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Disorder
Psychology
Alagappa University
15 pag.
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Introduction
Case Studies in ADHD.
Symptom presentation.
History of ADHD
Nursery rhyme presented in your book by Henrich
Hoffman, a German psychiatrist, (mid 1800s).
Phil, stop acting like a worm; The table is no place to
squirm; Thus speaks the father to his son. Severely says it,
not in fun. Mother frowns and looks around; Although she
doesn’t make a sound; But Phillip will not advise; He’ll have
his way at any price; He turns; And churns; He wiggles; And
jiggles; Here and there on the chair; Phil, these twists I
cannot bear.
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History
1902: George Still (Royal College of Physicians):
restlessness, inattentiveness, and overarousal in
children.
20th Century: encephalitis lethargica – epidemic
in America and Europe. Led to the idea that
ADHD was neurologically based.
Postencephalitic Behavior Disorder.
Minimal Brain Dysfunction.
Hyperkinetic Impulse disorder (DSM II diagnosis).
Attention Deficit Disorder (DSM III diagnosis).
Attention Deficit Hyperactivity Disorder (ADHD;
DSM-IIIR 1987).
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ATTENTION-DEFICIT/HYPERACTIVITY
A. Either (1) or (2):
(1) 6 or more of following have persisted for 6 months to degree that is
maladaptive and inconsistent
with developmental level:
Inattention
____ ____ often fails to pay attention to details or makes careless mistakes in
school or other activities
____ ____ often has difficulty sustaining attention
____ ____ often does not seem to listen when spoken to directly
____ ____ often doesn't follow through on instructions and fails to finish things
____ ____ often has difficulty organizing tasks and activities
____ ____ often reluctant to do things requiring sustained mental effort
____ ____ often loses things
____ ____ easily distracted
____ ____ often forgetful
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2) 6 or more of following have persisted for 6 months to degree that is maladaptive
and inconsistent
with developmental level:
Hyperactivity
____ ____ often fidgets with hands or feet or squirms in seat
____ ____ often leaves seat in class
____ ____ often runs or climbs excessively in inappropriate situations
____ ____ often has difficulty playing quietly
____ ____ often "on the go" or acts as if "driven by a motor"
____ ____ often talks excessively
Impulsivity
____ ____ often blurts out answers before question completed
____ ____ often has difficulty awaiting turn
____ ____ often interrupts or intrudes on others
B. ____ ____ Some symptoms present before age 7
C. ____ ____ Some impairment present in 2 or more settings
D. ____ ____ Symptoms do not occur exclusively during Pervasive
Developmental Disorder,
Schizophrenia, are not better accounted for by depression or anxiety
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Subtypes of ADHD
Attention Deficit Hyperactivity Disorder –
Predominantly Inattentive Type
Attention Deficit Hyperactivity Disorder –
Predominantly Hyperactive-Impulsive Type
Attention Deficit Hyperactivity Disorder –
Combined
New subtype: Sluggish Cognitive Tempo
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Controversies and Unresolved
Issues
The issue involving the diagnosis of ADHD,
inattentive type.
What is normal versus clinical?
ADHD diagnosis and age.
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Epidemiology
Prevalence: 3-5% children; 2-3% adolescents.
Cultural issues?
Gender differences: seen more in boys 6-9x.
Co-occurring disorders:
Conduct disorder
Depression.
Bipolar Disorder.
Anxiety Disorders.
Learning disorders
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Co-morbidity
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Additional problems for patients with
ADHD
Intelligence and academics
Problems with family and peer relationships
Emotional dysregulation
Sleep and health problems
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Developmental course of ADHD
Problems across the lifespan
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Etiology of ADHD
Genetic explanations
Neurological explanations
Structural problems within the brain
Neurotransmitters
Prenatal explanations
Social explanations
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Treatments for ADHD
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Stimulants and ADHD
Mechanism of action
Common Stimulants used to treat ADHD
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