Chapter 14 Flashcards
(267 cards)
1
Q
What moral development issues are associated with contemporary thinking about ADHD?
A
Moral development issues are totally absent from contemporary thinking about ADHD
This indicates a gap in understanding the broader implications of ADHD beyond behavioral symptoms.
2
Q
What is one of the major features of ADHD as conceptualized today?
A
Problems in sitting still
This symptom is often linked to hyperactivity and excess movement.
3
Q
What are the two primary focuses in the debate regarding ADHD symptoms?
A
Excess movement and inattention
The debate highlights differing perspectives on what constitutes the core symptoms of ADHD.
4
Q
What controversial issue is raised regarding the existence of ADHD?
A
Whether the disorder exists at all or is being fabricated
This reflects skepticism regarding ADHD’s classification and potential influences from drug companies and educational authorities.
5
Q
What follows the discussion of the existence of ADHD in the text?
A
Diagnostic criteria
This section provides a framework for identifying ADHD based on established symptoms.
6
Q
What typical feature of ADHD, although not a diagnostic criterion, is mentioned?
A
Impairment of peer relations
This feature underscores the social challenges faced by individuals with ADHD.
7
Q
What demographic factors are emphasized in the prevalence of ADHD?
A
Age, sex, and cultural differences
These factors can influence the rates and manifestations of ADHD across different populations.
8
Q
What section follows the discussion on the prevalence of ADHD?
A
Possible causes and correlates of ADHD
Understanding these factors is crucial for developing effective interventions.
9
Q
What does the text mention regarding the consequences of ADHD?
A
Typical consequences of ADHD
This section likely explores the impacts of ADHD on various aspects of life, including academic and social functioning.
10
Q
What is the final subject of the chapter regarding ADHD?
A
How to treat ADHD
Treatment options can vary widely and often involve a combination of behavioral, educational, and pharmacological approaches.
11
Q
What are the primary symptoms of ADHD?
A
Inattention and hyperactivity
ADHD is characterized by observable behaviors of inattention and/or excessive movement.
12
Q
How do some authorities prefer to define ADHD?
A
In terms of cognitive or neurological dysfunctions
They focus on aspects like the executive functions of the brain.
13
Q
Can ADHD be defined based on underlying causes?
A
No
Causes may be identifiable in groups of children but not in each individual case.
14
Q
What distinguishes the subtypes of ADHD?
A
The relative strength of inattention and hyperactivity symptoms
Subtypes are based on how these symptoms manifest in individual children.
15
Q
What shift in understanding about ADHD occurred due to Virginia Douglas’s research?
A
Attention problems were recognized as significant
Douglas’s work in the 1970s highlighted attention issues in children previously diagnosed as hyperactive.
16
Q
When did attention problems come to the forefront in diagnosing ADHD?
A
Starting with DSM-III in 1980
Prior to this, excessive movement was necessary for a diagnosis.
17
Q
What historical figure contributed to the study of attention processes?
A
William James
He wrote an essay titled ‘Stream of Thought’ reflecting on attention.
18
Q
Fill in the blank: ADHD is characterized by _______ and/or hyperactivity.
A
inattention
19
Q
True or False: ADHD can be diagnosed solely based on observable behavior.
A
False
The definition also considers cognitive and neurological factors.
20
Q
What was a major conceptual shift regarding ADHD in the late 20th century?
A
Recognition of attention problems as central to the disorder
This shift moved away from focusing primarily on hyperactivity.
21
Q
What is the conceptual controversy surrounding ADHD?
A
Whether ADHD is a real disorder or a fabrication of drug companies
This controversy includes debates about cultural influences and the role of pharmaceutical companies in defining ADHD.
22
Q
What argument do some make regarding ADHD’s identification rates in North America?
A
ADHD is a cultural product of Western societies
This argument is based on higher identification rates in North America compared to other countries.
23
Q
What societal pressures affect parents regarding child-rearing methods?
A
Competing demands to control unruly children and limitations on acceptable methods
These pressures can lead to a focus on individual children rather than societal issues.
24
Q
What has the ‘cultural anxiety’ regarding ADHD led to, according to Timimi et al. (2002)?
A
Deflection of focus from societal problems to the individual child
This shift has increased the popularity of the ADHD diagnosis and psychostimulant medications.
25
What do some critics claim about the construct of ADHD?
It is a fabrication of the pharmaceutical industry
## Footnote
This claim suggests that ADHD may not be a legitimate disorder but rather a creation for profit.
26
How is the 'cultural perspective' on ADHD viewed by professionals?
It is considered a misrepresentation of basic facts
## Footnote
This perspective is rejected by authors of an international consensus statement on ADHD.
27
What are the two categories of symptoms for attention deficit/hyperactivity disorder in both DSM-IV and DSM-5?
Inattention and hyperactivity/impulsivity
28
How many symptoms must an individual display in one of the categories for a minimum of 6 months to be diagnosed with ADHD?
At least six symptoms
29
What is an example of inattention in ADHD?
Failing to attend to details
30
What is an example of hyperactivity/impulsivity in ADHD?
Being fidgety
31
True or False: Both DSM-IV and DSM-5 require that the symptoms cause significant impairment.
True
32
In DSM-IV, how many settings must the symptoms cause impairment?
Two or more settings
33
In DSM-5, what has changed regarding the settings in which symptoms must be apparent?
Symptoms must be apparent in two or more settings
34
What was the age criterion for symptoms to be present in DSM-IV?
Before the age of 7
35
What is the new age criterion for symptoms in DSM-5?
Before the age of 12
36
List the three types of ADHD as defined in DSM-IV.
* Combined type
* Predominantly inattentive type
* Predominantly hyperactive-impulsive type
37
What must be specified in DSM-5 regarding the presentation of ADHD?
The current presentation (not type)
38
What additional specifier was added in DSM-5 for ADHD?
In partial remission
39
What must be specified in DSM-5 regarding the severity of ADHD?
Current severity (i.e., mild, moderate, or severe)
40
Fill in the blank: In DSM-IV, the term used if inattention criteria is met but hyperactivity/impulsivity criteria is not met is '_______'.
Predominantly inattentive type
41
Fill in the blank: In DSM-IV, the term used if hyperactivity/impulsivity criteria is satisfied but inattention criteria is not met is '_______'.
Predominantly hyperactive-impulsive type
42
What are the three categories of attention problems in the ICD-10 criteria for hyperkinetic disorders?
* Short duration of spontaneous activities
* Often leaving play activities unfinished
* Overfrequent changes between activities
* Undue lack of persistence at tasks set by adults
* Unduly high distractibility during study
43
What are the five activity problems listed in the ICD-10 criteria for hyperkinetic disorders?
* Very often runs about or climbs excessively in inappropriate situations
* Markedly excessive fidgeting and wriggling during spontaneous activities
* Markedly excessive activity in situations expecting relative stillness
* Often leaves seat in classroom or other situations when remaining seated is expected
* Often has difficulty playing quietly
44
What impulsivity problems are identified in the ICD-10 criteria for hyperkinetic disorders?
* Often has difficulty awaiting turns in games or group situations
* Often interrupts or intrudes on others
* Often blurts out answers to questions before they have been completed
45
In the ICD-10 criteria, what are the attention problems that must be demonstrated at school or nursery?
* Undue lack of persistence at tasks
* Unduly high distractibility
* Overfrequent changes between activities when choice is allowed
* Excessively short duration of play activities
46
What are the activity problems that must be demonstrated at school or nursery according to ICD-10 criteria?
* Continuous (or almost continuous) excessive motor restlessness
* Markedly excessive fidgeting and wriggling in structured situations
* Excessive levels of off-task activity during tasks
* Unduly often out of seat when required to be sitting
* Often has difficulty playing quietly
47
What types of direct observation are required to demonstrate abnormality of attention or activity?
* Direct observation of the criteria in A or B
* Observation of abnormal levels of motor activity or off-task behavior in settings outside home or school
* Significant impairment of performance on psychometric tests of attention
48
What are the exclusion criteria for hyperkinetic disorders in the ICD-10?
* Does not meet criteria for pervasive developmental disorder
* Does not meet criteria for mania
* Does not meet criteria for depressive disorder
* Does not meet criteria for anxiety disorder
49
What is the required onset age for hyperkinetic disorders according to ICD-10?
Before age of 7 years
50
What is the minimum duration for hyperkinetic disorders as per ICD-10?
At least 6 months
51
What is the minimum IQ requirement for a diagnosis of hyperkinetic disorder?
IQ above 50
52
True or False: ADHD is considered a single disorder according to many experts.
False
53
How does the DSM-5 classify ADHD compared to DSM-IV?
Identifies different presentations of ADHD rather than different subtypes
54
What analogy does Nigg (2006) use to describe different presentations of ADHD?
Analogous to different forms of cancer that share general resemblance but differ in causes and seriousness
55
What do developmental perspectives suggest about the symptoms of ADHD in individuals?
Many individuals are hyperactive early in life but may show mostly symptoms of impulsivity by adolescence
56
What did the meta-analysis by Nikolas and Burt (2010) reveal about the heritability of ADHD symptoms?
* Inattention: 71% heritable
* Hyperactivity: 73% heritable
57
Fill in the blank: The genetic effects on symptoms of hyperactivity appear to be _______.
additive
58
Fill in the blank: Inattention reflects the _______ of genetic markers.
interaction
59
What do Pelham and Fabiano estimate about negative interactions between children with ADHD and their parents?
Children with ADHD have one negative interaction per minute with their parents
## Footnote
Based on data reported by Danforth et al. (2006)
60
How many negative exchanges do children with ADHD have per minute with teachers or peers at school?
Two negative exchanges per minute
## Footnote
Based on data reported by Abikoff et al. (1993)
61
What is the estimated total of negative interpersonal interactions per year for children with ADHD?
Well over a million negative interpersonal interactions per year
## Footnote
Not counting sleep time
62
What behavior did Sally exhibit when greeting her father, Michael?
Sally leaped into her father's arms and then ran around the driveway ordering her friend off her bike
63
What incident occurred between Sally and her friend while riding bikes?
A screaming match erupted before her friend stormed off
64
What did Sally do in the kitchen that indicated her impulsivity?
Clambered up onto the counter and tumbled down to the floor
65
What was the result of Sally's temper tantrum at dinner?
Her father poured her a glass of chocolate milk to calm her down
66
What concerns did Sally's parents have regarding her behavior at school?
They received multiple notes from the teacher about her behavior and academic problems
67
What specific problem behaviors did Sally display in the classroom?
She jumps out of her seat, blurts out answers, disrupts class, and acts bossy with other children
68
What recommendation did Sally's teacher make after observing her behavior?
A psychological evaluation to identify underlying problems
69
What approach did the school psychologist use to evaluate Sally?
A multimodal approach gathering information from various sources and contexts
70
What components were involved in Sally's treatment for ADHD?
Methylphenidate trial, classroom-based intervention, and parent training on ADHD-management strategies
71
What was the outcome of the medication trial for Sally?
Gradual improvement in her classroom behavior and interactions with peers
72
What classroom intervention was implemented for Sally?
Moving her desk from distractions, posting daily schedules, and a token system
73
What positive changes occurred in Sally's household after treatment?
Increased positive interactions and enjoyment of each other's company
74
True or False: Peers generally like children with ADHD.
False
## Footnote
Studies have shown peers dislike children with ADHD (Mrug, Hoza, and Gerdes, 2001)
75
How quickly do other children typically reject a peer with ADHD?
Within 30 seconds and a few quick social interactions
76
What did an intensive longitudinal study reveal about friendships of children with ADHD?
Children with ADHD tend to be insensitive to their friends' wishes and may break game rules
77
What should be discounted when estimating the prevalence of ADHD?
Prevalence estimates based exclusively on ratings by a single informant
## Footnote
Relying solely on teacher or parent ratings can lead to inflated estimates.
78
What is the typical prevalence rate of ADHD according to DSM-IV criteria?
3–7 percent of school-age children
## Footnote
This rate is consistent with most other reputable estimates.
79
What factors can lead to inflated prevalence estimates of ADHD?
Relying solely on teacher ratings or solely on parent ratings
## Footnote
This can lead to estimates of one child in five or six having ADHD.
80
What does the DSM-5 suggest about ADHD prevalence rates?
The rates will likely be higher due to more liberal criteria
## Footnote
Data on prevalence rates calculated with DSM-5 criteria are not yet available.
81
What percentage of children with ADHD also meet the criteria for oppositional defiant disorder or conduct disorder?
30–50 percent
## Footnote
This indicates a significant comorbidity with aggressive and defiant behaviors.
82
What is the likelihood of children with ADHD suffering from major depression?
At least one-third
## Footnote
Comorbidity with anxiety disorders is also substantial.
83
What changes in ADHD symptoms occur as children mature?
Hyperactivity tends to decline, while inattention persists
## Footnote
Many behavior problems continue into adolescence.
84
What is the percentage of children with ADHD who continue to display symptoms as adolescents?
At least 70 percent
## Footnote
Symptoms may change but ADHD can persist throughout life.
85
What are some long-term consequences for individuals diagnosed with ADHD during school years?
Difficulty finding and maintaining employment
## Footnote
Risk is higher for those with disciplinary problems in school.
86
What is the gender distribution of ADHD diagnoses in children?
At least two-thirds of diagnosed children are boys
## Footnote
This statistic has led to controversy regarding societal perceptions of boys.
87
What societal critique exists regarding the diagnosis of ADHD in boys?
It is seen as societal repression of the natural temperaments of boys and men
## Footnote
Some argue that ADHD is a construct of middle-class anxiety.
88
What differences in brain structure have been found between boys and girls with ADHD?
Differences in the size of the splenum of the corpus callosum
## Footnote
This structure facilitates communication between brain hemispheres.
89
What negative mental health problems are girls with ADHD more likely to experience as adults?
Depression, anxiety, eating disorder, substance abuse, anti-social behavior
## Footnote
Girls with ADHD face profound long-term consequences.
90
In terms of school performance, how do girls with ADHD compare to boys?
Girls are at least as likely as boys to experience marked problems at school
## Footnote
This is based on multiple assessment methods.
91
What is the relationship between ADHD and comorbid anxiety and depression in adolescent girls?
Adolescent girls with ADHD are more likely to experience comorbid depression and anxiety than boys
## Footnote
This highlights the significant impact of ADHD on girls.
92
True or False: The prevalence of ADHD is increasing due to better awareness and diagnosis.
True
## Footnote
Increased awareness may lead to more diagnoses, complicating the assessment of actual prevalence changes.
93
Fill in the blank: ADHD can affect people throughout the _______.
lifespan
94
What does the term 'comorbidity' refer to in the context of ADHD?
The presence of one or more additional disorders alongside ADHD
## Footnote
Common comorbid disorders include oppositional defiant disorder, anxiety, and depression.
95
What is the range of ADHD prevalence estimates among children and adolescents in different countries?
0.9 to 20 percent
## Footnote
These estimates highlight the wide variations in ADHD prevalence globally.
96
What do large-scale multisite cross-cultural studies confirm about ADHD prevalence rates?
ADHD prevalence rates are very similar when using a uniform set of rigorous, standardized diagnostic criteria by skilled clinicians across various regions
## Footnote
Regions include Africa, Australia, Europe, and North America.
97
In Cuba, what factors influenced the referral of children with ADHD for psychiatric help?
Comorbid behavior problems and family stress
## Footnote
Medication for ADHD was scarce, leading to reliance on psychiatric help.
98
What did the World Health Organization's World Mental Health Survey initiative aim to determine?
The continuity of ADHD from childhood to adulthood
## Footnote
The study involved 43,772 participants from ten countries.
99
What percentage of childhood ADHD cases met full criteria for ADHD in adulthood, according to the WHO study?
50 percent
## Footnote
Stability rates varied from 33 to 84 percent across different countries.
100
How did young adults with chronic ADHD perform in terms of education and employment compared to controls?
They discontinued schooling earlier, had poorer school results, fewer friends, and lower self-esteem
## Footnote
They also received lower performance evaluations and were dismissed from jobs more frequently.
101
What was found to be significantly higher among young adults with chronic ADHD compared to non-diagnosed counterparts?
Rates of anxiety disorders, phobias, major depression, bipolar disorder, and substance dependence
## Footnote
This emphasizes the comorbidity of mental health issues with ADHD.
102
What has been a long-standing argument among researchers regarding ADHD?
Better recognition of its biological roots and associated disorders
## Footnote
This reflects a historical perspective on understanding ADHD.
103
What term did Eisenberg advocate against in the context of ADHD research?
Brainlessness
## Footnote
He emphasized the need for recognition of neuropsychological origins.
104
What is the prevailing view among scientists regarding the cause of ADHD?
ADHD is predominantly caused by neuropsychological factors
## Footnote
However, clear evidence of brain damage is still debated.
105
What has diminished the quest for a single neurological explanation of ADHD?
Recognition of the variability in behaviors corresponding to atypical brain structure or function
## Footnote
This makes it difficult to diagnose brain damage from observable behavior.
106
What does Nigg argue regarding the causes of ADHD?
Different causal paths may exist for different manifestations of ADHD
## Footnote
This suggests that subtypes of ADHD may have different causes.
107
Fill in the blank: ADHD diagnostic criteria identify a similar frequency of an underlying construct in different locations, independent of _______.
local judgments
## Footnote
This implies that cultural differences do not affect the core diagnosis of ADHD.
108
True or False: ADHD prevalence rates are universally accepted to be the same across cultures.
False
## Footnote
Although the underlying construct may be similar, cultural perceptions and diagnoses can vary.
109
What historical terms were used in the 1950s and 1960s to describe ADHD-related brain issues?
Minimal brain damage, minimal brain dysfunction, minimal cerebral damage, minimal cerebral dysfunction
## Footnote
These terms reflected attempts to describe ADHD without implying significant brain injury.
110
What cognitive and behavioral processes are primarily focused on in ADHD research?
Response inhibition, working memory, different types of attention processes
## Footnote
Includes sustained attention, selective attention, executive attention.
111
What is a key deficit observed in individuals with ADHD?
Deficit in response inhibition
## Footnote
This refers to a weak ability to deliberately respond to a non-target stimulus and not respond to a target stimulus.
112
Which brain regions are engaged during response inhibition tasks?
Prefrontal regions, including the dorsolateral prefrontal cortex (DLPFC)
## Footnote
These regions are critical for controlling inhibitions.
113
How does frontal lobe activation in individuals with ADHD compare to those without ADHD?
Individuals with ADHD show less frontal lobe activation
## Footnote
This reduced activation occurs across orbital, inferior, middle, and superior frontal areas.
114
What hypothesis explains the reduced activation in frontal regions for ADHD individuals?
Input from frontal regions is required to control inhibitions
## Footnote
Reduced input leads to undercontrolled behaviors.
115
What consistent finding is observed regarding the caudate region of the striatum in ADHD?
Reduced activation during response inhibition tasks
## Footnote
This finding is supported by multiple studies.
116
What is concluded about the fronto-striatal network in ADHD patients?
It is under-recruited during response inhibition
## Footnote
This pattern does not vary by age.
117
What deficits do children with ADHD show in comparison to healthy control children?
Working memory deficits
## Footnote
Neuroimaging studies for working memory have primarily been conducted in adults.
118
What areas show less activation in adults with ADHD during working memory tasks?
Frontal, temporal, and occipital areas
## Footnote
They show greater activation in midbrain, striatal, cerebellum, and middle frontal gyrus.
119
Which brain regions support effective control of attention during tasks?
Prefrontal and parietal cortices
## Footnote
Neural input from these areas is critical for attention control.
120
What is the overall pattern of activation in individuals with ADHD during attention tasks?
Underactivation of the fronto-parietal-striatal regions
## Footnote
This pattern correlates with anomalies in dopamine transmission.
121
What structural anomalies are associated with ADHD?
Smaller volumes and atypical function of the cerebellum
## Footnote
Studies indicate these anomalies are linked to ADHD.
122
What neural pathways are most prominently altered in ADHD?
Fronto-striatal-cerebellar, fronto-parietal-thalamic, fronto-cingulate circuits
## Footnote
A common denominator across these networks is the frontal cortex.
123
What are some possible causes for perturbations in brain regions associated with ADHD?
Structure, connectivity, or neurochemical make-up
## Footnote
Includes reduced size, communication issues, or dopamine neurotransmission.
124
What structural brain characteristics are associated with ADHD compared to individuals without the disorder?
Smaller frontal lobes, thinning of the cortex, developmental lag in cortical gray matter thickness
## Footnote
Supported by studies showing these characteristics in ADHD individuals.
125
What do executive functions refer to in the context of ADHD?
A set of brain processes that control planning, decision-making, problem-solving, and reacting to situations
## Footnote
Important for managing complex tasks and behaviors.
126
True or False: Executive dysfunction in ADHD can lead to significant behavioral consequences.
True
## Footnote
This is summarized in literature regarding ADHD.
127
What have some studies suggested about cortisol levels in children with ADHD compared to those without?
Children with ADHD have lower cortisol levels than children without ADHD
## Footnote
Studies: Klimes-Dougan et al., 2001a; Randazzo et al., 2008; Reynolds, Lane and Gennings, 2010
128
What have other studies shown regarding cortisol levels in children with ADHD?
Children with ADHD have higher cortisol levels than children without ADHD
## Footnote
Studies: Sondeijker et al., 2007; White and Mulligan, 2005
129
What complicates the understanding of cortisol levels in children with ADHD?
High rates of comorbid disorders
## Footnote
Common comorbid disorders include disruptive behavior disorders (DBDs) and anxiety disorders
130
What types of problems are common in children with ADHD and how do they relate to cortisol levels?
Disruptive behavior disorders (DBDs) and anxiety disorders have opposite relations with cortisol levels
## Footnote
DBDs may lower cortisol levels, while anxiety may increase them
131
What does research suggest about children with ADHD without comorbid disruptive behavior problems?
Their HPA responses to stress are not different than those of children without ADHD
## Footnote
Study: Snoek et al., 2004
132
What are the different subtypes of ADHD?
Primarily hyperactive and impulsive, primarily inattentive and unfocused, or both
## Footnote
Each subtype may have physiological differences
133
What did some studies find regarding cortisol reactivity to stress in children with combined symptoms of ADHD?
They have lower than normal cortisol reactivity to stress
## Footnote
Studies: Hastings et al., 2009; Van West et al., 2009
134
What is a contrasting argument about cortisol reactivity in children with ADHD?
The presence of comorbid DBDs contributes to lower cortisol reactivity
## Footnote
Study: van Goozen et al., 2007
135
Is it premature to draw strong conclusions about cortisol levels' role in ADHD?
Yes, it is premature
## Footnote
More research is needed to understand the role of cortisol in ADHD
136
What other aspects might distinguish children with ADHD from their peers?
Neurophysiological functioning
## Footnote
This may include differences in HPA axis activity
137
What is the association between ADHD and electrodermal activity (EDA)?
ADHD is associated with reduced EDA and electrodermal response (EDR)
## Footnote
This is linked to a weak behavioral inhibition system (BIS) contributing to impulsivity.
138
Who argued that stronger EDA reflects stronger BIS influence?
Fowles (1988)
## Footnote
This concept relates to the behavioral inhibition system's role in impulsivity.
139
What did many studies find regarding children with ADHD and EDA?
Children with ADHD have reduced EDA and less frequent EDR
## Footnote
Studies supporting this include Beauchaine et al. (2001) and Iaboni et al. (1997).
140
What contradictory finding was reported about girls with ADHD?
Girls with ADHD have higher EDA and more EDR
## Footnote
This finding was reported by Hermens et al. (2005).
141
What is the general finding regarding cardiac activity in children with ADHD?
There is little evidence of difference in baseline heart rate
## Footnote
However, children with ADHD may have smaller heart rate reactivity.
142
What have some researchers found regarding heart rate reactivity in children with ADHD?
Children with ADHD may have relatively smaller heart rate reactivity
## Footnote
Cited studies include Iaboni et al. (1997) and Jennings et al. (1997).
143
What differing finding exists regarding heart rate reactivity in ADHD?
Some researchers found slightly stronger reactivity in children with ADHD
## Footnote
Studies supporting this include Snoek et al. (2004).
144
What did a study suggest about heart rate reactivity patterns across ADHD subtypes?
Boys with hyperactivity problems showed reduced heart rate reactivity
## Footnote
This was observed in a study by Dykman, Ackerman, and Oglesby (1992).
145
What contributions of the autonomic nervous system have been studied in children with ADHD?
Contributions of the parasympathetic nervous system (PNS) and sympathetic nervous system (SNS)
## Footnote
Measured through respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP).
146
What were the findings of Beauchaine et al. (2001) regarding RSA and PEP in ADHD?
No differences in baseline or reactive measures of RSA and PEP between adolescents with and without ADHD
## Footnote
This suggests similarities in autonomic functioning.
147
How did hyperactive children respond to emotional films according to Bubier and Drabick (2008)?
More hyperactive children had reduced PEP reactivity
## Footnote
This suggests decreased SNS influence in these children.
148
What did Utendale (2005) find regarding RSA suppression in boys with ADHD?
Boys with the hyperactive-impulsive subtype showed strong RSA suppression
## Footnote
This was in anticipation of having blood drawn.
149
What did El-Sheikh and colleagues (2006) report about RSA and skin conductance level (SCL) reactivity?
Combined patterns of RSA and SCL reactivity predicted more ADHD-related problems
## Footnote
This was particularly noted when parents had high marital conflict.
150
What overall conclusion can be drawn from the research on autonomic physiology in children with ADHD?
The research has not produced clear findings on autonomic reactivity
## Footnote
There is uncertainty about their PNS and SNS activity compared to children without ADHD.
151
True or False: ADHD is a disorder with only one distinct physiological pattern.
False
## Footnote
ADHD encompasses multiple subtypes and is often accompanied by other emotional and behavioral problems.
152
What is the primary mode of transmission for ADHD?
Genetically
## Footnote
Confirmed by family, twin, and adoption studies.
153
What is the range of heritability estimates for ADHD according to early studies?
.50 to .98
## Footnote
Indicates a high genetic influence on ADHD.
154
What are the concordance rates for monozygotic twins regarding ADHD?
.80 to .98
## Footnote
Suggests a strong genetic link.
155
Is ADHD considered one of the most genetically influenced mental disorders?
True
156
What is known about the exact mechanisms of genetic transmission for ADHD?
Much less is known
## Footnote
Multiple genes have been linked, but research remains inconclusive.
157
What do experts agree about the cause of ADHD in relation to family environment?
ADHD does not result from deficiencies in the family environment
## Footnote
Family dysfunction and stress are important consequences.
158
What role do family problems play in children with ADHD?
Exacerbating factors
## Footnote
Correlations help understand family interaction patterns.
159
What increases the risk for ADHD in children?
* Family history of ADHD
* Comorbid psychopathology
* Adverse home or community environment
## Footnote
Risk factors correlate with the number of adversity indicators.
160
Do genetics completely account for children's ADHD?
No
## Footnote
Concordance rates for monozygotic twins do not reach 100 percent.
161
What may serve as a protective factor against ADHD in predisposed children?
A healthy family environment
## Footnote
Rarely studied due to participation issues.
162
How do family environments of children with ADHD compare to those without?
More stressful and conflict-ridden
## Footnote
Supported by various studies.
163
What discipline methods are more commonly used by parents of children with ADHD?
Negative methods
## Footnote
Parents are also more negative in exchanges.
164
Which age group shows more salient negative parenting in ADHD studies?
Preschool children
## Footnote
Negative parenting is less pronounced in school-age populations.
165
How do parents of children with ADHD typically feel about their marriages?
Relatively low levels of satisfaction
## Footnote
This is evident in many studies.
166
What other family issues can compound negative parenting in ADHD households?
* Poverty
* Maternal depression
## Footnote
These factors exacerbate the challenges faced by families.
167
What has been observed about family functioning after children with ADHD are placed on medication?
It improves
## Footnote
Multiple studies support this finding.
168
What is ADHD most commonly treated with?
Psychotropic medication
## Footnote
ADHD is the most common psychological disorder of children associated with treatment by medication.
169
How was the usefulness of medication for ADHD discovered?
By accident, in the Bradley Home in the 1930s
## Footnote
Psychiatrists initially performed brain surgery, and medication was used to relieve headaches, leading to unexpected improvements in behavior.
170
What medication did Charles Bradley use to treat children in the 1930s?
Benzadrine
## Footnote
Benzadrine is an amphetamine that was observed to improve work habits and behavior in children.
171
What theory did researchers propose regarding the effects of amphetamines?
Amphetamines alter the functions of the diencephalon, managing sensory stimuli
## Footnote
This theory was proposed by Maurice Laufer and Eric Denhoff in 1957.
172
What was the general attitude toward psychotropic drugs for children in the 1950s?
Used infrequently
## Footnote
Psychotropic drugs were not widely accepted for children during this period.
173
What major development occurred in the 1960s regarding ADHD medication?
Introduction of methylphenidate, known as Ritalin
## Footnote
Ritalin was effective and had fewer side effects compared to previous medications.
174
What became the gold standard for evaluating the effectiveness of new psychotropic drugs?
Randomized clinical trials with double-blind assignment
## Footnote
This method involves independent evaluation of medication effects by parents and teachers unaware of the treatment assignment.
175
What percentage of children in the United States were on stimulant medication by the end of the 1960s?
0.002 percent
## Footnote
This statistic reflects the extremely low prevalence of medication use at that time.
176
What misconception emerged from newspaper reports in 1970 about ADHD medication?
5–10 percent of children in public schools were on medication
## Footnote
This statistic referred to children diagnosed with special behavior and learning needs, not the general population.
177
What was one of the criticisms of the medicalization of ADHD in the 1970s?
Dubbed 'the chemical straightjacket'
## Footnote
Critics viewed this as a form of social repression and a myth about hyperactivity.
178
What was the outcome of the criticisms regarding Ritalin prescriptions?
Tightening of federal legal restrictions
## Footnote
This was a response to the backlash against the widespread use of stimulant medication.
179
What was the trend in Ritalin prescriptions from 1999 to 2001?
Reached about 9.3 percent of the child population in the West Coast of the USA
## Footnote
This marked a significant increase following earlier restrictions.
180
What are two newer medications introduced for ADHD treatment?
* Adderall
* Concerta
## Footnote
Adderall is an improved version of Benzadrine, and Concerta is a long-lasting methylphenidate.
181
What is Strattera?
An antidepressant shown to have some effect on ADHD
## Footnote
It is typically used for children who do not respond well to stimulant medications.
182
What concerns have been raised about long-term stimulant medication use?
* Long-term effectiveness
* Effects on physical growth
* Potential cardiovascular adverse events
* Risk of drug abuse
## Footnote
These concerns highlight the need for further studies on the long-term implications of ADHD medications.
183
What has recent research suggested about ADHD medication and drug abuse?
No evidence of correlation between being medicated for ADHD and abusing drugs
## Footnote
However, some medications may be misused by individuals for whom they were not prescribed.
184
Which countries have accepted the use of psychostimulant medication for ADHD despite initial opposition?
Most parts of the world, including the UK
## Footnote
Acceptance has grown globally, although there are cross-national differences in diagnosis and treatment.
185
What is the ICD-10 criteria's effect on ADHD diagnosis in European countries?
Reduces the number of children diagnosed with ADHD
## Footnote
These criteria specify problem behaviors in more than one setting.
186
What are the four prevailing psychological therapies for children with ADHD?
* Behavioral family intervention
* Cognitive and cognitive-behavioral intervention
* Social skills training
* Behavior modification at school
187
What is the primary focus of behavioral family intervention?
Teaching parents to consistently deliver positive reinforcement for appropriate behavior.
188
What is the recommended ratio of positive reinforcement to punishment in behavioral family intervention?
Positive reinforcement should be used several times more frequently than punishment.
189
What immediate consequence is suggested for negative behavior in children during behavioral family intervention?
A brief, non-physical consequence, such as a time-out.
190
What is crucial for parents to learn during behavioral family intervention?
To be specific, systematic, and consistent in measuring the child’s behavior.
191
What did Fabiano et al. (2009) find regarding the effect size for randomized clinical trials in behavioral family intervention?
The average effect size is 0.83 of a standard deviation, indicating moderate effectiveness.
192
What methodological approach is particularly emphasized in within-subjects designs for evaluating behavioral interventions?
Direct observation of the child's behavior at consecutive time points.
193
What distinction did Hinshaw (2006) make between cognitive-behavioral interventions for ADHD and those for depression or anxiety?
ADHD involves cognitive deficiency, while depression or anxiety involves cognitive distortion.
194
What are cognitive interventions aimed at in children with ADHD?
Training thinking processes such as fixation, attention, or working memory.
195
What challenges do cognitive-behavioral interventions face in treating ADHD?
Methodological problems and mixed results in effect sizes.
196
According to Toplak et al. (2008), how many original studies on direct cognitive training for ADHD were identified?
Only six original studies.
197
True or False: Research has convincingly demonstrated the usefulness of cognitive or cognitive-behavioral techniques in treating childhood ADHD.
False
198
Fill in the blank: Behavioral family intervention is derived from the principles of _______.
[behavior modification]
199
What is one key criticism of cognitive-behavioral interventions for ADHD according to Barkley (2007)?
They lack a conceptual foundation as they do not address social-learning deficits.
200
What type of techniques do cognitive-behavioral interventions include?
* Monitoring thinking processes
* Systematic problem-solving training
201
What is a common issue with studies evaluating cognitive-behavioral interventions for ADHD?
Many studies administer interventions to children already on medication.
202
What is one primary manifestation of ADHD?
Impaired peer relations
203
What is social skills training designed to improve?
Peer relations
204
True or False: Children with ADHD lack social skills.
False
205
What may children with ADHD lack that prevents them from using social skills?
Motivation, judgment, understanding of the situation, freedom from anxiety, positive expectations, self-confidence
206
What is a common approach used in social skills training for children with ADHD?
Modeling skills through demonstrations or videos
207
List some skills included in social skills training for children with ADHD.
* Making conversation
* Listening
* Sharing
* Making requests assertively
* Making appropriate compliments
* Handling criticism
208
What cognitive components are often included in social skills training?
* Problem-solving
* Mobilizing thought for self-control
* Appreciating others' perspectives
* Maintaining perspective in anger-provoking situations
209
What measures can help maintain skill learning in social skills training?
* Daily report cards
* Systematic positive reinforcement from teachers or parents
210
What did De Boo and Prins (2007) conclude about social skills training for ADHD?
It can be considered an effective experimental intervention pending further study
211
True or False: Abikoff et al. (2004) found social skills training to be more beneficial than medication alone.
False
212
According to Barkley (2007), what negative effects can social skills training have?
Stigma and cross-fertilization of anti-social attitudes
213
What is a highly effective intervention for classroom behavior management?
Daily report card
214
What does the daily report card provide for children with ADHD?
Rewards for achieving behavioral goals at school
215
What is the reported effectiveness of direct contingent reinforcement approaches?
Approaching 1.5 standard deviation units
216
What type of camp has shown success in providing direct contingent reinforcement to children with ADHD?
Therapeutic summer camp
217
What system is used in the therapeutic summer camp to reinforce appropriate social skills?
Token or point system
218
What is a significant obstacle to implementing contingency management in classrooms?
Teacher agreement and willingness to carry out the program
219
What happens to the benefits of contingency management when it is discontinued?
There is no reason to believe the benefits will continue
220
What was the primary purpose of the MTA study?
To provide the best answers to questions about the long-term impact of major treatment modalities for childhood ADHD
## Footnote
The MTA study aimed to evaluate the effectiveness of different treatment approaches over time.
221
How many children participated in the MTA study?
579 children
## Footnote
They were diagnosed with ADHD, including both inattention and hyperactivity.
222
What types of treatment conditions were included in the MTA study?
* Medication-only
* Multicomponent behavior therapy
* Combination of medication and behavior therapy
* Usual treatment condition
## Footnote
Each group received different forms of treatment over a 14-month period.
223
Which treatment condition showed the greatest improvement in ADHD symptoms?
Medication and combined-treatment conditions
## Footnote
These groups showed the most significant improvement in core symptoms and comorbid disorders.
224
What was a major finding regarding the long-term effects of the treatments in the MTA study?
By the follow-up at 36 months, the treatment groups no longer differed in terms of ADHD symptoms or comorbid oppositional defiant disorder
## Footnote
This suggests that the initial benefits of treatment diminished over time.
225
True or False: The MTA study found that ADHD is a condition with short-term effects only.
False
## Footnote
The study emphasized that ADHD has long-term effects that require ongoing research and treatment strategies.
226
What does the MTA study suggest about the predictors of long-term effectiveness of ADHD treatments?
They do not necessarily correspond to results for short-term effectiveness
## Footnote
This indicates complexity in evaluating treatment outcomes over time.
227
What is neurofeedback?
A technique using behavioral methods to train children with ADHD to modify abnormal EEG patterns
## Footnote
Neurofeedback aims to improve attention and self-regulation.
228
What is the Cogmed program designed to improve?
Working memory
## Footnote
Preliminary findings suggest it may have some success in enhancing working memory in children with ADHD.
229
Fill in the blank: The theory linking ADHD to poor nutrition was developed by Dr. _______.
[Benjamin Feingold]
## Footnote
Feingold proposed that food additives cause hyperactivity and learning disabilities.
230
What percentage of children on the Feingold diet reported significant reductions in ADHD symptoms according to Feingold's findings?
40 to 70 percent
## Footnote
This statistic highlights the potential impact of dietary changes on ADHD symptoms.
231
What did the meta-analysis by Kavale and Forness conclude about the effects of special diets on ADHD?
The true effects of the diet are trivial
## Footnote
They found that rigorous research designs showed smaller effects of dietary interventions.
232
True or False: The consumption of sugar has been proven to cause ADHD symptoms.
False
## Footnote
Studies like that of Milich and Pelham found no behavioral differences related to sugar consumption.
233
What is a potential reason why some children may display ADHD-like symptoms related to diet?
Allergies to some food substances
## Footnote
This suggests that dietary impacts on ADHD may vary among individuals.
234
What is the main focus of the chapter?
The dietary habits of children and their relation to attention, impulsivity, and hyperactivity
235
Does the author believe ADHD is caused by inadequate nutrition?
No
236
What deficiencies are linked to symptoms of inattention, impulsivity, and hyperactivity?
Iron, zinc, and magnesium
237
Can food allergies cause symptoms that mimic ADHD?
Yes
238
Which foods are mentioned as potential allergens that may mimic ADHD symptoms?
* Wheat
* Corn
* Soy
* Eggs
* Milk
* Certain food dyes and additives
239
Why is it important to understand how foods contribute to cognitive and emotional functions?
Foods influence attention, impulse control, emotional regulation, and problem-solving
240
What do our dietary choices affect regarding brain functions?
The capacity to manufacture essential neurotransmitters
241
What do we need from our diet to manufacture enzymes, cells, and tissues?
Materials necessary for life functions
242
What is a consequence of eating foods that cause allergic reactions?
Compromised ability to attend, think, and control emotions
243
What routine request does the author make for patients before initiating ADHD medication?
Screening for common food allergies
244
Fill in the blank: The selection of foods will determine our capacity to manufacture the essential __________ necessary for brain functions.
neurotransmitters
245
True or False: The author believes that food allergies can cause ADHD.
False
246
What are the two primary symptoms of ADHD?
Inattention and hyperactivity
## Footnote
Hyperactivity is often characterized by excessive movement.
247
By what age does DSM-5 presume that ADHD must be evident?
Age 12
## Footnote
There is evidence of ADHD in preschoolers as young as 4 years.
248
What is the counterpart disorder to ADHD in the ICD-10?
Hyperkinetic disorder
249
What role do genetics play in ADHD?
ADHD symptoms, including inattention and hyperactivity, are highly heritable.
250
What negative interpersonal interactions do children with ADHD experience?
Negative interactions with parents, teachers, and peers.
251
True or False: The frequency of ADHD diagnoses is decreasing.
False
## Footnote
The frequency of diagnoses may be increasing due to greater awareness.
252
What demographic is most commonly diagnosed with ADHD?
Males
253
What are common comorbid conditions in girls with ADHD?
Depression and anxiety
## Footnote
Boys often experience comorbid aggression.
254
What is a significant academic challenge faced by individuals with ADHD?
Higher likelihood of discontinuing schooling and poor academic performance.
255
What brain regions are implicated in ADHD?
Frontal lobe, fronto-parietal-striatal regions.
256
What is response inhibition?
The ability to suppress actions in response to irrelevant stimuli.
257
What cognitive deficits are linked to ADHD?
Working memory problems and impairment of attention processes.
258
What is the relationship between cortisol levels and ADHD?
Conflicting results exist regarding cortisol levels in children with ADHD.
259
How is ADHD primarily determined?
Genetically
## Footnote
ADHD is considered one of the most genetically influenced mental disorders.
260
What is a common treatment for ADHD involving medication?
Amphetamines and methylphenidate (e.g., Ritalin, Adderall).
261
What psychological therapies are used for children with ADHD?
Behavioral family intervention, behavior modification at school, cognitive-behavioral interventions, and social skills training.
262
What did the MTA study find regarding ADHD treatments?
Initial findings favored medication over behavioral treatment.
263
What is neurofeedback?
A neural-based intervention designed to modify abnormal EEG patterns.
264
What dietary changes have shown potential benefits for ADHD symptoms?
Eliminating food additives from the diet.
265
Fill in the blank: ADHD is often associated with __________ in children.
Negative parenting and family problems.
266
What is the significance of the fronto-striatal network in ADHD?
It is linked to response inhibition issues.
267
What long-term effects are concerns for ADHD medications?
Long-term effects of drugs developed by pharmaceutical companies.
