Psy 183 Attention-Deficit Hyperactivity Disorder

question II

What is the DSM-5TR presentations of ADHD and their general features?

predominantly hyperactive-impulsive: excessive movement, interrupting, blurting out, restlessness, “on the go”

predominately inattentive: careless mistakes, distractibility, forgetfulness, disorganization, avoiding sustained mental effort

combined prevention: meets criteria for both sets of symptoms

What groups are most affected by ADHD, and what contributes to risk?

found across cultures and socioeconomic groups

sex differences: hyperactive-umpulsive → more males than females, inattentive → more females than males

genetic contribution: high twin concordance; 40-50% have 1st degree relative with ADHD

risk factors: prenatal complications, prematurity, low birth weight, maternal smoking/drinking or anxiety, lead exposure, unstable home environments, TBI

course: often persists- 70% show symptoms into adulthood; 20% retain full disorder

What are the major consequences of ADHD?

poor academic performance and conduct issues

high comorbidity with learning disorders, mood disorders, anxiety, conduct disorder, Tourette’s

increased risk of accidents, STIs, job loss, unwanted pregnancy, delinquency

high prevalence in juvenile detention and prison population

low college graduation rates without treatment

What are the general features of psychostimulant treatment for ADHD?

effectiveness: 70% - 80% off children, improves attention and impulse control

advantages: rapid effect, not addictive when correctly prescribed, reduces later substance-abuse risk

side effects: insomnia, headache, nausea, possible growth delay at high doses, may unmask tic disorders

drawbacks: abuse potential if misused, recreational use can cause paranoia/psychosis, controlled substances

What non-medication treatments are used for ADHD?

structured routine and schedules

breaking tasks into smaller steos

immediate rewards and consistent consequences (time-out works; spanking ineffective)

minimizing distractions

for teens/adults: mindfulness, yoga, relaxation, time-management training

ineffective/unproven: EEG biofeedback, elimination diets, nutritional supplements

Are psychostimulants safe?

generally safe and effective when prescribed

not gateway drugs when used therapeutically

abuse risk mainly from non prescribed use (ex. snorting/injecting crushed pills)

high doses or misuse can lead to paranoia or psychosis

Vyvanse reduces misuse risk due to abuse-deterrent forumalotion (ADF)

What are typical signs of ADHD in adults?

seeking highly stimulating environments to focus

switching TV/radio frequently; difficulty waiting in line

zoning out during conversations or intimate moments

blurting or interrupting; impulsive remarks

creative, intuitive, “out of the box” thinking

chronic disorganization, procrastination, and time-blindness