adhd

describe the three subtypes of ADHD differ in symptomology

• predominantly inattentive type (ADHD-PI) 6+ in past 6 months

  • fails to give close attention to details

  • difficulty sustaining attention

  • doesn’t seem to listen when spoken to directly

  • does not follow through on tasks (sidetracked)

  • difficulty organizing tasks, poor time management

  • reluctant to engage in tasks that require sustained mental effort

  • often loses things necessary for tasks

  • often forgetful in daily activities

• predominantly hyperactive-impulsive type (ADHD-HI) 6+ in past 6 months

  • often fidgets or taps hands and feet

  • often leaves seat

  • often runs or climbs (feeling restless)

  • unable to engage in leisure activities quietly

  • uncomfortable being still for extended time

  • talks excessively

  • often blurts out an answer

  • often has difficulty waiting his or her turn

  • often interrupts or intrudes on others

• combined type (ADHD-C)

  • several inattentive or hyperactive-impulsive symptoms were present prior to 12

  • several inattentive or hyperactive-impulsive symptoms are present in 2 or more settings

  • there is clear evidence that the symptoms

describe any gender, life-course, or comorbidity differences between ADHD subtypes

gender

• girls may be more likely to display inattentive and disorganized symptoms

• girls with ADHD-HI tend to be referred at a younger age, and as hyperverbal not hyperactive

comorbid

• many children with ADHD also meet criteria for other disorders

• 50% meet criteria for ODD by age 7

• 30-50% develop CD

• in adulthood, 80% of individuals with ADHD have at least 1 coexisting psychiatric disorder

  • MDD, GAD, Bipolar, SUD

explain developmental insensitivity in the DSM regarding ADHD

DSM III and DSM IV diagnostic criteria were

• developed based on studies of children

• were not validated in adults

• often did not reflect symptoms described by ADHD adults

what gender differences exist for ADHD and how might we explain them

• over-referral of boys

• under-referral of girls

• diagnostic criteria continue to skew more towards boys’ experiences and symptoms

• disparity in prevalence across males and females is narrower in adulthood than childhood

describe the neural mechanisms involved in ADHD

basal ganglia

• groups of structures that work together

• important for response control and inhibition

frontostriatal circuitry

• connections which form pathways between frontal lobes and striatum

• messages are passed along these connections via neurotransmitters

• in adhd, the FC doesn’t work as well

  • frontal lobes smaller in volume

describe the genetic heritability of ADHD

• one of the most heritable disorders

• (h2=.7)

• rates of ADHD are 3x higher in biological parents of children with ADHD

• dopaminergic genes

what environmental risk factors exist for ADHD

• lead

• prenatal factors

• poverty

define temporal discounting and explain how it relates to ADHD

• desirability of a reward relative to how quickly that reward arrives

  • people with adhd tend to opt for smaller, more immediate rewards over bigger rewards that take longer to appear

explain how psychostimulants help treat ADHD

• increases dopamine levels in frontostriatal circuitry

• most kids (80%) show descreases in activity, disruptive behaviors, and enhanced sustained attention

what does research on school cutoffs tell us about ADHD

kids who are young for their grade (born right before cutoff) are more likely to be diagnosed with ADHD

describe the role neuropsychological testing plays in ADHD diagnosis

• ask people to do a variety of different cognitive tasks

• test battery should include multiple attentional and nonattentional tasks, as well as extensive clinical interview

• can differentiate ADHD from other psychiatric diagnoses which mimic symptoms of ADHD