ADHD

Question 1

DSM-5 characteristics

Answer 1

6 inattention symptoms for 6 months. poor attention to details, cannot sustain attention, does not listen, does not follow through, does not organize, avoids tasks, loses things, is distracted, is forgetful

6 hyperactive/impulsive symptoms. fidgets, leaves seat, runs/climbs, not quiet, talks a lot, blurts out, cannot wait turn, interrupts

Question 2

ADHD etiology

Answer 2

genetics and heredity. neuronal/brain developmental delay. neurological/neurotransmitter abnormalities. environmental factors. psychological factors.

Question 3

genetics of ADHD

Answer 3

genes are involved. 76% heritable. chromosome 16 is most obvious finding

Question 4

key neurotransmitters involved in ADHD

Answer 4

decreased tonic NE firing in PFC, decreased tonic DA firing in PFC, serotonin ????

Question 5

environmental factors

Answer 5

cigarette use/alcohol in pregnancy, lead poisoning, head injuries, high sugar, food color additives, a learned behavior, a reaction to stress

Question 6

management with medication

Answer 6

stimulant class has great efficacy in adults, teens, and children. promote DA and NE increased activity. most carry risk of addiction. non stimulants have less efficacy but carry no addiction risk

Question 7

management with psychotherapy

Answer 7

behavioral modification and training. self control therapy, parent training, relaxation, support, distraction control, cognitive restructuring, attention sustaining

Question 8

treatment by age

Answer 8

try to avoid stimulants for adults, since they are easily addicted to them! fine for kids

Question 9

how are non-stimulants different?

Answer 9

Atomoxetine is a NE reuptake inhibitor only. Guanfacine ER and clonidine ER agonize or stimulate the alpha 2 norepi receptor. may dampen NE release in brainstem. in frontal cortex, the receptors are on glutamate pyramidal neurons and help to improve signal to noise ratio