ADHD Flashcards
Prevalence rate of ADHD
10% of United States children ages 4 to 17 years.
Male to female ratio
2 to 1
Incidence rates of ADHD increase with…?
Age
ADHD among 10- to 17-year-olds being almost twice as high as rates of ADHD in children 5 to 9 years of age.
ADHD diagnosis is associated with
- children of families whose incomes are closer to the poverty level
- in single-parent households
- in those having Medicaid as opposed to private insurance or no insurance.
ADHD symptoms must be present by age…
12 years
Older adolescents and adults must have at least ?? of nine symptoms in each symptom category.
5 (for ages 17 years and older)
Pathophysiology of ADHD
- underactivation in frontocortical and frontosubcortical networks
- basal ganglia (particularly anterior caudate nucleus) abnormalities are the most consistent finding
- abnormal cortical maturation (or delayed maturating) within the frontal and temporal lobes
Heritability of ADHD
30–35% of first-degree relatives of children with ADHD also have the disorder, for a relative risk of 6 to 8 times that of the general population.
Environmental risk factors for ADHD
- prematurity
- birth complications
- maternal smoking
- lead exposure/toxicity
- moderate to severe traumatic brain injury.
Medication for ADHD
- Psychostimulant medications are the first-line psychopharmacological treatment (70–90% of patients benefit). They increase dopamine & norepinephrine levels.
- Non-stimulant medication is second line, not as effective as stimulants. They increase norepinephrine levels.
ADHD in adulthood
primary symptoms persist into adulthood for as many as 85% of individuals.
Dyslexia comorbidity with ADHD
25-40%
What accounts for the comorbidity of ADHD and dyslexia?
processing speed is the cognitive endophenotype that best accounts for the phenotypic covariance among the two disorders.
Treatment of ADHD symptoms with stimulants in children with epilepsy is:
effective, but carries increased (small) risk of seizure exacerbation in some children
Describe the results of the multimodal treatment study of children with ADHD
There was a large effect seen for medication treatment, for which the addition of behavioral therapy produced no significant added benefit. However, with regard to nonsymptom areas (e.g., social skills), there was added benefit noted with the behavioral therapy intervention.
Describe heritability of ADHD
70-80% in twin studies and 5-10x increased risk if 1st degree relative has ADHD
Components of sluggish cognitive tempo (SCT) not included in ADHD inattentive presentation diagnosis:
lethargy/excessive sleepiness
underactivity
slowness
Percent of children with ADHD that have comorbid SLDs:
40%
Which subtype of ADHD is more heritable?
Inattentive > hyperactivity
Describe research on methylphenidate treatment of ADHD in preschools versus older children.
There was a larger effect size among older children than preschoolers but both produced improvements in symptoms. Side effects (e.g., slowed growth rate) were observed in younger children, which led to physicians recommending behavior therapy first in preschool children.
True or false: ADHD occurs more often with comorbid conditions than without.
True
