Part IV: Attention-Deficit/Hyperactivity Disorder (ADHD)

DSM-5 Core Criteria

Symptom count

Age Rule

Pervasiveness Rule

Classic Triad

Three Presentations (Subtypes)

DSM-5 Core Criteria: Symptom count

6+ symptoms of Inattention and/or 6+ symptoms of Hyperactivity/Impulsivity (for 6+ months)

DSM-5 Core Criteria: Age Rule

Several symptoms must have been present before age 12

DSM-5 Core Criteria: Pervasiveness Rule

Symptoms must be present in two or more settings (e.g., home and shcool)

DSM-5 Core Criteria: Classic Triad

Inattention, Impulsivity, and Hyperactivity

DSM-5 Core Criteria: Three Presentations (Subtypes)

1. Combined (Most Common): Meets criteria for both inattention and H/I

2. Predominantly Inattentive: Meets criteria only for inattention

3. Predominantly Hyperactive/Impulsive: Meets criteria only for H/I

Etiology 

ADHD is a highly heritable neurobiological disorder

Neurobiology

Deficits in the frontal lobes, primarily the prefrontal cortext (PFC) (responsible for executive functions, inhibition, and working memory)

Neurotransmitters

Associated with deficits in the Dopamine (DA) and Norepinephrine (NE) systems

MTA Study (The landmark RCT)

• Core Finding (14 months): Medication (MED) was superior to Behavior Therapy (BEH) for treating the core symptoms (inattention, H/I).

• Combined Treatment (COMB) provided the best overall outcomes across social skills, classroom behavior, and academic performance.

Neurobiological Model (A: YES)

• ADHD is a valid, chronic, genetic, and neurobiological disorder

• Supported by high heritability and structural brain differences (PFC, DA/NE)

Ecological Mismatch (Armstrong)

• ADHD is a consequences of modern childhood, a mismatch between the child’s needs and the environment

• Rise of Technologies (trains for instant gratification) and Demise of Play (stifles biological need for movement, leading to inattentiveness(

Sociological Critique (Turtel)

• ADHD is a “Myth” or a “Fraudulent Disorder” used to pathologize normal children who are bored or developmentally unsuited to the rigid, sedentary demands of the modern school system.

• Claims the behavior is a “School Problem” that disappears in stimulating environments (like homeschool)