Week 3- ADHD Flashcards
ADHD prevalence
1-2% in adults
Higher in children
ODD
Behaviour disorder
Often violate rules and boundaries
To diagnose ADHD
18 potential symptoms
Inattention presentation: For diagnosis need at least 6 (5 for adults)
Hyperactive-impulsive presentation: Need at least 6
Combined presentation: 6+6
3 neuropsychological pathways to ADHD
Executive functions
Reward sensitivity
Timing/motor functions
Inattentive presentation of ADHD
a. Attention to details/ careless
b. Sustaining attention
c. Seems not to listen
d. Follow through instructions
e. Organizing tasks/activities
f. Avoids mental effort
g. Looses things
h. Easily distracted
i. Forgetful
Hyperactivity/impulsivity presentation of ADHD
a. Fidgeting / squirming
b. Leaves seat
c. Runs / climbs
d. Unable to play quietly
e. On the go / driven by motor
f. Talking excessively
g. Blurts out answer
h. Waiting turn
i. Interrupting / intruding
Lifespan symptom changes in adhd
Things that contribute to the heterogeneity of adhd
Age
Mental comorbidity
Mental comorbidity in Adhd
33%- 0 comorbid disorders
33%- 1 comorbid disorder
16%- 2 comorbid disorders
18%- 3 comorbid disorders
Criteria for normal behaviour in diagnosing developmental disorders
-Is behaviour age appropriate?
-Does it fit the context?
-Frequency/ duration of behaviour (needs to be persistent pattern in time)
-Developmental trajectory
-Effect of interventions
-Functional impairments because of behaviour
Diagnostic cycle of ADHD and tools
Signalling/ screening- Behaviour questionnaire
Medical history (parent/caretaker)- Interview
Medical history (teacher/ sports instructor)- Interview
Observation of the child- Interview/ observe play
Role of observation in ADHD assessment
-In a medical setting: Exclude other mental disorders
-Signals genetic/neurologic disorders
Defining the severity of ADHD symptoms is based on 3 aspects:
-Frequency
-Impairment
-Comparison to peers
IQ in ADHD
ADHD can be found in both low and high IQ
On average people with ADHD score 7-12 pts lower
Executive function pathway of ADHD relates to problems with
-Response inhibition
-Dysregulation of action and thought
-Meso-cortical branch
-Off-task behaviour
-Consistent behaviour symptoms
-Cognitive training can compensate
Reward sensitivity pathway of ADHD relates to:
Delay aversion
Different motivational style
Meso-limbic branch
Disruptive behaviour
Symptoms depend on environment
Cognitive strategies can compensate
ADHD medication
Stimulants
-MPH
-dexMPH
-dexAMP
-MAS-XR
Non-stimulants
-ATX
-Clonidine HCL extended-release
-Guanfacine extended-release