CHILD PSYCHOPATHOLOGY > Chapter 8 > Flashcards

Chapter 8 Flashcards

ADHD (224 cards)

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1
Q

What does ADHD stand for?

A

Attention-Deficit/Hyperactivity Disorder

ADHD is a neurodevelopmental condition affecting attention, behavior, and activity levels.

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2
Q

What are the primary symptoms of ADHD?

A
  • Inattention
  • Hyperactivity
  • Impulsivity

These symptoms cause impairment in major life activities.

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3
Q

Who is John in the context of ADHD?

A

A 7-year-old boy displaying symptoms of ADHD

John’s behaviors include impulsivity, hyperactivity, and difficulty following routines.

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4
Q

In what year did Heinrich Hoffmann write about hyperactivity?

A

1845

He described a character named ‘Fidgety Phil’ in a children’s storybook.

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5
Q

What is the significance of the accounts of Phil and Dusty N.?

A

They illustrate the primary symptoms of ADHD

Both boys exhibit inattentiveness, hyperactivity, and impulsivity.

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6
Q

ADHD can only be identified by characteristic behaviors that vary considerably from child to child. True or False?

A

TRUE

There are no distinct physical symptoms visible in scans or tests.

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7
Q

What are the emotional impacts of ADHD on children?

A
  • Frustration
  • Confusion
  • Sadness
  • Low self-esteem

Children may feel overwhelmed and struggle with relationships.

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8
Q

What is the estimated annual cost of ADHD in the United States?

A

$40 to $70 billion

This includes costs related to health care and education.

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9
Q

During the coronavirus pandemic, how were children with ADHD affected?

A
  • Increased sleep concerns
  • Negative emotions related to infection risk
  • Trouble with remote learning
  • Rule-breaking behavior

Children with ADHD faced unique challenges during lockdowns.

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10
Q

What coping strategies helped buffer against increases in substance use and mental health concerns for adolescents with ADHD during the pandemic?

A
  • Positive coping strategies
  • Adolescent routines

These strategies were effective in mitigating negative impacts.

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11
Q

Fill in the blank: ADHD is a ________ condition that causes differences in the brain related to attention, behavior, and activity levels.

A

neurodevelopmental

ADHD affects children and can lead to significant challenges.

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12
Q

Who first described the symptoms of ADHD in a medical textbook?

A

Melchior Adam Weikard in 1775

This marked the beginning of the medical understanding of ADHD.

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13
Q

In what year did Sir Alexander Crichton describe a syndrome similar to ADHD?

A

1798

His description included symptoms like early onset, restlessness, inattention, and poor school performance.

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14
Q

What term did George Still use in 1902 to describe symptoms of ADHD?

A

Disorder of poor ‘inhibitory volition’ and ‘defective moral control’

He was one of the first to describe ADHD symptoms.

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15
Q

What significant event in the early 1900s increased focus on children with ADHD symptoms?

A

Widespread compulsory education

This demanded self-controlled behavior in group settings.

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16
Q

What syndrome was associated with children who developed encephalitis during the 1917-1926 epidemic?

A

Brain-injured child syndrome

This was erroneously applied to children displaying similar behaviors without evidence of brain damage.

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17
Q

In the late 1950s, ADHD was referred to as hyperkinesis. What was believed to cause it?

A

Poor filtering of stimuli entering the brain

This led to the definition of hyperactive child syndrome.

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18
Q

In the 1970s, what additional symptoms were recognized as primary in ADHD?

A
  • Deficits in attention
  • Impulse control

This view has had a lasting impact on DSM criteria for ADHD.

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19
Q

What are the central impairments emphasized in recent ADHD models?

A
  • Poor self-regulation
  • Difficulty inhibiting behavior
  • Reward and motivational deficits

These impairments highlight the complexity of ADHD beyond attention deficits.

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20
Q

ADHD is included in DSM-5-TR as a neurodevelopmental disorder because it has what characteristics?

A
  • Early onset
  • Persistent course
  • Lasting alterations in neural development

ADHD often overlaps with other neurodevelopmental disorders.

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21
Q

What are the two core dimensions of ADHD identified in research?

A
  • Inattention
  • Hyperactivity–impulsivity

These dimensions predict different behavioral and cognitive impairments.

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22
Q

What is the severity classification for ADHD symptoms?

A
  • Mild
  • Moderate
  • Severe

Severity is based on the number of symptoms and their impact on functioning.

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23
Q

What is the diagnostic criterion for inattention in ADHD according to DSM-5-TR?

A

Six (or more) symptoms persisting for at least 6 months

Symptoms must negatively impact social and academic activities.

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24
Q

True or false: ADHD symptoms must occur exclusively during the course of another mental disorder.

A

FALSE

Symptoms should not be better explained by another mental disorder.

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25
Fill in the blank: ADHD symptoms must be present in _______ or more settings.
two ## Footnote This includes settings like home, school, or work.
26
What is the **impact** of ADHD on children and their families?
High costs to society and constant stress for families ## Footnote ADHD behaviors can be a source of frustration for parents, siblings, and teachers.
27
What does **inattention** refer to?
* Inability to sustain attention * Difficulty sticking to tasks * Problems remembering and following through on instructions * Challenges resisting distractions * Issues with planning and organization * Concerns with staying alert ## Footnote Inattention can result from failures in cognitive processes that control attention.
28
What is **attentional capacity**?
The amount of information we can remember and attend to for a short time ## Footnote Children with ADHD do not have a deficit in attentional capacity.
29
Define **selective attention**.
Ability to concentrate on relevant stimuli and ignore task-irrelevant stimuli ## Footnote Important for tasks like studying for a test.
30
What does **distractibility** indicate?
A deficit in selective attention ## Footnote Children with ADHD are more likely to be distracted by highly salient and appealing stimuli.
31
What is **sustained attention**?
Ability to maintain focus over time on unchallenging tasks ## Footnote A primary attention deficit in ADHD is sustained attention.
32
True or false: Children with ADHD can persist at uninteresting tasks even when they want to.
FALSE ## Footnote They often perform poorly on uninteresting or repetitive tasks.
33
What is the relationship between **alerting** and attention in children with ADHD?
Deficits in alerting may contribute to difficulties in sustaining attention ## Footnote Alerting involves preparing for what is about to happen and achieving an optimally alert attentional state.
34
What common complaints are associated with **inattention** in children?
* Not listening * Failing to follow instructions * Not finishing chores or assignments ## Footnote These complaints often arise from difficulties in focusing on less enjoyable tasks.
35
Fill in the blank: **Inattention** can result from a failure in one or more _______ that control attention.
cognitive processes ## Footnote This highlights the complexity of attention-related issues.
36
What is a common experience for children with ADHD during tasks?
Spontaneous mind wandering ## Footnote This can lead to functional impairments and performance deficits.
37
What is **hyperactivity–impulsivity** characterized by?
* Undercontrol of motor behavior * Poor sustained inhibition of behavior * Inability to delay a response or defer gratification * Inability to inhibit dominant responses ## Footnote These characteristics indicate an overall deficit in regulating behavior.
38
True or false: Symptoms of **hyperactivity** and **impulsivity** are conceptually distinct.
TRUE ## Footnote However, when children display one symptom, they usually display the other as well.
39
What are common behaviors of children with **hyperactivity**?
* Fidgeting * Squirming * Climbing * Running about * Touching everything in sight * Noisily tapping a pencil ## Footnote Their activity is excessively energetic and not goal-directed.
40
What is the effect of allowing children with ADHD to move and fidget during academic tasks?
They perform better on academic tasks ## Footnote This contrasts with children without ADHD, whose learning is impeded when told to move.
41
What behaviors characterize **impulsivity** in children?
* Inability to think before acting * Difficulty stopping ongoing behavior * Interrupting conversations * Acting without considering consequences ## Footnote Impulsivity can lead to minor mishaps and serious accidents.
42
What are the two forms of **impulsivity** mentioned?
* Cognitive impulsivity * Behavioral impulsivity ## Footnote Cognitive impulsivity involves disorganization and hurried thinking, while behavioral impulsivity includes acting without considering consequences.
43
What is **emotional impulsivity/dysregulation** characterized by?
* Impatience * Low frustration tolerance * Quickness to anger * Irritability ## Footnote It reflects how quickly an individual reacts with negative emotions to negative events.
44
What are the **three presentation types** of ADHD specified in DSM-5-TR?
* Predominantly inattentive presentation (ADHD-PI) * Predominantly hyperactive–impulsive presentation (ADHD-HI) * Combined presentation (ADHD-C) ## Footnote Each type is based on the individual’s primary symptoms.
45
Children with **ADHD-PI** are described as:
* Inattentive to details * Easily distracted * Careless * Not listening * Unfocused * Disorganized * Forgetful ## Footnote They may also experience anxiety and mood disorders.
46
What is a concern regarding the **ADHD-PI** presentation?
It may contain at least three diagnostic subgroups ## Footnote These subgroups may differ in their degree of impairment.
47
Children with **ADHD-HI** and **ADHD-C** presentations are more likely to display concerns in:
* Inhibiting behavior * Behavioral persistence * Aggression * Defiance ## Footnote They are also more likely to be rejected by peers.
48
What is the **primary attention deficit** in ADHD?
Inability to engage and sustain attention ## Footnote It also includes difficulty following through on directions while resisting distractions.
49
To diagnose ADHD using DSM-5-TR, symptoms must appear before age _______.
12 ## Footnote This is a change from the previous requirement of age 7.
50
What are the criteria for diagnosing ADHD according to DSM-5-TR?
* Symptoms must persist for more than 6 months * Occur more often and with greater severity than in peers * Occur across two or more settings * Interfere with social, academic, or occupational functioning * Not better explained by another mental disorder ## Footnote These criteria help differentiate ADHD from other conditions.
51
What can mimic the symptoms of ADHD?
* Illnesses * Accidents * Stressful life events * Learning disorders ## Footnote It is essential to investigate other possible reasons for the child's symptoms.
52
What is likely the cause of disruptive behaviors in children immediately after their parents separate?
Adjustment reaction ## Footnote This is often mistaken for ADHD, especially in children with mild intellectual disabilities or anxiety disorders.
53
True or false: Disruptive behaviors of children with learning disorders can be mistaken for **ADHD**.
TRUE ## Footnote Behaviors associated with mild intellectual disabilities, learning disorders, or conduct concerns may resemble ADHD.
54
What should be investigated before diagnosing **ADHD**?
* Developmental history * Parent and teacher reports * Normed assessment instruments * Behavioral observations ## Footnote A thorough assessment is essential to avoid misdiagnosis.
55
According to the text, a child can display **ADHD symptoms** without what?
Significant impairment ## Footnote Conversely, a child may show remitted symptoms but still experience significant maladjustment.
56
What is critical to assess when evaluating **ADHD**?
* Child’s symptoms * Impairment in functioning ## Footnote Both aspects are essential for an accurate evaluation.
57
Depending too heavily on individual symptoms or rating scales to diagnose **ADHD** can be what?
Unreliable and misleading ## Footnote This highlights the importance of a comprehensive assessment approach.
58
What are the **limitations** of the DSM-5-TR criteria for ADHD?
* Developmentally insensitive * Categorical view of ADHD * Lack of age adjustment for symptoms in younger children * Validity of changes in symptom number and expression untested ## Footnote These limitations highlight that DSM-5-TR criteria are designed to classify and diagnose ADHD but may lag behind new research findings.
59
What are the **two lists of symptoms** used by DSM-5-TR to define ADHD?
* Symptoms of inattention * Symptoms of hyperactivity–impulsivity ## Footnote These symptoms help in diagnosing ADHD and understanding its core characteristics.
60
Children with ADHD find it difficult to sustain mental effort during work or play and resist _______.
salient distractions ## Footnote This difficulty is a key characteristic of inattention in ADHD.
61
Children with ADHD are described as being extremely active but tend to not accomplish at a level that is _______.
commensurate with their energy level ## Footnote This highlights a common discrepancy in ADHD behavior.
62
What are the **three presentation types** of ADHD specified by DSM?
* Predominantly inattentive * Predominantly hyperactive–impulsive * Combined presentation ## Footnote These types are based on the primary symptoms exhibited by the individual.
63
A diagnosis of ADHD requires symptoms to appear before age _______.
12 ## Footnote This age requirement is part of the diagnostic criteria for ADHD.
64
What are some **cognitive deficits** displayed by children and adolescents with ADHD?
* Deficits in executive functions * Intellectual deficits * Impairments in academic functioning * Learning disorders * Distorted self-perceptions ## Footnote These deficits can significantly impact the daily functioning of children with ADHD.
65
What do **executive functions (EFs)** help manage in children?
* Self-awareness * Planning * Self-monitoring * Self-evaluation ## Footnote EFs are crucial for self-regulation and cognitive processes.
66
Children with ADHD may show deficits in which **specific executive functions**?
* Response inhibition * Vigilance * Working memory * Planning ## Footnote These deficits are closely related to symptoms of ADHD.
67
True or false: Most children with ADHD are of at least average overall intelligence.
TRUE ## Footnote Their challenges often stem from applying their intelligence rather than a lack of it.
68
Inattention at 7 years of age is the most consistent predictor of poor academic outcomes at age _______.
16 ## Footnote This highlights the long-term impact of inattention on academic performance.
69
What percentage of children with ADHD have a **specific learning disorder**?
Up to 45% ## Footnote This indicates a significant overlap between ADHD and learning difficulties.
70
Children with ADHD may experience lower productivity, grades, and scores on _______.
achievement tests ## Footnote These academic challenges are often exacerbated by co-occurring disorders.
71
What percentage of children with **ADHD** also have impairments in their **speech and language**?
30% to 60% ## Footnote This statistic highlights the significant overlap between ADHD and speech/language impairments.
72
In a study with preschoolers, symptoms of **hyperactivity–impulsivity** were related to what type of skills?
Poor language skills ## Footnote This indicates a specific relationship between hyperactivity and language impairment.
73
Symptoms of **inattention** in children with ADHD are more highly correlated with what skills?
Weaker receptive and expressive vocabulary skills ## Footnote This correlation suggests different types of language challenges based on ADHD symptoms.
74
Children with ADHD may have difficulty in understanding others’ speech and using appropriate language in everyday situations, referred to as **________**.
pragmatics ## Footnote Pragmatics is a key area where children with ADHD often struggle.
75
What are some primary difficulties faced by children with ADHD related to language?
* Impaired verbal working memory * Impaired discourse * Impaired pragmatic language skills ## Footnote These difficulties can contribute to social challenges for these children.
76
Excessive and loud talking, frequent shifts and interruptions in conversation, and inability to listen are examples of **________** in children with ADHD.
impairments ## Footnote These behaviors can lead to significant communication challenges.
77
Children with ADHD often exhibit speech production errors, fewer pronouns and conjunctions, and **________** comments.
tangential ## Footnote This can make their speech difficult to follow and understand.
78
What is a common consequence of unclear speech in children with ADHD?
Miscommunication ## Footnote This can lead to misunderstandings in social interactions.
79
True or false: Children with ADHD typically have clear and coherent speech.
FALSE ## Footnote Their speech is often characterized by errors and unclear links, making it hard for listeners to understand.
80
The statement by a boy with ADHD illustrates difficulties in **________**.
coherent speech ## Footnote The example shows how ADHD can affect clarity and organization in communication.
81
What are some **medical and physical concerns** experienced by children and adolescents with ADHD?
* Health-related concerns * Accident-prone * Risk-taking behaviors ## Footnote These concerns include higher rates of enuresis, encopresis, asthma, dental health issues, poor fitness, eating disorders, and sleep disturbances.
82
What specific **health-related concerns** are reported in children with ADHD?
* Higher rates of enuresis and encopresis * Asthma * Dental health concerns * Poor fitness * Eating concerns/disorders * Sleep disturbances ## Footnote Sleep disturbances include resistance to going to bed, difficulty falling asleep, and obstructive sleep apnea.
83
True or false: Children with ADHD are less likely to be **accident-prone** compared to their peers.
FALSE ## Footnote Over 50% of parents describe their child with ADHD as accident-prone, and they are about three times more likely to experience serious accidental injuries.
84
What are some **risk-taking behaviors** associated with ADHD?
* Early initiation of cigarette smoking * Substance-use disorders * Internet and videogame-use concerns * Risky sexual behaviors ## Footnote These behaviors may lead to more severe and persistent substance-use disorders compared to those without ADHD.
85
What is the relationship between **ADHD** and **life expectancy**?
Impulsive behavior predicts reduced life expectancy by an average of 8 years ## Footnote ADHD is associated with significantly increased rates of premature deaths, particularly from unnatural causes.
86
What findings suggest that ADHD is a **public health problem**?
* Higher rates of inpatient and outpatient hospitalizations * Emergency department visits * Medical costs more than double those without ADHD ## Footnote ADHD is linked to significant health-related concerns and costs.
87
What are common **social concerns** for children with ADHD?
* Difficulties in family life * Conflict with peers * Poor social communications * Disruptive behavior in social settings ## Footnote These concerns can lead to poor adolescent outcomes and other disorders, such as depression.
88
What family dynamics are often reported by families of children with **ADHD**?
* Negativity in interactions * Noncompliance by the child * Excessive parental control * Sibling conflict ## Footnote Parents may experience high levels of distress, including depression and substance use.
89
What are some **peer relationship difficulties** faced by children with ADHD?
* Disliked and rejected by peers * Few friends * Higher proportion of friends with learning and behavior concerns ## Footnote Their behavior often leads to social conflict and a negative reputation among peers.
90
Children with ADHD often display deficits in **executive functions (EFs)**. What does this affect?
Capacity for planning and self-regulation ## Footnote This impacts their ability to apply intelligence to everyday life situations.
91
What is a common misconception about children with ADHD regarding their **social reasoning**?
They are not deficient in social reasoning or understanding ## Footnote They often do not use their knowledge during social exchanges.
92
What is the significance of **close friendships** for adolescents with ADHD?
They may buffer negative outcomes of peer rejection ## Footnote Positive friendships can help meet social needs despite the challenges faced in peer relationships.
93
What is the **formal document** sent by the Second Continental Congress to King George III in mid-1776?
Declaration of Independence ## Footnote This document asserted the American colonies' formal separation from Great Britain and was officially adopted on July 4, 1776.
94
About **half or more** of children and adolescents with ADHD meet criteria for what disorder by age 7 or later?
oppositional defiant disorder (ODD) ## Footnote ODD symptoms include irritability and defiance, such as tantrums and talking back.
95
What percentage of children with ADHD eventually develop **conduct disorder (CD)**?
30% to 50% ## Footnote CD is more severe than ODD and involves violating societal rules.
96
ADHD that occurs early, particularly with severe symptoms of hyperactivity–impulsivity, increases the odds of **ODD/CD** by about how much?
10-fold ## Footnote This makes it one of the most reliable predictors of these disorders.
97
True or false: Longitudinal studies have found that **ADHD leads to ODD and CD** rather than vice versa.
TRUE ## Footnote Recent findings suggest that ODD and CD symptoms may also lead to later symptoms of ADHD.
98
What specific gene is associated with the regulation of neurotransmitters in the brain implicated in ADHD?
COMT ## Footnote Variations in this gene are related to persistent and severe ODD and CD outcomes.
99
ADHD is a risk factor for the later development of what personality disorder?
antisocial personality disorder (APD) ## Footnote APD involves a pervasive pattern of disregard for the rights of others.
100
What percentage of children with ADHD experience **excessive anxiety** or one or more anxiety disorders?
25% to 50% ## Footnote These children may worry about separation, social contacts, or trying new things.
101
Children with co-occurring ADHD and anxiety disorder(s) display more difficulties in what areas compared to those with either condition alone?
* Social functioning * Academic performance * Daily functioning * Quality of life ## Footnote They experience greater long-term impairment and mental health concerns.
102
As many as what percentage of young people with ADHD experience **depression**?
20% to 30% ## Footnote Many will develop depression or another mood disorder by early adulthood.
103
Being diagnosed with ADHD between what ages is a risk factor for future depression and suicidal behavior in adolescence?
4 and 6 years of age ## Footnote This risk is particularly significant for girls.
104
What is characterized by severe emotional and behavioral concerns with chronic irritability in individuals with ADHD?
disruptive mood dysregulation disorder ## Footnote This disorder is one of the mood disorders associated with ADHD.
105
The association between ADHD and depression may be due to what common factor?
family risk ## Footnote This suggests that depression in a child with ADHD is not solely due to the child's demoralization.
106
True or false: A diagnosis of childhood **bipolar mood disorder (BP)** sharply increases the child’s risk for previous or co-occurring ADHD.
TRUE ## Footnote However, a diagnosis of ADHD does not appear to substantially increase the risk for BP.
107
What percentage of children with **ADHD** display motor coordination difficulties?
30% to 50% ## Footnote Difficulties include clumsiness, poor performance in sports, and poor handwriting.
108
What is the condition characterized by marked motor incoordination and delays in achieving motor milestones in children with ADHD?
Developmental Coordination Disorder (DCD) ## Footnote As many as 50% of children with ADHD may have DCD.
109
What percentage of children with ADHD also have **tic disorders**?
20% ## Footnote Tic disorders include sudden, repetitive, nonrhythmic motor movements or sounds.
110
True or false: Tic disorders in children with ADHD significantly affect later psychosocial functioning.
FALSE ## Footnote Tic disorders decline to low rates by adolescence and do not appear to significantly affect later psychosocial functioning.
111
What psychological disorders are commonly associated with **ADHD**?
* Conduct concerns * Anxiety * Mood disorders ## Footnote As many as 50% of children with ADHD may meet criteria for oppositional defiant disorder or conduct disorder.
112
What percentage of children with ADHD experience **excessive anxiety**?
25% or more ## Footnote Co-occurring anxiety is associated with more social and academic difficulties.
113
What is the relationship between ADHD and **bipolar disorder**?
Controversial ## Footnote A diagnosis of childhood bipolar disorder sharply increases the risk for previous or co-occurring ADHD.
114
What is the estimated prevalence of **ADHD** in children and adolescents aged 4 to 17 years in North America?
5% to 9% ## Footnote Worldwide, just over 5% have ADHD.
115
What factors contribute to the identification of children with **ADHD**?
* Reports from parents * Reports from teachers * Reports from doctors ## Footnote Different adults may emphasize different symptoms when making a judgment.
116
ADHD occurs more frequently in which gender?
Boys ## Footnote Estimates range from 2% to 4% for girls and 6% to 9% for boys aged 6 to 12 years.
117
What ratio of boys to girls is observed in clinic samples for **ADHD**?
6:1 or more ## Footnote Boys are referred more frequently due to overt defiance and aggression.
118
What symptoms may girls with ADHD display that differ from boys?
* Inattentive/disorganized symptoms * Forgetfulness * Lethargic behavior * Mental confusion * Tendency to daydream ## Footnote Girls may go unrecognized if they do not display hyperactivity and disruptive behavior.
119
What major concerns do girls with ADHD face through adolescence and young adulthood?
* Anxiety * Depression * Romantic relationship difficulties * Conflict with mothers * Significant peer rejection ## Footnote Other concerns include deficits in academic achievement and high rates of service utilization.
120
What socioeconomic status (SES) group has slightly higher rates of **ADHD**?
Lower SES groups ## Footnote Low family income in childhood is associated with an increased likelihood of ADHD.
121
By kindergarten entry, African American children are _______ less likely to be diagnosed with ADHD than White children.
70% ## Footnote They are equally likely to display ADHD-related behaviors in the classroom.
122
What cultural factors can impact ADHD diagnoses?
* Cultural norms * Tolerance for symptoms ## Footnote In cultures valuing reserved behavior, ADHD symptoms may be less common.
123
What is the global trend regarding the identification of **ADHD**?
Identified in every country studied ## Footnote Rates vary due to differences in information sources and diagnostic methods.
124
What are the **symptoms of ADHD** that change with development?
* Hyperactivity * Impulsivity * Inattention ## Footnote Symptoms evolve from infancy through adolescence, as illustrated by the experiences of individuals diagnosed with ADHD.
125
In what age range do signs of **ADHD** likely present at birth?
Infancy ## Footnote Some mothers report overactivity in the womb, indicating early signs of ADHD.
126
What are some **early markers of ADHD symptoms** in infancy?
* Difficult temperament * Extreme activity * Unpredictability * Sensitivity to stimulation ## Footnote Reliable identification of ADHD is difficult prior to age 3.
127
True or false: Most infants with a **difficult temperament** will develop ADHD.
FALSE ## Footnote While a difficult temperament may indicate developmental issues, it cannot be solely taken as an early sign of ADHD.
128
What behaviors are common in **preschoolers with ADHD**?
* Sudden actions * Difficulty with routine * Excessive talking * Disruption of activities ## Footnote These behaviors become increasingly visible and significant around ages 3 to 4.
129
What academic challenges do children with **ADHD** face in elementary school?
* Low academic productivity * Distractibility * Poor organization * Trouble meeting deadlines ## Footnote Symptoms of inattention become particularly evident when children start school.
130
What percentage of children with ADHD continue to experience symptoms into **adolescence**?
50% or more ## Footnote Many adolescents with ADHD show significant impairments in emotional, behavioral, and social functioning.
131
What are some **theories** about the nature and causes of ADHD?
* Cognitive functioning deficits * Reward/motivation deficits * Arousal level deficits * Self-regulation deficits ## Footnote No single theory can explain all difficulties associated with ADHD.
132
What is a key characteristic of **cognitive deficits** in children with ADHD?
* Sustained attention issues * Response inhibition difficulties * Working memory challenges ## Footnote Cognitive deficits are important for understanding ADHD but do not support a single cognitive deficit as the cause.
133
What do children with ADHD experience regarding **reward sensitivity**?
* Higher reward threshold * Aversion to delay ## Footnote This affects their motivation and performance when rewards are unavailable or delayed.
134
What is the heritability estimate for **ADHD** based on twin studies?
About 75% ## Footnote ADHD is among the most heritable of childhood disorders.
135
What is the risk of a child developing ADHD if a **parent** has the disorder?
Nearly 60% ## Footnote This statistic highlights the strong genetic influence in ADHD.
136
What are some proposed causes of ADHD that have not been adequately tested?
* Sugar intake * Bad parenting * Poor school environment * Urban living ## Footnote Many of these claims lack strong, consistent support.
137
What role do **genetic influences** play in ADHD?
* Key causal factors * ADHD runs in families * Higher rates in biological relatives ## Footnote Genetic factors significantly contribute to the development of ADHD.
138
What are some **early behavioral indicators** of ADHD suggested in the text?
* Atypical motor development * Difficulties in sensory processing * Emotion dysregulation ## Footnote These indicators may help in the early detection of ADHD.
139
What are the **two types** of gene studies that have identified genomic risk regions associated with ADHD?
* Candidate gene studies * Genome-wide association studies (GWAS) ## Footnote These studies have highlighted several genes involved in neurotransmission and synaptic transmission related to ADHD.
140
Name **two neurotransmitters** that are central to the genes involved in ADHD.
* Dopamine * Serotonin ## Footnote Many candidate genes for ADHD are involved in the function of these neurotransmitters.
141
What is the role of **dopamine** in relation to ADHD?
* Central role in psychomotor activity * Involved in reward seeking ## Footnote Dopamine dysregulation has been found in brain structures implicated in ADHD.
142
True or false: The primary medications for ADHD act by enhancing the availability of **dopamine** in the synapse.
TRUE ## Footnote These medications primarily block the dopamine transporter (DAT1), increasing dopamine availability.
143
Which **dopamine receptor gene variant** is consistently associated with ADHD?
DRD4 (seven-repeat form) ## Footnote This gene is linked to sensation seeking and responsiveness to medication.
144
What do findings suggest about the **genetic architecture** of ADHD?
* Involves complex interactions within biological systems * Influenced by common and rare genetic variants ## Footnote The genetic predisposition to ADHD is likely due to multiple genes interacting across different chromosomes.
145
Fill in the blank: The effects of individual gene variants account for very little of the variance in **ADHD symptoms**.
ADHD symptoms ## Footnote Most heritable components of ADHD result from multiple genes.
146
What are some **environmental factors** that may influence the development of ADHD?
* Pregnancy complications * Maternal smoking * Exposure to toxins * Low birth weight * Severe stress during pregnancy ## Footnote These factors can compromise nervous system development before and after birth.
147
True or false: Maternal substance use during pregnancy is the primary cause of most cases of **ADHD**.
FALSE ## Footnote While it may contribute to some cases, it is not the primary cause.
148
What is the proposed effect of exposure to events that compromise fetal development on ADHD?
Creates a 'malleable' state ## Footnote This state may increase sensitivity to post-natal influences contributing to ADHD.
149
What is the significance of **epigenetic influences** in ADHD?
* Atypical microRNA functioning * Variation in DNA methylation ## Footnote These influences are emerging as important factors in understanding ADHD.
150
What are the **neurobiological causal factors** associated with ADHD?
* Diminished arousal or arousability * Underresponsiveness to stimuli * Deficits in response inhibition * Differences in brain structure, function, and connectivity ## Footnote Studies indicate that children with and without ADHD differ on psychophysiological measures.
151
Brain-imaging studies have revealed a consistent set of **neural circuits** associated with ADHD, including those related to which processes?
* Attentional processes * Inhibitory control and executive functions * Motivation * Frustration tolerance * Reward anticipation * Sustained attention ## Footnote These circuits are crucial for understanding ADHD symptoms.
152
Children with ADHD have a smaller **right prefrontal cortex** compared to children without ADHD. True or False?
TRUE ## Footnote Structural differences in the prefrontal cortex are significant in understanding ADHD.
153
What volume differences have been found in children with ADHD?
* Smaller total and right cerebral volumes (3% to 4%) * Smaller cerebellum * Differences in the accumbens nucleus, caudate nucleus, hippocampus, amygdala, and putamen ## Footnote These differences are most significant among children.
154
The **default mode network (DMN)** operates differently in ADHD. What is its typical function?
Active at rest, shuts off during task engagement ## Footnote Individuals with ADHD show weaker neural connectivity and deficient DMN deactivation during tasks.
155
Fill in the blank: A delay in brain maturation in children with ADHD has been noted particularly in the _______.
prefrontal regions ## Footnote This delay is associated with symptoms persisting into adulthood.
156
What did Dr. Philip Shaw's study reveal about the **cortical thickness** in children with ADHD?
* Delay of 2 to 3 years in reaching peak thickness * Greatest delay in the prefrontal cortex (about 5 years) ## Footnote The study tracked changes using MRI and compared ADHD children with typically developing children.
157
What neurotransmitters are suggested to be involved in ADHD?
* Dopamine * Norepinephrine * Epinephrine * Serotonin ## Footnote Evidence suggests a selective deficiency in dopamine and norepinephrine.
158
True or False: Sugar has been conclusively shown to be the cause of hyperactivity in children.
FALSE ## Footnote Studies have debunked the myth that sugar causes hyperactivity.
159
What factors may increase a child's risk for ADHD when combined with lead exposure?
* Exposure to nicotine during pregnancy * Variation in an iron metabolism gene ## Footnote Lead exposure is associated with ADHD symptoms, especially at low levels.
160
Family influences account for only a small amount of the variance in **ADHD symptoms**. True or False?
TRUE ## Footnote Negative family influences have received little support as explanations for ADHD.
161
What parenting practices may interact with a child's genetic makeup to moderate risk for ADHD?
* Interfering and insensitive early caregiving practices * Family conflict ## Footnote These factors can raise the severity of hyperactive-impulsive symptoms.
162
What is the relationship between a child's **early temperament** and the parent's **style of interaction**?
An overactive child with an overstimulating parent is a seemingly poor fit ## Footnote The interaction can influence the development of ADHD symptoms.
163
Parents of children with **ADHD** may also have what condition?
ADHD ## Footnote Parents' ADHD symptoms can lead to ineffective parenting behaviors.
164
Mothers with higher levels of **ADHD symptoms** show less involvement and more inconsistent discipline compared to mothers with what?
Lower levels of ADHD symptoms ## Footnote This can affect their children's behavior and development.
165
What genetic variant is associated with negative and controlling behaviors in mothers interacting with their children?
DAT1 ## Footnote Particularly when their children are highly disruptive.
166
Emerging research indicates that children's inherited **genetic variations** may result in what?
Heightened vulnerability ## Footnote This can lead to epigenetic changes affecting emotional-behavioral functioning.
167
The **DAT1 genotype** moderated the relationship between what two variables?
* Maternal variables * Paternal variables ## Footnote This relates to children's methylation and psychopathological risk.
168
Family concerns may arise from interacting with a child who is **impulsive** and difficult to manage. True or False?
TRUE ## Footnote This can lead to increased family conflict.
169
What type of studies provide support for the child-to-parent direction of effect in ADHD?
Double-blind placebo-controlled drug studies ## Footnote These studies show that medication can reduce children's symptoms and improve parental behavior.
170
Family conflict or parental **psychopathology** is likely related to the emergence of what symptoms in children?
* Oppositional symptoms * Conduct disorder symptoms ## Footnote Maternal depression can heighten these issues in children with ADHD.
171
Children with ADHD report observing more **interparental conflict** than children without ADHD. True or False?
TRUE ## Footnote This may worsen symptoms for predisposed children.
172
Many ADHD interventions aim to change patterns of what?
Family interaction ## Footnote This is to prevent escalating cycles of oppositional behavior and conflict.
173
ADHD has a strong **biological basis** and is considered what type of condition for many children?
Inherited condition ## Footnote It is likely a heterogeneous disorder at the neurobiological level.
174
Theories about ADHD emphasize deficits in what areas?
* Cognitive functioning * Reward/motivation * Arousal level * Self-regulation ## Footnote These factors contribute to the disorder's expression.
175
What factors may compromise the development of the nervous system related to ADHD symptoms?
* Pregnancy and birth complications * Maternal smoking during pregnancy * Low birth weight * Malnutrition * Maternal alcohol or drug use * Early neurological insult or trauma * Diseases of infancy ## Footnote These factors can have lasting impacts on ADHD symptoms.
176
ADHD appears to be related to differences in what part of the brain?
Frontostriatal circuitry ## Footnote This includes pathways connecting to the limbic system, cerebellum, thalamus, and default mode network.
177
Neuroimaging studies show differences in structure, connectivity, or activity in certain regions of the brain in children with ADHD, but they don’t tell us what?
Why ## Footnote The underlying reasons for these differences remain unclear.
178
The action of effective medications for ADHD suggests involvement of which neurotransmitters?
* Dopamine * Norepinephrine ## Footnote Evidence suggests a selective deficiency in these neurotransmitters.
179
Dietary research on ADHD is focusing on what types of nutrients?
* Micronutrients * Essential fatty acids ## Footnote These may play a role in managing ADHD symptoms.
180
Psychosocial factors in the family do not typically cause ADHD, but they can lead to what?
Greater severity of symptoms ## Footnote They may also contribute to the emergence of co-occurring conduct concerns.
181
ADHD is likely the result of a complex pattern of what?
Interacting influences ## Footnote This may involve several nervous system pathways.
182
The number of children with **ADHD** receiving help has more than ______ in recent years.
doubled ## Footnote Despite the increase, many children in greatest clinical need still do not receive specialty services.
183
What is the **primary treatment approach** recommended by the U.S. Surgeon General for ADHD?
* Stimulant medication * Parent management training * Educational intervention ## Footnote This combination is aimed at effectively managing ADHD symptoms.
184
Name the **primary treatments** for children with ADHD.
* Stimulant medication * Parent management training * Educational intervention * Summer treatment programs ## Footnote These treatments focus on managing symptoms and improving behavior.
185
What are the **additional treatments** for ADHD mentioned?
* Family counseling * Support groups * Individual counseling ## Footnote These treatments address individual and family stresses associated with ADHD.
186
True or false: There is a known **cure** for ADHD.
FALSE ## Footnote Various treatments can help manage symptoms, but there is no cure.
187
Stimulant medications have been used to treat ADHD since the chance discovery in the ______.
1930s ## Footnote They are the most studied and effective treatment for ADHD symptoms.
188
Name three types of **stimulant medications** used for ADHD.
* Dextroamphetamine (Dexedrine) * Amphetamine-dextroamphetamine (Adderall) * Methylphenidate (Ritalin) ## Footnote These medications alter activity in the brain's frontostriatal region.
189
What percentage of children with ADHD experience increases in sustained attention and impulse control from stimulants?
80% ## Footnote Stimulants also improve academic productivity and social interactions.
190
Fill in the blank: Stimulants can have a calming effect on a child’s **hyperactivity** and ______.
impulsivity ## Footnote This effect allows the child's true personality to come through.
191
What are the **side effects** of stimulant medications?
* Reduced appetite * Weight loss * Sleep concerns ## Footnote Most side effects are benign and can be managed by adjusting the dose.
192
What is the **controversy** surrounding stimulant medications for ADHD?
Concerns about overprescription and misuse ## Footnote Public awareness has led to legislative efforts to protect children from coercion in medication use.
193
What is **Parent Management Training (PMT)** focused on?
* Effective parenting practices * Coping strategies for parenting challenges * Managing oppositional behaviors ## Footnote PMT helps parents understand ADHD and provides guiding principles for raising a child with the disorder.
194
True or false: Stimulants are addictive for most children with ADHD.
FALSE ## Footnote They do not lead to an increased risk for later substance use when used appropriately.
195
What is the **role** of educational interventions for children with ADHD?
Managing disruptive classroom behavior and improving academic performance ## Footnote Educational interventions also teach prosocial and self-regulating behaviors.
196
What is the **focus** of intensive summer treatment programs for ADHD?
Enhancing adjustment at home and future success at school ## Footnote These programs combine various primary and additional treatments.
197
What is the **emerging rationale** for ADHD treatment?
Early detection and early intervention ## Footnote This applies to both medication and psychosocial treatments.
198
What are some **specific needs** of adolescents with ADHD that new treatments focus on?
* Family–teen relationships * Organization and planning skills * Impulsivity management * Driver education skills ## Footnote These needs are increasingly recognized in treatment research.
199
What is the **effect** of stimulant medications on children with ADHD?
Temporary and occurs only while taking the medication ## Footnote Stimulants are not a cure and do not provide long-term benefits.
200
What is the purpose of a **school–home-based reward program** for children with ADHD?
To evaluate the child on a daily report card for rewards or punishments ## Footnote This program involves teachers assessing the child's classroom conduct to facilitate rewards or consequences at home.
201
In Parent Management Training (PMT), parents learn to manage noncompliance using _______.
penalties such as loss of privileges or time-out ## Footnote PMT teaches parents effective strategies for managing their child's behavior.
202
What are the **two major advantages** of the Summer Treatment Program (STP)?
* Maximizes opportunities to build effective peer relations * Provides continuity to academic work ## Footnote The STP is designed to ensure that gains made during the school year are not lost.
203
True or false: PMT focuses mainly on changing the deficits underlying a child’s ADHD.
FALSE ## Footnote PMT primarily teaches parents to manage overt disruptive behaviors rather than addressing the underlying deficits.
204
What are the **four treatment groups** in the Multimodal Treatment Study of Children with ADHD (MTA Study)?
* Medication management * Behavioral treatment * Combined behavioral treatment and medication * Routine community treatment ## Footnote These groups were established to compare the effectiveness of different treatment approaches.
205
What did the MTA Study find about the effectiveness of **stimulant medication** compared to behavioral treatment?
Stimulant medication was superior to behavioral treatment ## Footnote The study indicated that while both treatments reduced ADHD symptoms, medication was more effective for core symptoms.
206
What is a key finding regarding the **long-term effects** of ADHD treatments from the MTA Study?
By 36 months, there were no significant treatment group differences in ADHD symptoms ## Footnote This suggests that the effects of both medication and behavioral treatments may diminish over time.
207
What strategies are recommended for **managing classroom behavior** in children with ADHD?
* Set realistic goals * Establish a reward system * Monitor performance * Use response-cost procedures ## Footnote These strategies aim to reduce disruptive behaviors and enhance academic productivity.
208
What are some **accommodations** that may help children with ADHD learn better in the classroom?
* Seating near the teacher * Designated movement area * Clearly posted rules * Frequent behavior cues ## Footnote These accommodations are designed to support children with ADHD in focusing and completing tasks.
209
What is the **Summer Treatment Program (STP)** designed to provide?
Intensive treatment in a camplike setting with classroom and recreational activities ## Footnote The STP integrates various treatment methods, including medication and social skills training.
210
What does the MTA Study suggest about the **predictors of adolescent outcomes** for children with ADHD?
Initial clinical presentation and ADHD symptom response are better predictors than treatment type ## Footnote Factors such as severity and co-occurring issues play a significant role in long-term outcomes.
211
Fill in the blank: The **MTA Study** is a landmark multisite study sponsored by the U.S. National Institute of Mental Health and the U.S. Department of _______.
Education ## Footnote This study represents the first large-scale, randomized clinical trial for children with ADHD.
212
What is the **cost-effectiveness** of starting treatment for children with ADHD with behavioral treatment compared to stimulants?
Behavioral treatment is less costly and produces equivalent or superior outcomes ## Footnote This approach is preferred for initial treatment of ADHD.
213
What is one **novel intervention** designed to target attention and cognitive control in children with ADHD?
Digital cognitive training ## Footnote Delivered through a video game-like interface via at-home play.
214
What is the name of the **prescription digital videogame** intended to improve attention function in children with ADHD?
EndeavorRX ## Footnote It is intended for children aged 8 to 12 with primarily inattentive or combined-type ADHD.
215
True or false: **EndeavorRX** has demonstrated sustained improvements in functioning related to ADHD symptoms in real-world settings.
FALSE ## Footnote While some improvements were noted in laboratory settings, sustained improvements in real-world settings have yet to be established.
216
What is the role of **family counseling** for families of children with ADHD?
Helps develop new skills, attitudes, and effective relationships ## Footnote Family members may experience frustration, blame, and anger.
217
What do **support groups** for parents of children with ADHD provide?
* Information sharing * Emotional support * Personal frustrations and successes * Referrals to professionals * Discoveries about effective strategies ## Footnote They help parents feel less isolated in their experiences.
218
What is a common issue faced by **children with ADHD** regarding their self-perception?
They may feel isolated and believe they are abnormal, stupid, or doomed to failure ## Footnote This is often due to a lack of successes and negative feedback.
219
What type of counseling attempts to address the concerns of children with ADHD?
Individual counseling ## Footnote It helps children understand ADHD and treatment options.
220
Fill in the blank: Many treatments for ADHD have not been scientifically substantiated, including _______.
allergy treatments ## Footnote Other untested treatments include homeopathic treatments, vestibular stimulation, and megavitamins.
221
What is the **primary approach** to treating ADHD?
* Stimulant medication * Parent management training * Educational intervention ## Footnote This combination helps children cope with symptoms and secondary concerns.
222
What is the **Summer Treatment Program (STP)** designed for?
Improving problem solving, academic functioning, and social skills ## Footnote It uses evidence-based intensive treatments in a therapeutic summer camp setting.
223
What did the **MTA Study** find regarding treatment options for children with uncomplicated ADHD?
Medication may be the best treatment option ## Footnote For those with oppositional symptoms, a combination of medication and behavioral treatment may be best.
224
What are the **additional interventions** for ADHD mentioned in the text?
* Family counseling * Support groups * Individual counseling for the child ## Footnote These interventions provide support to children and their families.
CHILD PSYCHOPATHOLOGY
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