Extensive notes of all the mandatory literature for course 1.6 Normal or Abnormal? Written by an Honour Student with relevant visual aids, all DSM V criteria and helpful overviews. I'll be happy if you leave your feedback or review :)!
Problem 1 - ADHD and Autism
ADHD
ADHD DSM-5
- An ongoing pattern of inattention and/or hyperactivity & impulsivity that interferes
with normal functioning or development, with either one of (these two types can
also be combined):
Inattention ( 6+ of these for at least 6+ m + impacts activities)
For 17y/o+, min 5 of these required
- Not paying attention to details/ careless mistakes
- Difficulty maintaining attention
- Doesn’t listen when spoken to
- Ignores instructions
- Difficulty organizing
- Dislikes/avoids tasks that require sustained mental effort
- Loses things needed for tasks
- Easily distractible
- Forgetful in daily activities
Hyperactivity and Impulsivity (6+ of these 6+m)
- Lots of fidgeting/squirming
- Leaving seat when expected to sit
- Runs/ climbs in inapp. situations
- Unable to engage in activities quietly
- Can’t sit still/restless
- Excessive talking
- Blurts out answer before end of question
- Has difficulty awaiting their turn
- Interrupts or intrudes on others frequently
B. Symptoms there before age of 12
C. Symptoms in 2+ settings/contexts (home, school…)
D. Symptoms reduce quality of educ., soc/occupational ability
E. Symptoms not caused by schiz/other
Prevalence: 5% of school-age children; 2.5% of adults
• 9% of children & ad. (not the most prevalent – specific phobia is, but most frequently diagnosed)
- cuz ↑ likely to be brought by parents (more disruptive than phobia)
• ↑ (13%), (4%) + c-c
• Symptoms mostly recognized in school children – most disruptive
• First recognized when child starts going to school, because learning & adjustment are significantly
affected
• Life-long diagnosis but can go into remission (coping with the disorder, not disrupting daily life as
much or very little)
• As child grows, ↓ symptoms , but 50% will continue to show symptoms into adulthood - can
affect IQ
• Issues in diagnosis
, o Gender differences in diagnosis – differently manifested in girls (more inattention – less
disruptive) and boys (more hyperactive - disruptive)
o Hard to insure whether the hyperactivity is tied to a situation or generalized
o Cultural context
Comorbidity: OCD & CD (Conduct disorder – violation of social norms/basic rights)
- low self-esteem → anxiety and depression
- Impaired executive functions – they do have normal theory of mind
Symptoms: Changeable mood, low self-esteem, bossiness, frustration;
Result: poor academic performance (score lower on tests – cuz of attention), conflict with teachers and
parents, don’t obey rules
• Family – see beh. as intentional and irresponsible → resentment
If mostly inattentive symptoms – worst in academic achievement (6+ inattentive symptoms and less than
6 hyperactive)
If mostly hyperactive/impulsive symptoms – worst in peer rejection and accidental injury (6+ hyperactive
symptoms and less than 6 inattentive)
• Difficulty making friends; failure to understand the intentions of their peers and are unable to
translate the correct social response into appropriate behavior
• In adulthood: ↓ success at work, interpersonal rel, academic outcomes & general life
satisfaction
CAUSES - Bio
• Genetic factors - heritability 76% - most heritable disorder
• Depends both on genetic and environmental potential
• Susceptibility to the disorder is inherited, has to be triggered by the environment
• Part of chromosome 16 has most evidence – dopamine, serotonin, norepinephrine (executive
functioning, inhibition…), ADHD have deficiency of dopamine – seek for rewards in the
environment
• Dopamine transporter gene, D4 & D5 receptors and SNAP-25 (a gene that controls the way
dopamine is released in the brain)
• Children with two copies of 10-repeat allele of a DAT1 gene (regulates the way dopamine is
released in the brain) + maternal prenatal smoking = ↑ risk
Brain
• Smaller brains → predictor of poor inhibition and self-regulation
• +slower development → problems with complex motor movement
• Mostly affected = frontal (↓ volume = ↓ inhibition), parietal, temporal & occipital, basal ganglia,
cerebellum (abnormalities = affects complex motor & cog responses)
• Striatal thalamic cortical circuit → involved with the desire for immediate reward
• ↓ Grey Matter altogether
Prenatal factors
• Maternal smoking & drinking – predicts abnormalities in the dopaminergic system
, • Low birth weight, respiratory distress & birth asphyxia (severely low supply of oxygen to
body that caused by abnormal breathing)
Environmental factors
• ↑ lead in blood
• Chronic exposure to nicotine/tobacco smoke
Psychological
Parent-child interaction
• Parents could be suffering from ADHD as well as it is so highly heritable → more likely to become
irritated
• Inconsistent and ineffective parenting
• Authoritarian parenting: + impatient with child
The attention from the parent may be rewarding/reinforcing
Theory of mind deficits (no)
↓ perfor. on executive functioning, but no strong evidence for poor TOM performance → no deficits in
social functioning!
TREATMENT - Bio
Ritalin (methylphenidate) – an amphetamine quieting effect on children, ↓ overactivity & distractibility +
↑ alertness → at school
Side effects: decreased blood flow to brain = impaired thinking ability & memory loss; disruption of
growth hormone; insomnia; psychosis
Pemoline - school beh. – ↑ cognitive processing, less negative side effects
Strattera - noncontrolled option, ↓ symptoms, but dk how it works
Side effects: decreased appetite, nausea, vomiting, fatigue, liver damage
Adderall – mix of amphetamine & dextro-amphetamine; no advantage over Ritalin & Strattera
Short-term effects of these are known but we dk the long-term ones
Behavioral training = positive reinforcement, structuring of learning materials in a way that minimizes
error and maximizes immediate feedback & success + family therapy
Time-out = positive reinforcement, for reducing aggressiveness, & non-compliance in the classroom
Behaviour management techniques e.g. teaching parents to identify & reward beh
Family therapy = Systemic = problem stem from bad family structure & organization – focus on comm
between child & mom
Parent management training = teach parent sot modify responses =
Functional family therapy = CBT + systemic, strengthens relationships by opening comm between parent
& child
CBT
Play therapy – for younger children
ARTICLE
Aim: To review non-pharmacological interventions for preschoolers, school-age children, adolescents and
adults
Method: meta-analysis of research papers by searching keywords (ADHD, children, parent training etc.)
, Results:
• Preschool children – parent training
o written material about ADHD
o Teach parents behavioral strategies
o Teach techniques to target and monitor problematic behaviors e.g. behavioral diary
o Reward prosocial behaviours through praise, positive attention and tangible rewards
o Decrease unwanted behaviours through planned ignoring, time-out, effective commands
and other similar non-physical disciplinary techniques
o Address parental risk factors (by counselling, support groups)
• Young school-age children
o Parent training – until age 12
▪ Management strategies – e.g. introducing mediating notebooks or diaries to
facilitate teacher–parent communications and the setting and reward of
educational goals-both academic and behavioural
o Classroom interventions
▪ Provision of psychoeducational information – written material that takes into
account the developmental and behavioural needs of the child
▪ use of both verbal and written instructions and avoidance of complex sentences
that involve several concepts
▪ behavioural strategies and techniques to identify and manipulate the
antecedents and consequences of the child’s behaviour
▪ Reward achievements and/or prosocial behaviours through praise, positive
attention and tangible rewards
▪ Decrease unwanted behaviours through planned ignoring, time-out
• Middle/high school children/ adolescents
o Classroom interventions
▪ psychoeducational information, environmental and management strategies as
outlined for young school-age children but with adaptations for this
developmental age group, e.g., use of a Weekly Report Card instead of a Daily
Report Card;
▪ teach study skills, including test-taking strategies; implement homework
completion sessions; reward systems can be extended to introduce longer-term
rewards
▪ regular sessions attended by parents, teachers and counsellors initially to identify
the child’s needs and formulate an intervention plan
▪ Implementation of individualised programmes
o CBT + Social Skills Training
▪ Provision of psychoeducational information
▪ Achievements and improvement can be rewarded
▪ Direct intervention (including role plays) with the child to improve social
communication skills focusing on both specific micro-skills (e.g., appropriate eye
contact, voice volume and tone, body positioning) and macro-skills which involve
more complex interactions (e.g., giving compliments, constructive feedback,
turn-taking, listening skills, conflict resolution, assertion)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through EFT, credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying this summary from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller zia818. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy this summary for R277,79. You're not tied to anything after your purchase.
