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1.6 Problem 6 Summary
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- Erasmus Universiteit Rotterdam (EUR)
Summary of 1.6 Problem 6 literatures and articles
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1.6 Problem 6Young, Fast and Wild
Attention Deficit Hyperactivity Disorder
ADHD- Persistent pattern of inattention and/or hyperactivity-impulsivity that’s at a
significantly higher rate than would be expect for the child at that developmental stage
Manifest behaviourally in many ways
Child sufferers typically have strong dislike for tasks requiring self-application and
mental effort, and easily distracted by irrelevant stimuli
Hyperactivity- high than normal level of activity
Manifest with excessive fidgetiness, running/climbing when inappropriate,
excessive talking
Appear constantly “on the go”
Impulsivity- act of reacting to a situation without considering the consequences
Manifest as impatience, difficultly appropriately delaying responses, constantly
interrupting others
Sometimes desire for immediate rewards
May result in accidents and indulging in dangerous activities
ADHD Diagnosis
- Must ensure hyperactivity/inattention significantly greater, and that it’s
generalised/persistent predisposition not confined to single context
DSM-5 for ADHD
Ongoing pattern of inattention and/or hyperactivity and impulsivity that interferes with normal
functioning or development, with the following
o Inattention: min. 6 of following, for min. 6 months
Paying little attention to details/making careless mistakes
Difficulty maintaining attention in activities
Doesn’t listen when spoken to directly
Ignores instructions
Difficulty organising
Dislikes/avoids tasks requiring sustained mental effort
Loses things needed for tasks
Easily distractible
Forgetful in daily activities
o Hyperactivity and impulsivity: min 6 of following, for min. 6 months
high level of fidgeting
not sitting still/leaving seat when expected to sit
runs/climbs in situations where inappropriate
unable to engage in activities quietly
excessive talking
blurts out answer before question finished
difficulty awaiting turn
interrupts/intrudes on others frequently
Symptoms present before age 12
Symptoms present in at least 2 setting
Symptoms reduce quality of educational, social, or occupational ability
Symptoms don’t occur during schizophrenia or other psychotic disorder and are not better explained
by another mental disorder
most individuals present both inattention and hyperactivity, but one often more
dominant
3 subtypes to be used if 6+ of dominant symptoms present with less than 6 of
less dominant symptoms present
1. Attention deficit hyperactivity disorder, predominantly inattentive
presentation
2. Attention deficit hyperactivity disorder, predominantly
hyperactive/impulsive presentation
3. Combined presentation
Approx. 50% also diagnosed with oppositional defiant
, If diagnosed with both, will exhibit worst of both disorders
Can define children with ADHD but not oppositional defiant disorder as:
1. More aggressive
2. Live in families with lower socioeconomic status
3. Parents exhibiting antisocial behaviour
Some ADHD leads to earlier onset of conduct disorder
¼ of children with combined presentation diagnosed with conduct disorder
o Perhaps as become involved in symptom escalation: behaviour causes
aggressive reactions, evoking aggressive/antisocial reactions in sufferer
Recognition/Symptom Display
Usually parents when child’s a toddler, just as school begins
Learning/adjustment at school very affected by disorder
Not all hyperactive toddlers go on to develop ADHD
Development into adolescence, symptoms lessen
Approx. 50% of cases develop into adulthood- affects intellectual functioning and
IQ
Comorbidity
Anxiety and depressive disorders with ADHD
Prevalence
Approx. 5% of school-age children internationally
2.5% of adults internationally
More common in boys than girls in childhood, not in adulthood
o Perhaps likelier to be referred for treatment
o Identification of girls been hampered by teacher/parent bias
Consequences
- Prone to temper outburst, frustration, bossiness, stubbornness, changeable
moods, poor self-esteem
o Academic achievement impaired causing conflict with teachers/family
- Family members frequently view outburst as intentional/irresponsible because of
the disruption caused
o Resentment within family
- Predominant inattentive symptoms= most academic achievement impairment
- Predominant hyperactivity/impulsivity= more peer rejection/accidental injury
- Aggressive/disruptive behaviour, struggle understanding peers’
intentions/responding correctly
o Difficulty making friends/integrating into social groups
- Adulthood
o Less success/safety at work
o Poorer interpersonal relationships
o Poorer academic outcomes
o Poorer general life satisfaction
Aetiology
Biological
Genetic factors
o One of most heritable psychiatric disorders
Proven in twin studies- 76% heritability
Proven in adoption studies
o Perhaps linked to chromosome 16?
May cause abnormalities in dopamine, norepinephrine and
serotonin symptoms
X- individual gene variant for ADHD must have small individual
effect
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