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3 Psych > ADHD > Flashcards

ADHD Flashcards

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1
Q

what is ADHD

A

attention deficit hyperactivity disorder

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2
Q

what is the triad of difficulties seen in ADHD

A

Inattention
Hyperactivity
Impulsivity

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3
Q

what other symptoms are seen in ADHD

A

impairing symptoms relating to self regulation with are:

  • developmentally inappropriate
  • impairing function
  • pervasive across settings
  • longstanding from age 5
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4
Q

what is a spectrum disorder

A

a disorder which the general population feature on with a clinically determined cut off based on level of impairment

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5
Q

what is the impact of childhood ADHD

A

Difficulties parenting
Increased level of home stress
High expressed emotions
Difficulties in peer relationships and reckless and dangerous behaviour
Poor problem solving ability
Inappropriate decision making
Significant barrier to learning and potentially exclusion from eduction
Higher likelihood of antisocial behaviour

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6
Q

what is the impact of adult ADHD

A

increase in psychiatric comorbidity
higher levels of criminality and antisocial behaviour
higher level of substance misuse
significant impairments in occupational function

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7
Q

why does ADHD get better with age

A

due to improvement in cortical thickness (maturation) that allows for the brain to compensate for cognitive deficits

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8
Q

what are the causes of ADHD

A

genetic predisposition
perinatal precipitants
psychological adversity

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9
Q

what genes are involved in ADHD

A

dopamine and serotonin transported genes

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10
Q

what perinatal factors can impact ADHD

A

tobacco and alcohol use during pregnancy
other illicit substance use
short or long labour, foetal distress, low forceps delivery and eclampsia
exposure to viral infection in first trimester

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11
Q

what psychological adversity factors can impact ADHD

A 
Inconsistent parenting 
Severe marital discord 
low social class 
large family size 
paternal criminality 
maternal mental disorder  
maltreatment and emotional
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12
Q

what neurobiological changes are seen in aDHD

A

Under-active function of the frontal lobe

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13
Q

what is the frontal lobe responsible for

A 
Reasoning 
Planning 
Impulse control 
Judgement 
Initiation of actions 
Social/sexual behaviour 
Long term memory
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14
Q

What neurochemical changes are seen in ADHD

A

excessively efficient dopamine removal system

reduction of norepinephrine and serotonin

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15
Q

how are children assessed for ADHD

A

a school observation
screening questionnaires
full history
exploration of attachment stye

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16
Q

how are adults assessed for ADHD

A

Historical concerns from family
Adult screening tools
Need to currently fit criteria, not historically
Assessment of cognitive difficulties and ability
Look at co-morbidities

17
Q

what is the diagnostic criteria for children to be diagnosed with ADHD

A

6 or more symptoms of inattentiveness and/or

6 or more symptoms of hyperactivity and impulsiveness

present before age 5

happens at home, in school and at clinic

symptoms get in the way of daily living

18
Q

what is the diagnostic criteria for adults to be diagnosed with ADHD

A

5 or more of the symptoms of inattentiveness and/or

5 or more of hyperactivity and impulsiveness

historical concerns since early age

symptoms must have moderate effect on daily life eg. (work, education, dangerous driving, difficulty making/keeping friends etc)

19
Q

what are the psychological treatments for mild, moderate and severe ADHD in children

A 
Parent Training 
Social Skills Training 
Sleep and Diet 
Behavioural Classroom management strategies 
Specific educational interventions
20
Q

what are the pharmacological interventions for moderate and severe ADHD

A

1st line - Stimulants
2nd line - SNRI
3rd line- Alpha agonist
4th line - antidepressants/antipsychotics

21
Q

what stimulants can be given in ADHD

A

Methylphenidate
Dexamfetamine
Lisdexamfetamine

22
Q

what SNRI is given in ADHD

A

Atomoxetine

23
Q

what alpha agonists are given in ADHD

A

Clonidine

Guanfacine

24
Q

how does methylphenidate work

A

stimulant - increases dopamine by blocking its transporter

25
Q

how does dexamphetamine work

A

stimulant

increases dopamine by blocking its transmitter, also increases extracellular norepinephrine and possibly serotonin

26
Q

how do SNRI’s work in ADHD

A

increase norepinephrine by blocking its transporter

27
Q

how do alpha agonists work

A

increase norepinephrine by reducing sympathetic stimulation

3 Psych (31 decks)

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