6/8- Attention Disorders and Treatment Flashcards
(42 cards)
T/F: Attention disorders are behavioral disorders caused by excessive restlessness and distractability, a problem that usually remits during childhood but occasionally persists into adulthood
False. This is the hold conceptualization
What are attention problems/disorders?
Complex disorder in unfolding development of the unconscious self-management system of the brain
- A problem of chemical dynamics in the brain
Impairments with attention disorders include what?
Chronic difficulties in self regulation by emotion
When do symptoms become apparent with attention disorders?
Symptoms may be noticeable in childhood, but may not be apparent until the individual encounters challenges of adolescence or adulthood
T/F: Attention disorders are genetic
True: appear to be primarily genetic, though environmental stressors and support may modify expression of symptoms (environment may make it better or worse!)
T/F: attention disorders increase risk of other comorbidities across the lifespan?
True
ADHD Criteria?
- Symptoms present before the age of 7
- Symptoms are present in more than 1 setting
- Symptoms may be primarily inattentive, hyperactive/impulsive or a combination of both
Inattentive symptoms?
- Makes careless mistakes; poor attention to detail
- Has difficulty sustaining attention
- Does not seem to listen
- Does not follow through or finish tasks
- Avoids activities that require sustained mental effort
- Loses things easily
- Is easily distracted
- Is forgetful
Hyperactivity/impulsivity symptoms?
Hyperactivity:
- Fidgets, squirms
- Has difficulty remaining seated
- Runs or climbs excessively (children), experiences subjective restlessness (adults)
- Has difficulty with quiet activities
- Is “on the go” or “driven by a motor”
- Talks excessively
Impulsivity:
- Blurts out answers before questions are completed
- Are impatient
- Often interrupts others
T/F: If someone has inattention/trouble focusing, the diagnosis to consider is ADHD
False; inattention is a symptom of many disorders
Inattention may be a symptom of what disorders?
- ADHD
- Mood disorders
- Anxiety disorders
- Thought disorders
- Pervasive developmental disorders
- Learning disorders
- Personality disorders
T/F: You can have ADHD (attention deficit hyperactivity disorder) that presents as inattentive
True
__% of children aged 3-5 meet the criteria for ADHD
2-6% of children aged 3-5 meet the criteria for ADHD
(increasingly diagnosed in ages 2-3) … some concerns arisen about using diagnostic criteria in such a young age group (need to wait until ~5 yo)
Early symptoms of ADHD are considered predictive of what?
Later behavioral problems
__% of children in elementary school meet criteria for ADHD? What is the distribution in gender?
3-7% of children in elementary school meet criteria for ADHD
Gender distribution varies:
- Boys more hyperactive
- Girls more inattentive
Elementary school aged kids with ADHD are at higher risk for what?
- Grade retention
- Special education
__% of pts diagnosed with ADHD as children continue to have the full clincial syndrome in adolescence?
78% of pts diagnosed with ADHD as children continue to have the full clincial syndrome in adolescence
Characteristics of ADHD in adolescents?
- Physical hyperactivity diminishes but inattention and impulsivity persists
- Have worse driving habits, more accidents, and more speeding tickets
- More consequences of sexuality
- More challenges in gaining teen’s cooperation with diagnosis and treatment
__% of children with ADHD continue to have symptoms in adolescence and adulthood?
30-70% of children with ADHD continue to have symptoms in adolescence and adulthood (4.4% prevalence)
Characteristics/impact of ADHD in adults?
- May influence job selection
- May tend to overwork due to inefficiency
- May have low frustration tolerance or relationship problems
- Impulsivity may be seen in driving, managing finances
- May have low self-esteem due to chronic feelings of underachievement
T/F: ADHD is something children commonly outgrow
False
- 78% continue into adolescence
- 30-70% continue into adulthood
Questions you can ask when taking a history of attention problems?
- Sitting through a movie
- Reading for pleasure
- Video games (may reveal inability to disengage*)
- Taking notes in class
- Organization skills, misplacing things
- Keeping their room in order
- Daydreaming
- Quickly lose interest
- Participation in conversations, interrupting, perception of peers
- Moodiness, frustration tolerance
*Thus, ADHD may not only involve inattention but also inability to remove attention from something that is especially stimulating
Neuropsychological testing focuses on what in assessing ADHD?
- Processing speed (WAIS III)
- Attention tests (Continuous Performance Test)
- Working memory tests (remember fewer details of story, but doesn’t decrease over time like dementia)
- Executive functioning (Wisconsin Card Sorting)– areas of difficulty suggest involvement of frontal cortex or regions projecting to the frontal cortex
What are some neuroimaging results seen in ADHD?
- Large MRI study demonstrated smaller brain volumes that did not normalize with maturity
- PET studies identified abnormalities of cerebral metabolism in the prefrontal and premotor areas of the frontal lobe in ADHD adults who had children with ADHD
