Ch.15

Question 1

Criteria for abnormality

statistical rarity

Answer 1

Abnormality itself doesn’t necessarily mean that a person has a disorder. There are several things that are correlated with having a disorder and several things that make it more necessary to diagnose someone as having a disorder.

statistical rarity:
- could define someone’s behaviour or traits as being abnormal because they are statistically rare. However, rarity doesn’t mean that someone has a disorder.
- i.e. not all infrequent conditions, like extraordinary creativity are pathological and some disorders like depression can be quite common.

• deviance from statistical or cultural norms

Question 2

Criteria for abnormality:

subjective distress

Answer 2

• refers to whether someone is suffering as a result of the symptom or trait.
• It possible that two people could experience the same
  symptom, but only one thinks it is a problem or experiences distress/suffering as a result of the symptom.
• Is subjective distress sufficient for diagnosis? In some cases, yes.
  – If someone is bothered enough by their anxiety to seek treatment, then it is very likely to be diagnosed and treated. (or is in abusive situations)
• Is subjective distress required for a diagnosis? No!
  – There are some disorders that don’t bother
  the people who have them at all. Instead, they bother the people around them. (narcissism. manic episodes associated with Bipolar Disorder)

• person is suffering
• internal

Question 3

Criteria for abnormality:

impairment

Answer 3

• crucial one for diagnosis
• refers to the impact of symptoms upon the person’s relationships, employment, safety, and health.
• Note that impairment could come from something other than a Psychological disorder, so it’s not the case that if you have problems with relationships or employment that you necessarily have a disorder

• issues with persons life (Danger)
• external

Question 4

Criteria for abnormality:

biological dysfunction

Answer 4

• some unusual patterns of neurotransmitter function in some disorders, and there are some types of brain damage or dysfunction that are associated with psychological disorders.
• some disorders have no obvious biological dysfunction, so we can’t always use biological evidence when considering a diagnosis.
• also have to be careful to look to see if there is a medical explanation for what we think is a symptom of a Psychological disorder

• physical abnormality (e.g., brain change)

Question 5

DSM 5: prevalence

Answer 5

percentage of people within a population who have a specific mental disorder.

Example:
• lifetime prevalence is at least 10 percent among females.
— odds are at least 1 in 10 she’ll experience an episode of major depression at some point in her life.

• at least 5 percent among males.
— odds are at least 1 in 20.

Question 6

DSM 5: comorbidity

Answer 6

co-occurrence of two or more diagnoses within the same person.

This extensive comorbidity raises the troubling question of whether DSM-5 is diagnosing genuinely independent conditions as opposed to slightly different variations of one underlying condition.

Question 7

DSM 5: categorical vs. dimensional

Answer 7

categorical model:
model in which a mental disorder differs from normal functioning in kind rather than degree.
— is either present or absent, with no in-between.
— Categories differ from each other in kind, not degree.
• Pregnancy fits a categorical model, because a female is either pregnant or she’s not.

dimensional model:
model in which a mental disorder differs from normal functioning in degree rather than kind.
— meaning that they differ from normal functioning in degree, not kind
• Height fits a dimensional model, because although people differ in height, these differences aren’t all or none.

Question 8

DSM 5: medicalizing normality

Answer 8

is its tendency to “medicalize normality,” that is, to classify relatively mild psychological disturbances as pathological.

— DSM-5 now allows individuals to be diagnosed with major depressive disorder following the loss of a loved one.

— Although this change may be justified by research, critics worry that it will open the floodgates to diagnosing many people with relatively normal grief reactions as disordered.

Question 9

Anxiety disorders: (be able to tell the different ones apart)

GAD- Generalized anxiety disorder

Answer 9

It tends to be always present and has been described as ‘free floating’ anxiety that isn’t tied to a particular trigger or situation.

• People with GAD tend to always be worried or on edge, but not about anything specific. It’s not hard to imagine how this would lead to subjective distress or impairment that would lead someone to seek treatment.

Question 10

Anxiety disorders:

panic disorder vs. a panic attack

Answer 10

panic attack
— brief, intense episode of extreme fear characterized by sweating, dizziness, light-headedness, racing heartbeat, and feelings of impending death or going crazy.

• can occur only rarely or on a daily basis for weeks, months, or even years at a time.
• peak in less than 10 minutes.
• some associated with specific situations.
• others come entirely out of the blue = generating fears of the situations in which they occur.
• can occur in every anxiety disorder, as well as in mood and eating disorders.

panic disorder
— repeated and unexpected panic attacks, along with either persistent concerns about future attacks or a change in personal behaviour in an attempt to avoid them.

• symptoms continue for a month or more.
• fear of future panic attacks
• often develops in early adulthood.
• associated with a history of fears of separation from a parent during childhood.

Question 11

Anxiety disorders:

phobias

Answer 11

phobia
— intense fear of an object or situation that’s greatly out of proportion to its actual threat.

• For a fear to be diagnosed as a phobia, it must restrict our lives, create considerable distress, or both.
• the most common of all anxiety disorders.
• One in nine of us has a phobia
  4 categories of phobias
  1. Natural environment
  2. Animals
  3. Mutilation/medical treatment
  4. Situations
• Social fears are just as common.
• widespread in childhood but disappear with age.

Question 12

Anxiety disorders:

agoraphobia

Answer 12

agoraphobia
fear of being in a place or situation from which escape is difficult or embarrassing, or in which help is unavailable in the event of a panic attack.

• become apprehensive in a host of settings, such as malls, crowded movie theatres, tunnels, bridges, or wide-open spaces.
• most debilitating of the phobias and occurs in about 1 in 20 of us.
• emerges in the mid-teens.
• usually a direct outgrowth of panic disorder.
• most people with panic disorder develop agoraphobia.
• seems to differ across cultures.

Question 13

Anxiety disorders:

PTSD

Answer 13

posttraumatic stress disorder (PTSD)
— marked emotional disturbance after experiencing or witnessing a severely stressful event.

Symptoms:

• flashbacks are among the hallmark symptoms.
• efforts to avoid thoughts.
• efforts to avoid feelings.
• efforts to avoid places.
• efforts to conversations associated with the trauma.
• recurrent dreams of the trauma.
• increased arousal such as sleep difficulties and startling easily.
• Reminders of the incident can trigger full-blown panic attacks.
• PTSD isn’t easy to diagnose.
• Some of its symptoms, such as anxiety and difficulty sleeping, may have been present before the stressful event.
• some people malinger (fake) PTSD to obtain government benefits.

Classifying:
— new class of “trauma and stressor-related disorders” in which the definition of a traumatic event is broad.
Includes:

• direct exposure to a traumatic event
  — rape, wartime combat, or a natural disaster.
• indirect exposure to a traumatic event, in which people learn about an event from a friend or relative who experienced threatened or actual death or in which people are exposed repeatedly to distressing details of a traumatic event.
  — such as the sexual abuse of an elderly person.

Question 14

Anxiety disorders:

OCD

obsessions vs. compulsions

Answer 14

obsessive compulsive disorder (OCD)
— condition marked by repeated and lengthy (at least one hour per day) immersion in obsessions, compulsions, or both.

obsession
— persistent idea, thought, or impulse that is unwanted and inappropriate, causing marked distress.

• “unacceptable” thoughts, about such topics as contamination, sex, aggression, or religion. be consumed with fears of being dirty or thoughts of killing others.
• disturbed by their thoughts and usually see them as irrational or nonsensical.
• often label themselves “crazy” or dangerous.
• Despite their best efforts, can’t find a way to make these thoughts stop.

compulsion
— repetitive behaviour or mental act performed to reduce or prevent stress.

• feel driven to perform the action that accompanies an obsession.

Common OCD rituals:
• repeatedly checking door locks, windows, electronic controls, and ovens.
• performing tasks in set ways, like putting on one’s shoes in a fixed pattern.
• repeatedly arranging and rearranging objects.
• washing and cleaning repeatedly and unnecessarily.
• counting the number of dots on a wall or touching or tapping objects.

Question 15

Mood disorders:

major depressive disorder

Answer 15

Chronic or recurrent state in which a person experiences a lingering depressed mood or diminished interest in pleasurable activities, along with symptoms that include weight loss and sleep difficulties.

• Depressive disorders can bean at any age but are most likely to strike people in their 30s.
• symptoms of depression may develop gradually over days or weeks.
• other cases, surface rather suddenly.
• is recurrent.
• experiences tive or six episodes over the course of a lifetime.
• Dysthymia is a milder chronic version of depression.

• Depression also appears to be linked to low levels of the neurotransmitter norepinephrine.
• diminished neurogenesis (growth of new neurons), which brings about reduced hippocampal volume.
• have problems in the brain’s reward and stress-response systems.
• decreased levels of dopamine, the neurotransmitter most closely tied to reward.
= This finding may help to explain why depression is often associated with an inability to experience pleasure.

Question 16

Interpersonal model: Depression as a social disorder

Answer 16

James Coyne hypothesized that depression creates interpersonal problems.

• When people become depressed, he argued, they seek excessive reassurance, which in turn leads others to dislike and reject them.
• depression is a vicious cycle.
• People with depression often elicit hostility and rejection from others, which in turn maintains or worsens their depression.
• As Constant worrying, mistrust, fears of rejection and abandonment, and socially inappropriate behaviours can also be a social turnoff to many people.

Question 17

Behavioral model: Depression as a loss of reinforcement

Answer 17

Peter Lewinsohn’s behavioural model proposes that depression results from a low rate of response-contingent positive reinforcement.

• when people with depression try different things and receive no payoff for them, they eventually give up.
• affording them little opportunity to obtain reinforcement from others.
• This view implies a straightforward recipe for breaking the grip of depression: pushing ourselves to engage in pleasant activities. Sometimes merely getting out of bed can be the first step toward conquering depression

Question 18

Cognitive model: Depression as a disorder of thinking

Answer 18

• Theory that depression is caused by negative beliefs and expectations.

• cognitive triad: negative views of oneself, the world, and the future.

• habitual thought patterns, called negative schemas, presumably originate in early experiences of loss, failure, and rejection.

• Activated by stressful events in later life, these schemas reinforce people with depression’s negative experiences.

• also suffer from cognitive distortions, which are skewed ways of thinking.
— selective abstraction, in which people come to a negative conclusion based on only an isolated aspect of a situation.

Question 19

Mood disorders:

bipolar disorder I

Answer 19

Presence of one or more manic episodes.

• depressive episodes to manic episodes

episodes often produce serious problems in social and occupational functioning, such as substance abuse and unrestrained sexual behaviour.

• among the most genetically influenced of all mental disorders.
• genes that increase the sensitivity of the dopamine receptors.
• decrease the sensitivity of serotonin receptors may boost the risk of bipolar disorder.
• at least some genetic overlap between psychotic symptoms in bipolar disorder and schizophrenia.

• people with bipolar disorder experience increased activity in structures related to emotion, including the amygdala.
• decreased activity in structures associated with planning, such as the prefrontal cortex.
•

• Cyclothymia is a milder chronic version of Bipolar Disorder.

Question 20

Mood disorders:

bipolar disorder II

Answer 20

Patients must experience at least one episode of major depression and one hypomanic episode.

Question 21

Learned helplessness

Answer 21

tendency to feel helpless in the face of events we can’t control.

• argued that it offers an animal model of depression.
• striking parallels between the effects of learned helplessness and depressive symptoms: passivity, appetite and weight loss, and difficulty learning that one can change circumstances for the better.

• But we must be cautious in drawing conclusions from animal studies because many psychological conditions, including depression, may differ in animals and humans.

• Seligman and his colleagues argued that persons prone to depression attribute failure to internal as opposed to external factors, and success to external as opposed to internal factors.

Question 22

Mood disorder vs Mood episode

Answer 22

In order to diagnose most mood disorders, you must establish the existence of mood episodes.

• A mood episode is the experience of severe mood symptoms for a prolonged period of time (a
  week or two, or longer).

Question 23

Mood episode:

depressive

Symptoms?
Correspond to which mood disorders?

Answer 23

includes the symptoms: depressed mood, loss of interest in things that used to be important, loss of appetite, fatigue or insomnia, agitation, and feelings of worthlessness or guilt. Some very severe versions include loss of contact with reality. Diagnosis of major depression occurs with long-lasting or recurring depressive episodes. This could lead to both subjective distress and impairment.

• fall and winter can trigger depressive episodes.
• May correspond to bipolar disorder I.

Question 24

Mood episode:

manic

Symptoms?
Correspond to which mood disorders?

Answer 24

Markedly inflated self-esteem or grandiosity, greatly decreased need for sleep, much more talkative than usual, racing thoughts, distractibility, increased activity level or agitation, and excessive involvement in pleasurable activities that can cause problems (like unprotected sex, excessive spending, reckless driving).

• triggered by negative and positive life situations.
• It may even include a loss of contact with reality, where the person believes that they are supernatural or royalty, or smarter than everyone else in the world.
• Many people in manic states feel great, but some feel very irritable and angry. A manic episode might not have ‘subjective distress’ associated with it, but it could certainly lead to impairment.
• spring or summer may initiate manic or hypomanic episodes.
• Bipolar I includes manic episodes, and may also
  include depressive episodes or mild depressive symptoms that alternate with the manic episodes

Question 25

Mood episode:

hypomanic

Symptoms?
Correspond to which mood disorders?

Answer 25

A less intense and disruptive version of a manic episode; feelings of elation, grouchiness or irritability, distractibility, and talkativeness.

• It involves feeling more ‘up’ than normal, but it doesn’t include any delusions or really extreme behaviours.
• people may be more productive than usual, or more creative and excitable. It isn’t a disorder in and of itself, and people often report that a hypomanic episode feels pretty great.
• Accordingly, a hypomanic episode wouldn’t have ‘subjective distress’ or ‘impairment’ associated with it.

Question 26

Personality disorder

Answer 26

• condition in which personality traits, appearing first in adolescence, are inflexible, stable, expressed in a wide variety of situations, and lead to distress or impairment.

• whether we perceive someone with a personality disorder as abnormal depends on the context in which their behaviour occurs.
• personality disorders often exhibit substantial comorbidity with each other and with other mental disorders.

Question 27

Personality and Dissociative Disorder:

Borderline personality disorder

Answer 27

condition marked by extreme instability in mood, identity, and impulse control.

• described this disorder as a pattern of “stable instability”.
• impulsivity and rapidly fluctuating emotions often have a self-destructive quality.

• According to Kernberg, individuals with borderline personality disorder can’t integrate differing perceptions of people, themselves included.
— This defect supposedly arises from an inborn tendency to experience intense anger and frustration from living with a cold, unempathetic mother.
- tend to “split” people and experiences into either all good or all bad.

• According to Marsha Linehan’s sociobiological model, ppl with BPD inherit a tendency to overreact to stress and experience lifelong difficulties with regulating their emotions

Question 28

Personality and Dissociative Disorder:

psychopathic personality disorder

Answer 28

psychopathic personality:
- condition marked by superficial charm, dishonesty, manipulativeness, self-centredness, and risk taking.

— Psychopathic personality is not formally a psychological disorder and is not listed in DSM-5. Nevertheless, it overlaps moderately to highly with ASP.
— is marked by a distinctive set of personality traits.

• most male, are guiltless, dishonest, manipulative, callous, and self-centred.
• but also tend to be charming, personable, and engaging.
• history of conduct disorder, marked by lying, cheating, and stealing in childhood and adolescence.
• typically aren’t psychotic or aggressive.
• They know full well that their irresponsible actions are morally wrong; they just don’t care.
• a lot in criminal system but also positions of leadership in corporations and politics.
• b/c of the traits interpersonal skills, superficial likeability, ruthlessness, and risk taking.
• don’t show much classical conditioning to unpleasant unconditioned stimuli.
  — abnormalities may stem from a deficit in fear, which may give rise to many of the other features of the disorder.
• aren’t motivated to learn from punishment and tend to repeat the same mistakes in life
• are underaroused.
• Yerkes-Dodson law: inverted U-shaped relationship between arousal on the one hand and mood and performance on the other.
• ppl who are habitually underaroused experience stimulus hunger: bored and seek out excitement.
• underarousal hypothesis may help to explain why those with psychopathic personality tend to be risk takers.

antisocial personality disorder (ASP):
- condition marked by a lengthy history of irresponsible and/or illegal actions.
— marked by a lengthy history of illegal and irresponsible actions.

Question 29

Dissociative disorder

Answer 29

condition involving disruptions in consciousness, memory, identity, or perception.

Question 30

depersonalization/derealization disorder

Answer 30

condition marked by multiple episodes of depersonalization.

• felt detached from yourself, as though you’re living in a movie or a dream or observing your body from the perspective of an outsider, = depersonalization.
• Derealization, the sense that the external world is strange or unreal, often accompanies both depersonalization and panic attacks.
• Only if people experience multiple episodes of depersonalization, derealization, or both do they qualify for a diagnosis of this.

Question 31

Personality and Dissociative Disorder:

Dissociative disorders: dissociative amnesia

Answer 31

inability to recall important personal information- most often related to a stressful experience that can’t be explained by ordinary forgetfulness.

• More commonly, psychologists diagnose dissociative amnesia when adults report gaps in their memories for child abuse.

Question 32

Personality and Dissociative Disorder:

Dissociative disorders: dissociative fugue

Answer 32

sudden, unexpected travel away from home or the workplace, accompanied by amnesia for significant life events.

• Fugues can last for hours or, in unusual cases, years.
• essential to find out whether the fugue resulted from a head injury, stroke, or other neurological cause.
• Moreover, some people merely claim amnesia to avoid responsibilities or stressful circumstances, relocate to a different area, and get a fresh start in life.

Question 33

Personality and Dissociative Disorder:

dissociative identity disorder:

Answer 33

condition characterized by the presence of two or more distinct personality states that recurrently take control of the person’s behaviour.

• disrupt the person’s usual sense of identity and may be observed by others or reported by the individual.

• “alters” often very different from the primary or “host” personality and may be of different names, ages, genders, and even races.

• women are more likely to receive a DID diagnosis and report more alters than men.

• identified intriguing differences among alters in their respiration rates, brain wave activity, eyeglass prescriptions, handedness, skin conductance responses, voice patterns, and handwriting.

— differences could stem from changes in mood or thoughts over time or from bodily changes, such as muscle tension, that people can produce on a voluntary basis.

• have falsified claims that alters are truly distinct.

— When psychologists have used objective measures of memory, they’ve typically found that information presented to one alter is available to the other, providing no evidence for amnesia across alters.

Question 34

Personality and Dissociative Disorder:

dissociative identity disorder: post traumatic model

Answer 34

DID arises from a history of severe abuse -physical, sexual, or both during childhood. This abuse leads individuals to “compartmentalize” their identity into distinct alters as a means of coping with intense emotional pain. In this way, the person can feel as though the abuse happened to someone else.

Question 35

Personality and Dissociative Disorder:

dissociative identity disorder: sociocognitive model

Answer 35

People’s expectancies and beliefs shaped by certain psychotherapeutic procedures and cultural influences, rather than early traumas- account for the origin and maintenance of DID.
- Advocates of this model claim that some therapists use procedures, like hypnosis and repeated prompting of alters, that suggest to patients that their puzzling symptoms are the products of indwelling identities.

• considerable support for the sociocognitive model and the claim that therapists, along with the media, are creating alters rather than discovering them.

Question 36

Schizophrenia

Answer 36

severe disorder of thought and emotion associated with a loss of contact with reality.

• to be diagnosed with schizophrenia, the individual must exhibit at least one of the following three symptoms: delusions, hallucinations, or disorganized speech.

• difficulties of individuals with schizophrenia arise from disturbances in attention, thinking, language, emotion, and relationships with others.

• characterized by one personality that’s shattered.

• mid-20s for males and the late 20s for females.

• as many as one-half to two-thirds of people with schizophrenia improve significantly, although not completely, and a small percentage recover completely after a single episode.

• fundamental impairments in schizophrenia in the ability to shift and maintain attention, which influence virtually every aspect of affected individuals daily lives

• When people develop schizophrenia, self-care, personal hygiene, and motivation often deteriorate. They may avoid conversation; laugh, cry, or swear inappropriately; or wear a warm coat on a sweltering summer day.

Question 37

Schizophrenia:

delusions vs. hallucinations

Answer 37

delusion:
- strongly held, fixed belief that has no basis in reality.
— Delusions commonly involve themes of persecution.

Delusions are called psychotic symptoms:
- psychological problem reflecting serious distortions in reality

• delusions of grandeur (greatness), elaborate themes of sexuality or romance, or centre on the body and may include a firm belief that one is infested with brain parasites or even that one is dead (Cotard’s syndrome). Etc.

hallucination:
- sensory perception that occurs in the absence of an external stimulus.

— can be auditory (involving hearing), olfactory (involving smell), gustatory (involving taste), tactile (involving the sense of feeling), or visual.
— Command hallucinations, which tell patients what to do.

Question 38

Schizophrenia:

disorganized speech

Answer 38

• language skips from topic to topic in a disjointed way.
  — peculiar language results from thought disorder.
• The usual associations that we forge between two words, such as mother-child, are considerably weakened or highly unusual for individuals with schizophrenia
• speech is so jumbled that it’s almost impossible to understand, = word salad.

Question 39

Schizophrenia:

catatonic symptoms

Answer 39

catatonic symptom
motor problem, including extreme resistance to complying with simple suggestions, holding the body in bizarre or rigid postures, or curling up in a fetal position.

— can be so severe that they refuse to speak and move, or they may pace aimlessly.

• may permit their limbs to be moved to any position, and then maintain this posture for lengthy periods of time, a condition called waxy flexibility.

• may also repeat a phrase in conversation in a parrot-like manner, a symptom called echolalia.

• At the opposite extreme, they may occasionally engage in bouts of frenzied, purposeless motor activity.

Question 40

Schizophrenia:

positive vs. negative symptoms

Answer 40

Pos and neg ≠ good and bad.
Pos and neg = added and removed

Positive:
• delusions (thoughts)
• hallucinations (perceptions)

Negative:
• lack of speech (alogia)
• lack of movement (catatonia)
• lack of emotion/motivation
• lack of self-care

Question 41

Schizophrenia:

enlarged ventricles

Answer 41

This finding is important for two reasons.

— First, these brain areas frequently expand when others shrink, suggesting that schizophrenia is a disorder of brain deterioration.
— Second, deterioration in these areas is associated with thought disorder.

• increases in the size of the sulci, or spaces between the ridges of the brain.

• decreases in (a) the size of the temporal lobes.

• activation of the amygdala and hippocampus

• symmetry of the brain’s hemispheres

• frontal lobes are less active when engaged in demanding mental tasks = phenomenon called hypofrontality.

Cognitive:
• memory impairment
• attention and executive function deficits

Question 42

Schizophrenia:

diathesis-stress model

Answer 42

perspective proposing that mental disorders are a joint product of a genetic vulnerability, called a diathesis, and stressors that trigger the vulnerability.

Early signs or markers of vulnerability:

• schizotypal personality disorder display some of these markers.
• include social withdrawal, thought and movement abnormalities.
• learning and memory deficits.
• elevated neuroticism.
• temporal lobe abnormalities.
• impaired attention.
• eye movement disturbances when tracking moving objects.

• difficulties begin early in life.
• vulnerable children’s lack of emotions and decreased eye contact and social responsiveness.
• development of it depends, in part, on the impact of events that interfere with normal development.
- Children of females who had the flu during their second trimester of pregnancy
- suffered starvation early in pregnancy
- experienced complications while giving birth
- Viral infections in the uterus may also play a key role in triggering certain cases of schizophrenia.
- these events probably create problems only for people who are genetically vulnerable to begin with

Question 43

Childhood Disorders: Recent Controversies:

Symptoms of autistic disorder

Answer 43

autism spectrum disorder (ASD)
DSM-5 category that includes autistic disorder and Asperger’s disorder

• Asperger’s disorder, a less severe form of autism.
— able to function effectively in a school or occupational setting.

• Symptoms of autism can best be described as on a continuum of severity, rather than in categorical terms.

Symptoms:
• severe deficits in language, social bonding, and imagination, usually accompanied by intellectual impairment
• DSM-5 Breaks syms into 2 categories
• social impairments and repetitive or restrictive behaviours, which can include repetitive speech or movements, resistance to change, and highly specialized and limited interests and preoccupation with certain foods or unusual objects

Question 44

Childhood Disorders: Recent Controversies:

Symptoms of ADHD

Answer 44

• childhood condition marked by excessive inattention, impulsivity, and activity.

• two subtypes one with hyperactivity and one without hyperactivity in which inattention is predominant.
• 30 and 80 percent of children with ADHD continue to display ADHD symptoms into adolescence and adulthood.

• behaviour patterns are likely to be labelled “hyperactive”.

• won’t remain in their seats, follow directions, or pay attention, and that they display temper tantrums with little provocation.

• often struggle with learning disabilities, difficulties with processing verbal information, and poor balance and coordination

• high level of physical activity often diminishes as children with ADHD mature and approach adolescence.

• by adolescence, impulsiveness, restlessness, inattention, problems with peers, delinquency, and academic difficulties comprise a patchwork of adjustment problems.

• Alcohol and substance abuse are frequent.

• Adults with ADHD are at increased risk for accidents and injuries, divorce, unemployment, and contact with the legal system.

• genetically influenced in many cases, 30-80%.
— What may be inherited are abnormalities in genes that influence (a) serotonin, dopamine, and norepinephrine; (b) a smaller brain volume; and (c) decreased activation in the frontal areas of the brain

• treated successfully with stimulant medications
— occasionally have serious side effects

• host of conditions that can cause problems in attention and behavioural control, including traumatic brain injuries, diabetes, thyroid problems, vitamin deficiencies, anxiety, and depression, must first be ruled out.