ADHD Flashcards
psychopathology in children
- disorders = common
- many adult mental disorders have symptoms emerging in childhood
- symptoms of the same disorder can manifest differently from kids - adults
- must consider child’s age and developmental level
DSM5 criteria ADHD
- at least 6 inattentive and/or hyperactive, impulsive symptoms
- at least for 6 months
- several symptoms prior to age 12
- several symptoms in 2+ settings
- symptoms interfere with social, academic, occupational functioning
* for teens/adults, >5 symptoms
DSM5 criteria for ADHD: inattentive type
- fails to give attention to detail, careless mistakes
- trouble sustaining attention in tasks/play
- do not seem to listen when spoken to directly
- do not follow through instructions/fails to finish school work or other tasks
- difficulty organizing tasks and activities
- dislikes/avoids tasks requiring sustained mental effort
- often loses things necessary for tasks/activities
- easily distracted by extraneous stimuli
- often forgetful in daily activities
DSM5 criteria for ADHD: impulsive-hyperactive type
- fidgets with hands or feet, squirms in seat
- leaves seat in situations where remaining in seat = expected
- runs about/climbs when it is inappropriate
(in teens/adults = restless feelings) - unable to play or engage in leisure activities quietly
- “on the go” or acting like they are driven by a motor
- talks excessively
- blurts out answers before question = completed
- difficulty waiting for their turn
- interrupts/intrudes on others
DSM5 - specifying presentation of ADHD
- predominantly inattentive (ADD out of term, subsumed in this category)
- predominantly hyperactive/impulsive
- combined (most)
prevalence and course
- 7.2% worldwide prevalence children <18, 4% of adults
- onset = 3-4 years old (predominantly inattentive usually identified later on)
- 3:1 male-female ratio in childhood (differences disappear in adulthood
- comorbidities: 80% have other disorder
1. ODD
2. CD/antisocial problems
3. specific learning disorders
4. mood disorders
5. SUD in teens+adults
ADHD myths
- “people with ADHD just need to try harder”
- “kids who can play videogames for hours cannot have ADHD”
- kids will hyperfocus on things they are interested in
- difficulty with regulating attention - hard to know when to focus/tune out - “only boys have ADHD”
- girls often overlooked and undiagnosed - “kids will grow out of ADHD”
- symptoms change over time and coping methods = developed - “children who take ADHD meds are more likely to abuse drugs”
- false - opposite!
impact of development of ADHD on life
refer to schema in notebook
biological view of ADHD
- genetics (75-80% variability)
- if a parent have ADHD, child has >50% chance of having ADHD - brain structure
- smaller brain volume
- abnormalities in brain structure and/or circuitry in prefrontal cortex/amygdala/caudate/putamen/hippocampus
- less dopamine and GABA
environemntal view of ADHD
- toxins, allergens, food additivities (minimal evidence)
- maternal smoking
- pregnancy + birth complications
- social adversity
OVERALL environment interacts with genetic predisposition
cultural expectations and ADHD diagnosis
- cultural expectations may explain differential rates of ADHD diagnoses
- how?
EBT: meds
stimulants
- ritalin most common
- highly effective short-term treatment
- reinforce ability to pay attention, improve on -task Bs, decrease negative Bs
- side effects: insomnia, decrease in appetite
non-stimulants
- works well for some individuals
- has not been studied as long/intensely as stimulants
MEDS MAY REDUCE SYMPTOMS, BUT DO NOT IMPROVE ALL AREAS OF FUNCTIONING
EBT: psychological and psychosocial interventions
goals:
1. decrease disruptive B
2. increase academic performance
3. increase social and/or organizational skills
types
1. behavioural therapy usually recommended as 1st treatment (includes summer program)
2. organizational skills training
3. CBT for adults
behavioural therapy: behavioural parent training/parent management
- focus on B and family relationship
- parent implemented
behavioural therapy: behavioural classroom management
- focus on classroom B, academic performance, peer relationships
- teacher implemented
