Behavioural and neurodevelopmental disorders Flashcards
What is ADHD?
Attention deficit hyperactivity disorder
High levels of impulsivity, hyperactivity and inattention
Highly comorbid with conduct disorder and ODD
What are some main differences between DSM and ICD diagnosing ADHD?
Age of onset differs
DSM ‘allows’ for comorbidity with autism
What is the worldwide prevalence of ADHD?
Around 3.4%
What are three biological theories for ADHD?
1. G____
2. N____ d____
3. H____ h____
- Genetic
- Neurotransmitter dysregulation
- Hypoarousal hypothesis
What is the genetic theory of ADHD?
Highly heritable
Dopamine receptor gene (D4) shows most robust evidence
What systems are involved with the neurotransmitter dysregulation theory for ADHD?
Dopamine and noradrenaline systems
What is the hypoarousal hypothesis of ADHD?
Stimuli not sufficiently arousing, so behaviour is stimulus-seeking
Not unique to ADHD (e.g. conduct disorders)
What are three psychosocial theories of ADHD?
- Executive function
- Family/systemic factors
- Environmental risk factors
What is the executive function theory for ADHD?
I____ b____ i____
Reinforced by s____ d____
Impaired behavioural inhibition
Reinforced by secondary deficits (e.g. self-regulation of affect)
What is the family/systemic factors theory of ADHD?
high ____
low ____
High stress and low support
Less ‘effective’ parenting, conflict, comorbidity
What are some environmental risk factors of ADHD?
Alcohol, smoking in pregnancy - but difficult to establish causality
A biological intervention for ADHD is medication.
What size effect does medication generally produce, what are some risks of medication, and what are some improvements medication makes?
Generally produce moderate effect sizes for symptom reduction
Risks include sleeping problems, reduced appetite and compliance
May improve teacher-reported symptoms, teacher-reported general behaviour and parent-reported quality of life
What are four psychological interventions for ADHD?
1. S____ s____ training
2. C____
3. N____
4. C____/a____
- Social skills training
- CBT
- Neurofeedback
- Complementary/alternative
What intervention for ADHD does NICE recommend for:
1. Children <5
2. Children 5+ and young people
3. Adults
- Group parent-training programme
- Psychoeducation + carer support
- Consider medication
What is conduct disorder?
Children show behaviours that appear almost intentionally vicious, aggressive and callous
What is oppositional defiant disorder?
Children who do not meet full criteria for conduct disorder but have regular temper tantrums, refuse to comply with instructions, or may appear to indulge in behaviours that annoy others
What is the prevalence rate of conduct disorder in boys compared to girls?
Boys = 4-16%
Girls = 1-9%
What is the median age of onset for conduct disorder?
11.6 years
Studies suggest that conduct disorder predicts antisocial personality disorder but only in what type of families?
Lower social economic status, or if parents have antisocial personality disorder or low verbal IQ
What three things have causal links with conduct disorder?
1. G____
2. N____ factors
3. P____ factors
Genetics, neuropsychological, prenatal factors
What is autism defined as?
A (neuro)developmental “disorder”
Not an illness or disease, it means the brain works differently
Different for everyone
What is the “Triad of impairment” of autism?
- Social interaction - difficulty ‘reading’ other people, emotion recognition in others
- Social communication - difficulties interpreting both verbal and non-verbal language, range from no speech to not understanding jokes
- Repetitive behaviours/interests - prefer routine, predictability, prefer to eat same food, travel same way, focused interests, sensory sensitivity
What is the worldwide prevalence of autism?
What are three factors that influence the prevalence of autism?
Around 1% but highly variable
Cultural differences, different diagnostic criteria, less data in older people and low and middle income countries
What are three genetic aspects of autism?
Prenatal origin but precise cause not been determined
Highly heritable
Several genes involved in synaptic plasticity
Explain a study into Weak central coherence as a cognitive factor of autism (contextual information)
Bias away from integrating contextual information for meaning (detail focus)
Remembering the gist of a story, not elements
Happé (1997):
Pronounce tear: ‘In her eye there was a big tear’
Pronounce tear: ‘In her dress there was a big tear’
Most of the participants with ASC (including those who passed ToM tasks) made relatively little use of context
What does the theory of mind deficit state about people with autism?
I____ in attributing t____ and f____ to others
Impairments in attributing thoughts and feelings to others
What does the Executive dysfunction theory about autism say?
- Umbrella term for functions such as p____, w____ m____, i____ c____ and s____ s____
- May be necessary for development of ____ of ____
- Particularly associated with ____ behaviours
Umbrella term for functions such as planning, working memory, impulse control, set shifting, and so on
May be necessary for development of ToM
Particularly associated with repetitive behaviours
What are four psychological interventions for autism?
1. P____ interventions
2. Interventions for l____ s____
3. Interventions for c__-____ problems
4. Interventions for s____ problems/f____ problems
- Psychosocial interventions (increase the understanding, sensitiveness and responsiveness to child’s patterns of communication and understanding and techniques that expand child’s communication, interactive play and social routines)
- Interventions for life skills
- Interventions for co-existing problems
- Interventions for sleep problems/feeding problems
What is ABA intervention?
A____ b____ a____ is a term for i____ that are based on o____ and u____ behaviours
(applied behavioural analysis) is a term for interventions that are based on observing and understanding behaviours
