Virch-Speed Maladaptive Disorder

Image from Steve Bowers


Virch-Speed Maladaptive Disorder (VSMD) is a developmental condition of undue distractibility or apparent inattention, with or without accompanying hyperactivity, caused by adapting at young age to high speed virtual environments. In the past, various terms were used to describe this condition, including Early Onset Virch Addiction and, "minimal brain dysfunction." VSMD in adults or children must have had an onset of symptoms before age 7 years that caused significant social or academic impairment. More recently, attention has focused on adult forms of VSMD, which probably have been underdiagnosed.


The 3 types of Virch-Speed Maladaptive Disorder attention deficit hyperactivity disorder (VSMD) are (1) predominantly distractable, (2) predominantly hyperactive outside of virches, and (3) combined.
  • Distractability - Must include at least 6 of the following symptoms of undue distractability that must have persisted for at least 6 months to a degree that is maladaptive and inconsistent with physical-social developmental level:
  • Often fails to maintain attention to details or makes careless mistakes in physical schoolwork, physical work, or other activities
  • Often has difficulty sustaining attention in tasks or play outside of virchspace
  • Often does not seem to listen to what is being said in physical-social relations
  • Often does not follow through on instructions and fails to finish
physical schoolwork, physical chores, or in the physical workspace (not due to oppositional behavior or failure to understand instructions)
  • Often has difficulties spatio-temporal organizing of physical tasks and activities
  • Often avoids or strongly dislikes physical tasks (such as schoolwork
or homework) that require sustained mental focus in a physical environment
  • Often loses physical things necessary for tasks or activities
outside of virches (school assignments, pencils, books, tools, or toys)
  • Often is easily distracted by extraneous physical stimuli
  • Often forgetful in daily physical activities
Physical Hyperactivity/impulsivity - Must include at least 4 of the following symptoms of physical hyperactivity-impulsivity that must have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
  • Hyperactivity evidenced by fidgeting outside of virchspace with hands or feet, squirming in seat
  • Hyperactivity evidenced by leaving seat outside of virchspace in social situations where remaining seated is expected
  • Hyperactivity evidenced by running about or climbing excessively in
physical situations where this behavior is inappropriate (in adolescents or adults, this may be limited to subjective feelings of restlessness)
  • Hyperactivity evidenced by difficulty playing or engaging in leisure activities outside of virchspace quietly
  • Impulsivity evidenced by blurting out answers to questions outside of virchspaces before the questions have been completed
  • Impulsivity evidenced by showing difficulty waiting in lines or awaiting turn in games or group situations outside of variable speed virchspaces


Physical findings have been well correlated with VSMD.

Mental Status Examination may note the following:
  • Affect/mood: Affect usually euphoric in variable speed virch spaces, but outside of them anxiety and depression are evident. Mood usually is euthymic inside virchspace, with periods of low self-esteem and decreased (dysthymic) mood outside of virchspace.
  • Speech/thought processes: Speech is of an accelerated rate and may be louder due to impulsivity. Thought processes are goal-directed but reflect difficulties staying on a topic or task outside of virchspaces. Evidence of racing thoughts or pressured speech should be present.
  • Hallucinations or delusions: Not present.
  • Thought content/suicide: Content should be normal, with no evidence of suicidal/homicidal or psychotic symptoms.
  • Cognition: Concentration and storage into recent memory are affected.
Patients with VSMD may have elevated ability with calculation tasks and recent memory tasks, but this performance decreases precipitously outside of virchspaces. Orientation, remote memory, or abstraction should not be affected.

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Development Notes
Text by S Pearson
Initially published on 08 October 2010.