Chapter 16 - ADHD Flashcards
What are the central features of ADHD?
-inattentive
-hyperactive/impulsive
What are the DSM-5 Criteria for Inattentive Symptoms?
- Fails to give close attention to detail/makes careless mistakes
- Difficulty sustaining attention in tasks/play
- Does not seem to listen when spoken to directly
- Does not follow through on instructions and fails to finish schoolwork or other tasks
- Difficulty organizing tasks or activities
- Dislikes or avoids tasks requiring sustained mental effort
- Often loses things necessary for tasks or activities
- Easily distracted by extraneous stimuli
- Often forgetful in daily activities
What are the DSM-5 Criteria for Hyperactive/Impulsive Symptoms?
- Fidgets with hands or feet or squirms in seat
- Leaves seat in situations where remaining seated is expected
- Runs about or climbs in situations where it is inappropriate (adols/adults: restless feelings)
- Unable to play or engage in leisure activities quietly
- “On the go” or acting like they are driven by a motor
- Talks excessively
- Blurts out answers before the question is completed
- Has difficulty waiting his/her turn
- Interrupts or intrudes on others
What are the DSM-5 criterias for ADHD diagnosis?
A. Persistent pattern of ≥6 inattention and/or ≥6 hyperactivity-impulsivity that interferes with functioning or development, present for ≥6 months*
B. Several symptoms present prior to age 12
C. Several symptoms present in ≥2 settings
D. Symptoms interfere with or reduce quality of social, academic, or occupational functioning
* For adolescents and adults, ≥ 5 symptoms
What is the prevalence, onset, gender differences, and comorbidities of ADHD?
-7.2% worldwide prevalence children <18 (Thomas et al 2015) -4% among adults (Stats Canada, 2017)
-Symptom onset around 3-4 years old
-3:1 male to female ratio in childhood (sex difference disappear in adults)
-Comorbidities - 80% w ADHD have another disorder
Myth vs Facts: People with ADHD need to just try harder.
-People with ADHD struggle with attention and focusing because of differences in brain functions
Myth vs Facts: Kids who can play video games for hours can’t have ADHD.
-People will hyperfocus on things they are interested in
-Difficulty with regulating attention- Hard to figure out when to focus and when to tune out
Myth vs Facts: Only boys have ADHD.
-Females are likely to be overlooked and undiagnosed
Myth vs Facts: Kids will grow out of ADHD.
-Symptoms will change over time and kids can learn ways to manage them
-Many people with untreated ADHD continues to be impaired in in adolescence and adulthood
Myth vs Facts: Children who take ADHD medication are more likely to abuse drugs.
-It’s the opposite! Having untreated ADHD increases the risk of substance use. Treatment for ADHD decreases the risk
How does the biological dimension explain ADHD?
-Genetics – account for about 75-80% of variability
-Brain structure & function
–smaller brain volume
–abnormalities in brain structure and/or circuity in prefrontal cortex, amygdala, caudate, hippocampus, putamen
–reductions in dopamine & GABA
How does the Social and Sociocultural dimension explain ADHD?
-Environmental
–toxins, allergens and food additives- Minimal evidence
–maternal smoking increases risk
–other pregnancy or birth complications may increase risk
-Social adversity associated with ADHD
-Cultural expectations may impact diagnosis
What are the evidence-based treatments for ADHD?
-Stimulant medications
-Psychological/psychosocial interventions
What are the different types of medications used?
-Stimulants: Ritalin (methylphenidate) most common
–highly effective short-term treatment
–side effects: insomnia, decreased appetite
-Non-stimulant (e.g., Strattera)
What are the different psychological/psychosocial interventions?
-Goals: improving functional impairment
-Behavioral Therapy- Recommended as 1st treatment for young children:
–Behavioral parent training/parent management
–Behavioral classroom management
–Intensive summer treatment programs
-Organizational skills training
-CBT for adults with ADHD
