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Problem 7. ADHD & Autism, Course 1.6 Normal or Abnormal, English Summary
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ADHDDisruptive disorders: They refer to behavioral problems that are characterized by impulsive,
disruptive and poorly controlled behavior.
Attention deficit hyperactivity disorder (ADHD): A persistent pattern of inattention and/or
hyperactivity-impulsivity that is at a significantly higher rate than it would be for a child at
his or her developmental stage.
Many ways of manifestation e.g. lack of attention in academic performance, occupation,
social situations
Usually they dislike tasks that need a lot of mental effort and focus and
would be easily distracted.
1. Hyperactivity: A higher than normal level of activity. E.g. excessive fidgetiness and
not remain seated, running, climbing, talk excessively. Difficulty in listening
attentively to a story.
2. Impulsivity: The act of reacting to a situation without considering the consequences.
It shows as impatience, and difficulty in delaying responses and constantly
interrupted others before they have finished what they have to say. Also, reflect
desire of immediate rewards or over delayed ones.
Result in accidents or dangerous activities.
Diagnosis
Main diagnostic criterion: Ensuring that hyperactivity or inattention is significantly greater
than normal for the child’s developmental stage and to ensure that it is a generalized and
persistent predisposition rather than one that is confined in a single context. Also:
Impairment present before 12 years and in two or more contexts.
Two diagnostic subtypes:
1. Attention deficit hyperactivity disorder, predominantly inattentive presentation
2. Attention deficit hyperactivity disorder, predominantly hyperactive/impulsive
presentation
3. If both elements present it is known as combined presentation.
o Combined presentation is highly a more significantly comorbid than all
psychopathologies with conduct disorders. (1/4)
Link with antisocial behavior
Worst manifestation of both disorders when
If distinguished the ones with conduct disorder are more aggressive,
low SES, have parent that exhibit anti-social behavior.
ADHD have better prognosis
Close link because disruptive behavior leads to aggressive
ADHD can be slightly comorbid with depression and anxiety
, Criteria of subtypes: Each subtype is used if six or more of the dominant symptoms are
present with fewer than six of less dominant symptoms present. (refers to the two
subtypes)
Course of ADHD: It is first recognized by parents when the child is a toddler. Usually when
the child begins school because it is a very affected field by ADHD. In adolescence symptoms
decrease and become less pronounced and half of the cases will continue in adulthood and
that can affect intellectual functioning very much.
Cultural influence: Some studies show that there is no significant difference across cultures
or ethnic groups and others indicate differences among countries. A possible explanation is
the cultural environment or the parenting.
Prevalence
5% of children in preschool and school, 2.5 % of adults
½ of diagnose children during childhood will carry the diagnosis in adulthood as well
More boys diagnosed but symptom existence same in both sexes but biased by
teachers and parents. Sex differences do not continue in adolescence.
Consequences
Attentional deficits and hyperactivity→ outbursts, frustration, changing moods,
poor self-esteem and that can result to poor academic performance and pervasive
behavior that is perceived by family as intentional and irresponsible that can result in
family conflict.
Social behavior→ Great difficulty in making friends and integrate fully in social
groups usually because they are aggressive and disruptive. As a result, they are
singled out rapidly because they are unable to understand social cues.
In adulthood→ Less success, safety, poor interpersonal relationships, academic
outcome an d life satisfaction.
Etiology of ADHD
Biological aspect
Genetic factors
One of the highest heritable psychiatric disorders:
Evidence from adoption studies showed that adopted children with ADHD is more
likely if the biological parent has the disorder.
The mechanism is not still completely explained, some things that are known are:
o Location on chromosome 16
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