ADHD

Question 0

What are 3 important other factors to diagnose with ADHD

Answer 0

1. Before age 12
2. 2+ settings
3. Must interfere and reduce functioning

Question 1

What are the two dimensions of symptoms for ADHD?

Answer 1

1. Inattention

2. Hyperactivity/impulsivity

Question 2

What are some environmental factors that cause ADHD?

Answer 2

Abuse, neglect, family adversity, situational stress

Question 3

What are some genetic origins of ADHD and how heritable is it?

Answer 3

• 0.75 (so chance that ADHD is driven by genetics is 75%)
• Polygenic disorder
• DR4 (less efficient receptor, can’t hold on to dopamine)
• DAT (dopamine transporter)
• If mom smokes while pregnant and baby has bad DR4 and DAT risk variants, then child has 9x more risk of getting ADHD

Question 4

Key brain regions in ADHD

Answer 4

Show a 3-10% reduction in volume of…

1. Orbital PFC
   - Working memory and exec fxn
2. Basal ganglia
3. Cerebellum (esp vermis)

Also involved…

1. R. inf PFC
   - behavioral inhibition
2. Anterior cingulate
   - Decrease use in problem solving. Instead use fronto-striato-insular-thalamic network which is slower
   - Stimulates fix this
3. Nucleus accumbens
   - Has less DAT

Question 5

Why can some people outgrow ADHD?

Answer 5

There is a 3 year lag in brain development in kids with ADHD. Some kids catch up! Lag is esp large in frontal cortices

Question 6

What are the postulated neuro chemical deficits in ADHD?

Answer 6

Dopamine and norepinephrine

-comes from the fact that stimulants inc dopamine and NE transmission

Question 7

What is something important to know about catecholamines and the PFC?

Answer 7

The PFC requires a moderate amt of catecholamines. Too much=stress and too few=fatigue