Behav. Sci. L3. Flashcards
What are the forms of ADHD
ADHD inattentive, hyperactive/impulsive, and combined
What is ADHD called in DSM5?
neurodevelopmental disorder
how is DSM5 different from DSM-IVTR?
- starts before age 12, not 8 2. symptoms must be in multiple settings 3. must cause social disability
what are the key symptoms of DSM5? what makes the diagnosis?
- poor attention to details (mistakes) 2. cannot sustain attention. 3. does not listen 4. does not follow through 5. does not organize 6. avoids task (age appropriate) 7. loses things 8. distracted 9. forgetful 10. fidgets 11. leaves seat 12. runs/climbs 13. not quiet/talks a lot 14. blurts out 15. cannot wait turn 16. interrupts (need 6 of these symptoms for 6 months to diagnose)
how does ADHD persist into adulthood?
inattentiveness tends to persist greater than hyperactivity/impulsivity
What etiology is involved in ADHD?
genetics!, neuronal/brain developmental delay, neurological/neurotransmitter abnormalities, environmental factors, psychological factors
which transmitters are involved in ADHD?
NE and dopamine mainly, serotonin and overall brain health as well
ADHD genes cause what?
abnormal receptor or enzyme proteins which increase for decrease neuronal firings and tone for NE allowing symptoms to develop
how does neurodevelopment correlate with ADHD?
pruning of neuronal connections happens later
where do ADHD patients have lower neuronal firing compared to normal?
lower in anterior cingulate and decreased NE, dopamine in frontal cortex - low activity
what environmental factors predispose ADHD
cigarette use/alcohol in pregnancy, lead poisoning, head injuries (esp frontal lobe), could also be learned behavior or reaction to stress
do high sugar and food color additives cause ADHD?
no proof
differential diagnoses for ADHD
autism spectrum disorder, learning disability, substance use disorder, personality disorder, bipolar
what is the most common associated condition in ADHD?
anxiety disorder (followed by depression, bipolar, and then substance use)
what class of medication is used to treat ADHD
stimulant class (promote DA and NE)
risk of stimulant class of drugs for treatment
addiction, paranoia in misuse, stunt growth, weight loss
non-stimulants as treatment compared to stimulants
less effective but no addiction risk, sedating and lower BP
what psychotherapy can be done to help treat ADHD
behavioral modification and training (self control therapy, relaxation, education support, distraction control, attention sustaining)
how is treatment for children approached?
slow release MPH, slow release amphetamine, immediate release stimulants, and then non stimulants
what are the non stimulant drugs
atomoxetine, clonidine ER, guanfacine
how is treatment for adults approached
non stimulants, slow release amphetamines, slow release MPH, immediate release stimulants
atomoxetine
NET inhibitor only (norepi reuptake inhibitor)
guanfacine ER and clonidine ER
agonize or stimulate the alpha-2 norepi receptor (dampen NE release and lower BP as autoreceptor); in frontal cortex - receptors are located on glutamate pyramidal neurons and help to improve signal to noise ratio which allows the neuron to fire appropriately when faced with multiple environmental stimuli - FINE TUNES FRONTAL CORTEX
