Lecture 18 - Child Abnormal Psychology: ADHD

Question 1

What type of disorder is ADHD?

Answer 1

Neuro-developmental Disorder

Question 2

What is the developmental trajectory of ADHD?

Answer 2

Hyperactivity symptoms are most pronounced in preschool… …decline over time.

Inattention symptoms become increasingly apparent with age…
…as peers undergo rapid maturation of prefrontal cortex …as school demands intensify.

Question 3

How do environments potentiate biological risk?

Answer 3

1. Teratogens and toxins (probably false)
2. Dietary factors (probably false)
3. Parenting practices (likely)

Question 4

What is the “Dual Pathway Model of ADHD”?

Sonuga-Barke, 2005

Answer 4

Two distinct processes, involving overlapping neural architecture, both shaped by environmental processes:

1. Deficits in inhibitory-based executive processes
2. Motivational dysfunction involving disruptive signalling of delayed reward

Question 5

What is ADHD?

Answer 5

An externalising disorder.

A persistent pattern of inattention and/or hyperactivity- impulsivity.

Question 6

What does hyperactivity and impulsivity refer to?

Answer 6

a. Often fidgets with or taps hands or feet or squirms in seat
b. Often leaves seat in situations when remaining seated is expected
c. Often runs about or climbs in situations where it is inappropriate.
d. Often unable to play or engage in leisure activities quietly.
e. Is often “on the go,” acting as if “driven by a motor”
f. Often talks excessively.
g. Often blurts out an answer before questions completed
h. Often has difficulty waiting his or her turn

i. Often interrupts or intrudes on others
(e. g., butts into conversations, games, or activities).

Question 7

What are ‘externalising disorders’?

List them.

Answer 7

Disorders that result in the externalisation of emotion.

ADHD
ODD
CD

Question 8

What are ‘disruptive behaviour disorders’ ?

List them.

Answer 8

Disorders that are disruptive to behaviour?

ODD
CD

Question 9

What are ‘neuro-developmental disorders’?

List them.

Answer 9

?

ADHD
ASD
Learning disorders

Question 10

What are the most co-morbid disorders with ADHD?

Answer 10

Highly co-morbid!
~50% ODD
~ 20% CD

2/3 of children with ADHD present with one or more co-morbid axis 1 disorder

Question 11

What male:female ratio is there for ADHD?

Answer 11

2:1

Question 12

What is the “delay aversion hypothesis”?

“Dual Pathway Model of ADHD”
Sonuga-Barke, 2005

Answer 12

Over time the negativity associated with this failure becomes associated with situations that signal the need to delay gratification.

This ‘delay aversion’ manifests as attempts to avoid/escape delay… …by attending to the most interesting/absorbing aspects of the environment …or acting on that environment (hyperactively)

Question 13

What effect may negative/punitive parenting reactions to hyperactive behaviour have according to the “delay aversion hypothesis”?

Answer 13

Make the delay experience even more aversive

Question 14

What effect may inconsistent parenting have according to the “delay aversion hypothesis”?

Answer 14

If rewarding events are promised but not delivered as predicted, delay may gradually then come to signal uncertainty/disappointment

Question 15

True or False?

There is no single test to identify ADHD

Answer 15

True

Question 16

How do we test for ADHD?

Answer 16

“objective tests” are primarily Continuous
Performance Tests (CPTs):
– TOVA (Test of Variables of Attention)
– Conner’s CPT
– Gordon Computerized Diagnostic System
– I.V.A. CPT

Note: Diagnosis must be multi-factorial

Clinical Interview

Collateral interviews

Question 17

How is ADHD treated?

Answer 17

Psychosocial interventions (parent training; classroom
programs) improve functioning.

However, only stimulant medication appears to act on the core features of the disorder.

Stimulants do not ‘cure’ ADHD

Combined treatment is preferable.

Question 18

DSM say that ADHD symptoms must be present from before the age….

Answer 18

12

Question 19

What is an Axis I disorder?

Answer 19

Axis I: All psychological diagnostic categories except mental retardation and personality disorder.

Question 20

What is an Axis II disorder?

Answer 20

Axis II: Personality disorders and mental retardation.

Question 21

What is an Axis III disorder?

Answer 21

Axis III: General medical condition; acute medical conditions and physical disorders.

Question 22

What is an Axis IV disorder?

Answer 22

Axis IV: Psychosocial and environmental factors contributing to the disorder.

Question 23

FIX CARD

Explain the role of genetics in ADHD?

Answer 23

No

• clear evidence that it follows the lineage of genetic risks in the family
• haven’t found the genome - missing heritability

Question 24

FIX CARD

Outline studies from the lecture

Answer 24

No

Question 25

What are the DSM criteria for ADHD?

Answer 25

• symptoms must have been present early on - in DSM said before 12
• occurring across 2 or more settings (e.g., home/ school/work; friends/relatives; other activities)
• clear evidence that the symptoms interfere with social, academic or occupational fnc
• not better explained by another condition

Question 26

FIX CARD

Answer 26

who is the driver of problems in the family?

Question 27

Outline the gene environment study -

Harold et al 2013

Answer 27

longitudinal

over time, the biological mother’s ADHD symptoms predict the impulsivity of the child

and the hostility toward the child from the foster mother

genetic loading drives the env. you get exposed to

Question 28

What were some old names for ADHD?

Answer 28

minimal brain dysfunction (damage)
during 1900-1950

hyperkinetic/hyperactivity syndrome (DSM II): 1950-69