Stimulants Attention- Deficit Hyperactivity Disorder Flashcards
ADHD is a Developmental neuropsychiatric disorder what does it mean that it s developmental
Impairment of growth/development
Developmental neuropsychiatric disorder what does it mean that it is neuropsychiatric
Neurological abnormality resulting in impaired ability to function.
when is its onset
childhood
is there such thing as adult onset
not well documented may be confounded with substance use
are ADHD and ODD similar
no different things
what are the 3 subtypes
inattentive
impulsive
combined
the H in ADHD refers to … not behaviour
brain function
which type was marketed as demon child
ADHD
T: Fidgety/restlessness, hyperactivity, difficulty waiting and
remaining seated, immature behaviours
impulsive types
T: Distracted, disorganized, forgetful, poor concentration, daydreaming
inattentive type
innatentive type is a deficit in …
Vigilant concentration
T: executive function (shifting attention), memory, attention= inattention
Vigilant concentration
impulsive type is a problem with the … instead of executive component
Cognitive alertness
T: motor and behavioural inhibition
Cognitive alertness
what is the most common type of ADHD
combined type
Hyperactivity refers to brain function, not behavioural description!
t
what do we use to stay on task and read extra pages
vigilant concentration
what are the 3 features of vigilant concentration
monitoring rules, updating system and response execulion
if you don’t see shift in card game rules what part of vigilant concentration is not working
monitoring rules
seeing which part of the task are completed and which are not :T
updating system
wait for the cue and then respond :T
response execution
what brain areas account for the lack of vigilant concentration in ADHD 3
norepinephrine system
what brain areas are involved in norepinephrine
Reticular activating system
what are the 2 subareas of the reticular formation involved in nonep staying on task
basal forebrain and locus coreruleys
what brain areas are ADHD people recruiting instead in reticular?
temporal compensating = verbal systems
T: continuing the same way and staying on task
preseverence
less nonep = less
perserverance
the lack of nonep also leads to a lack of …
reward dependance = sensitivity to rewards
attention focused internally not externally = not noticing existing in own thoughts
cognitive alertness
what kind of test would get at cognitive alertness
orienting (“noticing”) tasks
what are the 2 parts of cognitive awareness
sensory awareness
??• Detection: Monitoring, reaction
?
Cog alertness: how does sensory awareness present
Inability to ignore stimuli (lack of inhibition)
what brain area is involved in cognitive alertness
Mesolimbic/mesocortical pathway
how is not following through and making too big of promises related to reward 2
reward sensitive hypoactive
no delay discounting
what NT is impaired with the mesolimbic pathway
dopamine
we can tell if someone has ADHD based on their responses to prisoners dilemma
f thats subjective
brain activation in response to receiving unfair reward
how does brain activation in response to receiving unfair reward differ in ADHD
basoganglia active in control in ADHD does not respond selectively to unfair
they will accept it
how is dopamine involved in ADHD
cognitive alterness:
motivational significance to stimuli associated with reward
dopamine allows one to set a value on rewards
?
T: technical term for the domino effect
Temporal contiguity
what doesTemporal contiguity look like behaviourally
if you cannot focus you don’t develop skills= compounded &cascade
neuropsychiatric what do the 2 parts of this word mean
brain and chemical
can you see ADHD in the brain
yes it has an anatomical basis
what’s the difference between ADHD and acting out
anatomical profile= biological no Differentiate from emotional/cognitive disruption
how does ADHD brain respond differently to unfair rewards
basal ganglia does not respond selectively to unfair= no inhibition
T: intensive concentration on interesting and non-routine activities accompanied by temporarily diminished perception of the environment
hyperfocus
is there evidence for hyper focus symptom of ADHD
they begin to manifest in adulthood, not a symptom of adult onset, new symptom emerges as a result of development
hyper focus may be due to different effects of what NT
seretonin
3 key components of hyperfocus ?
don’t understand how time passes
aware of things they ignore but cannot give up what they’re doing
Prefrontal activation in word fluency
what about hyper focus implies serotonin is getting involved
the hypnotic spell of time passing
what brain area is activated when processing word fluency for. ADHD
prefrontal activation
T: Associated with mood and conduct disorders, OCD
depleted seretonin
what is the chemical name for Ritalin
methylphenidate
why use a stimulant to treat depression
activate the inhibitory centers because ADHD brain needs suppressant
what brain structures does methylphenidate target
mesolimbic structures
what NT does Methylphenidate focus on blocking
dopamine and nonep
Methylphenidate is derived from….
phenethylamine
phenethylamine is more potent than cocaine
t
phenethylamine is more potent than cocaine= more likely to be abused
f because the timing of saturation was so slow
methylphenidate is a More potent … than cocaine
inhibitor
Esther any euphoria associated with methylphenidate
no because it Enters the brain more slowly
why would you want More dopamine available for ADHD patients?
increase reinforcement
what did go no go task measure
inhibitory control
what did go no go task measure
inhibitory control
how did the go no go task get after the speed accuracy trade off
would get faster if doing better
what was the difference in reaction time between groups
none
what was the difference between groups then
accuracy (same for TD and on methylphenidate but more errors for ADHD not on meds)
in ADHD without treatment was it the false alarms or the misses that increased
both
were people with ADHDaware of their mistakes
yes
what do the false alarms and misses in ADHD tell us about their processing?
Delayed processing mechanism
this task was done in an FMRI what did this tell us about 2
parietal control = no brakes
frontal areas processesing mistakes = no intellectual impairment
list all the meds that can be used to treat ADHD
Dexedrine, adderall, methylphenidate
what does the dextrose in (Dextro)Amphetamines mean
R turning
what are the 2 (Dextro)Amphetamines
Dexedrine, Adderall
…. financed by US Air Force for sustained flight
Dexedrine
Dexedrine was called a … pill
go pill “no go pills” given after to ensure rest
what were the no go pills given after
benzo, nonbenzo
benzo, nonbenzo worked on what NT
GABA receptor modulator= increase GABA activity
what were the side effects of Dexedrine
tweaking and aggressive behaviours
who first discovered L and R rotating molecules
US Air Force
what did they find were the perks of R rotating molecules 2
- no body response
2. psychoactive components
R rotating Psychostimulants acted without the … usually accompanying this effect in the body
vasoconstriction
Incidents caused for decline in popularity related to what property of dexoamphetamines
psychoactive
how did Adderall get around patenting restrictions around naturally occurring substances
75% Dex, 25% Levo
Patenting possible because of the blend of salts
how does Dexedrine differ from Adderall
only in the % of R and L rotating
what do dexoamphetamines block reuptake of
dopamine and nonpenepherine
other than blocking reuptake how does dexoamphet work on dopamine
acts as an agonist= causes an action
how do dexo act as an agonist
reverse dopamine transporter which dumps out dopamine
what do dexo amphet do thats different from amphet
block non ep and dopamine
what are the 3 key features of why dexo amphet are so effective
- block
- leaky vesicles = more dumped out
- both nonep and dopamine
what aspect of dexo Allows more dopamine to be dumped
leaky vesicles
dexoamphet are promoted for ADHD treatment all over world
f only in North America
what about the dexoamphet induce euphoria
levo
if you take more dexoamphet the more effect
f more all or none but true for rhitalin
is there a problem of overprescription? what is the cause of this
culture
what aspects of culture in the 1980s relate to overprescription
Conflict erodes self-image= Self-Esteem” movement
Biology & Brain as a reason for maladaptive behaviour was apart of the cultural belief
true
what was the White, middle to upper-class belief that lead to problems with ADHD
wanted the advantage for their kids too
T: higher achievement leads to stability, resources are depleting= giving an edge
educational paranoia
how did self esteem movement contribute to ADHD
no attempt at behavioural control= would not accept behavioural interventions
how did policy influence over prescription of ADHD
accommodations gave kids an edge
what are the 3 biases in ADHD
sex, age, ethnicity
how did limited resources aspect of change in policy influence?
Physician with no background in psychology!!!!(prescription) not Psychologist (diagnosis)
what is the abuse potential of Ritalin, Adderall, Dexedrine
in td people
what schedule is ADHD meds
They’re legal, but they’re considered dangerous because of their high risk of abuse and dependence.= schedule 2
what is the educational advantage of abuse potential
used as a study aid
how does it benefit people as a study aid
Modest effects on working & episodic memory
how do these drugs influence long term memory
No effects on cognition or long-term memory
how did these drugs influence work on difficult or boring tasks
didn’t get better but kept going
why do these drugs sometimes not even work on working & episodic memory
state dependant memory
also termed sustained concentration, is defined as the ability to maintain concentrated attention over prolonged periods of time :T
vigilance
how do Ritalin, Adderall, Dexedrine act as athletic performance enhancer 2
– perseverance
– Confound with accommodation benefits
T: Prolonged abstinence related with school dismissal
drug holidays
T: Belief that medication use will result in drug-seeking
behaviours
gateway drug
what are the subjective effects of drug holidays
Lethargy, lack of motivation, depression
what happens to TD patients vigilance when on study aid drugs
did not get more vigilant but did keep going = No vigilance reduction
what happened to feedback mechanisms on study aids
more sensitive to feedback (enhanced awareness of errors)
what are the 2 problems with underprescritopn
drug holidays
gateways drug fallacy
the “withdrawl” assiociated with drug holidays is actually caused by what
rebound = return fo symptoms
what causes the anxiety and depression during drug holidays
result of external problems caused by social problems of symptoms recurring
how does drug abuse relate to ADHD drug use
Non-treated ADHD results in higher drug abuse rates
why does untreated ADHD lead to more drug use
self medicate
using meds Decrease of impulsivity = heightened inhibition
how does the abuse potential of cocaine compare to rhit
much more addictive because much more potent
what schedule is cocaine
1
why is cocaine so much more addictive than rhitalin
Shorter time to produce euphoria
why is cocaine preferred for recreational use
more potent more euphoria
how does abuse potential of cocaine compare to Amphetamine/Bath Salts
cocaine has Less aversive effects when “high”= cognition on bath salts
does cocanine effect cognition
no arousal and mood
why is cocaine less dangerous than the amphet
(no) physical withdrawal in cocaine only changes in system = no needing
are amphet and bath salts or cocaine preferred for recreational use
Cocaine preferred for recreational use
how does cocaine change reinforcement schedules
Not responsive to punishment
Not responsive to positive reinforcement
how do you get someone off cocaine
Sensitive to combination of punishment and reinforcement (not for everyone though)
what happens to the delayed gratification in people addicted to cocaine
can’t do
