ADHD

Question 1

why is early intervention in mental disorders important?

Answer 1

• prevent chronic & ingrained mental health problems
• by age 14 > 50 % mental health problems established > increase to 75% by age 24
• early psychopathology disrupts normal developmental milestones in education & social development

Question 2

What are the different types of childhood disorders?

Answer 2

• internalising disorders: inwardly expressing symptoms, e.g. sadness, anxiety
• externalising disorders: outwardly, expressing symptoms, e.g. aggression
• ADHD falls under externalising disorders

Question 3

what are key facts about ADHD?

Answer 3

• affects 5% of population
• boys more affected than girls
• Comorbidity > 50% have other diagnosis > mood disorder, learning problems & anxiety

Question 4

what is the DSM diagnostic criteria for ADHD?

Answer 4

• three main clusters:
  > inattention: doesn’t pay attention, can’t organise, forgetful, easy, distracted
  > impulsivity: can’t wait turn, interrupts others
  > hyperactivity: fidget, leave seat in class, talk successively
• diagnosis based on 6 or more symptom for at least 6m in 2 setting
• onset symptoms
• sometimes required before age of 12

Question 5

what are impacts of ADHD?

Answer 5

• academic performance: poor achievement, social impairment
• adolescence: higher risk of SUD
• adulthood: relationship problems, early mortality

Question 6

how does ADHD impact families?

Answer 6

• families of children w/ ADHD experience increased stress, depression & anxiety
• marital discord
• lack of understanding from parents = negative perceptions of child (lazy, disruptive)
• harsh parenting behaviour = exacerbate child symptoms

Question 7

what are biological factors in ADHD?

Answer 7

• high heritability > 70% , high genetic risk = also increase risk for diff disorder e.g. autism, anxiety, depression
• 1st degree relative= 9x risk
• genes related to catecholamines pathways (dopamine, norepinephrine) are implicated.
• neurobiological factors: frontal & stratal areas show lower activation > reduction in brain volume
• ADHD brain > delayed development esp in frontal & temporal areas

Question 8

what are environmental factors in ADHD?

Answer 8

• birth complications & exposure to toxins during pregnancy = increase adhd risk
• maternal smoking & drinking during pregnancy
• food additives > increase hyperactive & impulsive behaviour
• parental style & family structure > socioeconomic factors
• environmental factors interact w/ genes = vulnerability
• parents w/ adhd impact child behaviour die to attention & organisation difficulties

Question 9

what are cognitive factors in ADHD?

Answer 9

• ADHD individuals perform poorly on task measuring inhibition >working memory & executive functions
• cognitive deficits observed on group lvl
• medication can slightly improve cognitive functioning in adhd ppl

Question 10

what is the learning theory in ADHD?

Answer 10

• parents may reinforce problematic behaviour w/ adhd children
• impulsive behaviours reinforced w/ immediate reward

Question 11

how is ADHD assessed in children & what are problems with it?

Answer 11

• child inability to verbalise = assessment can be challenging >info from parents, teacher & direct observation for accurate diagnosis
• look for symptoms in diff settings & ruling out of other potential issues
• psychological testing : IQ testing for cognitive assessment
• assessing daily life impact

Question 12

what are treatments for ADHD?

Answer 12

• psychoeducation for parents to understand adhd = help shift negative narratives
• environmental adjustments for child > i.e. classroom modifications
• CBT > address co-excisitng problems, anger management & communication skills
• lifestyle adjustment > healthy diet & exercise
• behavioural theory: reinforcement: reward system for desired behaviours etc
• medication > methylphenidate and amphetamines, is a last resort, especially for severe cases < side effects: headache, nausea, decreased appetite, insomnia, dizziness, irritability