mental health, theme 3

attention deficit hyperactivity disorder (ADHD)

a persistent pattern of inattention and/or hyperactivity-impulsivity that is higher than normal (lack of attention, making careless mistakes etc.)

hyperactivity

a higher level of activity than normal

impulsivity

acting without considering the consequences

3 diagnostic subtypes of ADHD

• ADHD, predominantly inattentive presentation

• ADHD, predominantly hyperactive/impulsive presentation

• combined presentation (both)

DSM-5 criteria for ADHD

• an ongoing pattern of inattentive and/or hyperactivity-impulsivity that interferes with the normal functioning of development

• inattention: at least 6 of the symptoms for at least 6 months

• hyperactivity and impulsivity: at least 6 of the symptoms for at least 6 months

• symptoms were there before the age of 12

• symptoms are present in at least 2 settings (school, at home etc.)

• symptoms reduce the quality of educational, social or occupational ability

• symptoms cannot be caused by other disorders

prevalence of ADHD

5% of children —> 2.5% of adults, 50% of children will carry it into adulthood, more common in boys because they are more likely to be diagnosed

consequences of ADHD

• impaired academic achievements

• peer rejection and accidental injuries (hyperactivity/impulsivity)

• greater difficulty with making friends

• less success and safety at work (adults)

biological factors of ADHD

• genetic factors (most inheritable disorder, 76% inherits it)

• neurological factors (the brains are smaller, deficits in executive functioning)

• prenatal factors (maternal smoking/drinking)

• environmental factors (could be caused by biochemical imbalances, little evidence)

psychological factors of ADHD

• parent-child interaction

• Theory of Mind deficits

behavioral strategies and family interventions for ADHD

• Time-out (TO)

• behavior management techniques

• systematic family therapy

• parent management training

• functional family therapy

time-out

reducing disruptive behaviors, by removing the child from the situation and directing them to sit or stand somewhere for 5-15 minutes to calm down.

behavior management techniques

treatment methods that can be used directly or taught to parents as an aid to control and respond to their children at home

systematic family therapy

childhood problems result from inappropriate family structures and organization —> therapist is concerned with the boundaries between parents and child and their way of communicating

parent management training

teaching parents to modify their responses in a way that acceptable behaviors are reinforced instead of antisocial behaviors

functional family therapy

family-based intervention which focusses on strengthening the relationships in the family by opening up communication between parents and child

medication treatments of ADHD

—> most adopted treatment of ADHD, about 42% are treated this way

• Ritalin: decreases distractibility and increases alertness —> can cause side effects and drug abuse (no studies about the long-term effects of ritalin)

• Strattera: only non-stimulant medication approved by US

• Clonidine: slows down high blood pressure and is used in combination with other psychostimulants

• Antidepressants: only used when psychostimulants aren’t working, helps with ADHD symptoms for unknown reasons

psychostimulants

medications that increase CNS activity —> 2 side effects that are common: trouble sleeping & decreased appetite (have a paradoxical effect in people with ADHD, in normal people it makes them faster in everything but in people with ADHD it slows them down)

conclusions of ADHD article

• ADHD requires age-specific treatments that evolve over time

• Parent training is key for younger children

• CBT most effective for adults

• multimodel treatments (medication+therapy) works best for severe cases

• more research is needed