ADHD

Question 1

(ADHD) HiTop Category

Answer 1

under disinhibited and antagonistic externalizing disorders under antisocial behaviour

Question 2

ADHD

Answer 2

-motoric and verbal hyperactivity
-problems maintaining focus in conversations and activities
-impulsive or erratic behaviours
-not episodic, but a way of being in the world but symptoms do fluctuate depending on the circumstances

Question 3

Untreated ADHD

Answer 3

if adhd is left untreated, lower educational attainment, early pregnancies, more run ins with the law etc and other lasting effects are more likely to occur

Question 4

(ADHD) Onset

Answer 4

-symptoms almost always emerge in early childhood, some improve with age and brain maturation
-but at least ⅓ retain their diagnosis in adulthood

Question 5

(ADHD) Specifiers

Answer 5

-specifiers: ADHD-I (inattention), ADHD-H (hyperactivity), or ADHD-HI (mixed)

Question 6

(ADHD) George Still Definition

Answer 6

-lack self control
-showed symptoms of overactivity/inattention in school
-still noted they had poor inhibitory volition and defective moral control

Question 7

ADHD & Influenza Outbreak

Answer 7

• Behavior problems among children who survived encephalitis during epidemic, & those who suffered birth trauma, head injury, or exposure to toxins

Question 8

(ADHD) 1950s Definition

Answer 8

hyperkinesis
* attributed to poor filtering of stimuli entering brain
* Led to definition of hyperactive child syndrome
* motor overactivity seen as main feature

Question 9

ADHD Contreversies

Answer 9

-skeptisicim about the diagnosis
-abnormal development (then persistent symptom into adulthood) or lag in dveelopment (would resolve by adulthood)
-ADHD in girls and women

Question 10

(ADHD) Can’t Be Explained By

Answer 10

-a better suited disorder
-not present in just one setting, bc then behviour could be attributed to the setting
-must be an inability to do these things, not a refusal

Question 11

Parents w/ADHD

Answer 11

• ADHD is familial
• ADHD in both parents and kids contribute to reciprocal negative interactions, bth parents and kids with ADHD make conflict spiral put of cotnrol, which may in turn negatively impact the child’s developmental course and parents mental health
  -passive evocative rGE

Question 12

Problems for Families w/ADHD

Answer 12

• Interactions between children with ADHD and parents with ADHD characterized by negative behavior from both parents and children
• Children with ADHD less compliant, more oppositional, and less often able to follow parental requests through to completion
• Parents with ADHD who have children with ADHD show lower levels of involvement and positive parenting, higher levels of negative parenting and higher levels of inconsistent discipline

Question 13

(ADHD) Prenatal Factors

Answer 13

• Mother’s use of cigarettes, alcohol, or other drugs during pregnancy associated with ADHD

Question 14

(ADHD) Genetic Predisposition

Answer 14

about 1/3 of biological relatives of children with ADHD have the
disorder

Question 15

(ADHD) Adoption Studies

Answer 15

• ADHD rates are about 3x times higher in biological vs. adoptive parents of children with ADHD

Question 16

(ADHD) Twin Studies

Answer 16

• About 80% heritability estimates for HI and IA behaviors
• Little evidence for shared environmental influence

Question 17

(ADHD) Heterotypic Continuity Explanations

Answer 17

1) failure models
2)shared etiopathogenic factors

Question 18

(ADHD) Failure Model

Answer 18

Impulsivity/ hyperactivity/ inattention lead to higher levels of interpersonal conflict (with peers, teachers, parents), rejection, lack of support, and poor skills development
* All of these factors increase risk of subsequent depression and other forms of psychopathology
* Difficulties in social interactions significantly predict depression
* Peer rejection mediates the relationship between aggression and depression

Question 19

(ADHD) Shared Etiopathogenic Factors

Answer 19

• Irritability in childhood shared among CD, ODD, depression, anxiety disorders
• Genetic or constitutional factors that influence children’s irritability levels in early childhood as expressed in ADHD also predispose them to anxiety and depression in adolescence and/or adulthood
• Familial risk for psychopathology explains both

Question 20

(ADHD) Homotypic Continuity

Answer 20

-having a disorder at one time point predicts having the same disorder at a a later time point
-same disorder evident at different points in development
-ex. ADHD in childhood is assc w/ ADHD in adolescene and or adulthood

Question 21

(ADHD) Heterotypic Continuity

Answer 21

-having a disorder at one time poitn predicts having a different disorder at a later time point
-underlying processes or factors that contribute to one disorder can also lead to the development of a different disorder over time, behaviours and association with ADHD could make them predisposed
-ex: ADHD in childhood is associated with MDD or SUD in adoleadnce or adulthood

Question 22

(ADHD) ALSPAC Study

Answer 22

• Age 7.5 and again at 14
• ADHD at 7.5 associated with ADHD at 14 (homotypic)
• ADHD at 7.5 also associated with:
• Other externalizing disorders(e.g., ODD, CD; kind of homotypic)
• GAD, PTSD, and MDD
• Of all disorders, ADHD showed the most cross-domain effects
• E.g., at age 7.5, ADHD was a stronger predictor of GAD at 14 than any other disorder (including any internalizing)

Question 23

ADHD in Adolesecne

Answer 23

-Some outgrow
* At least 50% of clinic-referred elementary school children don’t; sometimes problems get worse
* Significant impairments continue emotional, behavioral, and social functioning
* Children who met diagnostic criteria for ADHD in childhood (ages 5–11): in adolescence more likely to exhibit oppositional defiant behaviors, anxiety/depression, and involvement with the juvenile justice system

Question 24

ADHD in Adulthood

Answer 24

-rates of ADHD diagnosis persistence ranged from 5.7% to 77%
-all studies observed high rates of symptomatic persistence ranging from 60% to 86%
-doesnt remit, or continues in a form not captured by criteria
-hyperactivity less relevant for adults
-adults may be able to better mask or make sympoms less relevant

Question 25

Adult ADHD Vulnerabilites

Answer 25

-educational functioning -operational functioning -mental health -physical health -antisocial personality disorder -criminality -substance misuse -vulnerable for SUD (earlier onset of use and heavier users) -4x more likely to have mood disorders -5x more likely to have anxiety disorder -2x more likely to have personality disorder, esp ASPD -NSSI -suicide attempts 14%

Question 26

(ADHD) Onset of Symptoms

Answer 26

-hyper-impulse symptoms become more visible and significant at ages 3-4 -those with persistent pattern of hyperactive-impulsive and oppositional behaviour for at least 1 year are likely to continue to have difficulties later in childhood

Question 27

ADHD in Elementary Schoolers

Answer 27

-syptomtoms especially evidnt when child statrsts school -oppositional defiant behaviours may increase bc more is asked of them -8-12 defiance and hostility may be serious problems -increased problems with self care, personal responsibility, chores, trustwothernisss, independence, social relationships, academics

Question 28

(ADHD) ODD/CD Comrbidities

Answer 28

80% of children with ADHD have a co-occuring psychological disorder -oppositional defiant disorder and conduct disorder -50% of children meet criteria for ODD by age 7 or later -about 30-50% of children develop CD -cmmon predisposing cause for ADHD,ODD, and CD -genetics and shared envrionment

Question 29

(ADHD) Anxiety Disorder Comorbididty

Answer 29

-25% of children with ADHD experience excessive anixety -20-30% of children will have a comorbid mood disorder

Question 30

(ADHD) Associated Negative Outcomes

Answer 30

*Poor academic and vocational performance, Fewer years of school, lower status *More interpersonal problems with Peers, often teachers *Problems with parent-child relationships *Higher rates of accidents * Broken bones * Car accidents * Speeding tickets *Initiate sexual activity at an earlier age so Increased risk of STIs and unplanned pregnancies *Reduced Life expectancies

Question 31

(ADHD) Associated Cognitive Deficits

Answer 31

1. executive functioning 2. cognitive processes 3. language processes 4. motor processes 5. emotional processes

Question 32

(ADHD) Cognitive Processes

Answer 32

working memory, mental computation, planning and anticipation, flexibility of thinking, use of organizational strategies

Question 33

(ADHD) language processes

Answer 33

verbal fluency, communication, use of self-directed speech

Question 34

(ADHD) motor processes

Answer 34

allocation of effort, following prohibitive instructions, response inhibition, motor coordination and sequencing

Question 35

(ADHD) emotional processes

Answer 35

self regulation of arousal level, tolerating frustration, mature moral reasoning

Question 36

(ADHD) Prevalance

Answer 36

-4-8% of school aged children in NA -estimated worldwide prevalence rate of 5.2%

Question 37

(ADHD) Gender Differences

Answer 37

-8.1% of adults in the US report a lifetime (some point in their life) hostory of the disorder -boys 6x more likely to be in treatment in boys, bc boys are reffered to treatment more bc their symptoms are more disruptive -diagnosed more often in boys than girls in all cultures

Question 38

(ADHD) Lay Diagnosis

Answer 38

-Lay diagnosis: ppl who havent recieved a formal diagnosis (diagnosed by GP but not assesed properly) and are not treatment (just meds), rates increasing -4.4% of US adults meet criteria for current ADHD

Question 39

(ADHD) Cultural Differences

Answer 39

-similar rates in all countries with mandatory primary education, mostly bc its studied more in these places, but may manifest differently in other places -highest rates in SA and africa (8-12%) -lowest rates in japan and china (2-5% -european and NA in the middle (4-6%)

Question 40

Combined Type (ADHD-HI)

Answer 40

-Most often referred for treatment -more likely to display: * problems inhibiting behavior * problems with behavioral persistence * aggression, defiance, peer rejection,

Question 41

(ADHD) Hyperactivity

Answer 41

inability to voluntarily inhibit dominant or ongoing behavior * Hyperactive behaviors include: * fidgeting, difficulty staying seated * moving, running, climbing about, touching everything in sight * excessive talking and pencil tapping * accomplishing little despite extreme activity

Question 42

(ADHD) Impulsivity

Answer 42

-cognitive impulsivity -behavioural impulsivity

Question 43

(ADHD) Cognitive Impulsivity

Answer 43

disorganization hurried thinking, need for supervision

Question 44

(ADHD) Behavioural Impulsivity

Answer 44

difficulty inhibiting responses whens situations require

Question 45

(ADHD) Predominant HI

Answer 45

-rare -preschoolers; limited validity for older children * may be a distinct subtype of ADHD-HI

Question 46

(ADHD) Hyperactivity-Impulsivity

Answer 46

-strong link between hyperactivity and impulsivity suggesting both are fundamental deficits in regulating behaviour -Primary attention deficit in ADHD is inability to engage and sustain attention and follow through on directions or rules while resisting salient distractions

Question 47

(ADHD) Inattention

Answer 47

-difficulty during work or play to focus on one task or to follow through on requests or instructions -inability to sustain attention particularly for repetitive structures and less enjoyable tasks -deficits may be seen in one or more types of attention -selective attention/distractibility -sustained attention/vigilance -alerting -inattentive, drowsy, daydreamy, spacey, in a fog, easily confused -may have learning disability, process info slowly, have trouble remembering things, have low academic achievement (more prevelant in girls) -often anxious, apprehensive, socially withdrawn, with mood disorders