ADHD

Question 1

What does ADHD stand for?

Answer 1

• Attention Deficit
• Hyperactivity
• Disorder

Question 2

What is ADHD?

Answer 2

A co-occurring cluster of impairing symptoms, relating to self-regulation (‘executive functioning’).

Question 3

ADHD is a diagnostic triad of….

Answer 3

1. Inattention.
2. Hyperactivity.
3. Impulsivity.

Question 4

What is ‘combined type’ ADHD also known as?

Answer 4

Hyperkinetic disorder.

Question 5

For a diagnosis of ‘combined type’ ADHD to be made, what criteria must be met?

Answer 5

Triad of difficulties, which are:

• developmentally inappropriate.
• impairing.
• pervasive.
• longstanding.

Question 6

How may the core symptoms of ADHD impact someone at home and in the community?

Answer 6

• Complicated to parent.
• Raised family stress levels.
• Increased anger and upset.
• Increased risk of harm (ie. impulsive behaviour).

Question 7

How may the core symptoms of ADHD impact on school life?

Answer 7

• Barrier to learning.
• Frequently in trouble.
• Disorganisation, forgetting, losing things.

Question 8

Give examples of co-morbid difficulties with ADHD.

Answer 8

• Social communication difficulties.
• LD.
• Attachment difficulties.
• Mood and anxiety problems.
• Behavioural disorders (ODD/CD (ADHD is almost always present in conduct disorder)).
• Substance use.

Question 9

Outline the psychological management in ADHD.

Answer 9

1st line - parent training

2nd line - social skills training (sleep + diet)

Question 10

Outline the pharmacological management in ADHD.

Answer 10

1st line - Methylphenidate (ritalin - a stimulant)
2nd line - Atomoxetine
3rd line - antidepressants, antipsychotics

Question 11

What are medications used in the treatment of ADHD known as?

Answer 11

Stimulants

Question 12

What do stimulants do?

Answer 12

Improve dopaminergic neurotransmission in networks involved in executive functioning.
Particularly affect the prefrontal cortex, amongst many.
This directly improves the core symptoms as a result.

Question 13

Describe the side effects of stimulants.

Answer 13

Side effects are usually minor, and involve appetite and sleep reduction

Dysphoria, anxiety and tics are also possible

Question 14

Give 2 examples of non-stimulant drugs which can be used in the treatment of ADHD, and detail their mode of action.

Answer 14

Atomoxetine – noradrenergic and dopaminergic agonist.

Guanfacine – alpha-2 agonist, effects on prefrontal cortex/ADHD control.