Lecture 7: ADHD

Question 1

Females with ADHD present more commonly with which subtype; why is this a problem?

Answer 1

• Inattentive subtype
• Less disruptive behavior in females may contribute to referral bias causing under identification and lack of tx

Question 2

What is the tourette’s syndrome triad?

Answer 2

• Tics
• ADHD
• Obsesseive compuslive sx’s (OCS)

Question 3

Which other disorder needs to be considered in both the initial assessment and ongoing management of children with ADHD?

Answer 3

Chronic Tic Disorder

Question 4

ADHD is an information processing dysfunction where in the brain; primarily due to deficinecy of which 2 NT’s?

Answer 4

• Within prefrontal cortex (executive functioning)
• Deficiency of dopamine and norepinephrine

Question 5

According to the DSM-5 how many sx’s should a child vs. patient >17 y/o have for making dx of ADHD?

Answer 5

• Children: should have 6 or more
• Adults: should have at least 5 sx’s

Question 6

According to the DSM-5 what are 9 sx’s of the inattentive type of ADHD?

Answer 6

• Fails to give close attention to details or make careless mistakes
• Difficulty sustaining attention
• Does not appear to listen
• Struggles to follow through on instructions
• Difficult with organization + loses things + easily distracted
• Avoids or dislikes tasks requiring a lot of thinking
• Is forgetful in daily activities

Question 7

According to the DSM-5 what are the sx’s that fit the hyperactive type of of ADHD?

Answer 7

Question 8

What are the clinical practice guidelines for treating preschool-aged children (4-5 years of age) with ADHD?

Answer 8

• Prescribe evidence-based parent- and/or teacher-administered behavior therapy as the 1st line tx
• Prescribe methylphenidate if the behavior therapy does not provide significant improvement and the child continues to have moderate to severe sx’s

Question 9

What are the clinical practice guidelines for treating elementary school-aged children (6-11 years of age) with ADHD?

Answer 9

• Prescribe FDA approved meds for ADHD and/or evidence-based parent and/or teacher-administered behavior therapy as tx for ADHD
• Preferably both medication and behavior therapy should be used together
• Evidnce is particularly strong for stimulant medications

Question 10

What is a potential AE associated with Bupropion?

Answer 10

↑ risk of seizure

Question 11

Which stimulant used for ADHD is a re-uptake inhibitor of catecholamines AND also releases catecholamines?

Answer 11

Amphetamines

Question 12

Dysfunctional brain region in ADHD

Answer 12

Dorsal anterior midcingulate cortex

Question 13

What is an accurate, objective test for the diagnosis of ADHD?

Answer 13

TOVA - test of variables of attention

*good for adults and children*

Question 14

What are the clinical practice guidelines for treating adolescents (12-18 years of age) with ADHD

Answer 14

• prescribe FDA approved medications for ADHD with assent
• maybe behavior therapy
• Preferably, medication and behavior therapy together

Question 15

What are the three domains of adaptive functioning necessary to diagnose intellectual developmental disorder?

Answer 15

1) conceptual

2) social

3) practical

Question 16

What 2 medications are FDA approved for the irritability and agitation associated with autism?

Answer 16

1) risperidone
2) aripiprazole