ADHD Symptoms and Prevalence (DSM-5)

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Questions and Answers

Which task measures Delay Frustration (DeFT)?

Maudsley's Index of Childhood Delay Aversion (MIDA)

Delay Reaction Time (DRT)

Delay Frustration (DeFT) involves responding to simple math questions with delays (correct)

Tapping task

What was found to be the most common neuropsychological deficit in the study?

Delay Reaction Time

Timing (correct)

Delay Frustration

Inhibition

How does the performance of siblings without ADHD compare to that of ADHD children in terms of neuropsychological deficits?

They consistently perform worse than ADHD children.

They have intermediate scores between controls and ADHD children. (correct)

They have scores identical to controls.

They show no variation compared to ADHD children.

Which of the following tasks assesses the Timing Perception Deficit (TPD)?

Tapping task Signup and view all the answers

What was the relationship between delay deficits and IQ as found in the study?

Delay deficits were positively associated with IQ scores. Signup and view all the answers

What factor might contribute to the underdiagnosis of ADHD in girls?

Parents and teachers may hold biases against girls with ADHD. Signup and view all the answers

In which population was the detection of externalizing disorders found to be lower?

Moroccan, Turkish, and Surinamese parents Signup and view all the answers

What is the prevalence of diagnosed ADHD among adults worldwide?

2.5% Signup and view all the answers

Which type of ADHD symptoms is predominantly associated with difficulties in academic achievement?

Inattentive symptoms Signup and view all the answers

What emotional challenges may individuals with ADHD commonly experience?

Temper outbursts and poor self-esteem Signup and view all the answers

Which of the following is NOT a consequence of ADHD behavior in children?

Enhanced social skills Signup and view all the answers

What misconception might contribute to family resentment towards children with ADHD?

Believing ADHD behaviors are intentional and irresponsible Signup and view all the answers

What is the primary action mechanism of psychostimulants used in ADHD treatment?

Inhibition of dopamine and norepinephrine transporters Signup and view all the answers

Which pharmacological treatment is considered a first-line option for ADHD?

Methylphenidate Signup and view all the answers

What distinguishes second-line medications for ADHD from first-line medications?

They are prescribed after no response, intolerance, or contraindication to stimulants. Signup and view all the answers

What is a limitation mentioned regarding the mechanisms of action of ADHD medications?

They do not account for long-term brain alterations. Signup and view all the answers

In which brain regions does atomoxetine primarily prevent norepinephrine reuptake?

All brain regions Signup and view all the answers

What genetically based factor can affect a patient's response to stimulant treatment?

Presence of SNPs on certain genes Signup and view all the answers

What is a primary association noted with delay-rich settings in children?

Development of aversive properties linked to negative emotions from failure. Signup and view all the answers

Which type of medication is noted for having a delayed onset and offset in efficacy compared to psychostimulants?

Norepinephrine reuptake inhibitors Signup and view all the answers

Which factor is said to influence the emergence of delay aversion and ADHD in impulsive children?

Setting high standards and being unforgiving of failures. Signup and view all the answers

What role do dopamine transporters play in the treatment of ADHD when using psychostimulants?

They inhibit reuptake, thereby increasing neurotransmission. Signup and view all the answers

What distinguishes DTAP ADHD from MSP ADHD?

DTAP results from cognitive impairments, while MSP is a motivational expression. Signup and view all the answers

Which of the following non-pharmacological interventions lacks strong evidence for efficacy in ADHD treatment?

Cognitive training Signup and view all the answers

Which area of the brain is particularly associated with MSP ADHD?

Ventral-striatal network, associated with reward processing. Signup and view all the answers

Which characteristic relates to MSP ADHD regarding environmental context?

It varies significantly based on environmental circumstances. Signup and view all the answers

What is a likely cognitive outcome for children with DTAP ADHD?

Severe and generalized cognitive impairment. Signup and view all the answers

What mechanism in MSP ADHD allows children to adapt their performance?

Development of alternative information-processing strategies. Signup and view all the answers

Which social issue is highlighted as a risk factor for ADHD in children?

Failure to follow through on promised rewards. Signup and view all the answers

Which best describes the implications of classical conditioning in MSP ADHD?

It indicates that environmental risks may be social rather than neurobiological. Signup and view all the answers

What factor is suggested to influence ADHD children's slower stop-signal reaction times (SSRTs)?

Temporal structure of the stop-signal paradigm Signup and view all the answers

Which statement is true regarding the association between delay aversion and inhibitory control in ADHD?

Delay aversion may be a result of poor inhibitory control over time. Signup and view all the answers

In the described study, what performance effect was observed between ADHD and control children on the tasks?

ADHD had a large negative effect on performance across both tasks. Signup and view all the answers

What is a likely reason ADHD children experience negatively associated emotions when faced with delay?

Poor performance on extended tasks. Signup and view all the answers

How are the choice delay and stop-signal tasks connected according to the findings?

There is no correlation between performance on the two tasks. Signup and view all the answers

What was a key aspect of the choice delay task design in relation to response inhibition?

The inhibition load for choosing large delayed rewards was trivial. Signup and view all the answers

Which factor may contribute to the delayed attention often seen in ADHD children?

Preference for immediate gratification. Signup and view all the answers

What is implied about the relationship between stop signals and inter-stimulus-interval (ISI) durations in ADHD children?

Varying ISI durations contribute to longer SSRTs. Signup and view all the answers

What diagnostic approach was utilized in the study regarding ADHD children?

Only the two specified measures were used. Signup and view all the answers

Study Notes

ADHD (DSM-5) Symptoms and Prevalence

ADHD is a persistent pattern of inattention and/or hyperactivity-impulsivity, significantly higher than expected for a child's developmental stage.
Behaviors can include lack of attention in various settings (academic, occupational, social), making careless mistakes, difficulty maintaining focus, not listening, disorganization, and difficulty completing tasks requiring sustained effort.
Hyperactivity can manifest as excessive fidgeting, leaving seats inappropriately, excessive running/climbing, excessive talking, and always being "on the go".
Impulsivity includes interrupting, impatience, and a desire for immediate gratification.
Symptoms must be present before age 12, present in at least two settings, and impact educational, social, or occupational functioning.
ADHD is diagnosed in approximately 5% of school-aged and preschool children and 2.5% of adults globally. Boys are more often diagnosed than girls, thought this may be due to greater referral rates and girls exhibiting less disruptive behaviors. However, sex differences in presentation may not be seen in adulthood.

ADHD Diagnosis

Diagnosis requires an ongoing pattern of inattention and/or hyperactivity-impulsivity.
Inattention criteria: at least six symptoms are required for at least 6 months. Includes difficulty paying attention to details, difficulty sustaining attention in activities, difficulty listening, following instructions, disorganization, avoiding tasks requiring sustained mental effort, losing things, distractibility, and forgetfulness.
Hyperactivity/Impulsivity: 6 or more symptoms are required for at least 6 months. Includes excessive fidgeting, inability to sit still, excessive running/climbing, difficulty engaging in quiet activities, excessive talking, blurting out answers, interrupting, and difficulty waiting their turn.
Symptoms must be present in at least two settings (e.g., home and school)
Symptoms must interfere with normal functioning or development.

ADHD Subtypes

Predominantly inattentive presentation: meeting only the inattention criteria in the past 6 months.
Predominantly hyperactive/impulsive presentation: meeting only the hyperactivity/impulsivity criteria in the past 6 months.
Combined presentation: meeting both inattention and hyperactivity/impulsivity criteria.

Comorbidities

Oppositional defiant disorder (ODD) is found in 50% of individuals diagnosed with combined presentation.
Conduct disorder (CD) may be a comorbidity, and occurs in 45-60% of ADHD children.
Anxiety and depression are comorbid in a minority of children with ADHD.
Adults with ADHD are at increased risk for antisocial personality disorder, substance abuse, mood disorders, anxiety disorders, marital problems, traffic accidents, and frequent job changes.

Causes of ADHD

Strong genetic component, with a heritability of 76%. This affects dopamine, norepinephrine, and serotonin systems.
Specific genes (dopamine transporter gene, dopamine D4 and D5 receptors, SNAP-25) are implicated and have small individual effects.
Environmental interactions are significant. Prenatal exposure to nicotine, pre- or perinatal complications, maternal drinking during pregnancy, low birth weight, lead exposure, and exposure to chronic nicotine are examples of environmental factors influencing ADHD.

Treatments of ADHD

Stimulant medications (methylphenidate, amphetamines) are highly effective, reducing demanding, disruptive, and non-compliant behaviors in over 70% of ADHD children.
Non-stimulant medications (atomoxetine, clonidine, guanfacine) impact norepinephrine levels and are sometimes used as second-line treatments.
Behavioral therapies are also effective in reducing symptoms, reinforcing positive behaviors and extinguishing negative ones. These interventions often involve parents and teachers.
Combined medication and behavioral therapies typically yield the best outcomes.

Cognitive, Psychological and other Factors

Children with ADHD show impaired executive function, particularly with planning and inhibition.
Psychological factors include parenting styles, especially authoritarian methods.
ADHD children may find it difficult to make friends or integrate into social groups.
Symptoms often decrease during adolescence, but about half of adults will still show symptoms.
Adults often face issues in maintaining steady employment, relationships, social life and safety.

Cognitive Tests of ADHD and Treatments

Continuous Performance Test (CPT): measures sustained attention and response inhibition, common in ADHD.
Stroop Task: measures the ability to inhibit responses and color naming, common in ADHD.
Trail Making Test: measures cognitive flexibility and attention, common in ADHD
Controlled Word Association Test (COWAT): measures verbal fluency and category fluency.
Conners' Parent Rating Scale (CPRS): an 80-item scale completed by the child's parent used to assess ADHD symptoms.

Non-Pharmacological Treatments

Behavioral therapies help change behaviors and thought patterns, which are vital components of treatment to be sustainable
Cognitive training to improve attention, and executive functions.
Neurofeedback, a form of biofeedback, may help improve self-control over brain activity patterns.
Dietary modifications, like removing artificial food colors and other dietary interventions, have some impact at changing ADHD symptoms, though not huge.

Other important points

Symptoms reduce over time in children with ADHD
There is often overlap of ADHD symptoms and other conditions. ADHD is a major condition impacting overall well-being, so timely and appropriate interventions are recommended.
Computerized training of working memory is a potentially effective intervention to treat ADHD symptoms.
The relationship between ADHD and motivational factors and delay aversion has also been explored. There may be pathways for ADHD as a motivational style, differing from the pathway of regulation of thought and action.

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Description

Explore the symptoms and prevalence of ADHD as outlined in the DSM-5. This quiz covers key behaviors associated with ADHD, including inattention, hyperactivity, and impulsivity, as well as the demographic data regarding its diagnosis. Gain insights into how these symptoms manifest at different developmental stages.