ADHD Flashcards
Impact of adult ADHD?
- increase freq of psychiatric COMORBIDITY
- HIGHER levels of CRIMINALITY
- higher levels of SUBSTANCE abuse
- impairment in OCCUPATIONAL fxn (easily accomodated)
what causes AHDH?
- perinatal percipitants
- psychosocial adversity
- genetic predisposition
> all 3 leads to neuroanatomical BRAIN changes > cognitive and behavioural fts of ADHD
What are perinatal factors that cause ADHD?
- use of TOBACCO and ALCOHOL during pregnancy
- —-ADHD-like kids with fetal alcohol syndrome
- ADHD a/w signif. premature baby and perinatal HYPOXIA
- others: fetal distress, forceps delivery, eclampsia, unusally short or long labour
- exposure to a vital infection
What is meant by psychosocial ?adversity?
links to PARENTING styles
—-marital discord, low social class, large family size, paternal criminality, emotional trauma
Which area of the brain is LEAST active in ADHD?
- Prefrontal region of the are
- resp. for EXECUTIVE functioning (making decisions, initiation of actions), inability to self-manage time…
What is the neurochemistry behind ADHD?
-appears to be an —excessively EFFICIENT dopamine-removal system
What is the 3 characteristic signs of ADHD?
TRIAD of:
- INATTENTION
- HYPERACTIVITY
- IMPULSIVITY
What is essential for the diagnosis of ADHD in adults?
- should have a MODERATE effect on diff. areas on their life —-UNDERACHIEVING at work/school
- dangerous driving
- hard to make and keep friends
- diffic. relationships
What are psychosocial interventions?
- parent training
- social skills training
- SLEEP AND DIET (reduce gluten, reduce SUGAR)
- behvavioural classroom
What is the first line rx for moderate to severe pharmacological rx?
-1st line (STIMULANTS): METHYLPHENIDATE, DEXAMFETAMINE, LISDEXAMFETAMINE
How does ADHD affect daily functioning?
- impairs self-regulation
- impairs executive functioning/ emotional regulation
- pervasive ACROSS various settings (school, home)
- LONGSTANDING since 5y,o
How does ADHD differ in adults?
- more INATTENTIVE symptoms
- less obvious HYPERACTIVITY and impulsivity
What is the impact of childhood ADHD?
- hard to parent
- INCREASED home stress/emotions
- difficulties in PEER relationships
- inappr. decision making
- exclusion from EDUCATION
- antisocial behaviour
When left untreated, what occurs with ADHD patients?
- 3-5 fold INCR. in divorce risk
- 60% become suspended from school
- 50% in MVA
What theory lies in the fact that ADHD symptoms die down with age?
- the maturation of the brain> THICKENING of the cortex allows the brain to COMPENSATE for cognitive deficits
How likely is the offspring of an ADHD pt gonna get ADHD?
- 60%
Sibling risk of ADHD?
15%
What genes are involved in ADHD?
- dopamine and serotonin
What forms of psychosocial adversities predisposes one to ADHD?
- severe MARITAL discord
- low SOCIAL class
- Large family size
- paternal criminality
- maternal mental d.o
- emotional trauma and maltreatment
Briefly state the causal factors and compounding factors of ADHD.
Genetic risk is an IMPORTANT precursor; which is COMPOUNDED by ONE or MORE psychosocial risk factors
Which part of the brain is UNDERACTIVE in ADHD?
- frontal lobe
needed for EXECUTIVE functioning- reasoning/planning/judgement/social and sexual behavior/ long term memory
Wit anxiety, which parts of the brain is underactive?
- A LARGE majority of the brain is underactive
- why you can’t think straight when you suffer from anxiety…
What occurs in ADHD neuro-chemically?
- excessively efficient REMOVAL of dopamine (d.t HIGH conc. of DOPAMINE TRANSPORTER)—-therefore LESS dopamine a/w with adhd (REWARD system is not as active—-UNLESS MULTIPLE ACTIVITIES is done at once)
ADHD involves the reduction of dopamine and 2 other NTs…what are they?
- serotonin (influences MOOD, SOCIAL behaviour, SLEEP and MEMORY)
- Norepinephrine (affects ATTENTION when acting as a STRESS hormone)
