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KNES 367 > adhd > Flashcards

adhd Flashcards

1
Q

what is ADHD

A

attention deficit hyperactivity disorder (not a great definition)
NDD
lifelong condition - start in childhood, continue into adulthood
- people can be borderline (often seen in women) - first period and menopause can push it over the edge
becomes a condition when the deficit begins to impact your life
spectrum condition

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2
Q

what traits do people with ADHD show deficits in

A
  • behavioural inhibition
  • sustained attention
  • resistance to distractions
  • regulating attention level depending on the demand of the activity
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3
Q

what are the potential causes of ADHD

A

genetics
neurology
NOT environmental or social

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4
Q

how are genetics a cause of ADHD

A

75% of cases
genes that code certain development instructions are different than people without ADHD
- dopamine problems - DAT1 gene

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5
Q

how is neurology a cause of ADHD

A

20-25% of cases
- when something has caused the frontal lobe to not develop properly
ex: mother substance abuse, lead poisoning, toxin exposure, early TBI

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6
Q

what parts of executive functioning are impaired in ADHD (7)

A

(all inhibited to some degree in ADHD)
1. self awareness
2. inhibition
3. verbal working memory - voice in head telling you what to remember
4. visual working memory - gps of mind, being able to reactivate instructions and use them to get where you’re going / accomplish a goal
5. emotion regulation
6. self motivation - lack motivation to do things you don’t always like
7. planning - having a goal and being able to map out the path (big and small goals)

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7
Q

what are the three types of ADHD

A
  • combined type
  • impulsive / hyperactive type
  • inattentive / distractible type
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8
Q

what is the impulsive / hyperactive type of ADHD

A

fidgeter
not able to control volume
talking excessively
get in face
interuptting
don’t wait their turn

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9
Q

what is the inattentive / distractible type of ADHD

A

not able to focus / easy to distract
forgetful
sensory sensitivities
careless mistakes when understimulated
trouble with organisation
losing and misplacing things

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10
Q

why are girls more likely to be diagnosed than boys

A

girls = more inattentive type, don’t cause trouble (fly under radar)
boys = more likely hyperactive and disruptive

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11
Q

what is ADHD paralysis

A

when they become so overwhelmed by environment / info / task that they freeze
- not because of lack of motivation
- inability of the frontal lobe to take info, process it, and start the task
- task avoidance

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12
Q

what is time blindness

A

hard to intrinsically tell time
- so entranced by something that the rest of the day falls apart

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13
Q

what are sleep challenges associated with ADHD

A
  • challenges falling asleep but also bad sleep quality
  • feeling tired even when you’ve had enough sleep
  • insomnia is common
  • stimulants (coffee) don’t have the same effect
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14
Q

what is the mortality for people with ADHD (when untreated)

A
  • worse than other conditions (neuro and substance abuse)
  • 5x more likely to die before the age of 45
  • late diagnoses - increases risk for premature death
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15
Q

what are the relative rates of mental health conditions in people with ADHD

A
  • higher rates of anxiety disorder in kids and adults (higher in adults)
  • increased rates of depression in kids with ADHD and peaks in high school and then tapers

(most adults will get diagnosed with all 3 (ADHD, GAD, depression))

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16
Q

ADHD itself doesn’t kill you, what does?

A
  • higher rates of violence, crime, substance use, accidents, risky behaviours
  • most common cause of death is accidents due to risky behaviour
  • high rates of suicide (impulsive without rational descions, unable to regulate emotions)
17
Q

when is the median age of diagnosis in kids

A

~6
(anywhere from 4-13 is common)
(no stats on adults)

18
Q

what are the DSM V diagnostic criteria

A

6+ symptoms in kids (parent or teacher reported)
5+ symptoms in adults and adolescents
- need to be dealing with them for at least 6 months and be developmentally inappropriate
- symptoms present in 2 or more settings in the person’s life

19
Q

what is the ASRS (adult ADHD self report scale)

A

4 or more greyed out section checked = high chance of ADHD
- higher score = more likely to have ADHD

20
Q

what do kids ADHD assessments involve

A
  • parent and child interviews (psych)
  • patient history
  • child behaviour rating scales (parent and teacher)
  • screening tools
21
Q

why is ADHD misdiagnosed

A

GP not qualified (need psych consult)
can display as other conditions - symptoms can co-occur

22
Q

what are the 3 lines of pharma treatment available

A
  1. Stimulants
  2. non stimulants - norepi
    - both above target NTs
  3. hypertensive drugs - BP medication - targets alpha 2 receptors
23
Q

what do you need to look for in order to get pharma treatment

A

persons urgency
- how soon do they need it to work
- comorbid conditions
- symptoms (very unregulated = third line)

24
Q

does everyone need medication

A

no
- ADHD is variable
- if someone is able to put practises in place to manage then they don’t need meds

25
Q

what are stimulants

A
  • works right away (no buildup time)
  • floods brain with dopamine to support symptoms
  • low potential for addiction
  • wears off - degrades throughout the day

vyvanse, adderall, ritalin

26
Q

what are non stimulants

A
  • takes 6 weeks to work (need to build up slowly to see benefits)
  • no addiction
  • lasts longer
  • mood regulators (don’t let you feel full range of emotions)
  • prevent degradation of dopamine in brain
  • symptoms if you forget to take them are rough
  • take if you can’t take stimulants / anxiety

effexor, strattera

27
Q

what is the difference between vyvnase and adderall

A

vyvanse
- not addictive
- lead up time (longer to absorb)

adderall
- can be addictive
- feel it right away

both
- flood brain with dopamine
- can be prescribed to kids

28
Q

what are the side effects of ADHD meds

A
  • dry mouth (most common)
  • decreased appetite - esp with vyvanse
  • rapid HR - esp when first starting (careful with exercise) - can also increase anxiety
  • sweaty / difficulty regulating temp
  • sleep issues - has to do with when you take meds
29
Q

what are the levels of scientific evidence

A

best - systematic / meta analysis
RCT
non randomised control trials
observational studies
worst - qual studies

30
Q

what is CBT (cognitive behavioural therapy)

A

focus on thought and change the way you think / approach that thought
- best - lots of support that it improves symptoms

RCT and meta analysis level evidence

31
Q

does mindfulness work for ADHD

A

has RCT level evidence
has to be continuous throughout the day

32
Q

does neurofeedback work for ADHD

A

helps to stimulate parts of the brain that are inactive (frontal lobe mainly in NDDs)
has RCT level evidence

33
Q

can diet alone improve symptoms

A

no scientific evidence for this

KNES 367 (16 decks)

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