How do you change impulsive behavior

Psychiatry, Psychosomatics & Psychotherapy

ADHD is characterized by three core symptoms - impaired attention (attention disorder), impulse control (impulsivity) and activity (hyperactivity). The behavioral problems always appear early in development, usually in the first five years of life, and can be observed in several areas of life (e.g. family and kindergarten) at the same time. Although both classification systems assume that the hyperkinetic symptoms occur in several areas of life, the abnormalities in the various areas of life can be differently pronounced. The symptoms are typically more pronounced in situations in which the children or adolescents are expected to have a longer attention span, for example in class, with homework or with meals. Signs of the disorder may appear to a very small extent or not at all if the child is in a new environment, if he is only confronted with someone else or if he is devoting himself to his favorite activity, even if it requires increased attention (e.g. computer - or Lego game). The absence of symptoms in the examination situation is therefore not a clear indication that the disorder is not present.

According to the international classification system (International Classification of Diseases, ICD-10), ADHD is diagnosed if the three main symptoms occur side by side in at least two areas of life in a pronounced form. In the US system (Diagnostic and Statistical Manual of Mental Disorders, DSM-IV), a more differentiated approach is used: Here one subdivides into a mixed type, which has all three main symptoms equally and corresponds to the ICD-10, into a predominantly inattentive type ( Hyperactivity / impulsivity are less pronounced) and a predominantly hyperactive-impulsive type (attention disorder is less pronounced).

Attention Disorders - Distractibility

Children with attention deficit disorders are usually noticed by increased distractibility, lack of concentration, discontinuation of activities and avoidance of challenging situations. The signs are particularly pronounced when tasks are given to them (e.g. schoolwork) or rules have to be followed. However, the children concerned often do not like games or activities such as painting or handicrafts either; they are too exhausted by such activities and they lack the patience.

Children with impaired attention often make careless mistakes in homework or other work, and are careless about details. They do not seem to hear what is being said, are susceptible to external stimuli / distractions, can structure tasks poorly, are forgetful and often lose objects that are necessary for certain situations (e.g. pens, sports equipment).

Impulsiveness - rash action

Children with impaired impulse control behave impulsively, i.e. they act without thinking. They are impatient and constantly burst into other people's conversations or games. It is difficult for them to wait for their turn. They talk carelessly, a lot, unchecked and often change the subject.

Impulsive children do not fit in well in a community and usually disrupt the regular processes in the family, kindergarten and school. They also often have problems assessing the facial expressions and gestures of their counterpart. You quickly feel threatened and provoked. This impulsive behavior is often equated with aggressiveness.

Violent mood swings, a general strong irritability, lack of distance, interfering speeches and outbursts of anger about minor causes (frustration intolerance) are also possible signs of impaired impulse control.

Hyperactivity - excessive urge to move

If there is a strong urge to move in connection with motor restlessness, one speaks of hyperactivity. Children are always in action when they are hyperactive. You are constantly waving your hands and feet or sliding back and forth on the chair, are generally restless and - even in unsuitable situations such as in school lessons - are constantly on the move. They have great difficulty being still and are often noticed by playing excessively loudly. The children are also often eager to experiment, have a poor risk assessment and sleep little. In adolescents, motor restlessness is significantly reduced in many cases, while impulsiveness and attention disorders often persist.