Lecture 19: ADHD

Question 1

Attention - the _______ or _________ direction of mental processes to specific (5)

Answer 1

The voluntary or involuntary direction of mental processes to specific:

1. Perceptions
2. Cognitions
3. Emotions
4. Motivations
5. Actions

Question 2

Voluntary attention + example

Answer 2

Attention that is goal-driven

e.g paying attention while studying

Question 3

Involuntary attention + example

Answer 3

Attention that is stimulus drive

E.g. attention to a loud noise

Question 4

ADHD or Attention-deficit/hyperactivity disorder is characterized by maladaptive deficits in (3)

Answer 4

1. Attention
2. Activity level
3. Impulsivity

Question 5

A trait or behavior isn’t adaptive/maladaptive in itself but only relative to an ________

Answer 5

Environment

Question 6

Adaptionist hypothesis for “hyper” - activity

Answer 6

In some ancestral environments e.g. environments with persistent food scarcity, high levels/hyperactivity = increased foraging yields = adaptive!

Question 7

Adaptionist hypotheiss for “in”attention

Answer 7

In some ancestral environments e.g high risk, low/moderate levels of focused attention = more time for scanning behaviors = life-saving behaviors to avoid being eaten

Question 8

Adaptionist hypothesis for impulsivity

Answer 8

In some ancestral environments eg. High novelty (present not good predictor of future), moderate/high levels of short-term goal pursuit (“impulsivity”) = future is difficult to predict/difficult to plan —> spontaneity helps

Question 9

People with ADHD can have (3) symptoms of hyperactivity/impulsivity

Answer 9

1. Both
2. Few or no
3. One or the other

Question 10

Symptoms of hyperactivity typically diminish/disappear in ________/_________ but inattention, impulsivity, restlessness and poor planning typically persist throughout ________

Answer 10

1. Adolescence/adulthood
2. Adulthood

Question 11

There has been a large increase in rates of ADHD over the past 30 years (this can mean two things)

Answer 11

1. There is a real increase in the people with ADHD
2. There is increased detection of people with ADHD

Question 12

Large increase in rates of diagnosis has sparked debate about the potential _________ of ADHD

Answer 12

Overdiagnosis

Question 13

Onset of ADHD - There are usually high activity levels in a _______, but not always associated with SDHS since some ________ are highly active but don’t go on to develop ADHD

Answer 13

Toddlers

Question 14

Sex differences of ADHD
A) _____ are twice as likely as ______ to be diagnosed with ADHD
B) _______ are more likely to be diagnosed with ADHD with a predominantly inattentive presentation

Answer 14

Males are twice as likely as females to be diagnosed with ADHD

but

Females are more likely to be diagnosed with ADHD with a predominantly inattentive presentation

Question 15

Racial differences in ADHD - ______ ______ are slightly more likely to receive an ADHD diagnosis and treatment than ____-_____ _________

Answer 15

White Americans > non-White Americans

Question 16

Associated features of ADHD (8)

Answer 16

1. Irritability
2. Mood lability
3. Lowered frustrations tolerance
4. Mild delays in language/motor/social development
5. Impaired academic and/or work performance
6. Reduced behavioral inhibition
7. Increased novelty seeking
8. Lowered self-esteem

Question 17

Mood lability

Answer 17

Rapidly changing mood

Question 18

Risk factors of ADHD (7)

Answer 18

1. Low birth rate
2. Smoking during pregnancy
3. Infection during pregnancy
4. Alcohol use during pregnancy
5. Dietary factors
6. Neurotoxin exposure
7. Genetics

Question 19

ADHD is associated with higher rates of (9)

Answer 19

1. Higher risk of anxiety
2. Higher risk of depression
3. Higher risk of suicide
4. Poor school performance
5. Poor occupational performance
6. Conduct disorder
7. Antisocial personality disorder
   8 Substance use
8. Incarceration

Question 20

Neurobiology of ADHD (2 main theories)

Answer 20

1. Dysregulation of MDP
2. Underactivation of prefrontal cortex

Question 21

MDP mediates what system

Answer 21

The reward system

Question 22

Dopamine transfer deficit theory of ADHD

Answer 22

People with ADHD may anticipate rewards less than people without it

Question 23

In people without ADHD dopaminergic cells initially respond with a spike of activity to the ________ of rewards

After repeated reinforcement dopaminergic cells eventually respond with a spike of activity to the _______ of rewards

This process is also called?

Answer 23

Consumption

Anticipation

The process is called the “dopamine transfer”

Question 24

The anticipatory dopaminergic activity helps the person ______ _______ until the reward is consumed

Answer 24

Sustain attention

Question 25

In people with ADHD often the dopaminergic cells fail to undergo ________ ________

Answer 25

Dopamine transfer

Question 26

People with ADHD have an under/over active anticipatory reward response

Answer 26

Under

Question 27

Under active anticipatory reward response results in symptoms of inattention and impulsivity in ADHD like (6)

Answer 27

1. Difficulty sustaining attention 2. Difficulty following through on instructions 3. Dislikes/avoids tasks that require sustain mental 4. Difficulty waiting one’s turn 5. Interrupts others 6. Blurting out answers before someone is done talking

Question 28

Under active anticipatory reward response results in the _________ of future rewards

Answer 28

Discounting

Question 29

Discounting i.e

Answer 29

Underestimation

Question 30

ADHD is often interpreted as (3) which as adverse effects in the self esteem of people with ADHD

Answer 30

1. Laziness 2. Irresponsibility 3. Lack of cooperation

Question 31

Underactivation of prefrontal cortex results in difficulty with (3)

Answer 31

1. Response inhibition 2. Working memory 3. Planning

Question 32

Treatment of ADHD (3)

Answer 32

1. Stimulant medication 2. CBT 3. insight-oriented therapy

Question 33

Stimulant medication for ADHD common examples (2)

Answer 33

1. Ritalin 2. Adderal

Question 34

What do stimulants do to the dopaminergic activity in the reward system? (Up/down regulate)

Answer 34

Upregulate

Question 35

What is the most effective treatment for ADHD between Stimulant medication, CBT, and insight-oriented therapy

Answer 35

Stimulant medication

Question 36

CBT for ADHD is for ______ symptoms and is thought of as _______ therapy rather than the _______ treatment.

Answer 36

1. Behavioral 2. Adjunct 3. Primary

Question 37

Insight oriented therapy helps with the effects of ADHD on a persons _____ _____ and _____ _____ and is again the _______ therapy and not _______ treatment.

Answer 37

1. Self concept and self esteem 2. Adjunctive 3. Primary