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Attention Deficit Hyperactivity

Disorder
Psychology
Alagappa University
15 pag.

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Attention Deficit Hyperactivity
Disorder

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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

Brand name generic name properties


half life 2-4 hours; effective 3-6
Ritalin methylphenidate hours; low anorectic and cardiac
effects; often preferred by children
half life 6-12 hours; effective for 4-6
Dexadrine dextroamphetamine hours; larger anorectic, cardiac
effects; insomnia
half life 12 hours; effective 12-24
Cylert Pemoline hours; lowest stimulant effect; low
abuse potential

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