Exam 4 Ilardi Flashcards
ADHD DSM-5
Six or more symptoms -children up to age 16 or
Five or more for adolescents 17 and older
1. Fails to give close attention to details or makes careless mistakes.
2. Has trouble holding attention on tasks or play activities.
3. Does not seem to listen when spoken to directly.
4. Does not follow through on instructions and fails to finish tasks.
5. Trouble with organization tasks and activities.
6. Avoids, dislikes, or is reluctant to do tasks that require mental effort.
7. Loses things necessary for tasks and activities.
8. Is easily distracted
9. Is forgetful in daily activities.
Hyperfocus
Will lock in on something until they reach the top level. Will not be interrupted.
Hyperactivity and Impulsivity DSM-5
Six or more symptoms for children up to age 16, or five or more adolescents 17 and older and adults; symptoms have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
1. Fidgets with or taps hands or feet, or squirms in seat.
2. Leaves seat in situations when remaining seated is expected.
3. Runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
4. Unable to play or take part in leisure activities quietly.
5. Is “on the go” acting as if “driven by a motor”
6. Talks excessively
7. Blurts out an answer before a question has been completed
8. Has trouble waiting his/her turn.
9. Interrupts or intrudes on others (e.g., butt into conversations or games)
ADHD diagnosis requires either AD or HD (or both)
Several symptoms present before age 12
ADHD Prevalence
~10% of school age population; ~5% of adult population
Gender ratio ~3:1 (male/female)
Only about half of people who have ADHD diagnostic in school have it as an adult
ADHD Causes
Heritability ~50% Frontal cortex (impulse control, attentional focus, logical sequencing) Reward/pleasure circuits Dopamine function (DRD2, DBH genes) Norepinephrine – helps regulate alertness, mental stamina, attentional focus Omega03, zinc deficiency Food additives (elimination diet) Screen time?
ADHD Treatments
•Stimulants (Ritalin/Concerta [methylphenidate], Adderall/Vyvanse, Strattera) [less addictive than benzos but way more highly monitored]
o MTA Study 8-Year Results
o Ritalin quickly metabolized; Adderall slow (half-life 10 hours)
•Cognitive-behavior therapy (CBT), behavior therapy (BT)
•Omega-3
•Exercise
•Light Therapy
•Elimination diet (avoid processed foods)
•Meditation
Hyper Paradox
already hyper + stimulant
Major Eating Disorders
- Anorexia nervosa
- Bulimia nervosa
- Binge Eating disorder
- OSFED
Anorexia Nervosa
- Restricted energy intake -> clinically underweight
- Intense fear of becoming “fat” / gaining weight
- Disturbance of body image
Anorexia Subtypes
- Restricting
2. Binge/Purge
Anorexia Nervosa Prevalence
- Lifetime Prevalence ~ 1% female, 0.3% Male
- 10-15% die of starvation, medical complications, or suicide
- Prominent medical difficulties include: malnutrition, dry yellow skin, amenorrhea (loss of menstruation), cold sensitivity, slow heartbeat, dehydration, loss of potassium (risk of heart or kidney failure),
Anorexia Co-morbidity
• 35% co-morbidity with OCD
oAnorexia is genetically linked with OCD
• Stimulus → Obsessional thoughts → Anxiety → Rituals → [Reduce Anxiety]
• Stimulus (look in the mirror, try on clothes) → Obsessional thoughts (I’m going to get fat) → Anxiety → Rituals (Count calories –hard limit – around 400-600 calories/day) → [Reduce Anxiety]
Bulimia Nervosa
A. Recurrent episodes of binge eating (“amount of food that is definitely more than most people would eat”)
B. Sense lack of control
C. Recurrent compensating behavior(s) to prevent weight gain (vomiting, laxative use, diuretics, enemas, exercise)
D. Binges/purges occur at least once a week for 3 months
E. Self-evaluation unduly influences by body shape/weight
F. No diagnosis of anorexia (typically average weight, often slightly overweight)
Bulimia Prevalence
• Lifetime Prevalence: ~2% (women), < 1% (men)
• Up to 20% of college-age women may exhibit binge/purge symptoms
G. People with Bulimia are typically not thin (usually a little overweight).
• Have a genetic overlap with addictive disorders
Binge Eating Disorder
- Recurrent and persistent episodes of binge eating
- Binge eating episodes are associated with three (or more) of the following:
•Eating much more rapidly than normal
•Eating until feeling uncomfortably full
•Eating large amounts of food when not feeling physically hungry
•Eating alone because of being embarrassed by how much one is eating
•Feeling disgusted with oneself, depressed, or very guilty after overeating - Marked distress regarding binge eating
- Absence of regular compensatory behaviors (such as purging).
