ADHD

Question 1

Diagnosis of ADHD DSM-4 5 criteria

Answer 1

Criterion A - E.

Question 2

3 parts of criterion A

Answer 2

1. Split into 2 categories (inattention and hyperactivity).
2. Children must exhibit 6+ symptoms in either category.
3. Symptoms persisted for at least 6 months that is inconsistent for developmental level.

Question 3

Rate of school children with ADHD

Answer 3

3-5%

Question 4

Examples of inattention

Answer 4

Difficulty sustaining attention, giving close attention to details, does not seem to listen when spoken to, forgetful, distractible.

Question 5

Hyperactivity/impulsivity examples

Answer 5

Fidgets with hands/feet/squirms in seat, leaves seat when sitting is expected, talks excessively/blurts out answers, interrupts or intrudes on others.

Question 6

Criterion B

Answer 6

Symptoms present before age 7 (12 in DSM-5).

Question 7

Criterion C

Answer 7

Symptoms exhibited in 2+ settings

Question 8

Criterion D

Answer 8

Clear evidence of clinically significant impairment in social/school functioning

Question 9

Criterion E

Answer 9

Cannot be better accounted for by another disorder (changed in DSM-V).

Question 10

Proportion of children with ADHD having inattentive/combined/hyperactive type

Answer 10

1. Inattentive: 27%.
2. Combined: 55%.
3. Hyperactive: 18%.

Question 11

Durston et al. (2003) ADHD brain function in go/nogo Pokemon task

Answer 11

ADHD children had greater difficulties on all nogo trials. ADHD children had lower levels of activity for control-related circuits (frontostriatal/frontoparietal).

Question 12

Cortese et al. (2012) meta-analysis of networks in ADHD

Answer 12

Multiple networks in addition to the classic frontostriatal and fronto parietal network.

For adults: hypofunction in frontoparietal and somatomotor networks; hyperfunction in default, ventral attention, and dorsal attention networks.

Question 13

Gene x environment interaction

Answer 13

High-risk COMT gene more susceptible to adverse effects of low birth weight.

Question 14

2 single-risk accounts of ADHD

Answer 14

1. Executive difficulties.
2. Attention difficulties.

Question 15

Which specific executive dysfunction in ADHD and 2 tasks?

Answer 15

Inhibition deficit.

1. Go/nogo task: impact on ability to inhibit a prepotent response.
2. Stop-signal task: impact on ability to inhibit an already inhibited response.

Question 16

Inhibition in stop-signal task when signal appears immediately after go stimulus vs. after a long time.

Answer 16

Inhibition is easy when immediately after (way before response about to occur). Inhibition much harder when just about to respond.

Question 17

2 measures of performance in stop-signal task

Answer 17

1. Probability of inhibition at each stop-signal delay.
2. Stop-signal reaction time.

Question 18

Schachar et al. (2000) stop-signal task in ADHD

Answer 18

Probability of inhibiting accurately is lower in ADHD than in controls at all lengths of stop-signal delays (period between go and stop).

Question 19

Development of ADHD

Answer 19

Children rarely remain in the hyperactive type classification over time. Mostly shift to combined type.

Development disorder - suggests not a single, underlying core deficit.

Question 20

Martinussen et al. (2005) meta-analysis on WM in ADHD

Answer 20

Effect sizes for spatial storage/central executive WM greater than verbal storage/central executive WM.

Question 21

Sounga-Barke et al. (2003) study on executive dysfunction and delay aversion in ADHD

Answer 21

Executive dysfunction and delay aversion make significant independent contributions to predictions
of ADHD symptoms.

Question 21

Are all EFs affected in ADHD?

Answer 21

Shifting does not always seem to be affected. WM/maintenance seems to be affected (alongside inhibition).

Question 22

4 problems with EF account

Answer 22

1. Developmental nature of ADHD.
2. Not all EFs are affected.
3. Sensitivity (some children with ADHD do well on EF tasks).
4. Specificity (the profile of executive difficulties in ADHD and autism overlaps).

Question 23

Attention difficulties account

Answer 23

More basic aspects of attention (compared to higher-order executive aspects of attention that overlap with EF).

Question 24

Which aspects of attention are affected in ADHD?

Answer 24

1. Selective attention and spatial orienting are normal. 2. Difficulties in sustained attention (vigilance/arousal).

Question 25

How does sustained attention to response task (SART) differ from classic no-go tasks?

Answer 25

Go/nogo involves repeating 'go' signals with infrequent 'stop' signals. SART uses a constant varied stream and needs continuous visual monitoring to detect the infrequent target letter.

Question 26

Johnson et al. (2007) ADHD, HFA and NT controls on SART task

Answer 26

ADHD group made more omission errors (not responding when should have) than HFA and controls (both fixed and random SART). Both ADHD and HFA made more commision errors (responding when shouldn't have) than controls (in random SART).

Question 27

Omission errors

Answer 27

Missed responses when should have responded (lapses in attention.

Question 28

Commission errors

Answer 28

Responses when should have withheld (poor inhibition).

Question 29

Attention in ADHD

Answer 29

Perhaps associated with both control and sustained attention skills. Impaired conflict and alerting networks in Attentional Network task.

Question 30

Manly et al. (2001) test of everyday attention-children (TEA-Ch)

Answer 30

Robust difference between NT controls and children with ADHD. Selective attention, attentional control/switching/sustained attention seem to be related. Sustained attention most impaired, selective controls similar to controls.

Question 31

Fair et al. (2012) on ADHD vs. control across multiple processes

Answer 31

ADHD differed from controls on all tasks, but different profiles occurred, with variable differences across profiles.