psy 474 2
Terms
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- What is ADHD
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Inattention Type (cannot concentrate, distracted ,disorganized)
HyperImpulsive Type (excessive talking,fidgety, interupts) - Types of ADHD
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Combined (ADHD-C)=6 or more symptoms of both
Inattentive (ADHD-I)=6 or more symptoms of Inattention, less than 6 symptoms of hyperactivity/impulsivity
Hyperimpulsive (ADHD-H)=6 or more symptoms of Hyperact/ Impulsivity, less than 6 symptoms of inattention - other properties
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Behavior interferes w/ abilities in multiple settings (home, school, peers)
Behavoirs present in early childhood (onset before 7)
Duration of symptoms at least 6 months
No objective tests to diagnose (only subjective) - Limitations
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Not developmentally sensitive: symptoms of hyperimpulsivity decrease w/ age
Heterogeneous
Not sex-specific (girls more likely to be socialized against showing hyper/impl sx - Characterisitics
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Prevalence: 3-5% (declines w/ age)
More boys than girls
More in low SES
Associated problems - Associated problems
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ODD,CD, LD, ANX, DEP
(ODD/CD more common in combined)
ODD, CD, LD=externalizing behaviors (affect family/ peers in over way)
ANX, DEP= internalizing - Etiology
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Highly heritable (twin studies .75-.95 heritability)
Neurotransmitters: dopamine, neuropinephrine) - Barkley's Integrative Model
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Primary deficit= weakened ability to inhibit behavior. All other deviations are secondary.
Primary deficit arises as product of biological factors. - Executive Functions
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=cognitive processes that contribute to self-regulation
Includes inhibition, attention, working memory, flexibility of thought, emotional regulation.
Problems can cause other [behavioral] problems - Family context
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Transitional effect: brings out worst in parent and child.
Protective factor: positive parenting - Social Context
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increased chance of peer rejection and social isolation
ADHD-C more peer rejection
ADHD-I more peer neglect - Intervention
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Medecine (ritalin, etc): very effective but only if done correctly/daily parent, teacher reports on doses, regular schedule
Psychotherapy: behavior management, cognitive behavioral therapy, anger management, Social skills training, parent training - MTA Study
- Combined subtype. Randomly assigned to: psychotherapy only, medication only, combined both, or community care
- MTA Results
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Combined treatment most effective [in improving family relations, lower total med. dose, reported school gains]
For severity of symptoms, Medication alone was just as effective as Combined. (both better than therapy alone or community care) - Alternative Treatment
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Elimination Diets- sugar, food sensitives (but will not cure)
Nutritional supplements
Acupuncture (no evidence of effectiveness)
BioFeedback (no evidence)