Behavioral Science - ADHD - Thomas L. Schwartz Flashcards Preview

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Flashcards in Behavioral Science - ADHD - Thomas L. Schwartz Deck (16):
1

What inattention symptoms must a patient have had for 6 months in order to consider a diagnosis of ADHD?

Poor attention to details --> mistakes
Does not listen
Cannot sustain attention
Does not follow through
Does not organize
Avoids tasks
Loses things
Is distracted
Is forgetful

2

What impulsive/hyperactive symptoms must a patient have had for 6 months in order to consider a diagnosis of ADHD?

Fidgets
Leaves seat
Runs/climbs
Not quiet
Talks a lot
Blurts out
Cannot wait
Interrupts

3

T/F: Most milder cases of ADHD are not noticed until later in life when the demands (ie academic) are greater.

True
Symptoms of inattentiveness persist longer than impulsive/hyperactive symptoms

4

How heritable is ADHD?

76%
Chromosome 16
Dopaminergic genes, NE genes

5

What activation in the brain is missing in ADHD?

anterior cingulate

6

What environmental factors might be associated with ADHD?

Cigarette smoking in pregnancy
Lead poisoning
Head injuries
High sugar
Food color additives
Learned behavior
Reaction to stress

7

What other disorders should be in the differential when diagnosing ADHD?

Autism Spectrum Disorder
Learning Disability
Substance Use Disorder
Personality Disorder
Bipolar Disorder

8

What are the non-stimulant treatments for ADHD?

Atomoxetine (Strattera) (Norepi reuptake inhibitor)

BP meds (alpha-2 NE agonists)
Guanfancine ER
Clonodine ER

carry no addiction risk
can be sedating

9

What are the goals of psychotherapy with ADHD?

Self control
Behavioral parent training
Relaxation
Education support
Distraction control
Attention Sustaining
Cognitive Restructuring

10

What is first line ADHD therapy for little kids?

Meds first
More aggressive stimulants recommended for younger kids

11

How do Guanfancine ER and Clonodine ER work for ADHD if they are BP meds?

In the brainstem they may dampen NE release and lower BP as an autoreceptor;
In the frontal cortex, these receptors are located on the glutamate pyramidal neurons and help to improve the signal to noise ratio, allowing the neuron to fire appropriately when faced with multiple environmental stimuli. This fine tunes the frontal cortex and helps with prioritizing, response inhibition and vigilance

12

ADHD patients tend to have what differences from the general population?

Less schooling
Lower self esteem
More divorces
Greater addiction rates
Greater antisocial behavior
same rates of medical illness

13

A 19 yo college student presents and meets criteria for ADHD inattentive type. What other psychiatric disorder will he most likely have outside of his ADHD?

A. Anxiety
B. Bipolar
C. Depression
D. Alcoholism

Anxiety

14

A 30 yo ADHD patient has failed to respond to methylphenidate, which of the following likely has a stronger effect on dopamine release in the brain?

A. Guanfancine ER
B. Atomoxetine
C. Amphetamine
D. Clonodine ER

Amphetamine
always the strongest on dopamine

15

A 15 yo with ADHD combined type has a functional MRI scan. What is the most likely finding?

A. Hyperactive amygdala
B. Hypoactive cerebellum
C. Hyperactive orbitofrontal cortex
D. Hypoactive orbitofrontal cortex

Hypoactive orbitofrontal cortex

16

What stimulants are used to treat ADHD?

Methylphenidate
Amphetamine

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