Task 1 - ADHD Flashcards
3 subtypes of ADHD
1) Predominantly inattentive type ->6 or more symptoms of inattention, fewer than 6 symptoms of hyperactivity-impulsivity
2) predominantly hyperactive-impulsive type-> 6plus hyperactive-impulsive, minus6 inattentive
3) combined type -> 6plus of both
other symptoms/side effects
-poor relationships with others
-poorly in school
-45-60 percent develop a conduct disorder, abuse drugs, violate the law
-adults diagnosed as children are at increased risk for:
antisocial PD, substance abuse, mood and anxiety disorders, marital problems, traffic accidents, legal infractions, frequent job changes
Prevalence
- 5 percent of children develop ADHD
- boys: 3x more likely than girls
- girls: less disruptive behavior , may be under-identified
- symptoms persist into young adulthood
Prevalence
- 5 percent of children develop ADHD
- boys: 3x more likely than girls
- girls: less disruptive behavior , may be under-identified
- symptoms persist into young adulthood in about 75 percent
- 4.4 percent of adults could be diagnosed with ADHD
PFC
- smaller in volume
- abnormal activation when attempting to inhibit responses
- immaturity hypothesis: brains are slower to develop than brains of other children
- > explains why in some children symptoms of ADHD decline with age
Neurotransmitter
- dopamine, seretonin, norepinephrine appear to function abnormally
- dopamine transporter gene may be abnormal in ADHD
other biological factors
- ADHD runs in families, genetic factors play a role in vulnerability
- ADHD associated with low birth weight, premature delivery, difficult delivery leading to oxygen deprivation
Treatments ADHD (4)
1) stimulant drugs
2) other drugs
3) antidepressants
4) behavioral therapies
stimulant drugs
- ritalin, dexedrine, adderall
- enhancing release/inhibiting reuptake
- 70-85p respond to drugs
- side effects: reduced appetite, insomnia, edginess, gastrointestinal upset, increase of tics
- risk of abuse
example USA stimulant drugs
- longitudinal study of children
- 72p of those with ADHD received stimulants
- majority of children did not have symptoms meeting diagnostic criteria for ADHD
other drugs
- affect norepinephrine levels
- atomoxetine, clonidine, guanfacine
- reduce tics and increase cognitive performance
antidepressants
- some positive effects on cognitive performance
- but not as effective as stimulants
- example: Bupropin has particularly strong effects on dopamine levels and more effective than other antidepressants
behavioral therapy
- highly effective in reducing symptoms
- focuses on reinforcing attentive, goal-directed and prosocial behaviors and extinguishing impulsive and hyperactive behaviors
Example – Child and parents might agree that she/he will earn a chip every time she/he obeys request to wash hands. If child refuses to comply, she/he will lose chip. At end of the week, child can exchange chips for activities such as eating ice cream or extra TV time.
partial remission
-period during which an improvement of sufficient magnitude is observed
-individual is no longer fully symptomatic but continues to display evidence of more than minimal symptoms
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Article: training and transfer effects of executive functions in preschool children - study
-focus on visuospatial WM or inhibitory control
Article: training and transfer effects of executive functions in preschool children - tasks
Visuospatial WM task:
- visual stimuli on screen
- remember location and order
- > clicking on targets in correct oder
Inhibition tasks:
- go/no-go task (respond to certain stimuli, no response when other stimuli)
- stop-signal task (respond quickly when stimulus was present except when followed by a stop signal)
- flanker task (5 arrows pointing right/left, response in accordance with arrow in middle, ignoring others)
Article: training and transfer effects of executive functions in preschool children - findings
- WM task: effective, effects on non trained WM tasks and transfer effects on measures of attention -> possible to improve cognitive functioning through WM tasks
- Inhibition task: no significant effects
The role of diet in ADHD
-Western diet is full of fat, sodium, sugar and food additives (= associated with greater symptoms of hyperactivity).
- not clear that diet causes ADHD or other forms os psychopathology
- when synthetic foods removed from diet -> small number of children show improvement
ADHD and family
- children with ADHD -> likely belong to families with frequent disruptions, in which parents are prone to aggressive/hostile behavior and substance abuse
- shared genetic effects on impulsivity and cognitive problems
- genetic factors in ADHD prompt disruptive behavior in children -> prompts hostile parenting
- > even with genetically unrelated parents this was found to be the case
cognitive test of ADHD (5)
-aim: test attention and whether individual is able to inhibit responses
1) Continuous performance test ( CPT)
2) Stroop task
3) trail marking test
4) controlled word association test (COWAT)
5) Conner’s Parent rating scale (CPRS)
cognitive test ADHD- continuous performance test (CPT):
- press space bar on computer when seeing a letter except when letter ‘X’
- > ADHD: less able to inhibit and longer reaction times
cognitive test ADHD - stroop task
- test ability to inhibit responses
- presenting words of colors that are presented in different color
- ADHD children: more time to respond and make more errors
cognitive test ADHD - trail making test
- children are instructed to connect circles by drawing lines -alternating between circles labelled with numbers and circles labelled with letters
- until they reach circle labelled ‘end’
- > if ADHD, worse performance
cognitive test ADHD - controlled word association test (COWAT)
- measures verbal fluency
- ‘name all animals you can beginning with letter..’
- ADHD: impaired performance
