ADHD & Impulse Control Disorders Flashcards
___% of children and ____% of adults have ADHD.
5% children, 2.5% adults
ADHD is a persistent patter on _____ or _______ or both which interferes w. function/development
inattention, hyperactivity/impulsivity
ADHD dx according DSM5 requires ___ criteria sxs for ____ mo and impact on social/occupation
6 sxs for 6 mo
Inattention or hyperactive?
careless mistakes unsustained attention doesn't appear to listen doesn't follow thru w. work difficulty organizing avoids sustained effort loses things easily distracted forgetful
inattention
Inattention or hyperactive?
fidget leaves seat run/climb excessively doesn't play quietly "on the go" talks excessively blurts answers difficulty waiting turn interrupts/intrudes
hyperactive
ADHD dx requires sxs present prior to…
age 12
ADHD sxs must be present in how many settings?
2 or more
Remission of ADHD requires < ___ sxs for how long?
< 6 sxs for 6 mo or more
What are three components of ADHD evaluation in primary care?
medical, developmental/educational, psychosocial.
Three pathophys factors to development of ADHD?
environmental
NT (DA, NE) alterations
Neutroanatomical changes (PFC, etc)
AAP ADHD Tx for ages 4-5 yo…
1st line: behavior therapy
PRN methylphenidate
AAP ADHD tx for 6+ yo and adolescent
1st line: medication
+
behavior therapy
AAFP ADHD tx for adults
1st line: amphetamine
2nd: atomoxetine/buproprion if substance abuse
3. antidepressants
+
CBT
what drug should be prescribed if you are concerned about abuse, price, or stimulant related heart conditions?
atomoxetine (NE reuptake inhibitor)
in CBT… thoughts influence _____ which alter ______
thoughts influence feelings which alter behavior
Can IED experience guilt?
yes
What condition?
- recurrent episodes of aggressive behavior
- out of proportion aggression
- not premeditated
- causes distress
IED
IED is diagnosed at what age or older?
6 or older
Tx options for IED
SSRI +/- CBT, behavioral modification
Conduct disorder must be age ___ or older
7 older
sxs of conduct d/o are similar to…
ADHD
which ICD has the below risk factors?
- parental rejection/neglect
- difficult infant temperament
- harsh discipline, abuse
- unstable role models
one of MC pediatric psych d/o
conduct d/o
Which ICD has the below characteristics?
-rights of others or societal norma violated 3x in past 12 mo.
CD
the below are sxs of which ICD?
- aggression to people/animals
- destruction of property
- deceitfulness/theft
- serious violation of rules
CD
Does CD have guild/empathy?
no
Tx for CD
individual, group, parental behavior therapy
ADHD drugs
Which ICD is defined as:
-recurrent pattern of negative, defiant, disobedient, hostile behavior toward authority figures
oppositional defiant disorder
ODD is associated with what other psych condition?
ADHD
ODD can lead to…
conduct disorder
ODD is treated with ____, not so much ____
therapy, not so much Rx
ODD is negative, hostile, defiant behavior > ____ mo with ___+ of the below
- loses temper
- argues w. adults
- defies adults requests/rules
- deliberately annoys
- blames others
- easily annoyed
- angry or resentful
- spiteful or vindictive
6 mo with 4+ sxs
kleptomania is linked to FHx of ___
OCD
Therapy tx for kleptomania (3)
CBT + desensitization +/- aversion
What Rx may provide mild benefit in kleptomania?
SSRIs, naltrexone
With kleptomania, you should always look for…
psych co-morbidities
Kleptomania is MC in _____ sex while pyromania is MC in ____
klepto = women
pyromania = men
Tx for pyromania
psychotherapy
what is the only compulsive addictive d/o in the DSM5?
pathological gambling
3 phases of pathological gambling…
winning phase
losing phase
desperation phase
DSM5 requires the presenece of ___+ of the below sxs within ____ mo
- preoccupation w. gambling
- excitement achieved w. higher stakes
- unable to stop/cutback
- restless/irritable when trying to stop
- serves as escape of other problems or mood
- chasses losses
- lies to people
- jeopardized relationships/employment
- relies on other people’s money
4+ in 12 mo
