ADHD Flashcards
What are the 3 domains that symptoms of ADHD fall into?
Hyperactivity, Inattention, Impulsivity
Give examples of hyperactivity symptoms in ADHD
- Difficulty remaining seated
- Running about/climbing when inappropriate
- Fidgeting
- Unduly noisy when playing
- Unable to modulate motor activity according to social context or demand
Give examples of Inattention
Jumps from task to task Can't focus at school, makes careless mistakes, forgets things Difficulty following instructions Poor organisation Often losing things Distractable
Give examples of Impulsivity
Impulsive acts - runs into road Acts without thinking Answers before a question is complete Trouble waiting for turn Talking excessively without response to social restraints
What is the prevalence of ADHD in the UK
1-2%
But this is variable due to rates of diagnosis
What is the male to female ratio of ADHD
4:1
ADHD is a highly heritable disorder T/F
True
The 5 genes most associated with ADHD account for how much of the heritability?
4.2%
How much higher is the risk if a 1st degree relative also has ADHD
5x risk
What are some prenatal risk factors for ADHD
Maternal smoking, alcohol and other drugs of abuse, anticonvulsants and anxiolytics
What are some perinatal risk factors for ADHD
Low birth weight
Prematurity
Obstetric complications
Wealthy children are more likely to have ADHD T/F
False
Extremely deprived institutional environments are associated with higher rates of ADHD
The total brain size in ADHD is ____, particularly in what areas?
\_\_Smaller\_\_ Cerebellum Corpus callosum Caudate Frontal regions
In ADHD, what change is associated with DRD4?
Reduction in cortical thickness
In ADHD, the reward centres (amygdala and ventral striatum) are larger, causing overstimulation resulting in the symptoms of ADHD (T/F)
False
What is the role of Executive Function areas of the brain
Inhibitory control
Working memory
Planning
Attentional flexibility
How is delayed reward affected in ADHD
Reduction in activity of reward processing areas
Waiting is harder and the reward is less rewarding
Which areas of the brain control delay aversion
Dorsolateral prefrontal cortex, ventral medial prefrontal cortex, amygdala and temporal pole
Differences in function of delay aversion areas of the brain, has what result in ADHD
Harder and less pleasant to wait
The default mode network is more active during rest or work?
Rest
What change in the default mode network results in symptoms of ADHD
Reduced attenuation during rest-to-task transitions
What neurotransmitters are involved in ADHD
Dopamine, Norepinephrine, Serotonin
What 4 attributes are needed for a diagnosis of ADHD
- Core features present in more than one setting
- Features are developmentally inappropriate
- Present early in development
- Causing impairment
What questionnaires can be used to aid a diagnosis of ADHD
Conner’s questionnaire
SNAP-IV
What 4 things make up the basis of treatment for ADHD
Psychoeducation
Environmental modification
Treating co-occurring and co-morbid disorders
Medication
What is the first line treatment for ADHD
Methylphenidate and Lisdexamfetamine
What is the MOA of methylphenidate
Prevent re-uptake of Dopamine and Norepinephrine in synapses
What side effects need monitoring when giving methylphenidate
Reduced appetite, reduced rate of growth, weight gain
Increased pulse rate and increased blood pressure
What are some side effects of methylphenidate
Headache Abdominal pain Irritation/anger Difficulty sleeping Worsening/emergence of tics Cardiac risks
