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Quiz: Co-occurring Conditions

Test your understanding of the conditions that travel with ADHD and how to think about treating them with these review questions.

1. What is comorbidity?

  1. A rare complication only seen in severe ADHD
  2. A term for ADHD that resolves on its own
  3. The medical name for masking
  4. Two or more conditions present in the same person at the same time
Show Answer

The correct answer is D. Comorbidity is the medical term for two or more conditions present in the same person at the same time, and the chapter notes it's the norm in ADHD, not the exception, with roughly two-thirds of children affected. Option A wrongly limits it to severe cases. Option B misdescribes the term as a resolution rather than a co-presence. Option C confuses it with masking, an unrelated concept.

Concept Tested: Comorbidity

See: Chapter 6

2. What is ADHD burnout?

  1. A rare complication only seen in severe ADHD
  2. A period of profound exhaustion and functional collapse following months or years of masking and over-performance
  3. A synonym for the DSM-5 diagnosis of ADHD
  4. A mild form of ADHD that doesn't require treatment
Show Answer

The correct answer is B. ADHD burnout is described as the crash at the end of an unsustainable compensation run — exhaustion, plummeting function, and emotional depletion after masking and over-performance, illustrated by Sana's collapse in her first job. Option A misstates it as a rare complication rather than a common pattern. Option C confuses it with the formal diagnosis itself. Option D understates its seriousness; the chapter treats it as a significant collapse, not a mild variant.

Concept Tested: ADHD Burnout

See: Chapter 6

3. According to this chapter, what structurally distinguishes bipolar disorder from ADHD?

  1. Bipolar disorder is episodic — distinct periods of elevated or depressed mood as a departure from baseline — while ADHD traits are chronic and always-on
  2. Bipolar disorder never involves sleep changes
  3. ADHD is episodic while bipolar disorder is chronic and always-on
  4. ADHD only affects children, while bipolar disorder only affects adults
Show Answer

The correct answer is A. The chapter's distinguishing structure is time: ADHD traits are present since childhood and vary by situation, while bipolar disorder shows distinct episodes, days-to-weeks long, that depart from the person's baseline mood and energy. Option B is false; bipolar episodes often involve reduced need for sleep. Option C reverses the correct pattern. Option D contradicts the chapter's point that ADHD is a lifespan condition, not childhood-only.

Concept Tested: Bipolar Disorder Distinction

See: Chapter 6

4. Why can a reading disability like dyslexia hide behind an ADHD diagnosis for years, according to this chapter?

  1. Dyslexia and ADHD never occur in the same person, so there is no real confusion
  2. Dyslexia only appears after adolescence, so it cannot be confused with childhood ADHD
  3. Reading disabilities always improve on their own without any intervention
  4. ADHD's missing homework can mask a reading problem, and a reading problem can look like inattention, since nobody focuses well on text they can't decode — the tell is domain-specific struggle
Show Answer

The correct answer is D. The chapter describes mutual camouflage: ADHD's missed homework hides a reading problem, and unreadable text looks like an attention problem, with the real tell being struggle that craters one subject while sparing others. Option A contradicts the chapter's stated high co-occurrence rate. Option B is false; dyslexia can be present from early schooling. Option C contradicts the chapter's recommendation of testing and intervention.

Concept Tested: Dyslexia

See: Chapter 6

5. How does this chapter distinguish ADHD's discouragement from depression, at home?

  1. Depression only occurs in people without ADHD
  2. ADHD's discouragement is usually situational and interest-responsive, lighting up when something novel arrives, while depression flattens even the interesting things
  3. ADHD discouragement and depression are identical and cannot be told apart
  4. Depression is always caused directly by ADHD medication
Show Answer

The correct answer is B. The chapter's key distinction is that ADHD's discouragement responds to novelty and interest, while depression flattens even things the person would normally enjoy, especially alongside hopelessness or withdrawal lasting weeks. Option A is false; depression co-occurs with ADHD at elevated rates. Option C collapses a distinction the chapter deliberately draws. Option D misattributes depression's cause to medication rather than the chronic-struggle pathway the chapter describes.

Concept Tested: Depression

See: Chapter 6

6. According to this chapter, what determines whether defiant behavior in a child with ADHD reflects true oppositional defiant disorder rather than the "transition tax" and demand overload?

  1. Whether the child is diagnosed with ADHD at all
  2. Whether the parents use any form of discipline
  3. Whether the defiance persists across all settings and relationships even after demands are adjusted and the relationship is repaired
  4. Whether the child is male or female
Show Answer

The correct answer is C. The chapter explains that much apparent opposition improves once ADHD is treated and the demand structure is repaired; true ODD is the pattern that persists across settings and relationships even after that repair. Option A conflates two separate diagnoses. Option B introduces an unrelated variable the chapter doesn't use as a distinguishing test. Option D has no basis in the chapter's discussion.

Concept Tested: Oppositional Defiant Disorder

See: Chapter 6

7. Dev's parents assume his stimulant medication has "stopped working" because tenth grade is collapsing, and want a higher dose. Based on this chapter, what should happen first?

  1. Re-screen for what else might be true — such as a reading disability or emerging low mood — before assuming the medication itself is the problem
  2. Immediately double the medication dose without further evaluation
  3. Stop all treatment since medication clearly cannot work long-term
  4. Assume the original diagnosis must have been wrong
Show Answer

The correct answer is A. The chapter's worked example shows Dev's collapse was actually driven by an undiagnosed reading disability and emerging low mood, not medication failure — the lesson is to re-screen before re-dosing. Option B jumps to a fix without checking the actual cause. Option C overreacts by abandoning treatment that was working. Option D wrongly discards an accurate original diagnosis.

Concept Tested: Screening For Comorbidities

See: Chapter 6

8. A teenager snores heavily and struggles with daytime fog and inattention. Which response best matches this chapter's guidance?

  1. Immediately increase his ADHD stimulant dose to counter the fog
  2. Assume the snoring is unrelated and only address the school performance
  3. Treat it as a sleep-study referral for possible sleep apnea, since apnea can mimic ADHD outright rather than just adjusting stimulant medication
  4. Dismiss it as normal teenage tiredness that needs no attention
Show Answer

The correct answer is C. The chapter is explicit that snoring plus daytime fog is a sleep-study referral, not a stimulant adjustment, because sleep apnea can mimic ADHD outright. Option A treats the wrong system. Option B ignores a clearly connected symptom the chapter flags. Option D dismisses a pattern the chapter treats as clinically significant.

Concept Tested: Sleep Disorders

See: Chapter 6

9. A parent notices their teenager with ADHD has started mentioning thoughts of self-harm. According to this chapter's "when to seek help" guidance, what should happen?

  1. Wait a few weeks to see if the feelings pass on their own
  2. Address it immediately as a professional emergency, outranking every other concern in this book, such as by contacting 988 in the US
  3. Treat it as a routine topic for the next scheduled ADHD follow-up appointment
  4. Assume it's just a phase related to typical teenage moodiness and takes no action
Show Answer

The correct answer is B. The chapter is unambiguous that any mention of self-harm or suicide is an immediate professional matter, naming 988 in the US, and states this outranks every other priority in the book. Option A delays action the chapter says should be immediate. Option C wrongly treats an emergency as routine. Option D dismisses a serious warning sign.

Concept Tested: When To Seek Help

See: Chapter 6

10. A clinician is treating a patient who has both ADHD and severe, active suicidal thoughts. Using this chapter's treatment order principles, how should the clinician prioritize care?

  1. Treat the ADHD first in all cases, since it is the root cause of everything else
  2. Treat every condition in exactly the order they were diagnosed, regardless of severity
  3. Ignore the suicidal thoughts entirely and focus only on functional improvement
  4. Safety comes first — active suicidality outranks ADHD treatment and every other condition until it is addressed
Show Answer

The correct answer is D. The chapter's treatment-order principles state plainly that safety comes first — active suicidality, an eating disorder at medical severity, or serious substance dependence outranks everything, ADHD included. Option A ignores the safety-first principle in favor of a rigid rule. Option B contradicts the chapter's point that order is reasoned per person, not fixed by diagnosis sequence. Option C is a dangerous dismissal the chapter would never support.

Concept Tested: Treatment Order Decisions

See: Chapter 6