Attention Deficit Hyperactivity Disorder

Question 1

What is the prevalence of ADHD?

Answer 1

documented for over 200 years

most common neurodevelopmental disorder: 4-6% of adults, 5-7% of children

80% diagnosed as children continue into adolescence
65% continue into adulthood

diagnosis rates consistent across the globe in the past decade

Question 2

What are the three main types of ADHD?

Answer 2

hyperactive-impulsive: excessive movement or talking, trouble waiting

inattentive: lack of attention regulation

combined: impulsivity and attention dysregulation

Question 3

What is the testing of ADHD?

Answer 3

no blood or imaging tests available

only psychological: computer-based, psychoeducational, neuropsychological

Question 4

What are the comorbidities of ADHD?

Answer 4

anxiety

ASD

learning disabilities

oppositional defiant disorder

conduct disorder

depression

substance abuse

Question 5

What are misdiagnoses of ADHD?

Answer 5

mood disorders

anxiety

thyroid conditions

brain injury

substance use: steroid use

Question 6

What are the genetic risk factors of ADHD?

Answer 6

77-88% heritable

Question 7

What are the in utero risk factors of ADHD?

Answer 7

low birth weight

premature birth

exposure to toxins: alcohol, smoking, lead, cocaine

stress

Question 8

What are the after birth risk factors of ADHD?

Answer 8

nutrition

brain trauma

social deprivation?

Question 9

What are the genetics of ADHD?

Answer 9

7,300 possible genetic components identified

2-8x risk if family member has ADHD

Question 10

What are myths about ADHD?

Answer 10

ADHD rates rising due to increased sugar intake: rates have not been increasing, and sugar doesn’t matter

bad parents cause children to develop ADHD: small risk, only if extremely neglected

children spend too much time inside nowadays this is why they are so restless: not what they’re doing, just giving them less time

Question 11

How has ADHD been historically male?

Answer 11

now known to be equal

women are less likely to be diagnosed as children due to historically higher IQs

originally though female ADHD was less severe: not true

only in last 20 years female diagnoses more common, still statistically more male diagnosis though

Question 12

What do males with ADHD struggle with?

Answer 12

struggle most with working memory and educational functioning

Question 13

What do females with ADHD struggle with?

Answer 13

struggle most with social functioning, time perception, stress, and mood disorders

Question 14

What is reduced brain volume in ADHD?

Answer 14

frontostriatal network: prefrontal cortex, dorsal anterior cingulate cortex, caudate nucleus, putamen

cerebellum

nucleus accumbens

amygdala

hippocampus

differences decrease with age

Question 15

What is delayed grey matter development in ASD?

Answer 15

differences in area volumes may be due to delayed development

peaks 3 years AFTER non-ADHD children grey matter peaks: most prominent in pre-frontal regions

Question 16

What is reduced white matter in ADHD?

Answer 16

corpus callosum significantly smaller

decreased cortical thickness

decreased myelination found in DTI study of ADHD patients in prefrontal areas

Question 17

What is brain function in ADHD?

Answer 17

fMRI studies show ADHD patients may have different neural reward pathway

impaired neural pathways: timing, working memory, attention, cognitive control

Question 18

What are the neurochemical deficit theories of ADHD?

Answer 18

two theories on how ADHD is linked to abnormalities in dopamine and the reward pathway

dynamic developmental theory

dopamine transfer deficit theory

Question 19

What is the dynamic developmental theory?

Answer 19

dysfunction of dopamine transmission in the frontal-limbic circuits

Question 20

What is the dopamine deficit theory?

Answer 20

while there is a normal tonic level of dopamine, the phasic dopamine response to reinforcement is altered in children with ADHD

Question 21

What is the behavioral neuroenergenetics model of ADHD?

Answer 21

lack of energy in the neurons create a hypo-energy state, causing less energy available for each task

Question 22

What is the state regulation model of ADHD?

Answer 22

dysregulation in the regulation of vigilance underlies the attention deficits in ADHD

Question 23

What is the executive dysfunction model of ADHD?

Answer 23

variations in the structure and function of the executive control network

Question 24

What is therapy for ADHD?

Answer 24

psychotherapy: behavioral therapy, cognitive behavioral therapy

psychosocial interventions: family/marital/partner therapy, parenting skill training, behavioral classroom management and academic accommodations

Question 25

What are medications for ADHD?

Answer 25

stimulants: most common, increases dopamine and norepinephrine

non-stimulants: take longer to work, used when stimulants no longer work

may be prescribe along with antidepressants

Question 26

What are animal models of ADHD?

Answer 26

KO DAT or decrease DA –> genetic

environmental: give mom crack cocaine, babies have ADHD symptoms

not many because not as much research until recently

Question 27

What are fMRI studies of ADHD?

Answer 27

fMRI studies: most focus on ADHD vs NT children, high preference for males