PSYC 492 UNIT 3 - Childhood Neuropsychiatric Disorders & Guest Lecture -- 3.21.24 Flashcards
Autism Spectrum Disorder is a developmental disability that can cause ———–, ————-, and ——– challenges.
social, communication, behavioral
3.21.24-Neuropsychiatric Disorders
In order to be diagnosed with Autism Spectrum Disorder, a person must:
- have ————– deficits in social communication and social interaction that present ————–.
- have ———— and ———— patterns of behavior, interests, or activities
persistent; multiple contexts
restrictive; repetitive
According to the DSM-V, a person with ASD has:
- challenges in social-emotional ————
- deficits in —————— behaviors used for social interaction
- deficits in ————-, ————–, and ————- relationships.
- reciprocity
- nonverbal communicative
- developing; maintaining; understanding
A person with ASD has restrictive, repetitive patterns of behavior, interests, or activities manifested by at least 2 of 4 things:
- stereotyped or repetitive motor movements, use of objects or speech
- insistence on sameness, inflexible adherence to routines, or ritualized patterns of behavior (verbal or nonverbal)
- highly restricted, fixed interests taht are abnormal in intensity or focus
- hyper or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment
In Autism Spectrum Disorder, symptoms must be present in ————————- (but may not ————).
early developmental period; become fully manifested until later
T/F
People with ASD must have an intellectual impairment in order to be diagnosed.
False; ASD can be with or without accompanying intellectual impariment
T/F
A language impairment is not a requirement in order to be diagnosed with ASD.
True
According to the DSM, how many/what are the severity levels of ASD?
3 levels
Level 1: requiring support (speaks but lacks reciprocity; difficulty switching activities)
Level 2: requiring substantial support (simple/limited sentences, distress when changing focus)
Level 3: requiring very substantial support (non-verbal; great distress when changing focus.
To be diagnosed with ASD, the individual’s disturbances are not better explained by ————— or —————–.
- intellectual disability
- global developmental delay
For people with ASD, symptoms cause —————– in social, occupational, or other important areas of current functioning.
significant impairment
add some flashcards that make you figure out which disorder
According to the CDC ——- of 1000 (or 1 in ——) 8-year-olds has ASD.
18.5; 54
Boys are how many times more likely to be diagnosed than girls with ASD.
4x
Boys = 1/34
Girls = 1/45
Why are girls (potentially) underdiagnosed with ASD?
2 reasons
- different symptom presentation (less restrictive/repetitive behaviors)
- better as masking social aspects
Which group of children is least likely to be diagnosed with ASD?
- black
- Asian/Pacific Islander
- white
- Hispanic
Hispanic (1/60)
ASD is strongly ———- and there is evidence supporting it as a ———- disorder.
heritable; biological
Explain how brain growth in children with ASD seems to differ from children without the disorder.
Children with ASD seem to have overgrowth of the brain between ages 2-4.
Overgrowth ends around 5-6 then stops (no significant enlargement after this point)
Later in adolescence/childhood, there seems to be a decline in gray matter volume.
————– is not observed in all people with ASD. What are some reasons this might be?
Brain overgrowth
- not a common pathological mechanism?
- neurobiological subtype with larger brain?
- pattern of general physical overgrowth?
People with ASD seem to have ————- overgrowth, including the ———— of typical growth patterns.
unequal; reverse (brain grows front to back instead of back to front)
Unequal overgrowth in children with ASD leads to ————- of prematurely developing regions from the rest of the cortex, which causes ———————–.
uncoupling; differences in connectivity
During which developmental processes does overgrowth in people with ASD occur? What other effect does this have?
3 processes for question 1
synaptogenesis, myelination, pruning
effects white matter: high white matter integrity early on, but then lower integrity later
In adults with ASD, we see abnormalities in which brain structures?
7 regions
- fronto-temporal
- fronto-parietal
- amygdala-hippocampal complex
- cerebellum
- basal ganglia
- anterior and posterior cingulate regions
T/F
Symptoms of ASD must be persistent and found in multiple domains to warrant a diagnosis.
True
T/F
ASD is characterized by an overgrowth of the brain in early years.
True
T/F
No differences exist between the brains of girls and boys with ASD.
False
In boys and girls with ASD, where are functional brain differences found? What do these brain areas affect?
3 differences
Primary motor cortex and supplementary motor area: correlated with restricted and repetitive behaviors in girls
Middle and superior temporal gyri: language network
Parietal and lateral occipital cortex: visuospatial attentional system
Attention Deficit/Hyperactivity Disorder is a persistent pattern of ——– and/or ————-/———- that interferes with functioning or development.
inattention; hyperactivity-impulsivity
What 3 things are necessary in order to be diagnosed with ADHD?
- 6+ symptoms of inattention and/or 6+ symptops of hyperactivity (5 in people 17 or older)
- symptoms have persisted for 6 or more months
- symptoms are inconsistent with developmental level
What are some examples of inattention in people with ADHD?
5
- careless mistakes/doesn’t pay close attention to detail
- doesn’t follow through on instructions
- trouble organizing tasks and activities
- easily distracted
- loses things necessary for tasks and activities
What are some examples of hyperactivity/impulsivity in people with ADHD?
5
- often fidgets/squirms in seat
- runs about or climbs where it isn’t appropriate (restlessness for adults)
- often talks excessively
- difficulty waiting their turn
- often “on the go” or acts as if “driven by motor”
According to the DSM, in order to be diagnosed with ADHD:
- several symptoms were present prior to age —–
- several symptoms were present in ——- (#) settings
- clear evidence that —————
- not due to ————-
- 12
- 2
- symptoms interfer with function
- other disorder
In addition to attentional deficits, people with ADHD have accompanying issues with ————, including:
- ———-, impulsivity, and poor ——–
- problems with regulating/inability to detatch ————
executive function
- response inhibition; poor planning
- attention
A person with ADHD’s inability to regulate their attention (detach their attention from something) is consistent with the ————— hypothesis.
hyperfocus
ADHD diagnoses have recently surged (4.4 million in 2003 to 6.4 in 2011). Why might this be?
Social Policy impacts
1. the ADA offers accommodations and reimbursements for people with ADHD; this was not always the case
2. “consequential accountability legislation” – special education designation; SES disparities –> schools receive more funding if they have higher test scores. They can omit people with ADHD’s scores from their aggregate to get more funding.
What is the prevalence of ADHD diagnoses in children between ages of 3-17?
9.8% of children between 3-17 (ages 3-5: 2%; ages 6-11: 10%; ages 12-17: 13%)
ADHD has high comorbidity with which disorders?
6
(highest to lowest)
- mental, emotional, behavioral disorder
- behavior or conduct problem
- anxiety
- depression
- ASD
- Tourette syndrome
Women with ADHD tend to present with more ———– forms, and there are potentially more ——— onset cases.
inattentive; adult-onset
A —————— might exist with ADHD; meaning women may have lower prevalence but more severe symptoms.
gender
According to the BE GIRLS study, girls showed ———— deficits and onset of ——————- in mid to teen years.
executive functioning; disordered eating
According to the BE GIRLS study, into adulthood, girls were at high risk for ——————— and ————– but NOT for ————-. Additionally —————- pathology declined.
According to the BE GIRLS study, into adulthood, girls were at high risk for -antisocial behavior and peer rejection but NOT for substance use-. Additionally eating-related pathology declined.
According to BE GIRLS study
As adults, women with ADHD were at higher risk for experiencing —————— and ————-.
As adults, women with ADHD were at higher risk for experiencing intimate partner violence and self-harm (both non-suicidal self injury and suicide attempts)
According to BE GIRLS study
For women with ADHD ————– exist into mid and late 20’s, even for those ————————————-.
For women with ADHD impairments exist into mid and late 20’s, even for those whose ADHD symptoms were no longer detectable.
ADHD is associated with increased re-uptake of ———–, which results in decreased levels of extracellular ———–.
both blanks are the same
dopamine
3.28.24 ADHD part 2 and Cerebrovascular
What support is there for the “reduced dopamine hypothesis” in ADHD?
2 things
- Ritalin, concerta (methylphenidate) as successful management tool. This is a psychostimulant that is a dopamine re-uptake inhibitor.
- Gene coding for the dopamine transporter 1 (DAT1), which regulates the dendsity of transporters.
3.28.24 ADHD part 2 and Cerebrovascular
Both ——– and ——— factors contribute to ADHD.
genetic; environmental
3.28.24 ADHD part 2 and Cerebrovascular
What support is there for genetic factors that contribute to ADHD?
twin studies vary from .6 to .9 heritability estimates
3.28.24 ADHD part 2 and Cerebrovascular
No single gene seems to play a major role in ADHD. The most study genes have been associated with variations in the ————— ———— and ——– genes.
dopamine receptor and transporter genes
3.28.24 ADHD part 2 and Cerebrovascular
What are four environmental factors that are associated with ADHD?
list 4
- exposure to certain toxins (lead, PCBs) in utero or postnatal (BUT effects on specific to ADHD)
- exposure to prenatal smoking or alcohol
- premature birth, low birth rate
- psychosocial adversity, high levels of family conflict
3.28.24 ADHD part 2 and Cerebrovascular
ADHD is associated with disturbances in 3 dopaminergic pathways. List them and their associated cognitive symptoms.
- mesocortical: cognitive symptoms
- mesolimbic: motivational deficits and reward circuitry
- nigrostriatal: cognitive symptoms and reward
3.28.24 ADHD part 2 and Cerebrovascular
ADHD dopaminergic pathway
The mesocortical pathway extends from the ———– to ———. It is likely associated with ————- symptoms in ADHD.
VTA to PFC; cognitive symptoms
VTA = ventral tegmental area; PFC = prefrontal cortex
3.28.24 ADHD part 2 and Cerebrovascular
ADHD dopaminergic pathway
The mesolimbic pathway extends from the ——— to the ————–, ————, and ————. It is associated with —————– deficits and ——— circuitry in people with ADHD.
The mesolimbic pathway extends from the VTA to the nucleus accumbens-, amygdala, and hippocampus. It is associated with motivational deficits and rewardcircuitry in people with ADHD.
3.28.24 ADHD part 2 and Cerebrovascular