ADHD Flashcards
What is ADHD?
Attention Deficit Hyperactivity Disorder
It is a co-occurring cluster of impairing symptoms relating to self-regulation (executive functioning)
Diagnostic triad of ADHD?
- Inattention
- Hyperactivity
- Impulsivity
Most common ADHD sub-type?
Combined type ADHD, AKA hyperkinetic disorder
Features of combined type ADHD?
Triad of difficulties and are: • Developmentally inappropriate • Impairing • Pervasive (present in all aspects of life and in all environments, e.g: home, school, etc) • Longstanding
What type of disorder is ADHD?
Spectrum disorder - there is a symptom cluster on a continuum in the general population
Cut-off is based on impairment, clinical judgement, score on rating scales, etc
Impact of the core symptoms of ADHD?
In home / community:
• These kids are complicated to their parents and family stress levels are high (viewed as a family burden)
• Increased anger and upset
• Increased risk of harm, e.g: due to impulsive behaviour
School:
• It is a barrier to learning
• Tend to be in trouble frequently
• Disorganised, forgetful and often lose belongings
Impact on self-worth, interpersonal and social connections
Increased RTAs, other accidents, etc
School and occupation suffer
Higher divorce rate and increased risk of early parenthood
Co-morbid symptoms that commonly occur alongside ADHD?
- Co-morbid disorder symptoms
- Hyperactive symptoms
- Inattentive symptoms
- Impulsivity symptoms
Co-morbid difficulties that arise with ADHD?
Social communication difficulties
Learning Disability (LD)
Attachment difficulties, e.g: parents and friends often find it difficult to bond with these complex children
Mood and anxiety problems
Behavioural disorders - when these arise in children, it is almost universally assoc. with ADHD:
• Oppositional Defiant Disorder (ODD)
• Conduct Disorder (CD)
Substance misuse
Outcome of ADHD in adults?
High rates of crime, substance misuse and psychiatric disorder
Occurrence of ADHD?
5% worldwide (although this likely is only the case when the diagnostic criteria are broader)
i.e: common; however, it is still under-diagnosed
Cause of ADHD?
There are genetic, environmental and neurobiological risk factors, e.g: peri-natal insults
Genetic risk is an important precursor but this may be compounded/turned on by 1 of several environmental risk factors, which may be antenatal; these causal factors results in structural & functional differences across several regions / networks
Environmental factors affect ADHD at every level of development: • Genes • Brain structure and function • Cognition • Symptoms
Effect of ADHD on memory?
Assoc. with significant deficits in both executive and non-executive aspects of working memory
NOTE - working memory in children with ADHD resembles that of patients with Alzheimer’s disease
Imporant information to collect and use to make a diagnosis of ADHD?
Parent and school reports
Screening questionnaires:
• SDQ
• DAWBA
Structured diagnostic questionnaires:
• Conners Rating Scale
• ADHD rating scale
• SNAP IV
Background info regarding risk
Careful review of co-morbidities
Background risk factors for ADHD?
FH
Male gender
SE status (difficult to determine, as SE status may contribute to ADHD or ADHD could result in low SE status)
Examinations that can be carried out
School observation
Observation in clinic room
Potentially cognitive assessment
NOTE - these are not always helpful
