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17 Cards in this Set

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What is ADHD
Inattention Type (cannot concentrate, distracted ,disorganized)
HyperImpulsive Type (excessive talking,fidgety, interupts)
Types of ADHD
Combined (ADHD-C)=6 or more symptoms of both

Inattentive (ADHD-I)=6 or more symptoms of Inattention, less than 6 symptoms of hyperactivity/impulsivity

Hyperimpulsive (ADHD-H)=6 or more symptoms of Hyperact/ Impulsivity, less than 6 symptoms of inattention
other properties
Behavior interferes w/ abilities in multiple settings (home, school, peers)
Behavoirs present in early childhood (onset before 7)
Duration of symptoms at least 6 months
No objective tests to diagnose (only subjective)
Limitations
Not developmentally sensitive: symptoms of hyperimpulsivity decrease w/ age
Heterogeneous
Not sex-specific (girls more likely to be socialized against showing hyper/impl sx
Characterisitics
Prevalence: 3-5% (declines w/ age)
More boys than girls
More in low SES
Associated problems
Associated problems
ODD,CD, LD, ANX, DEP
(ODD/CD more common in combined)
ODD, CD, LD=externalizing behaviors (affect family/ peers in over way)
ANX, DEP= internalizing
Etiology
Highly heritable (twin studies .75-.95 heritability)
Neurotransmitters: dopamine, neuropinephrine)
Barkley's Integrative Model
Primary deficit= weakened ability to inhibit behavior. All other deviations are secondary.
Primary deficit arises as product of biological factors.
Executive Functions
=cognitive processes that contribute to self-regulation
Includes inhibition, attention, working memory, flexibility of thought, emotional regulation.
Problems can cause other [behavioral] problems
Family context
Transitional effect: brings out worst in parent and child.
Protective factor: positive parenting
Social Context
increased chance of peer rejection and social isolation
ADHD-C more peer rejection
ADHD-I more peer neglect
Developmental Course
Toddler/Preschool: problems with hyperactivity and impulsivity first seen. @age 3, uncontrolled conduct becomes differentiated pattern (can distinguish)

Mid Childhood: attention problems more prominent; ADHD-C more prevalent

Late Childhood/Ad: antisocial activities, hyperactivity and impulsivity decline, ADHD-I more prevalent

Adulthood: 40% continue symptoms; maybe problems w/ alcohol/drug abuse, antisocial
Intervention
Medecine (ritalin, etc): very effective but only if done correctly/daily parent, teacher reports on doses, regular schedule
Psychotherapy: behavior management, cognitive behavioral therapy, anger management, Social skills training, parent training
MTA Study
Combined subtype. Randomly assigned to: psychotherapy only, medication only, combined both, or community care
MTA Results
Combined treatment most effective [in improving family relations, lower total med. dose, reported school gains]

For severity of symptoms, Medication alone was just as effective as Combined. (both better than therapy alone or community care)
Medication concerns
If properly on medication, @ lower risk for drug use.
Not addictive.
If taken as directed, will not get hi, but potential for abuse.
Side effects:dec appetite, weight loss, sleep problems, tics
Alternative Treatment
Elimination Diets- sugar, food sensitives (but will not cure)
Nutritional supplements
Acupuncture (no evidence of effectiveness)
BioFeedback (no evidence)