ADHD/ODD/CD

Question 1

ADHD triad

Answer 1

inattention
impulsivity- high potential for harm
hyperactivity - excessive and inappropriate motor activity

Question 2

3 other diagnostic criteria for AHDD

Answer 2

sx in more than one setting

onset before 12

functional impairmen

Question 3

more common female presentation of ADHD

Answer 3

inattentive

Question 4

heritability of ADHD

Answer 4

80% heritability coefficient, parent has 50% or more chance of child having dx

Question 5

define default mode network and connection to ADHD

Answer 5

task negative network- network activates by default when person is not involved in task

ADHD pts have trouble deactivating this network

Question 6

first line tx for ADHD

Answer 6

medication (usually stimulants)- one of the only times this is the case

behavioral therapy also for parenting deficits and co morbidities

Question 7

pattern of behavior in ODD

Answer 7

3 categories: angry/irritable mood, argumentative/defiant behavior, vindictiveness

at least 6 mos w/ 4+ sx including w/ ppl not siblings

Question 8

which disease has some overlap w/ ODD

Answer 8

disruptive mood dysregulation disorder- when both criteria are met DMDD overrules ODD

Question 9

distribution of ODD in gender

Answer 9

more common in young boys, tends to even out in older children

Question 10

common impact of ODD

Answer 10

school dropout, parental abuse, depression, marital disruption and interpersonal problems

tend to be viewed as more of the patients control than ADHD

Question 11

ODD pronosis

Answer 11

1/4 will have no further dx

boys with severe ODD: 30% progress to conflict disorder and 40% of these move to antisocial

Question 12

tx for ODD (3)

Answer 12

parent management training- positive reinforcement and more effective discipline, less focus on negative, need to be consistent and predictable

cognitive problem solving skills training- usually involves play training

social skills training program

Question 13

define conduct disorder

Answer 13

repetitive and persistent pattern of behavior w/ violation of rights of others, violation of norms or rules

Question 14

4 categories of CD behaviors

Answer 14

aggression to people or animals

destruction of property

deceitfulness or theft

serious violation of rules

Question 15

gender difference w/ CD

Answer 15

childhood onset mainly male, adolescent ratio M:F is lower

Question 16

etiologies of CD

Answer 16

mainly environemental: eg poverty, gang membership

some biologicial- less autonomic fear activation

Question 17

CD good and bad px factors

Answer 17

poor: comorbidities, poor language skills or low IQ, childhood onset, callousness
good: female, higher IQ, theft rather than violence presentation, adolescent presentation

Question 18

difference b/w CD and antisocial personality

Answer 18

ASPD only after age 18, will have a history of CD

Question 19

tx of CD

Answer 19

multisystemic therapy: around 4 months, active involvement w/ patient and family and school

parent training, family therapy, medications if needed, behavioral techniques