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Abnormal Psych > ADHD > Flashcards

ADHD Flashcards

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1
Q

when was ADHD first described?

A

in 1902 by Dr. George Still

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2
Q

How have has the ADHD category changed over the years?

A
  • 1960s: Minimal Brain Dysfunction (MBD)
  • 1970s: Attention deficit Disorder (ADD); +/- H for hyperactivity
  • 1980s: ADD plus attention Deficit Hyperactivity disorder (ADHD) for hyperactivity
  • DSM 4 and 5 use ADHD for all cases; 3 subtypes
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3
Q

what are the 3 subtypes of ADHD?

A

1) ADHD- Predominantly Inattentive (ADHD-PI)
2) ADHD-Predominantly hyperactive and impulsive (ADHD-PHI)
3) ADHD-Combined Type (ADHD-C)

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4
Q

what are the criteria for Criteria for ADHD-PI ?

A

6 of the following for 6 months
• Fails to give attention to details
• Difficulty sustaining attention in work/play
• Doesn’t listen when spoken to directly
• Doesn’t follow through on instructions; fails to finish work
• Has difficulty organizing tasks/activities
• Easily distracted
• Avoids tasks requiring mental effort
• Loses things necessary for tasks/activities
• Often forgetful in daily activities

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5
Q

What is the criteria for ADHD-PHI

A

6 of the following for 6 months
• Fidgets with or taps hands
• Leaves seat, when expected to remain seated
• Runs or climbs inappropriately
• On the go
• Unable to play quiet activities
• Talks excessively
• Blurts out answers before question is finished
• Difficulty waiting his/her turn
• Interrupts or intrudes on others
> must occur in 2 environments and cause distress/dysfunction

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6
Q

what is incidence?

A

How many NEW cases in some time period (e.g. one year)

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7
Q

What is prevalence? (point, annual, lifetime?)

A

How many existing cases in some time period
→ Point prevalence: How many cases now
→Annual Prevalence: How many cases in the past year. (not same as annual incidence – is almost always larger)
→ Lifetime Prevalence: What proportion of the population will at some point in their lives show these symptoms. (biggest numbers)

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8
Q

what are clinical estimates?

A

→How many appear in clinics with disorder
• Easy and inexpensive to calculate
• Leads to underestimation of frequency
- gender bias (girls seek help)

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9
Q

what are community estimates

A

→ How many cases in community sample
• Questionnaires/ surveys to find people with these disorders who may/may not have received treatment
• Expensive and time-consuming
• We need large samples

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10
Q

what is the prevalence of ADHD according to DSM 5?

A

5% in children, 2.5% in adults

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11
Q

average age of onset?

A

→ Primarily hyperactive and impulsive – fairly early (preschool/early primary school)
→ Primarily inattentive – a little later (later primary school/elementary school and highschool

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12
Q

sex bias

A

ADHD-PHI = more boys,
ADHD-PI = equal in both,
overal 2m:1f ratio

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13
Q

what % of the population has ADHD?

A

5-9%

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14
Q

51% of ADHD are comorbid for another disorder. list the disorders and percentages.

A
  • 11% depression
  • 7%conduct disorder
  • 11%anxiety disorder
  • 25% have a mixture of all 3
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15
Q

what are some other disorders that overlap with ADHD

A

Oppositional defiant disorder (70%), Bipolar, Tourette’s

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16
Q

what are the 2 psychological processes interrupted in ADHD

A

attention (arousal and vigilance) and executive function (response inhibition and working meory)

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17
Q

are kids with ADHD introverts or extroverts?

A

extreme extroverts because they have a chronically low level of brain arousal.

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18
Q

what is the go, no go task. How do ADHD kids perform

A

response inhibition task where buttons are pressed in association with biased stimuli (90% of one)
- ADHD kids are unable to inhibit response to press the more common button

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19
Q

What is the Stop task, how do ADHD kids do?

A

tone sounds before the stimulus and they must not press either button. So we are looking to see if they can inhibit the response to touch a button
→ Kids with ADHD have a lot of trouble with thi

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20
Q

What types of working memory are impaired in ADHD?

A

o There is a small deficit in verbal memory for kids with ADHD
o There is substantial deficit with visual working memory for kids with ADHD

21
Q

what are some brain activity in AHDH kids?

A 
• 20%  have abnormal EEG activity 
•  Less right > left asymmetry, 
• More cortical slow wave activity 
- suggest underarousal
•Weaker ERP
- poor alerting to new stimulus
22
Q

___% of people with R cortical lesions have ADHD

A

90%

23
Q

What are some abnormalities of blood flow in the brain for ADHD kids?

A
  • Low blood flow in caudate and frontal lobes (esp. in the white matter)=low levels of information transfer
  • High blood flow in primary sensory cortices (temporal, occipital lobes)
  • low blood flow in basal ganglia
24
Q

What areas of the brain are smaller in ADHD?

A

-prefrontal cortex, corpus callosum, cerebellum

25
Q

How do the 3 neurotransmitters talked about in class relate to ADHD?

A

Dopamine
→ Most involved in the reward systems of the brain (pleasure)
• ADHD drugs increase the amount of dopamine the brain
Norepinephrine
→ Used/produced in the reticular formation (involved in attention)
• Lower in ADHD
Serotonin
→ lower in ADHD patients (blood)

26
Q

what are additive effects?

A

If the gene is present then it’s product shows up in your phenotype and it doesn’t matter what other genes are present
ex. One gene codes for 10point iQ another for 30 the result is a 40 point IQ

27
Q

What are Non-additive effects

A

recessent/dominant alleles

ex. Eye color

28
Q

What are Epistatic effects?

A

Whether a gene is expressed (genes activity) depends on the presence of absence of a gene somewhere else in the genome

29
Q

What are epigentic effects?

A

Not only the two alleles, or another unrelated gene but also depends on a set of chemical markers that are on some of your genes. If the marker is present then the gene is shut of as if it is not there

30
Q

what is SNP: Single nucleotide polymorphisms

A

→ A single change in one base pair which can cause a gene to work differently

31
Q

what is CNV: Copy number Variations

A

→ all of us have multiple copies of the same pieces of the same parts of chromosomes
Insertion: chunks of duplicated DNA
Deletion: Chunks of missing DNA

32
Q

in terms of epigenetic are twins 100% concordant

A

NO they are less than 100%

33
Q

DZ twins share what genes? (%)

A

50% of genes (just as any siblings do)
o Share 50% of additive effects
o Share 25% of non-additive effects
o Different epigenetic markers

34
Q

what is the heritability coefficient?

A

o Proportion of variability in phenotype accounted for by genetic not environmental variability in the population

35
Q

what is the formula for heritablity coefficient?

A

h2=2(R^MZ – R^DZ)

36
Q

what is the heritability of ADHD

A

.60 - .90

37
Q

what is linkage analysis

A

look within a family tree and compare genes with people in the tree who have the disorder with people in the tree who don’t have the disorder

38
Q

What are association studies?

A

Looking at individuals who do have the symptoms and are comparing them genetically to people who do not have the disorder

39
Q

Candidate gene approach?

A

o Search for link between theoretically interesting genes (candidate genes) and disorder
o Figure out what generally is happening in the disorder that might be caused by genetic factors and then look to see if these genes differ between individuals who have the disorder and those who don’t

40
Q

Whole-Genome scan?

A

o Search the entire Genome for promising areas on chromosomes that are different for people with and without the disorder
o Search those areas for specific genes

41
Q

what are the 2 candidate genes of ADHD?

A

→ DAT1 – dopamine transporter gene: Chromosome 5

→ DRD4 – dopamine D4 receptor gene: Chromosome 11

42
Q

what does it mean to look at endophenotype?

A

aren’t comparing individuals who have the full phenotype for a disorder but instead individuals who have one of the characteristics – endophenotype (attention deficit, or brian structure, or memory problem)

43
Q

advantages of looking at endophenotypes?

A
  • Can study people without the disorder, but with the same endophenotype. (Easier because we can work with a bigger sample)
  • Good if disorder is polygenic (multiple gene alleles involved). We can narrow down the number of genes involved by looking at the endophenotype instead
  • Good if disorder has several different causal paths
  • Good if disorders share same endophenotype because we can learn about both disorders simultaneously
44
Q

what 3 temperaments are associated with ADHA

A

Extraversion (based on dompaine), Neuroticism and conscientiousness (???)

45
Q

what are some Environmental and social factors associated with ADHD?

A
  • Low Birth Weight – prematurity, less months of gestation
  • Prenatal alcohol exposure
  • Maternal diabetes
  • Pre- and post- natal toxin exposure (Mercury; manganese; lead)
  • Low socio economic status (don’t know why – could be epigenetic)
46
Q

what are some treatments of ADHD?

A

• Stimulants:
o Ritalin (3% of U.S. kids on ADHD meds, 75% respond)
• Tricyclic anti-depressants (when stimulants fail)
• Psychological therapies (Behaviour modification, CBT)

47
Q

the cerebellum has multiple connections with

A

the basal ganglia and the prefrontal cortex

48
Q

25% of adults with ADHD also meet the criteria for

A

Antisocial Personality Disorder.

Abnormal Psych (8 decks)

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