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Psychopathology > Task 1 - ADHD > Flashcards

Task 1 - ADHD Flashcards

1
Q

DSM Criteria

A

A. 6 or more symptoms of inattention
-> disruptive and developmentally inappropriate
B. 6 or more symptoms of hyperactive-impulsivity for at least 6 months and disruptive and developmentally inappropriate
C. Symptoms present before age 7-12
D. impairment from symptoms present in two or more settings

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2
Q

ADHD Definition

A

Deficits in patience and concentration + impulsive, driven and disorganized behaviors

  • subtypes
  • onset age before 7-12
  • often difficulty in school and relationships
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3
Q

ADHD subtypes

A
  • Predominantly inattentive type
  • Predominantly hyperactive-impulsive type
  • Combined Type
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4
Q

Predominantly inattentive type

A
  • if six or more symptoms of inattention are present but <6 or hyperactive impulsivity
  • sluggish tempo might also be important component (slow retrieval from memory and slow processing)
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5
Q

Predominantly hyperactive-impulsive type

A

-diagnosed if 6 or more symptoms of hyperactivity-impulsivity but less than 6 of inattention

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6
Q

Combined Type

A

-diagnosed if six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity present

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7
Q

Prevalence

A

5% of children develop ADHD

  • > 20-25% of ADHD patients have severe learning disability
  • > boys 3x more likely to develop it
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8
Q

Long-Term Outcomes

A
  • symptoms persists into young adulthood in 75% of cases
  • increased risk for: Antisocial PD, substance abuse, mood and anxiety disorders, marital problems, traffic accidents, frequent job changes
  • > often: lifelong difficulties in school, work and social relationships
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9
Q

Biological Factors

A
  • PFC smaller in children with ADHD
  • > regulates attention, organizing, and planning
  • > abnormal activity when attempting to inhibit processes
  • Immaturity hypothesis
  • abnormal catecholamine neurotransmitter function (dopamine, serotonin, norepinephrine)
  • Heritability
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10
Q

Immaturity Hypothesis

A

Proposes: children with ADHD neurologically immature

  • brains slower to develop than normal
  • > inability to maintain attention and behavioral control at appropritate level for age
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11
Q

Heritability

A

Siblings of children with ADHD: 3-4x more likely to develop it

  • genetic factors implicated in twin studies
  • 76% heritablity
  • dopamine transporter genes might be abnormal
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12
Q

Psychological & Social Factors

A
  • ADHD children more likely to belong to families experiencing frequent disruptions
  • e.g. father more likely to be antisocial/criminal,
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13
Q

Treatments

A

Stimulants
Antidepressants
Behavioral Therapies

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14
Q

Stimulant treatment

A

e. g. Ritalin, Dexedrine, Aderall
- 70-85% respond with decreases in demanding, disruptive, and noncompliant behavior
- increases in mood, goal-directedness, social interactions
- increase dopamine levels in brain: enhance release and inhibit reuptake
- side effects (reduced appetite, insomnia etc.)

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15
Q

Antidepressants

A
  • often prescribed when both ADHD and depression present
  • positive effects on cognitive performance
  • not as effective as stimulants
  • symptoms often return upon discontinuation
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16
Q

Behavioral Thepries

A

Focus on reinforcement of attentive, goal-directed, and prosocial behaviors

  • extinguishing of impulsive and hyperactive behaviors
  • engage teachers and parents to change rewards and punishments
  • > highly effective in symptom reduction
17
Q

Most effective ADHD treatment

A

Studies suggest combination of drug treatment (e.g. ritalin) and behavioral therapy as most effective

18
Q

Article: Klingberg et al. Association between Working Memory and ADHD

A

Working Memory training of children with ADHD led to reduction in symptoms of inattention and hyperactivity-impulsivity

  • > imrpovement of response inhibition and reasoning
  • > suggests association between WM and reasoning ability
19
Q

Article: Prins et al. : computerized WM training with game elements

A

CAI: computerized assisted instruction programs

  • gaming format: includes storyline, frequent and immediate feedback, multiple sensory modalities
  • > Results: WM training with game elements improved: motivation, training performance, and working memory
20
Q

Article: Sonuga-Barke: dual pathway model of behavior and cognition

A

Dual Pathway Model:

  • ADHD as outcome of two pathway impairments
    1. poor inhibitory control: dysregulation of thought and action pathway (DTAP)
    2. poor delay aversion: Motivational Style pathway (MSP)
  • > ADHD symptoms: behavioral dysregulation (1)
  • > poor task engagement: cognitive dysregulation (2)
21
Q

Computerized assisted instruction (CAI) programs

A
  • clear goals and objectives
  • highlighting of important mateiral
  • immediate feedback regarding resposne accuracy
22
Q

Inhibitory Control Neural correlate

A

Associated with meso-cortical branch of the dopamine system projecting in cortical control centers (e.g. PFC)
-> in ADHD: DTAP causes behavioral symptoms and poor quality task engagement

23
Q

Delay Aversion Neural Correlates

A

Linked to meso-limbic dopamine branch associated with reward circuits (nucleus accumbens)

  • > alterations in reward mechanisms and characteristics of child’s early environment
  • > MSP impairment
24
Q

DTAP ADHD

A
  • poor inhibitory control
  • context independent
  • severe and generalized cognitive dysregulation
  • categorical
  • less associated with genetic factors
25
Q

MSP ADHD

A
  • delay aversion
  • context dependent
  • limited pattern of cognitive impairment associated with provision, protection and utilization of time
  • continuously distributed triat
  • more closely associated with genetic factors
26
Q

Article: Sonuga-Barke: Triple-Pathway Model

A

Triple pathway model of ADHD:

  1. inhibitory control (DTAP)
  2. Delay aversion (MSP)
  3. temporal processing
    - > three independent patterns of deficits, each affecting some patients
27
Q

Article: Thorell et al. - WM training of preschool children with ADHD

A

WM training was effective among preschool children with ADHD:
better response inhibition, visuospatial WM, and Verbal WM
-> suggests WM training to be effective in ADHD treatment to improve cognitive functioning (15 min per day for 5 weeks had significant effects)

28
Q

Article: Zeeuw et al. - Multiple pathway model support

A

Study testing whether hypothesized pathways lead to separate cognitive deficits segregating ADHD subtypes

  • segregation into 4 components found:
    1. cognitive control
    2. reward sensitivity
    3. timing
    4. vigilance
  • > no individual with deficits on more than 2 components
  • > separable subtypes of ADHD supported
  • support for neurobiological framework of separate biological pathways to ADHD: separable cognitive deficits
  • > suggestion of fourth pathway with deficits in vigilance
29
Q

Triple pathway model

A

ADHD symptoms suggested to be caused by three independent neurobiological pathways:

  • dorsal frontostriatal pathway involved in cognitive control (inhibitory control)
  • ventral frontostriatal pathway involved in reward processing (delay aversion)
  • frontocerebellar pathway related to temporal processing

Psychopathology (6 decks)

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