD (Valko et al. 2010, Bauermeister et al. 2005). Furthermore, time blindness is also linked to the dysfunction of the cerebellum, also known as the little brain (Frings et al. 2010). Individuals with cerebellar lesions or dysfunction (without ADHD) and people with ADHD had similarly impaired performance on time processing tasks when compared to typically developing participants (Frings et al. 2010).
Overall, time blindness can significantly impact every aspect of a person’s life. Deficits in the perception and estimation of time leads individuals with ADHD to view life perpetually from the present moment (Ptacek et al. 2019). Such carpe diem perspective on life is characterized by difficulties with planning and impulse control, which in turn may lead to impulsive, addictive behaviours (Ptacek et al. 2019).
Therefore, well-informed treatment for ADHD may take into account the chronically fast running inner clock of individuals with ADHD, and incorporate a reward-based structure to foster sustained attention and productivity.
Author: Katalin Mezei, BA (Hons) Psych & Crim, G. Dip Psych, MSc Health Psych
Katalin Mezei is a Provisional Psychologist now based in Brisbane, having completed my undergraduate and Master’s training in the United Kingdom. My aim is to help people identify my clients’ core values and help them live according to them.
To make an appointment with Katalin please call M1 Psychology Loganholme on (07) 3067 9129 or Vision Psychology Wishart on (07) 3088 5422.
References
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