Attention-Deficit Hyperactivity Disorder (ADHD)

Mrs. DawsonPsychologyPeriod 5..

ADHD

• So what does it mean all together?• It basically means that the person is so unfocused

that they lack the capacity to narrow their focus into one task which allows them to serve as a disturbance to others.

• Psychology defines it as:– A psychological disorder marked by the appearance

by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity.

Associated Features

• Extreme inattention• Hyperactivity• Impulsivity• Shifting social, academic, vocational achievements

(decrease).• Carelessness, forgetfulness, attention problems.• Defiance.• Resistance to authority.• Tend to be easily distracted and cannot follow through on

instructions.• Fidgety.• Talkative.

Etiology..(Where can get this ADHD thing you

speak of)• Genes/Genetics

– Usually runs in families, often are inherited from parents.

• Environmental Factors– Lead Exposure (especially in preschoolers)– Cigarettes & Alcohol (use of one or the other -even of both -puts one in danger of major brain deficiencies

as well as those they may be around or pregnant with).– Pesticides– Flouride– Complications During Pregnancy .

• Brain Injuries/Previous Illnesses– Celiac Disease & Food Allergies– Complications During Pregnancy

• Even though only a small number of children contribute to this statistic it remains a key cause thought of in some cases.• Sugar/Sugar Substitutes

– Some studies have shown that refined sugars contribute to ADHD symptoms (especially if the child is using sugar-substitutes).

• Food Additives– Artificial colors, preservatives -increase in activity may increase hyperactivity to abnormally higher levels.

• Medication

What makes you vulnerable?• What could make a person vulnerable to developing

ADHD?– Lack of parenting

• When a parent isn't as consistent as they should be.• Or when they fail to always be there for the child.

– Stressful family situations• Family arguments that children may be dragged into.

– Excessive exposure to TV and video games• This does not mean that television is bad but too much of a good

thing -you know the rest!– Lack of structure at school

• Teachers that teach willy-nilly and have no real “game plan” for their day -lack of lesson plan.

– When children are genetically blesses with ADHD they tend to be vulnerable to pesticides, toxins, or other triggers.

This is what some of these symptoms look like…

http://www.youtube.com/watch?v=z2hLa5kDRCA

DSM-IV-TR Criteria..(Keep in mind that you are not qualified to

diagnose your classmates)• Inattention• Often does not give close attention to details or makes careless mistakes in

schoolwork, work, or other activities.• Often has trouble keeping attention on tasks or play activities.• Often does not seem to listen when spoken to directly.• Often does not follow instructions and fails to finish schoolwork, chores, or duties

in the workplace (not due to oppositional behavior or failure to understand instructions).

• Often has trouble organizing activities.• Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort

for a long period of time (such as schoolwork or homework).• Often loses things needed for tasks and activities (e.g. toys, school assignments,

pencils, books, or tools).• Is often easily distracted.

– Is often forgetful in daily activities.I. Either A or B:Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level

DSM-IV-TR Criteria cont.

• Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:

• Hyperactivity• Often fidgets with hands or feet or squirms in seat.• Often gets up from seat when remaining in seat is expected.• Often runs about or climbs when and where it is not appropriate (adolescents or

adults may feel very restless).• Often has trouble playing or enjoying leisure activities quietly.• Is often "on the go" or often acts as if "driven by a motor”.• Often talks excessively.• Impulsivity• Often blurts out answers before questions have been finished.• Often has trouble waiting one’s turn.• Often interrupts or intrudes others (e.g., butts into conversations or games).

DSM-IV-TR cont.

• Some symptoms that cause impairment were present before age 7 years.• Some impairment from the symptoms is present in two or more settings

(e.g., at school/work and at home).• There must be clear evidence of significant impairment in social, school ,

or work functioning.• The symptoms do not happen only during the course of a Pervasice

Developmental Disorder, Schizophrenia, or other Psychotic Disorder.• The symptoms are not better accounted for by another mental disorder

(e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

• Based on these criteria, three types of ADHD are identified:ADHD, Combined Type: if both criteria 1A and 1B are met for the past 6 monthsADHD, Predominantly Inattentive Type: if criterion 1A is met but criterion 1B is not met for the past six months ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion 1B is met but Criterion 1A is not met for the past six

Three Different types of ADH

• Combined Type– They show symptoms that fall under the criteria to

meet the Inattentive aspect of ADHD as well as the Hyperactive/Impulsivity aspects (generally equally).

• Predominantly Inattentive Type– They show symptoms “predominantly” in the regions

of Inattentiveness. • Predominantly Hyper-Active Impulsive Type

– They show symptoms “predominantly” in the regions of Hyperactive/Impulsiveness.

• These kids may struggle with things such as dysgraphia.

Prevalence?

Treament Forms

• There are two basic physiological (mind and body) ways to treat generally all Psychological Disorders:

– Therapy (for the mind).– Medication (for the body).

• Sometimes both may be required.

Treatments for ADHD

• Trade Name Generic Name Approved• Age Adderall amphetamine3 and older• Adderall XRamphetamine (extended release) 6 and older• Concert amethylphenidate (long acting) 6 and older• Daytran amethylphenidate patch 6 and older• Desoxyn methamphetamine hydrochloride 6 and older• Dexedrine dextroamphetamine 3 and older• Dextrostat dextroamphetamine 3 and older• Focalindex methylphenidate 6 and older• Focalin XRdexmethylphenidate (extended release) 6 and older• Metadate ERmethylphenidate (extended release) 6 and older• Metadate CDmethylphenidate (extended release) 6 and older• Methylin methylphenidate (oral solution and chewable tablets) 6 and older• Ritalin methylphenidate 6 and older• Ritalin SRmethylphenidate (extended release) 6 and older• Ritalin LAmethylphenidate (long acting) 6 and older• Strattera atomoxetine 6 and older• Vyvanselis dexamfetamine dimesylate 6 and older

Other Treatments for ADHD• Combined Type:

– A mixture of the other medications.– FDA usually only prescribes them for underaged (3-6 year

olds) seeing as most adults will be tempted to start abusing the drugs.

• Inattentive Type:– Otherwise known as the “Winnie the Pooh” stage (as Dr.

Daniel Amen puts it) is most responsive to stimulants.– These include Ritalin, Attend and Adderall.

• Hyperactive/Impulsive Type:– Straterra: regulates attention and impulsivity.

• It basically calms the patient down to a normal level aside from their norm of being elevated.

Treatments in Depth

• Therapy– Helping someone organize things, encouraged to use

organizers, be clear and consistent in speech– Typically when rules are followed the patient is

rewarded for the desired behavior -remind you of something

• Cognitive Behavior Therapy

• Exercise ability to think before acting, resist negative impulses etc.

Prognosis

Prognosis

• Late Teens- develops into a stage of deficit within the realms of education and social functioning.

• Small amounts become antisocial & pick up drug abuse.

• 2/3’s of them show no evidence of mental disorders.

• Typically once patients hit their mid-20s they don’t experience behavioral, mental or emotional problems (that aren’t considered abnormal).

Review

Discussion Question…

• Do you believe that ADHD is a serious disorder? Is it at a level comparable to the common cold or cancer? Support your response.

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