Attention Deficit Hyperactivity Disorder Flashcards
What is the definition of ADHD?
Persistent pattern of inattention and/or hyperactivity that is more frequent and severe than is typically observed in individuals at a comparable level of development and which interferes with functioning and/or development.
What is the prevalence of ADHD?
4-5% of children
What are some genetic factors contributing to ADHD?
Dopamine and serotonin transporter genes
What are some perinatal factors contributing to ADHD?
Alcohol and tobacco use in pregnancy
Significant prematurity and perinatal hypoxia
Other birth complications (short or long labour, foetal distress, low forceps delivery, eclampsia)
Exposure to viral infection in first trimester
What are some psychosocial adversity factors potentially contributing to ADHD?
Inconsistent parenting
Severe marital discord
Lower social class
Large family size
Paternal criminality
Maternal mental disorder
Maltreatment
Emotional trauma
(Relationship between causation and simple association cannot truly be established)
What is the neurobiology of ADHD?
Underactive frontal lobe function (reasoning, planning, impulse, etc)
What is the neurochemistry of ADHD?
Excessively efficient dopamine-removal system
Reduction of noepinephrine and serotonin
What is the impact of childhood ADHD?
Difficulties parenting
Increased level of home stress and high expressed emotions
Emotional dysregulation leading to difficulties in peer relationships and dangerous behaviour
Poor problem solving ability
Barrier to learning
Higher likelihood of antisocial behaviours
What is the impact of adult ADHD?
Psychiatric comorbidity
Higher levels of criminality/antisocial behaviour/substance misuse
Impairment in occupational function
What are some clinical features of ADHD?
Triad of inattention, hyperactivity, impulsivity
Symptoms are: developmentally inappropriate, impairing functioning, pervasive across settings, and longstanding from age 5
What are some investigations of ADHD?
ADHD is a spectrum disorder - cut off is clinically determined, aided by screening and assessment tools (Conners, Strengths and Difficulties Questionnaire)
Generally 5-6 symptoms in individual domains getting in the way of life
What is the psychological management of mild/moderate/severe ADHD in children?
Parent training
Social skills training
Sleep and diet (controversial)
Behavioural classroom management strategies
Specific educational interventions
What is the pharmacological management for moderate-severe ADHD?
1st line: stimulants (methylphenidate or dexafetamine)
2nd line: SNRI (atomoxetine)
3rd line: alpha agonist (clonidine or guanfacine)
