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Symptoms can be far less detrimental in some vocational settings than in others. For those patients whose responsibilities and finances support it, a secretary or executive assistant can handle aspects of the work which the patient finds difficult. Similarly, the patient and family members can help structure a home life which maximizes the patient's strengths and avoids many pitfalls associated with the patient's vulnerabilities. However, the stress of these demands on spouses and family members should not be ignored. Involvement of the family and significant others in psychoeducation and psychotherapy can be vital to the long-term success of treatment. Since adult ADHD is a chronic disorder, many will need treatment indefinitely, and those placed on medications for ADHD need to be assessed longitudinally. The clinician and patient should jointly identify specific target symptoms, behaviors, and goals to be monitored over time so that decisions can be made about whether to continue active treatment. In the early stages of treatment, the clinician should assess the degree of response and side effects to medication, and adjust types and dosages of medications. Frequent follow-up appointments from a few weeks to a month apart should be scheduled. In later stages of treatment, less frequent visits may be needed. Once maximal clinical benefit has been achieved, the clinician should discuss issues such as drug holidays, frequency of medication dosing throughout the day, and medication-free weekends. The range of long-term outcomes of treating adult ADHD has yet to be determined, but what is known so far speaks to the need for active intervention and thoughtful long-term follow-up. untreated, ADHD can cause significant impairment throughout the life cycle. Diagnosis can lead to far-reaching changes. Psychoeducation can help affected individuals to understand why their biology and environment may be conspiring to thwart their ability to achieve their full potential. Treatment of ADHD can improve social and occupational functioning and self-esteem and reduce impulsive high-risk behaviors. With diagnosis and treatment, many adults whose early promise and good intentions have yielded to overwhelming personal and professional struggles can gain new self-perspective and hope. Several books for clinicians, 60-64 books for patients, 65-67 and Web sites68-71 may provide more guidance on this topic. PP, for example, lopressor extended. Edwards, Joanna, MA1; Hawthorne, Jennifer, MA2; Copeland, Patricia, MA3; Pfefferbaum, Betty, MD4; Pynoos, Robert, MPH, MD5; Gurwitch, Robin, PhD6; Foy, David, PhD7 1 Pepperdine University Graduate School of Education and Psychology, Hermosa Beach, CA, USA 2 Clinical Psychology, Pepperdine University Graduate School of Education and Psychology, CA, USA 3 Pepperdine University Graduate School of Education and Psychology, CA, USA 4 University of Oklahoma, Oklahoma City, OK, USA 5 Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA 6 Oklahoma University Health Sciences Center, Oklahoma City, OK, USA 7 Pepperdine University Graduate School of Education and Psychology, Encino, CA, USA While nearly 200 studies on psychological consequences of community disaster have been published in the past 25 years, virtually none have sampled both adult and youth survivors in the same study Norris, et al., 2002 ; . Thus, little is presently known about actual differences in severity of posttraumatic reactions between adults and youth in response to the same disaster. Additionally, while most studies indicate that females score higher on measures of posttraumatic distress, none have assessed for a possible interaction between gender and developmental stage. This unique study directly compares adult and youth reactions to a community disaster while controlling for exposure severity. We investigated differences in posttraumatic reactions across gender and developmental stage in a sample of 3, 218 youth and 894 teachers within the Oklahoma City Public School system. The survey was conducted seven weeks following the bombing, and the IES-R Weiss & Marmar, 1999 ; was utilized to assess posttraumatic reaction severity. We found significant effects, with females scoring higher than males, and adults higher than youth. However, there was no significant interaction between gender and developmental stage. These findings suggest that the field will benefit by future disaster studies including both adults and youth in their sampling and lotrimin.
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