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PS2028 - Mental Health & Clinical Psychology > ADHD - aetiology & presentation > Flashcards

ADHD - aetiology & presentation Flashcards

1
Q

how many children are clinically diagnosed with a mental disorder?

A

1 in 10

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2
Q

higher levels of e___ and c___ d___ in 5-16 year olds?

A
  • emotional
  • conduct disorders
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3
Q

is ADHD more present in boys or girls?

A

BOYS

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4
Q

how many risk factors did Rutter (1975) identify to work out where vulnerability for certain disorders may come from in children?

A

6

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5
Q

what symptoms are twice as common for 10 year old children in the inner city vs Isle of Wight?

A
  • poor concentration
  • hyper vigilance to perceived fear stimuli
  • stimulus avoidance
  • excessive worry
  • denial
  • rage
  • social withdrawal
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6
Q

MD, FD, SC, MP

what 4 symptoms are all factors that lead to other childhood disorders?

A
  • marital distress
  • family dysfunction
  • social class
  • maternal psychopathy
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7
Q

is a single factor responsible for a disorder?

A
  • NO
  • it is an adversity
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8
Q

do symptoms influence the outcome or onset of disorder?

A

OUTCOME

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9
Q

there are lots of brain changes between what ages?

A

5 - 20 years

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10
Q

what happens if there are disruptions to brain development in children?

A
  • altered brain development
  • potential disorders
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11
Q

what is ADHD?

A
  • chronic condition
  • attention deficit
  • impulsivity, poor concentration, easily distracted
  • hyperactivity disorder
  • exaggerated motor activity
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12
Q

ADHD can lead to dysfunctions in what domains?

A
  • problem solving
  • planning
  • orienting
  • alerting
  • cognitive flexibility
  • decision making
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13
Q

what could ADHD lead to?

A
  • poor academic achievement
  • low intelligence
  • low self-esteem
  • negative view by peers
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14
Q

significant amount of symptoms displayed prior to age ?

A

12

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15
Q

what is needed for a diagnosis in childhood?

A
  • should present at least 6 from a cluster of 8 symptoms for “AD” (attention deficit)
  • should present at least 6 from cluster of 9 symptoms for “HD” (hyper-activity)
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16
Q

why was there a significant change between DSM-4 and DSM-5 in terms of ADHD diagnosis?

A

DSM-4 did not take into account that adults could suffer with ADHD too, deemed as “childhood disorder” only

17
Q

what are the 3 subtypes of ADHD?

A
  • predominantly inattentive (I)
  • predominantly hyperactive-impulsive type (HI)
  • combined hyperactive-impulsivity and inattentive (C)
18
Q

what are the characteristics of the predominantly inattentive subtype of ADHD?

A
  • the majority of symptoms (six or more) are in the inattention category (1) and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree
  • children with this subtype are less likely to act out or have difficulties getting along with other children
  • they may sit quietly, but they are not paying attention to what they are doing
  • therefore, the child may be overlooked, and parents and teachers may not notice symptoms of ADHD
19
Q

what are the characteristics of the predominantly hyper-active-impulsive subtype of ADHD?

A
  • most symptoms (six or more) are in the hyperactivity-impulsivity categories (2)
  • fewer than six symptoms of inattention are present, although inattention may still be present to some degree
20
Q

what are the characteristics of the combined hyper-active-impulsivity and inattentive subtype of ADHD?

A
  • six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present
  • most children with ADHD have the combined type
21
Q

how to go about diagnosing ADHD?

A
  • GP first port of call - but need child psychiatrist for final diagnosis
  • need to discount other causes of hyperactivity/inattention such as medical conditions and psychological conditions
  • co-morbidities with anxiety, CD, substance abuse, Tourette’s etc.
22
Q

what is the epidemiology of ADHD?

A
  • children in US/UK > Africa and Middle East
  • 5.2% US adults have ADHD, so not just childhood disorder
  • boys > girls for all sub-types
  • young > old = HI type
  • poor > rich = HI type
  • poor > rich = receive treatment
23
Q

what has an effect on how/if a child receives treatment?

A
  • gender and wealth have an effect
  • children from poor areas are first to receive diagnosis but last for treatment
24
Q

what is the aetiology of ADHD?

A
  • combination of psychosocial and biological
  • diathesis stress model
  • might have genetic marker but might need environmental trigger
  • dietary effects not linked to ADHD or TV viewing
  • maternal smoking, pregnancy and delivery complications and disruptions to development due to environmental toxicity
25
Q

what is the aetiology of ADHD: biological?

A

genetics, neuroanatomical, IUGR

26
Q

e,b,c

what is the aetiology of ADHD: psychosocial?

A

environment, behaviour, cognition

27
Q

how do pre/neo-natal effects have an effect on ADHD acquisition?

A
  • children at risk if have history of pre-term delivery or low birth weight
  • foetal exposure to toxins could lead to hyperactivity or impulsivity
  • maternal tobacco (link between nicotine and dopamine function)
  • birth complications
28
Q

how do genetics have an effect on ADHD acquisition?

A
  • high heritability = 75%
  • high MZ twin concordance rate
  • many GWAS and candidate gene associations
  • linked to dopamine, serotonergic and noradrenergic function
29
Q

how do genetics have an effect on ADHD acquisition - what receptor gene is the strongest candidate?

A

D4

29
Q

at what age does the brain get its peak thickness?

A
  • 7.5 control
  • 10.5 ADHD
  • brain maturation delay specially in PFC
  • ADHD probably a neurodevelopmental disorder
30
Q

how does ADHD continue into adulthood?

A
  • majority of children with ADHD do not have ADHD in adulthood
  • majority of adults with ADHD did not have ADHD in childhood
  • insufficient methodologies, currently provide unclear information about the nature of late-onset symptoms which could exist but be down to many things (e.g., childhood-onset symptoms that were not detected earlier due to failure to come to clinical attention)
31
Q

what is adult-emergent ADHD?

A
  • slightly different pattern to childhood ADHD (less hyperactivity and more I than HI or C types)
  • gender difference not as clear cut
    high co-morbidity (bipolar, substance abuse)
  • treatments similar
32
Q

why is it difficult to accurately diagnose ADHD in adults based on self-report alone?

A
  • retrospective recall of childhood symptoms is used to diagnose ADHD in adults
  • but, parental-and self-report retrospective recall of childhood ADHD symptoms is poor
  • adults with ADHD both overreport and underreport current ADHD symptoms and associated impairment, while adults without ADHD overreport ADHD symptoms

PS2028 - Mental Health & Clinical Psychology (13 decks)

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