ADHD

Question 1

Describe approaches for identifying and describing attentional dysfunction, especially attentional dysfunction associated with attention deficit-hyperactivity disorder.

Answer 1

ADHD is a disorder of excessive inattention, hyperactivity, impulsivity, or a combo of these factors that is a long term disease for which medication treatment is indicated.

• Affects 3-7% of school-aged children; Male 2:1 Female
• Neuropsychological Deficits: Deficit in frontal-striatal-cerebellar pathways. Includes….

Alerting – thalamus + Ant/Post Cortical
Orienting – Parietal lobes and frontal eye fields
Executive control – anterior Cingulate, Thalamus, Frontal lobes

• Difficulties in focusing – esp things not exciting (seriously).
• Poor working memory
• Impulsivity – act before thinks..
• Lack of hyperactivity does not mean lack of attn deficit hyperactivity disorder.

Question 2

Describe the functional impact of attention deficit-hyperactivity disorder.

Answer 2

• Education: greater change of not graduating HS, getting a bachelors, professional degree. Higher risk of incarceration (6% in men).
• Greater chance of developing comorbidities: antisocial personality disorder, major depression, Euresis, oppositional disorder, conduct disorder, Multiple anxiety, Social or simple phobia.
• Substance Abuse: drug abuse, tobacco use, alcohol abuse, alcohol dependence, or drug dependence.
• Problems for children in school: Need academic tutoring, higher percentage repeat grade, need special class, have a reading disability, math disability, or learning disability.

Question 3

Describe at least 5 models for understanding why co-morbidity with other psychiatric disorders is high for individuals with attention deficit-hyperactivity disorder.

Answer 3

1) . Underlying genetic vulnerability: Tourette’s gene shared between tics, ADHD, OCD, LD, and social phobia.
2) .Developmental changes: Conduct disorder and ADHD can occur in school age. ADHD, CD, and PSUD (stimulant use disorder) in adolescence can involve substance abuse. ADHD, ASP and PSUD can pursue into adulthood w/ behavioral problems.
3) . Psychological effects of having ADHD: cognitive model of ADHD and depression.
4) . Living with others who are irritated by the ADHD: Anger and devaluation of others is a way to fight back against the constant intrusion into life. Can cause oppositional defiant disorder
5) . Self-treating the problem: trying harder, stop and think, behavioral programs do not work alone. Need to be put on medication by a physician. Stimulants (Ritalin, Adderall, Desoxyn), Atomoxetine, Buproprion, Modafinil, Alpha-agonists work in 90% of individuals

Question 4

State the likely need for long-term treatment for individuals with attention deficit-hyperactivity disorder.

Answer 4

• 50% of boys w/ ADHD continue to have attentional symptoms into adulthood. All girls continue to have these symptoms into adulthood.
• Hyperactvity tends to decrease as get older, relatively rare in late adolescence
• Inner restlessness, impulsivity, and attentional symptoms remain throughout life
• Responsiveness to and appropriateness of treatment continues through adolescence into adulthood
• Improvement in attn w/ stimulant usage last only as long as stimulant is in body.