ADHD Flashcards
What is ADHD classified as in the DSM-5?
A developmental disorder.
What is the essential feature of ADHD?
A persistent pattern of inattention and/or hyperactivity-impulsivity. Importantly, these factors must be shown to impact development in a clinically significant manner.
What are the three types?
- Inattentive
- Hyperactive/impulsive
- Combined
What is diagnosis based on?
Symptoms that have occurred over the past 6 months, typically before age 12.
Some symptoms of inattentive type? (6)
- Distracted
- Problems focusing
- Hard listener
- Poor following of instructions
- Problems organizing
- Avoids disliked tasks
Some symptoms of hyperactive/impulsive type? (5)
- Fidgets or taps
- Not able to stay seated
- Unable to do things quietly
- Always on the go
- Talks too much
How many symptoms does each need for diagnosis?
- Inattentive = 6 of 9
- Hyperactive/Impulsive = 6 of 9
- Combined = 6 of 9 of inattentive and 6 of 9 of hyperactive/impulsive
What is a key feature in ADHD diagnostic?
Manifestations must appear in multiple settings.
Prevalence of ADHD?
7.2% (Male to female ration 3:1)
2.5% in adults
(varies worldwide and through life)
How does culture affect diagnostic?
-Primarily for elementary school boys (North American)
-Different around the world
What is comorbidity?
When you have more than one illness.
Comorbidity of ADHD?
1/3 children are diagnosed with only ADHD. Most have another underlying disorder.
What are first-degree biological relatives?
Relatives that share 50% of their genetic material (siblings, parents…)
What is the etiology of ADHD?
80% genetic (one of most inheritable disorder)
Is there a specific gene for ADHD?
No.
What are environmental/developmental risk factors? (2)
- Children with a specific mutation in the dopamine reuptake transporter (DAT1) are more likely to exhibit symptoms of ADHD if their mothers smoked during pregnancy.
- Perinatal Hypoxia - shortage of oxygen during birth.
Behavioral markers with ADHD?
Rewards apparently have less of an influence over the behavior of children with ADHD.
What is the Dual Pathway Model?
Theory about ADHD suggesting dysfunctions in both systems are to blame (executive function (frontal lobe) or reward function (mesocorticolimbic dopamine system)
Brain areas implicated in ADHD?
- Alerting Network (Frontal Cortex, Parietal Cortex, Thalamus) (Weaker with ADHD)
- Frontostriatal Circuit (Dorsal anterior cingulate cortex, ventral anterior cingulate cortex, Nucleus Accumbens, Putamen, Amygdala, Cerebellum, Caudate Nucleus)
Treatment for ADHD?
Drugs of the psychostimulant variety (Ritalin/Concerta/Adderall/Dexedrine) (70-90% effective)
How do these drugs work?
The drugs are dopamine receptor blockers. They bind to the receptor and block dopamine from entering receiving neuron so dopamine builds up in the synapse.
What is the prefrontal cortex receptor stimulation?
By increasing the levels of DA and NA release we can increase the alertness of ADHD patients at the right dose. If too much they can become too stressed.
