Attention - Deficit/Hyperactivity Disorder (ADHD)

How was ADHD viewed in the early 1900s?

It was believed to be caused by poor “inhibitory volition” and “defective moral control.”

What historical event influenced early ideas about ADHD as a brain disorder?

The encephalitis epidemic of 1917–1918, which led to the concept of “brain-injured child syndrome.”

What is the current understanding of the core difficulty in ADHD?

Problems in self-regulation and behavioral inhibition.

What is the duration requirement for ADHD symptoms?

Symptoms must persist for at least 6 months.

By what age must ADHD symptoms appear?

Symptoms must be present before age 12, with evidence of onset before age 7.

In how many settings must symptoms be present?

Two or more settings (e.g., home and school).

What must symptoms cause to qualify for diagnosis?

Clear functional impairment or interference with developmentally appropriate functioning.

How many inattention symptoms must be shown for diagnosis?

• Children: 6 or more

• Adults: 5 or more

Give 3 examples of inattention symptoms.

• Easily distracted

• Avoids tasks needing sustained effort

• Often forgetful in daily activities

How many hyperactivity-impulsivity symptoms are required?

• Children: 6 or more

• Adults: 5 or more

Give 3 examples of hyperactivity-impulsivity symptoms.

• Talks excessively

• Blurts out answers

• Fidgets or squirms

What are the subtypes of ADHD?

• Predominantly Hyperactive-Impulsive

• Predominantly Inattentive

• Combined Type

Can subtypes of ADHD change over time?

Yes, individuals may shift subtypes as they mature.

What are some associated issues with ADHD?

• Learning problems

• Executive function deficits

• Low self-worth or inflated ego

• Language impairments

• Sleep problems

• Risky behavior

What is the prevalence of ADHD in children and adults?

• 2–10% in children

• 1–6% in adults

What comorbidities are commonly seen with ADHD?

• MDD, OCD

• Mood and anxiety disorders

• Learning and communication disorders

• Tic and coordination disorders

How heritable is ADHD?

70–90% genetic contribution; higher concordance in MZ twins than DZ.

Which genes are linked to ADHD?

Dopamine transporter gene (DAT) and dopamine receptor gene (DRD4).

Name a few prenatal risks for ADHD.

• Smoking during pregnancy

• Birth complications

• Early developmental issues

What brain structures show differences in ADHD?

Smaller corpus callosum, right frontal lobe, basal ganglia, and cerebellum

What neurotransmitter is primarily involved in ADHD?

Dopamine.

What are the main treatments for ADHD?

• Medication

• Parent Management Training (PMT)

• Educational intervention

• Combined/intensive interventions

• Additional supports

What medications are commonly used for ADHD?

• Stimulants (e.g., Adderall, Ritalin, Vyvanse)

• Non-stimulants (e.g., Strattera)

• Antidepressants (e.g., Wellbutrin)

• Blood pressure meds (e.g., Clonidine, Guanfacine)

What does Parent Management Training (PMT) include?

• Behavior modification

• Environmental structuring

• Reducing conflict

What are examples of educational interventions?

• Daily report cards

• Visual schedules

• Classroom structure to support attention

What are examples of additional interventions for ADHD?

• Counseling

• Support groups

• Caution against controversial treatments