SM_104b: ADHD Flashcards
ADHD is a ____ that presents as ____, ____, and ____
ADHD is a neurobiological developmental disorder of focus / attention / organization, hyperactivity, and impulsivity that presents as behavioral issues, problems with academics / work, and social issues
Describe DSM-5 criteria for ADHD
ADHD DSM-5 criteria
- Persistent pattern of inattention and/or hyperactactivity-impulsivity that interferes with functioning or development AND has persisted for 6 months
- Six or more symptoms in one/both categories: inattention, hyperactivity/impulsivity
- Several symptoms must appear before age 12 years
- Several symptoms must occur in at least 2 settings
- Symptoms interfere with or reduce quality of social, academic, or occupational functioning
- Symptoms are not better explained by another psychiatric disorder
Describe inattentive symptoms of ADHD
Inattentive symptoms of ADHD
- Often fails to give close attention to detail or makes careless mistakes
- Difficulty sustaining attention in tasks or activities
- Does not seem to listen when spoken to directly
- Does not follow through or finish schoolwork, chores, or duties at work
- Difficulty organizing
- Avoids or dislikes tasks that require sustained mental effort
- Often loses things necessary for tasks or activities
- Easily distracted by extraneous stimuli or unrelated thoughts
- Forgetful
Describe hyperactive/impulsive symptoms of ADHD
- Often figdgets with or taps hands/feet or squirms in seat
- Often leaves seat in situations when remaining seated is expected
- Runs / climbs in situations where it is inappropriate or limited to feeling restless in adolescents or adults
- Difficulty playing or engaging in leisure activities quietly
- Often on the go, acts as if driven by a motor
- Talks excessively
- Blurts out answers or completes others’ sentences
- Difficulty waiting for one’s turn or waiting in line
- Interrupts / intrudes on others
Predominantly inattentive presentation of ADHD requires ____
Predominantly inattentive presentation of ADHD requires at least 6 of 9 criteria of inattention
Predominantly hyperactive/impulsive presentation of ADHD requires ____
Predominantly hyperactive/impulsive presentation of ADHD requires at least 6 of 9 criteria of hyperactivity/impulsivity
Combined presentation of ADHD requires ____
Combined presentation of ADHD requires at least 6 of 9 criteria of both the inattentive and hyperactivity/impulsivity subsets
____ symptoms of ADHD usually abate through adolescence but many individuals continue to have symptoms into adulthood
Hyperactive/impulsive symptoms of ADHD usually abate through adolescence but many individuals continue to have symptoms into adulthood
Almost 2/3 of children with ADHD have at least one ____
Almost 2/3 of children with ADHD have at least one other mental, emotional, or behavioral disorder
Etiology of ADHD is ____ but also involves ____ risk factors
Etiology of ADHD is strongly genetic but also involves environmental risk factors
Environmental risk factors for ADHD include ____, ____, ____, and ____
Environmental risk factors for ADHD include smoking / alcohol / drugs during pregnancy, lead exposure, brain injury, and premature delivery and low birth weight
People with ADHD have structural and functional differences in the ____ and ____ compared to controls
People with ADHD have structural and functional differences in the prefrontal cortex and striatum compared to controls
Prefrontal cortex is involved in ____ including ____, ____, and ____
Prefrontal cortex is involved in executive function including planning, prioritizing, and decision making
(differences in ADHD)
Striatum is involved in ____ including ____, ____, and ____
Striatum is involved in emotional executive function including risk / reward, reinforcement, and motivation
(differences in ADHD)
People with ADHD have ____ total brain volumes, for all four lobes, and the cerebellum
People with ADHD have smaller total brain volumes, for all four lobes, and the cerebellum
Describe diagnosis of ADHD
Diagnosis of ADHD
- Patient interview
- Parent interview
- Rating scales from parents and teachers
- Complete medical history
- Physical examination in the past year
- Vision and hearing tests in children
- Neuropsychological testing by a psychologist
- Speech and language assessment
Neuroimaging tests are ____ in evaluation of ADHD
Neuroimaging tests are NOT used in the evaluation of ADHD
____ is the best treatment for core ADHD symptoms
Medication alone (stimulant) with or without therapy is the best treatment for core ADHD symptoms
(combination treatment with meds and behavioral therapy better for other areas of functioning)
____ are first-line medications for ADHD
Stimulants are first-line medications for ADHD
Stimulant classes for ADHD are ____ and ____
Stimulant classes for ADHD are methylphenidate and amphetamine mixed salts
(short-acting and long-acting in each)
Ritalin (regular) is a ____ used to treat ADHD
Ritalin (regular) is a short-acting methylphenidate used to treat ADHD
Adderal is a ____ used to treat ADHD
Adderal is a short-acting amphetamine mixed salt used to treat ADHD
Stimulants for ADHD act by ____ and ____
Stimulants for ADHD act by stimulating portions of the brain that are underactive and increasing available dopamine and norepinephrine by blocking reuptake transporters and facilitating release into synapse
Atomexetine is a non-stimulant used for ADHD that acts as a ____
Atomexetine is a non-stimulant used for ADHD that acts as a selective norepinephrine reuptake inhibitor
____ and ____ are non-stimulant alpha agonists used to treat ADHD
Guanfacine and clonidine are non-stimulant alpha agonists used to treat ADHD
(reduce CNS activation)
Guanfacine is an ____ used to treat ADHD that ____
Guanfacine is an alpha agonist used to treat ADHD that reduces CNS activation
(non-stimulant)
Clonidine is an ____ used to treat ADHD that ____
Clonidine is an alpha agonist used to treat ADHD that reduces CNS activation
(non-stimulant)
Common side effects of stimulants for ADHD are ____, ____, ____, and ____
Common side effects of stimulants for ADHD are decreased appetite, insomnia, headache, and nausea
Common side effects of guanfacine and clonidine for ADHD are ____, ____, and ____
Common side effects of guanfacine and clonidine for ADHD are sedation, drowsiness, and depression
Common side effects of atomexetine for ADHD are ____, ____, and ____
Common side effects of atomexetine for ADHD are nausea, stomach pain, and mood swings / irritability
Non-medical treatments for ADHD include ____ and ____
Non-medical treatments for ADHD include behavior modification / parent training and academic accomodations (504 plan or IEP)
Behavior therapy techniques for ADHD include ____, ____, ____, and ____
Behavior therapy techniques for ADHD include
- Positive reinforcement
- Time-out
- Response cost
- Token economy
Describe the significance of ADHD
Significance of ADHD: lifelong problems with behavior in
- School / work
- Relationships
- Substance use
