DSM-5 ADHD criteria
- Inattention
- fails to give close attention to details
- has difficulty sustaining attention
- does not seem to listen when spoken to directly
- does not follow through on instructions
- has difficulty organising tasks and activities
- easily distracted by extraneous stimuli - Hyperactivity & Impulsivity
- often figets
- runs around in situations not appropriate
- unable to play
- often talks excessively
- often has difficulty waiting their turn
A. Several symptoms present prior to age 12 years.
B. Several symptoms present in two or more settings
What type of disorder is ADHD?
Externalising disorder, but also shows comorbidity with neural developmental disorders.
So is currently conceptualised as a ‘neurodevelopmental disorder’
Gender rates for ADHD
More common in males than females (2:1)
ADHD comorbidities
66% of children with ADHD present with at least one comorbid Axis 1 disorder (all psychological diagnostic categories)
What is developmental trajectory of ADHD?
Hyperactivity is noticed first, and then inattention
Non-inherited possible causes of ADHD?
- Teratogens and toxins (exposure during critical periods in pregnancy)
- Dietary factors (synthetic food colours)
- In younger kids, high levels of involvement by the parent results in lower levels of ADHD in older years
Genetic loading of ADHD?
Quite high (0.8)
Gene-environment correlation of ADHD (evocative and passive)
Evocative gene-environment correlation = child characteristics that are genetically based…evoke negative responses from parents
Passive gene-environment correlation = the same genes that underlie ADHD in the child…underlie parenting problems in their parents.
What is the dual pathway model of ADHD?
- Deficits in inhibitory-based executive processes
2. Motivational dysfunction involving disruptive signalling of delayed reward
The Delay Aversion Hypothesis
Predicts that ADHD children’s preference for immediate small over large delayed rewards will be reduced when stimulated, which makes time appear to pass more quickly, is added to the delay interval.
Attempts to avoid delay by attending to the most interesting/absorbing aspects of the environment.
Current best treatments for ADHD?
Psychological interventions (parent training; classroom programs) improve functioning
However, only stimulant medication appears to act on the core features of the disorder
DSM-5 OPPOSITIONAL DEFIANT DISORDER criteria
A. A pattern of negativistic, hostile, and defiant behaviour lasting at least 6 months, four or more of following:
- often loses temper
- often argues with adults
- often actively defies/refuses to comply with adults requests/rules
- often deliberately annoys people
- often blames others for mistakes
- is often touchy of easily annoyed by others
- is often angry and resentful
- is often spiteful or vindictive
Patterson’s Coercion Theory in relation to ODD
He believed that the essence of learning show these aggressive behaviours reside in the moment to moment interactions you had with your parents as a child.
You learnt how to get what you wanted through aggressive/coercive means.
What does Patterson’s model show about reinforcement in ODD
The moment that one person stops the battle (parent or child) they are simultaneously reinforced.
Parents = negatively reinforced Child = positively reinforced
Deviancy groups ODD
Where those that like to cause problems start to group together at school
DSM-5 CONDUCT DISORDER criteria
A. A repetitive and persistent pattern of behaviour in which the basic rights of others or rules are violated, by 3 or more of:
- aggression to people and animals
- destruction of property
- deceitfulness or theft
- serious violations of rules
CONDUCT DISORDER onset
Childhood-onset type = onset of at least one criterion characteristic of CD prior to 10 years of age.
Adolescent-onset type = absence of any criteria characteristic of CD prior to age 10 years (this is more common).
Define Low CU Traits (hot)
Highly reactive to emotional cues.
Have hostile attributional biases - they think the world is against them.
They feel a lot of self-negative energy and they turn that on other kids, aggressively.
Define High CU Traits (cold)
Tend to be more severe and chronic.
Show both reactive and proactive aggression.
Show punishment insensitivity (don’t pay attention to punishment; just focus on reward cues).
Between high and low CU traits, which are heritable and which are environmental?
Low CU traits have low heritability, most comes from the environment
High CU traits show much greater heritability
Best psychological treatment for ODD
Behavioural Parent Training
Minuchin: Hierarchical structure of a healthy family
Unless the parents work together it can be very difficult to get these treatments to work.
