B7-075 ADHD Flashcards
ADHD onsets before the age of […], but diagnosis can only be established after age […]
ADHD onsets before the age of [12], but diagnosis can only be established after age [4]
diagnostic criteria of ADHD requires symptoms occurring in […] setting
two or more
(i.e. school, home, church, etc) (helps rule out environmental factors)
ADHD is associated with […] intelligence, but often coexists difficulties at school or other cognitive disorders
normal
three stages of attention
- alerting
- orienting
- executive attention
the ability to maintain attention over long periods of time
alerting
(vigilance, sustained attention)
the ability to limit attention to a subset of possible sensory inputs
orienting
(selective attention, divided attention)
the ability to prioritize attention in the context of competing demands
executive attention
(conflict monitoring, attention switching)
ADHD was first introduced to the DSM III as
ADD
a diagnosis of ADHD requires symptoms of […] and […]
inattention
hyperactivity/impulsivity
(six symptoms within six months that have direct negative impacts on social/occupational functioning)
diagnostic criteria requires ADHD symptoms present before age
12
subtype: both inattention and hyperactivity/ impulsivity criteria are met
combined presentation
subtype: inattention criteria are met; hyperactivity/ impulsivity criteria are not met
predominantly inattentive presentation
subtype: inattention criteria are not met; hyperactivity/ impulsivity criteria are met
predominantly hyperactive/impulsive presentation
[boys/girls] are more likely to be diagnosed with ADHD
boys
diagnosis of ADHD in […] may require ancillary information
adults
(family members, academic documentation, etc)
way to differentiate ADHD from other psychiatric disorders like anxiety, OCD, etc
ADHD must have long history, back to childhood
ADHD is correlated with high incidence of lifetime diagnosis of [4]
anxiety disorders
MDD
antisocial personality disorder
alcohol/drug dependencies
activity of the Default Mode Network is found to […] in activity during attention-demanding tasks in ADHD
decrease
neurotransmitters implicated in ADHD
dopamine
NE
structures implicated in ADHD [4]
dorsolateral prefrontal cortex
cingulate
caudate
putamen
(he referred to cingulate + caudate + putamen as frontostriatal circuit)
stimulant medications for ADHD [2]
methylphenidate
amphetamine
non-stimulant medications for ADHD [4]
atomoxetine
bupropion
guanfacine
clonidine
first choice medication for ADHD in children
methylphenidate
first choice medication for ADHD in adults
amphetamines
aspects of CBT that can be helpful in ADHD [4]
psychoeducation and organization/planning
problem solving skills
managing distractibility
relapse prevention
the inability to engage in leisure activities quietly and difficulty waiting one’s turn are examples of
hyperactivity/impulsivity
losing things, trouble organizing, and task avoidance are examples of
inattention
the number of symptoms required to diagnose a subtype of ADHD is
6
(out of 9)
[…]% of children with ADHD have another mental, emotional, or behavioral condition
60
when diagnosing adults, […] can be unreliable so ancillary information is used
retrospective recall
adderall and vyvanse are
amphetamines
ritalin and concerta are
methylphenidate
what attention system is responsible for achieving and maintaining alertness?
alerting
what attention system helps in preparing the mind for processing incoming stimuli?
alerting
what attention system is responsible for directing attention to specific locations in the brain?
orienting
what attention system helps in selecting information from sensory inputs?
orienting
what attention system is responsible for controlling and regulating cognitive processes?
executive
what attention system helps in high cognitive functions such as goal setting, planning, and decision making?
executive
what attention system is composed of the brainstem and subcortical structures?
alerting
what attention system is composed of the neocortex, particularly the parietal lobe?
orienting
what attention system is composed of the neocortex, particularly the frontal lobe?
executive
involves interacting brain regions that are active when a person is not focused on the outside world
default mode network (DMN)
engagement and disengagement from the […] is impaired in ADHD
default mode network
like all neuropsych disorders, symptoms must interfere with […] functioning to be diagnosed
social/occupational
implicated in working memory and complex attention
DLPFC
to meet criteria for diagnosis, symptoms of ADHD must be present in […] setting
more than one
what disorders should be ruled out in the diagnosis of ADHD [4]
anxiety disoder
conduct disorder
MDD
oppositional defiant disorder
what combination of therapies is most effective in treating ADHD
psychostimulants + behavioral treatments
symptoms must be present before the age of
12
albuterol can […] symptoms of ADHD
exacerbate
comorbid […] disorders can co-exist with ADHD
anxiety
most prominent demographic factor associated with ADHD diagnosis
sex
(males more likely to be diagnosed than females)
