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PSY4105 - Disorders > Chapter 14 > Flashcards

Chapter 14 Flashcards

1
Q

What moral development issues are associated with contemporary thinking about ADHD?

A

Moral development issues are totally absent from contemporary thinking about ADHD

This indicates a gap in understanding the broader implications of ADHD beyond behavioral symptoms.

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2
Q

What is one of the major features of ADHD as conceptualized today?

A

Problems in sitting still

This symptom is often linked to hyperactivity and excess movement.

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3
Q

What are the two primary focuses in the debate regarding ADHD symptoms?

A

Excess movement and inattention

The debate highlights differing perspectives on what constitutes the core symptoms of ADHD.

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4
Q

What controversial issue is raised regarding the existence of ADHD?

A

Whether the disorder exists at all or is being fabricated

This reflects skepticism regarding ADHD’s classification and potential influences from drug companies and educational authorities.

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5
Q

What follows the discussion of the existence of ADHD in the text?

A

Diagnostic criteria

This section provides a framework for identifying ADHD based on established symptoms.

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6
Q

What typical feature of ADHD, although not a diagnostic criterion, is mentioned?

A

Impairment of peer relations

This feature underscores the social challenges faced by individuals with ADHD.

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7
Q

What demographic factors are emphasized in the prevalence of ADHD?

A

Age, sex, and cultural differences

These factors can influence the rates and manifestations of ADHD across different populations.

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8
Q

What section follows the discussion on the prevalence of ADHD?

A

Possible causes and correlates of ADHD

Understanding these factors is crucial for developing effective interventions.

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9
Q

What does the text mention regarding the consequences of ADHD?

A

Typical consequences of ADHD

This section likely explores the impacts of ADHD on various aspects of life, including academic and social functioning.

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10
Q

What is the final subject of the chapter regarding ADHD?

A

How to treat ADHD

Treatment options can vary widely and often involve a combination of behavioral, educational, and pharmacological approaches.

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11
Q

What are the primary symptoms of ADHD?

A

Inattention and hyperactivity

ADHD is characterized by observable behaviors of inattention and/or excessive movement.

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12
Q

How do some authorities prefer to define ADHD?

A

In terms of cognitive or neurological dysfunctions

They focus on aspects like the executive functions of the brain.

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13
Q

Can ADHD be defined based on underlying causes?

A

No

Causes may be identifiable in groups of children but not in each individual case.

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14
Q

What distinguishes the subtypes of ADHD?

A

The relative strength of inattention and hyperactivity symptoms

Subtypes are based on how these symptoms manifest in individual children.

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15
Q

What shift in understanding about ADHD occurred due to Virginia Douglas’s research?

A

Attention problems were recognized as significant

Douglas’s work in the 1970s highlighted attention issues in children previously diagnosed as hyperactive.

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16
Q

When did attention problems come to the forefront in diagnosing ADHD?

A

Starting with DSM-III in 1980

Prior to this, excessive movement was necessary for a diagnosis.

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17
Q

What historical figure contributed to the study of attention processes?

A

William James

He wrote an essay titled ‘Stream of Thought’ reflecting on attention.

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18
Q

Fill in the blank: ADHD is characterized by _______ and/or hyperactivity.

A

inattention

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19
Q

True or False: ADHD can be diagnosed solely based on observable behavior.

A

False

The definition also considers cognitive and neurological factors.

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20
Q

What was a major conceptual shift regarding ADHD in the late 20th century?

A

Recognition of attention problems as central to the disorder

This shift moved away from focusing primarily on hyperactivity.

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21
Q

What is the conceptual controversy surrounding ADHD?

A

Whether ADHD is a real disorder or a fabrication of drug companies

This controversy includes debates about cultural influences and the role of pharmaceutical companies in defining ADHD.

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22
Q

What argument do some make regarding ADHD’s identification rates in North America?

A

ADHD is a cultural product of Western societies

This argument is based on higher identification rates in North America compared to other countries.

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23
Q

What societal pressures affect parents regarding child-rearing methods?

A

Competing demands to control unruly children and limitations on acceptable methods

These pressures can lead to a focus on individual children rather than societal issues.

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24
Q

What has the ‘cultural anxiety’ regarding ADHD led to, according to Timimi et al. (2002)?

A

Deflection of focus from societal problems to the individual child

This shift has increased the popularity of the ADHD diagnosis and psychostimulant medications.

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25
Q

What do some critics claim about the construct of ADHD?

A

It is a fabrication of the pharmaceutical industry

This claim suggests that ADHD may not be a legitimate disorder but rather a creation for profit.

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26
Q

How is the ‘cultural perspective’ on ADHD viewed by professionals?

A

It is considered a misrepresentation of basic facts

This perspective is rejected by authors of an international consensus statement on ADHD.

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27
Q

What are the two categories of symptoms for attention deficit/hyperactivity disorder in both DSM-IV and DSM-5?

A

Inattention and hyperactivity/impulsivity

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28
Q

How many symptoms must an individual display in one of the categories for a minimum of 6 months to be diagnosed with ADHD?

A

At least six symptoms

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29
Q

What is an example of inattention in ADHD?

A

Failing to attend to details

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30
Q

What is an example of hyperactivity/impulsivity in ADHD?

A

Being fidgety

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31
Q

True or False: Both DSM-IV and DSM-5 require that the symptoms cause significant impairment.

A

True

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32
Q

In DSM-IV, how many settings must the symptoms cause impairment?

A

Two or more settings

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33
Q

In DSM-5, what has changed regarding the settings in which symptoms must be apparent?

A

Symptoms must be apparent in two or more settings

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34
Q

What was the age criterion for symptoms to be present in DSM-IV?

A

Before the age of 7

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35
Q

What is the new age criterion for symptoms in DSM-5?

A

Before the age of 12

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36
Q

List the three types of ADHD as defined in DSM-IV.

A
  • Combined type
  • Predominantly inattentive type
  • Predominantly hyperactive-impulsive type
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37
Q

What must be specified in DSM-5 regarding the presentation of ADHD?

A

The current presentation (not type)

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38
Q

What additional specifier was added in DSM-5 for ADHD?

A

In partial remission

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39
Q

What must be specified in DSM-5 regarding the severity of ADHD?

A

Current severity (i.e., mild, moderate, or severe)

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40
Q

Fill in the blank: In DSM-IV, the term used if inattention criteria is met but hyperactivity/impulsivity criteria is not met is ‘_______’.

A

Predominantly inattentive type

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41
Q

Fill in the blank: In DSM-IV, the term used if hyperactivity/impulsivity criteria is satisfied but inattention criteria is not met is ‘_______’.

A

Predominantly hyperactive-impulsive type

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42
Q

What are the three categories of attention problems in the ICD-10 criteria for hyperkinetic disorders?

A
  • Short duration of spontaneous activities
  • Often leaving play activities unfinished
  • Overfrequent changes between activities
  • Undue lack of persistence at tasks set by adults
  • Unduly high distractibility during study
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43
Q

What are the five activity problems listed in the ICD-10 criteria for hyperkinetic disorders?

A
  • Very often runs about or climbs excessively in inappropriate situations
  • Markedly excessive fidgeting and wriggling during spontaneous activities
  • Markedly excessive activity in situations expecting relative stillness
  • Often leaves seat in classroom or other situations when remaining seated is expected
  • Often has difficulty playing quietly
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44
Q

What impulsivity problems are identified in the ICD-10 criteria for hyperkinetic disorders?

A
  • Often has difficulty awaiting turns in games or group situations
  • Often interrupts or intrudes on others
  • Often blurts out answers to questions before they have been completed
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45
Q

In the ICD-10 criteria, what are the attention problems that must be demonstrated at school or nursery?

A
  • Undue lack of persistence at tasks
  • Unduly high distractibility
  • Overfrequent changes between activities when choice is allowed
  • Excessively short duration of play activities
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46
Q

What are the activity problems that must be demonstrated at school or nursery according to ICD-10 criteria?

A
  • Continuous (or almost continuous) excessive motor restlessness
  • Markedly excessive fidgeting and wriggling in structured situations
  • Excessive levels of off-task activity during tasks
  • Unduly often out of seat when required to be sitting
  • Often has difficulty playing quietly
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47
Q

What types of direct observation are required to demonstrate abnormality of attention or activity?

A
  • Direct observation of the criteria in A or B
  • Observation of abnormal levels of motor activity or off-task behavior in settings outside home or school
  • Significant impairment of performance on psychometric tests of attention
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48
Q

What are the exclusion criteria for hyperkinetic disorders in the ICD-10?

A
  • Does not meet criteria for pervasive developmental disorder
  • Does not meet criteria for mania
  • Does not meet criteria for depressive disorder
  • Does not meet criteria for anxiety disorder
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49
Q

What is the required onset age for hyperkinetic disorders according to ICD-10?

A

Before age of 7 years

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50
Q

What is the minimum duration for hyperkinetic disorders as per ICD-10?

A

At least 6 months

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51
Q

What is the minimum IQ requirement for a diagnosis of hyperkinetic disorder?

A

IQ above 50

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52
Q

True or False: ADHD is considered a single disorder according to many experts.

A

False

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53
Q

How does the DSM-5 classify ADHD compared to DSM-IV?

A

Identifies different presentations of ADHD rather than different subtypes

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54
Q

What analogy does Nigg (2006) use to describe different presentations of ADHD?

A

Analogous to different forms of cancer that share general resemblance but differ in causes and seriousness

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55
Q

What do developmental perspectives suggest about the symptoms of ADHD in individuals?

A

Many individuals are hyperactive early in life but may show mostly symptoms of impulsivity by adolescence

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56
Q

What did the meta-analysis by Nikolas and Burt (2010) reveal about the heritability of ADHD symptoms?

A
  • Inattention: 71% heritable
  • Hyperactivity: 73% heritable
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57
Q

Fill in the blank: The genetic effects on symptoms of hyperactivity appear to be _______.

A

additive

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58
Q

Fill in the blank: Inattention reflects the _______ of genetic markers.

A

interaction

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59
Q

What do Pelham and Fabiano estimate about negative interactions between children with ADHD and their parents?

A

Children with ADHD have one negative interaction per minute with their parents

Based on data reported by Danforth et al. (2006)

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60
Q

How many negative exchanges do children with ADHD have per minute with teachers or peers at school?

A

Two negative exchanges per minute

Based on data reported by Abikoff et al. (1993)

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61
Q

What is the estimated total of negative interpersonal interactions per year for children with ADHD?

A

Well over a million negative interpersonal interactions per year

Not counting sleep time

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62
Q

What behavior did Sally exhibit when greeting her father, Michael?

A

Sally leaped into her father’s arms and then ran around the driveway ordering her friend off her bike

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63
Q

What incident occurred between Sally and her friend while riding bikes?

A

A screaming match erupted before her friend stormed off

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64
Q

What did Sally do in the kitchen that indicated her impulsivity?

A

Clambered up onto the counter and tumbled down to the floor

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65
Q

What was the result of Sally’s temper tantrum at dinner?

A

Her father poured her a glass of chocolate milk to calm her down

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66
Q

What concerns did Sally’s parents have regarding her behavior at school?

A

They received multiple notes from the teacher about her behavior and academic problems

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67
Q

What specific problem behaviors did Sally display in the classroom?

A

She jumps out of her seat, blurts out answers, disrupts class, and acts bossy with other children

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68
Q

What recommendation did Sally’s teacher make after observing her behavior?

A

A psychological evaluation to identify underlying problems

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69
Q

What approach did the school psychologist use to evaluate Sally?

A

A multimodal approach gathering information from various sources and contexts

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70
Q

What components were involved in Sally’s treatment for ADHD?

A

Methylphenidate trial, classroom-based intervention, and parent training on ADHD-management strategies

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71
Q

What was the outcome of the medication trial for Sally?

A

Gradual improvement in her classroom behavior and interactions with peers

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72
Q

What classroom intervention was implemented for Sally?

A

Moving her desk from distractions, posting daily schedules, and a token system

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73
Q

What positive changes occurred in Sally’s household after treatment?

A

Increased positive interactions and enjoyment of each other’s company

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74
Q

True or False: Peers generally like children with ADHD.

A

False

Studies have shown peers dislike children with ADHD (Mrug, Hoza, and Gerdes, 2001)

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75
Q

How quickly do other children typically reject a peer with ADHD?

A

Within 30 seconds and a few quick social interactions

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76
Q

What did an intensive longitudinal study reveal about friendships of children with ADHD?

A

Children with ADHD tend to be insensitive to their friends’ wishes and may break game rules

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77
Q

What should be discounted when estimating the prevalence of ADHD?

A

Prevalence estimates based exclusively on ratings by a single informant

Relying solely on teacher or parent ratings can lead to inflated estimates.

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78
Q

What is the typical prevalence rate of ADHD according to DSM-IV criteria?

A

3–7 percent of school-age children

This rate is consistent with most other reputable estimates.

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79
Q

What factors can lead to inflated prevalence estimates of ADHD?

A

Relying solely on teacher ratings or solely on parent ratings

This can lead to estimates of one child in five or six having ADHD.

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80
Q

What does the DSM-5 suggest about ADHD prevalence rates?

A

The rates will likely be higher due to more liberal criteria

Data on prevalence rates calculated with DSM-5 criteria are not yet available.

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81
Q

What percentage of children with ADHD also meet the criteria for oppositional defiant disorder or conduct disorder?

A

30–50 percent

This indicates a significant comorbidity with aggressive and defiant behaviors.

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82
Q

What is the likelihood of children with ADHD suffering from major depression?

A

At least one-third

Comorbidity with anxiety disorders is also substantial.

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83
Q

What changes in ADHD symptoms occur as children mature?

A

Hyperactivity tends to decline, while inattention persists

Many behavior problems continue into adolescence.

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84
Q

What is the percentage of children with ADHD who continue to display symptoms as adolescents?

A

At least 70 percent

Symptoms may change but ADHD can persist throughout life.

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85
Q

What are some long-term consequences for individuals diagnosed with ADHD during school years?

A

Difficulty finding and maintaining employment

Risk is higher for those with disciplinary problems in school.

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86
Q

What is the gender distribution of ADHD diagnoses in children?

A

At least two-thirds of diagnosed children are boys

This statistic has led to controversy regarding societal perceptions of boys.

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87
Q

What societal critique exists regarding the diagnosis of ADHD in boys?

A

It is seen as societal repression of the natural temperaments of boys and men

Some argue that ADHD is a construct of middle-class anxiety.

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88
Q

What differences in brain structure have been found between boys and girls with ADHD?

A

Differences in the size of the splenum of the corpus callosum

This structure facilitates communication between brain hemispheres.

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89
Q

What negative mental health problems are girls with ADHD more likely to experience as adults?

A

Depression, anxiety, eating disorder, substance abuse, anti-social behavior

Girls with ADHD face profound long-term consequences.

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90
Q

In terms of school performance, how do girls with ADHD compare to boys?

A

Girls are at least as likely as boys to experience marked problems at school

This is based on multiple assessment methods.

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91
Q

What is the relationship between ADHD and comorbid anxiety and depression in adolescent girls?

A

Adolescent girls with ADHD are more likely to experience comorbid depression and anxiety than boys

This highlights the significant impact of ADHD on girls.

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92
Q

True or False: The prevalence of ADHD is increasing due to better awareness and diagnosis.

A

True

Increased awareness may lead to more diagnoses, complicating the assessment of actual prevalence changes.

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93
Q

Fill in the blank: ADHD can affect people throughout the _______.

A

lifespan

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94
Q

What does the term ‘comorbidity’ refer to in the context of ADHD?

A

The presence of one or more additional disorders alongside ADHD

Common comorbid disorders include oppositional defiant disorder, anxiety, and depression.

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95
Q

What is the range of ADHD prevalence estimates among children and adolescents in different countries?

A

0.9 to 20 percent

These estimates highlight the wide variations in ADHD prevalence globally.

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96
Q

What do large-scale multisite cross-cultural studies confirm about ADHD prevalence rates?

A

ADHD prevalence rates are very similar when using a uniform set of rigorous, standardized diagnostic criteria by skilled clinicians across various regions

Regions include Africa, Australia, Europe, and North America.

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97
Q

In Cuba, what factors influenced the referral of children with ADHD for psychiatric help?

A

Comorbid behavior problems and family stress

Medication for ADHD was scarce, leading to reliance on psychiatric help.

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98
Q

What did the World Health Organization’s World Mental Health Survey initiative aim to determine?

A

The continuity of ADHD from childhood to adulthood

The study involved 43,772 participants from ten countries.

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99
Q

What percentage of childhood ADHD cases met full criteria for ADHD in adulthood, according to the WHO study?

A

50 percent

Stability rates varied from 33 to 84 percent across different countries.

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100
Q

How did young adults with chronic ADHD perform in terms of education and employment compared to controls?

A

They discontinued schooling earlier, had poorer school results, fewer friends, and lower self-esteem

They also received lower performance evaluations and were dismissed from jobs more frequently.

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101
Q

What was found to be significantly higher among young adults with chronic ADHD compared to non-diagnosed counterparts?

A

Rates of anxiety disorders, phobias, major depression, bipolar disorder, and substance dependence

This emphasizes the comorbidity of mental health issues with ADHD.

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102
Q

What has been a long-standing argument among researchers regarding ADHD?

A

Better recognition of its biological roots and associated disorders

This reflects a historical perspective on understanding ADHD.

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103
Q

What term did Eisenberg advocate against in the context of ADHD research?

A

Brainlessness

He emphasized the need for recognition of neuropsychological origins.

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104
Q

What is the prevailing view among scientists regarding the cause of ADHD?

A

ADHD is predominantly caused by neuropsychological factors

However, clear evidence of brain damage is still debated.

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105
Q

What has diminished the quest for a single neurological explanation of ADHD?

A

Recognition of the variability in behaviors corresponding to atypical brain structure or function

This makes it difficult to diagnose brain damage from observable behavior.

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106
Q

What does Nigg argue regarding the causes of ADHD?

A

Different causal paths may exist for different manifestations of ADHD

This suggests that subtypes of ADHD may have different causes.

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107
Q

Fill in the blank: ADHD diagnostic criteria identify a similar frequency of an underlying construct in different locations, independent of _______.

A

local judgments

This implies that cultural differences do not affect the core diagnosis of ADHD.

108
Q

True or False: ADHD prevalence rates are universally accepted to be the same across cultures.

A

False

Although the underlying construct may be similar, cultural perceptions and diagnoses can vary.

109
Q

What historical terms were used in the 1950s and 1960s to describe ADHD-related brain issues?

A

Minimal brain damage, minimal brain dysfunction, minimal cerebral damage, minimal cerebral dysfunction

These terms reflected attempts to describe ADHD without implying significant brain injury.

110
Q

What cognitive and behavioral processes are primarily focused on in ADHD research?

A

Response inhibition, working memory, different types of attention processes

Includes sustained attention, selective attention, executive attention.

111
Q

What is a key deficit observed in individuals with ADHD?

A

Deficit in response inhibition

This refers to a weak ability to deliberately respond to a non-target stimulus and not respond to a target stimulus.

112
Q

Which brain regions are engaged during response inhibition tasks?

A

Prefrontal regions, including the dorsolateral prefrontal cortex (DLPFC)

These regions are critical for controlling inhibitions.

113
Q

How does frontal lobe activation in individuals with ADHD compare to those without ADHD?

A

Individuals with ADHD show less frontal lobe activation

This reduced activation occurs across orbital, inferior, middle, and superior frontal areas.

114
Q

What hypothesis explains the reduced activation in frontal regions for ADHD individuals?

A

Input from frontal regions is required to control inhibitions

Reduced input leads to undercontrolled behaviors.

115
Q

What consistent finding is observed regarding the caudate region of the striatum in ADHD?

A

Reduced activation during response inhibition tasks

This finding is supported by multiple studies.

116
Q

What is concluded about the fronto-striatal network in ADHD patients?

A

It is under-recruited during response inhibition

This pattern does not vary by age.

117
Q

What deficits do children with ADHD show in comparison to healthy control children?

A

Working memory deficits

Neuroimaging studies for working memory have primarily been conducted in adults.

118
Q

What areas show less activation in adults with ADHD during working memory tasks?

A

Frontal, temporal, and occipital areas

They show greater activation in midbrain, striatal, cerebellum, and middle frontal gyrus.

119
Q

Which brain regions support effective control of attention during tasks?

A

Prefrontal and parietal cortices

Neural input from these areas is critical for attention control.

120
Q

What is the overall pattern of activation in individuals with ADHD during attention tasks?

A

Underactivation of the fronto-parietal-striatal regions

This pattern correlates with anomalies in dopamine transmission.

121
Q

What structural anomalies are associated with ADHD?

A

Smaller volumes and atypical function of the cerebellum

Studies indicate these anomalies are linked to ADHD.

122
Q

What neural pathways are most prominently altered in ADHD?

A

Fronto-striatal-cerebellar, fronto-parietal-thalamic, fronto-cingulate circuits

A common denominator across these networks is the frontal cortex.

123
Q

What are some possible causes for perturbations in brain regions associated with ADHD?

A

Structure, connectivity, or neurochemical make-up

Includes reduced size, communication issues, or dopamine neurotransmission.

124
Q

What structural brain characteristics are associated with ADHD compared to individuals without the disorder?

A

Smaller frontal lobes, thinning of the cortex, developmental lag in cortical gray matter thickness

Supported by studies showing these characteristics in ADHD individuals.

125
Q

What do executive functions refer to in the context of ADHD?

A

A set of brain processes that control planning, decision-making, problem-solving, and reacting to situations

Important for managing complex tasks and behaviors.

126
Q

True or False: Executive dysfunction in ADHD can lead to significant behavioral consequences.

A

True

This is summarized in literature regarding ADHD.

127
Q

What have some studies suggested about cortisol levels in children with ADHD compared to those without?

A

Children with ADHD have lower cortisol levels than children without ADHD

Studies: Klimes-Dougan et al., 2001a; Randazzo et al., 2008; Reynolds, Lane and Gennings, 2010

128
Q

What have other studies shown regarding cortisol levels in children with ADHD?

A

Children with ADHD have higher cortisol levels than children without ADHD

Studies: Sondeijker et al., 2007; White and Mulligan, 2005

129
Q

What complicates the understanding of cortisol levels in children with ADHD?

A

High rates of comorbid disorders

Common comorbid disorders include disruptive behavior disorders (DBDs) and anxiety disorders

130
Q

What types of problems are common in children with ADHD and how do they relate to cortisol levels?

A

Disruptive behavior disorders (DBDs) and anxiety disorders have opposite relations with cortisol levels

DBDs may lower cortisol levels, while anxiety may increase them

131
Q

What does research suggest about children with ADHD without comorbid disruptive behavior problems?

A

Their HPA responses to stress are not different than those of children without ADHD

Study: Snoek et al., 2004

132
Q

What are the different subtypes of ADHD?

A

Primarily hyperactive and impulsive, primarily inattentive and unfocused, or both

Each subtype may have physiological differences

133
Q

What did some studies find regarding cortisol reactivity to stress in children with combined symptoms of ADHD?

A

They have lower than normal cortisol reactivity to stress

Studies: Hastings et al., 2009; Van West et al., 2009

134
Q

What is a contrasting argument about cortisol reactivity in children with ADHD?

A

The presence of comorbid DBDs contributes to lower cortisol reactivity

Study: van Goozen et al., 2007

135
Q

Is it premature to draw strong conclusions about cortisol levels’ role in ADHD?

A

Yes, it is premature

More research is needed to understand the role of cortisol in ADHD

136
Q

What other aspects might distinguish children with ADHD from their peers?

A

Neurophysiological functioning

This may include differences in HPA axis activity

137
Q

What is the association between ADHD and electrodermal activity (EDA)?

A

ADHD is associated with reduced EDA and electrodermal response (EDR)

This is linked to a weak behavioral inhibition system (BIS) contributing to impulsivity.

138
Q

Who argued that stronger EDA reflects stronger BIS influence?

A

Fowles (1988)

This concept relates to the behavioral inhibition system’s role in impulsivity.

139
Q

What did many studies find regarding children with ADHD and EDA?

A

Children with ADHD have reduced EDA and less frequent EDR

Studies supporting this include Beauchaine et al. (2001) and Iaboni et al. (1997).

140
Q

What contradictory finding was reported about girls with ADHD?

A

Girls with ADHD have higher EDA and more EDR

This finding was reported by Hermens et al. (2005).

141
Q

What is the general finding regarding cardiac activity in children with ADHD?

A

There is little evidence of difference in baseline heart rate

However, children with ADHD may have smaller heart rate reactivity.

142
Q

What have some researchers found regarding heart rate reactivity in children with ADHD?

A

Children with ADHD may have relatively smaller heart rate reactivity

Cited studies include Iaboni et al. (1997) and Jennings et al. (1997).

143
Q

What differing finding exists regarding heart rate reactivity in ADHD?

A

Some researchers found slightly stronger reactivity in children with ADHD

Studies supporting this include Snoek et al. (2004).

144
Q

What did a study suggest about heart rate reactivity patterns across ADHD subtypes?

A

Boys with hyperactivity problems showed reduced heart rate reactivity

This was observed in a study by Dykman, Ackerman, and Oglesby (1992).

145
Q

What contributions of the autonomic nervous system have been studied in children with ADHD?

A

Contributions of the parasympathetic nervous system (PNS) and sympathetic nervous system (SNS)

Measured through respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP).

146
Q

What were the findings of Beauchaine et al. (2001) regarding RSA and PEP in ADHD?

A

No differences in baseline or reactive measures of RSA and PEP between adolescents with and without ADHD

This suggests similarities in autonomic functioning.

147
Q

How did hyperactive children respond to emotional films according to Bubier and Drabick (2008)?

A

More hyperactive children had reduced PEP reactivity

This suggests decreased SNS influence in these children.

148
Q

What did Utendale (2005) find regarding RSA suppression in boys with ADHD?

A

Boys with the hyperactive-impulsive subtype showed strong RSA suppression

This was in anticipation of having blood drawn.

149
Q

What did El-Sheikh and colleagues (2006) report about RSA and skin conductance level (SCL) reactivity?

A

Combined patterns of RSA and SCL reactivity predicted more ADHD-related problems

This was particularly noted when parents had high marital conflict.

150
Q

What overall conclusion can be drawn from the research on autonomic physiology in children with ADHD?

A

The research has not produced clear findings on autonomic reactivity

There is uncertainty about their PNS and SNS activity compared to children without ADHD.

151
Q

True or False: ADHD is a disorder with only one distinct physiological pattern.

A

False

ADHD encompasses multiple subtypes and is often accompanied by other emotional and behavioral problems.

152
Q

What is the primary mode of transmission for ADHD?

A

Genetically

Confirmed by family, twin, and adoption studies.

153
Q

What is the range of heritability estimates for ADHD according to early studies?

A

.50 to .98

Indicates a high genetic influence on ADHD.

154
Q

What are the concordance rates for monozygotic twins regarding ADHD?

A

.80 to .98

Suggests a strong genetic link.

155
Q

Is ADHD considered one of the most genetically influenced mental disorders?

156
Q

What is known about the exact mechanisms of genetic transmission for ADHD?

A

Much less is known

Multiple genes have been linked, but research remains inconclusive.

157
Q

What do experts agree about the cause of ADHD in relation to family environment?

A

ADHD does not result from deficiencies in the family environment

Family dysfunction and stress are important consequences.

158
Q

What role do family problems play in children with ADHD?

A

Exacerbating factors

Correlations help understand family interaction patterns.

159
Q

What increases the risk for ADHD in children?

A
  • Family history of ADHD
  • Comorbid psychopathology
  • Adverse home or community environment

Risk factors correlate with the number of adversity indicators.

160
Q

Do genetics completely account for children’s ADHD?

A

No

Concordance rates for monozygotic twins do not reach 100 percent.

161
Q

What may serve as a protective factor against ADHD in predisposed children?

A

A healthy family environment

Rarely studied due to participation issues.

162
Q

How do family environments of children with ADHD compare to those without?

A

More stressful and conflict-ridden

Supported by various studies.

163
Q

What discipline methods are more commonly used by parents of children with ADHD?

A

Negative methods

Parents are also more negative in exchanges.

164
Q

Which age group shows more salient negative parenting in ADHD studies?

A

Preschool children

Negative parenting is less pronounced in school-age populations.

165
Q

How do parents of children with ADHD typically feel about their marriages?

A

Relatively low levels of satisfaction

This is evident in many studies.

166
Q

What other family issues can compound negative parenting in ADHD households?

A
  • Poverty
  • Maternal depression

These factors exacerbate the challenges faced by families.

167
Q

What has been observed about family functioning after children with ADHD are placed on medication?

A

It improves

Multiple studies support this finding.

168
Q

What is ADHD most commonly treated with?

A

Psychotropic medication

ADHD is the most common psychological disorder of children associated with treatment by medication.

169
Q

How was the usefulness of medication for ADHD discovered?

A

By accident, in the Bradley Home in the 1930s

Psychiatrists initially performed brain surgery, and medication was used to relieve headaches, leading to unexpected improvements in behavior.

170
Q

What medication did Charles Bradley use to treat children in the 1930s?

A

Benzadrine

Benzadrine is an amphetamine that was observed to improve work habits and behavior in children.

171
Q

What theory did researchers propose regarding the effects of amphetamines?

A

Amphetamines alter the functions of the diencephalon, managing sensory stimuli

This theory was proposed by Maurice Laufer and Eric Denhoff in 1957.

172
Q

What was the general attitude toward psychotropic drugs for children in the 1950s?

A

Used infrequently

Psychotropic drugs were not widely accepted for children during this period.

173
Q

What major development occurred in the 1960s regarding ADHD medication?

A

Introduction of methylphenidate, known as Ritalin

Ritalin was effective and had fewer side effects compared to previous medications.

174
Q

What became the gold standard for evaluating the effectiveness of new psychotropic drugs?

A

Randomized clinical trials with double-blind assignment

This method involves independent evaluation of medication effects by parents and teachers unaware of the treatment assignment.

175
Q

What percentage of children in the United States were on stimulant medication by the end of the 1960s?

A

0.002 percent

This statistic reflects the extremely low prevalence of medication use at that time.

176
Q

What misconception emerged from newspaper reports in 1970 about ADHD medication?

A

5–10 percent of children in public schools were on medication

This statistic referred to children diagnosed with special behavior and learning needs, not the general population.

177
Q

What was one of the criticisms of the medicalization of ADHD in the 1970s?

A

Dubbed ‘the chemical straightjacket’

Critics viewed this as a form of social repression and a myth about hyperactivity.

178
Q

What was the outcome of the criticisms regarding Ritalin prescriptions?

A

Tightening of federal legal restrictions

This was a response to the backlash against the widespread use of stimulant medication.

179
Q

What was the trend in Ritalin prescriptions from 1999 to 2001?

A

Reached about 9.3 percent of the child population in the West Coast of the USA

This marked a significant increase following earlier restrictions.

180
Q

What are two newer medications introduced for ADHD treatment?

A
  • Adderall
  • Concerta

Adderall is an improved version of Benzadrine, and Concerta is a long-lasting methylphenidate.

181
Q

What is Strattera?

A

An antidepressant shown to have some effect on ADHD

It is typically used for children who do not respond well to stimulant medications.

182
Q

What concerns have been raised about long-term stimulant medication use?

A
  • Long-term effectiveness
  • Effects on physical growth
  • Potential cardiovascular adverse events
  • Risk of drug abuse

These concerns highlight the need for further studies on the long-term implications of ADHD medications.

183
Q

What has recent research suggested about ADHD medication and drug abuse?

A

No evidence of correlation between being medicated for ADHD and abusing drugs

However, some medications may be misused by individuals for whom they were not prescribed.

184
Q

Which countries have accepted the use of psychostimulant medication for ADHD despite initial opposition?

A

Most parts of the world, including the UK

Acceptance has grown globally, although there are cross-national differences in diagnosis and treatment.

185
Q

What is the ICD-10 criteria’s effect on ADHD diagnosis in European countries?

A

Reduces the number of children diagnosed with ADHD

These criteria specify problem behaviors in more than one setting.

186
Q

What are the four prevailing psychological therapies for children with ADHD?

A
  • Behavioral family intervention
  • Cognitive and cognitive-behavioral intervention
  • Social skills training
  • Behavior modification at school
187
Q

What is the primary focus of behavioral family intervention?

A

Teaching parents to consistently deliver positive reinforcement for appropriate behavior.

188
Q

What is the recommended ratio of positive reinforcement to punishment in behavioral family intervention?

A

Positive reinforcement should be used several times more frequently than punishment.

189
Q

What immediate consequence is suggested for negative behavior in children during behavioral family intervention?

A

A brief, non-physical consequence, such as a time-out.

190
Q

What is crucial for parents to learn during behavioral family intervention?

A

To be specific, systematic, and consistent in measuring the child’s behavior.

191
Q

What did Fabiano et al. (2009) find regarding the effect size for randomized clinical trials in behavioral family intervention?

A

The average effect size is 0.83 of a standard deviation, indicating moderate effectiveness.

192
Q

What methodological approach is particularly emphasized in within-subjects designs for evaluating behavioral interventions?

A

Direct observation of the child’s behavior at consecutive time points.

193
Q

What distinction did Hinshaw (2006) make between cognitive-behavioral interventions for ADHD and those for depression or anxiety?

A

ADHD involves cognitive deficiency, while depression or anxiety involves cognitive distortion.

194
Q

What are cognitive interventions aimed at in children with ADHD?

A

Training thinking processes such as fixation, attention, or working memory.

195
Q

What challenges do cognitive-behavioral interventions face in treating ADHD?

A

Methodological problems and mixed results in effect sizes.

196
Q

According to Toplak et al. (2008), how many original studies on direct cognitive training for ADHD were identified?

A

Only six original studies.

197
Q

True or False: Research has convincingly demonstrated the usefulness of cognitive or cognitive-behavioral techniques in treating childhood ADHD.

198
Q

Fill in the blank: Behavioral family intervention is derived from the principles of _______.

A

[behavior modification]

199
Q

What is one key criticism of cognitive-behavioral interventions for ADHD according to Barkley (2007)?

A

They lack a conceptual foundation as they do not address social-learning deficits.

200
Q

What type of techniques do cognitive-behavioral interventions include?

A
  • Monitoring thinking processes
  • Systematic problem-solving training
201
Q

What is a common issue with studies evaluating cognitive-behavioral interventions for ADHD?

A

Many studies administer interventions to children already on medication.

202
Q

What is one primary manifestation of ADHD?

A

Impaired peer relations

203
Q

What is social skills training designed to improve?

A

Peer relations

204
Q

True or False: Children with ADHD lack social skills.

205
Q

What may children with ADHD lack that prevents them from using social skills?

A

Motivation, judgment, understanding of the situation, freedom from anxiety, positive expectations, self-confidence

206
Q

What is a common approach used in social skills training for children with ADHD?

A

Modeling skills through demonstrations or videos

207
Q

List some skills included in social skills training for children with ADHD.

A
  • Making conversation
  • Listening
  • Sharing
  • Making requests assertively
  • Making appropriate compliments
  • Handling criticism
208
Q

What cognitive components are often included in social skills training?

A
  • Problem-solving
  • Mobilizing thought for self-control
  • Appreciating others’ perspectives
  • Maintaining perspective in anger-provoking situations
209
Q

What measures can help maintain skill learning in social skills training?

A
  • Daily report cards
  • Systematic positive reinforcement from teachers or parents
210
Q

What did De Boo and Prins (2007) conclude about social skills training for ADHD?

A

It can be considered an effective experimental intervention pending further study

211
Q

True or False: Abikoff et al. (2004) found social skills training to be more beneficial than medication alone.

212
Q

According to Barkley (2007), what negative effects can social skills training have?

A

Stigma and cross-fertilization of anti-social attitudes

213
Q

What is a highly effective intervention for classroom behavior management?

A

Daily report card

214
Q

What does the daily report card provide for children with ADHD?

A

Rewards for achieving behavioral goals at school

215
Q

What is the reported effectiveness of direct contingent reinforcement approaches?

A

Approaching 1.5 standard deviation units

216
Q

What type of camp has shown success in providing direct contingent reinforcement to children with ADHD?

A

Therapeutic summer camp

217
Q

What system is used in the therapeutic summer camp to reinforce appropriate social skills?

A

Token or point system

218
Q

What is a significant obstacle to implementing contingency management in classrooms?

A

Teacher agreement and willingness to carry out the program

219
Q

What happens to the benefits of contingency management when it is discontinued?

A

There is no reason to believe the benefits will continue

220
Q

What was the primary purpose of the MTA study?

A

To provide the best answers to questions about the long-term impact of major treatment modalities for childhood ADHD

The MTA study aimed to evaluate the effectiveness of different treatment approaches over time.

221
Q

How many children participated in the MTA study?

A

579 children

They were diagnosed with ADHD, including both inattention and hyperactivity.

222
Q

What types of treatment conditions were included in the MTA study?

A
  • Medication-only
  • Multicomponent behavior therapy
  • Combination of medication and behavior therapy
  • Usual treatment condition

Each group received different forms of treatment over a 14-month period.

223
Q

Which treatment condition showed the greatest improvement in ADHD symptoms?

A

Medication and combined-treatment conditions

These groups showed the most significant improvement in core symptoms and comorbid disorders.

224
Q

What was a major finding regarding the long-term effects of the treatments in the MTA study?

A

By the follow-up at 36 months, the treatment groups no longer differed in terms of ADHD symptoms or comorbid oppositional defiant disorder

This suggests that the initial benefits of treatment diminished over time.

225
Q

True or False: The MTA study found that ADHD is a condition with short-term effects only.

A

False

The study emphasized that ADHD has long-term effects that require ongoing research and treatment strategies.

226
Q

What does the MTA study suggest about the predictors of long-term effectiveness of ADHD treatments?

A

They do not necessarily correspond to results for short-term effectiveness

This indicates complexity in evaluating treatment outcomes over time.

227
Q

What is neurofeedback?

A

A technique using behavioral methods to train children with ADHD to modify abnormal EEG patterns

Neurofeedback aims to improve attention and self-regulation.

228
Q

What is the Cogmed program designed to improve?

A

Working memory

Preliminary findings suggest it may have some success in enhancing working memory in children with ADHD.

229
Q

Fill in the blank: The theory linking ADHD to poor nutrition was developed by Dr. _______.

A

[Benjamin Feingold]

Feingold proposed that food additives cause hyperactivity and learning disabilities.

230
Q

What percentage of children on the Feingold diet reported significant reductions in ADHD symptoms according to Feingold’s findings?

A

40 to 70 percent

This statistic highlights the potential impact of dietary changes on ADHD symptoms.

231
Q

What did the meta-analysis by Kavale and Forness conclude about the effects of special diets on ADHD?

A

The true effects of the diet are trivial

They found that rigorous research designs showed smaller effects of dietary interventions.

232
Q

True or False: The consumption of sugar has been proven to cause ADHD symptoms.

A

False

Studies like that of Milich and Pelham found no behavioral differences related to sugar consumption.

233
Q

What is a potential reason why some children may display ADHD-like symptoms related to diet?

A

Allergies to some food substances

This suggests that dietary impacts on ADHD may vary among individuals.

234
Q

What is the main focus of the chapter?

A

The dietary habits of children and their relation to attention, impulsivity, and hyperactivity

235
Q

Does the author believe ADHD is caused by inadequate nutrition?

236
Q

What deficiencies are linked to symptoms of inattention, impulsivity, and hyperactivity?

A

Iron, zinc, and magnesium

237
Q

Can food allergies cause symptoms that mimic ADHD?

238
Q

Which foods are mentioned as potential allergens that may mimic ADHD symptoms?

A
  • Wheat
  • Corn
  • Soy
  • Eggs
  • Milk
  • Certain food dyes and additives
239
Q

Why is it important to understand how foods contribute to cognitive and emotional functions?

A

Foods influence attention, impulse control, emotional regulation, and problem-solving

240
Q

What do our dietary choices affect regarding brain functions?

A

The capacity to manufacture essential neurotransmitters

241
Q

What do we need from our diet to manufacture enzymes, cells, and tissues?

A

Materials necessary for life functions

242
Q

What is a consequence of eating foods that cause allergic reactions?

A

Compromised ability to attend, think, and control emotions

243
Q

What routine request does the author make for patients before initiating ADHD medication?

A

Screening for common food allergies

244
Q

Fill in the blank: The selection of foods will determine our capacity to manufacture the essential __________ necessary for brain functions.

A

neurotransmitters

245
Q

True or False: The author believes that food allergies can cause ADHD.

246
Q

What are the two primary symptoms of ADHD?

A

Inattention and hyperactivity

Hyperactivity is often characterized by excessive movement.

247
Q

By what age does DSM-5 presume that ADHD must be evident?

A

Age 12

There is evidence of ADHD in preschoolers as young as 4 years.

248
Q

What is the counterpart disorder to ADHD in the ICD-10?

A

Hyperkinetic disorder

249
Q

What role do genetics play in ADHD?

A

ADHD symptoms, including inattention and hyperactivity, are highly heritable.

250
Q

What negative interpersonal interactions do children with ADHD experience?

A

Negative interactions with parents, teachers, and peers.

251
Q

True or False: The frequency of ADHD diagnoses is decreasing.

A

False

The frequency of diagnoses may be increasing due to greater awareness.

252
Q

What demographic is most commonly diagnosed with ADHD?

253
Q

What are common comorbid conditions in girls with ADHD?

A

Depression and anxiety

Boys often experience comorbid aggression.

254
Q

What is a significant academic challenge faced by individuals with ADHD?

A

Higher likelihood of discontinuing schooling and poor academic performance.

255
Q

What brain regions are implicated in ADHD?

A

Frontal lobe, fronto-parietal-striatal regions.

256
Q

What is response inhibition?

A

The ability to suppress actions in response to irrelevant stimuli.

257
Q

What cognitive deficits are linked to ADHD?

A

Working memory problems and impairment of attention processes.

258
Q

What is the relationship between cortisol levels and ADHD?

A

Conflicting results exist regarding cortisol levels in children with ADHD.

259
Q

How is ADHD primarily determined?

A

Genetically

ADHD is considered one of the most genetically influenced mental disorders.

260
Q

What is a common treatment for ADHD involving medication?

A

Amphetamines and methylphenidate (e.g., Ritalin, Adderall).

261
Q

What psychological therapies are used for children with ADHD?

A

Behavioral family intervention, behavior modification at school, cognitive-behavioral interventions, and social skills training.

262
Q

What did the MTA study find regarding ADHD treatments?

A

Initial findings favored medication over behavioral treatment.

263
Q

What is neurofeedback?

A

A neural-based intervention designed to modify abnormal EEG patterns.

264
Q

What dietary changes have shown potential benefits for ADHD symptoms?

A

Eliminating food additives from the diet.

265
Q

Fill in the blank: ADHD is often associated with __________ in children.

A

Negative parenting and family problems.

266
Q

What is the significance of the fronto-striatal network in ADHD?

A

It is linked to response inhibition issues.

267
Q

What long-term effects are concerns for ADHD medications?

A

Long-term effects of drugs developed by pharmaceutical companies.

PSY4105 - Disorders (7 decks)

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