14.2 Attention-Deficit/Hyperactivity Disorder (ADHD)
3 min read•july 9, 2024
ADHD is a neurodevelopmental disorder marked by and -. It impacts daily functioning across multiple settings, with symptoms starting before age 12. There are three subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and combined.
ADHD has biological, psychological, and environmental causes. It affects academic, social, and occupational functioning. Treatment options include medication (stimulants and non-stimulants) and non-pharmacological approaches like , CBT, and educational interventions.
Overview of Attention-Deficit/Hyperactivity Disorder (ADHD)
Primary symptoms of ADHD
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- Neurodevelopmental disorder marked by persistent inattention and/or hyperactivity-impulsivity interfering with functioning or development
- Symptoms present before age 12 occur in multiple settings (home, school, work)
- Inattention symptoms involve difficulty sustaining focus, distractibility, failing to follow instructions or complete tasks, avoiding mentally demanding activities, losing important items, forgetfulness in daily routines
- Hyperactivity-impulsivity symptoms include fidgeting or squirming, trouble staying seated, excessive running or climbing (children), difficulty with quiet activities, constantly "on the go" or "driven by a motor," excessive talking, blurting out answers or interrupting, struggling to wait for turns
Subtypes of ADHD
- (ADHD-PI) primarily exhibits inattention symptoms may appear sluggish, daydreamy, easily confused
- (ADHD-HI) mainly shows hyperactivity-impulsivity symptoms appears restless, fidgety, disruptive
- (ADHD-C) displays both inattention and hyperactivity-impulsivity most common subtype
- Symptom presentation can shift over time leading to changes in subtype diagnosis
Etiology and Impact of ADHD
Contributing factors for ADHD
- Biological factors
- Genetic influences with 60-90% heritability
- Neurochemical imbalances in dopamine and norepinephrine systems
- Structural and functional brain differences (reduced volume in prefrontal cortex and striatum)
- Psychological factors
- Executive functioning deficits (working memory, inhibitory control, cognitive flexibility)
- Emotional regulation and motivation difficulties
- Environmental factors
- Prenatal substance exposure (alcohol, tobacco)
- Low birth weight and prematurity
- Toxin exposure (lead)
- Family dysfunction and adverse childhood experiences
Impact of ADHD on functioning
- Academic functioning impairments
- Difficulty completing assignments and studying effectively
- Lower grades and higher academic underachievement rates
- Increased school dropout risk
- Social functioning challenges
- Trouble maintaining friendships and relationships
- Impaired social skills and problem-solving abilities
- Higher peer rejection and social isolation rates
- Occupational functioning issues
- Difficulty maintaining employment
- Lower job performance and productivity
- Increased workplace accidents and injuries risk
Treatment of ADHD
Treatments for ADHD
- Pharmacological treatments
- Stimulant medications (methylphenidate, amphetamines)
- Increase dopamine and norepinephrine brain levels
- Improve attention, reduce hyperactivity and impulsivity
- Non-stimulant medications (atomoxetine, guanfacine)
- Increase norepinephrine or activate alpha-2 adrenergic receptors
- Improve attention and reduce hyperactivity
- Stimulant medications (methylphenidate, amphetamines)
- Non-pharmacological treatments
- Behavioral therapy teaches strategies for managing symptoms and improving functioning (positive reinforcement, time management, organizational skills training)
- Cognitive-behavioral therapy (CBT) addresses maladaptive thoughts and behaviors develops coping strategies and problem-solving skills
- Parent training and education teaches strategies for managing child's behavior and creating supportive home environment
- Educational interventions and accommodations include individualized education plans (IEPs), classroom modifications, assistive technology
Key Terms to Review (21)
ADHD Self-Report Scale: The ADHD Self-Report Scale (ASRS) is a self-assessment tool designed to help individuals evaluate their own symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). This scale consists of a series of questions that assess both inattention and hyperactivity-impulsivity, enabling individuals to reflect on their behaviors and experiences related to ADHD symptoms. The ASRS is often used in clinical settings and research to facilitate the diagnosis and understanding of ADHD in various populations.
Anxiety Disorders: Anxiety disorders are a group of mental health conditions characterized by excessive fear or worry that disrupts daily functioning. They encompass various disorders that can lead to physical symptoms like increased heart rate and sweating, and can significantly impact a person's quality of life.
Attention-Deficit/Hyperactivity Disorder: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development. Individuals with ADHD often face challenges in sustaining attention, following through on tasks, and regulating their activity levels, which can impact their academic and social performance. Understanding ADHD is crucial as it also intersects with various developmental and intellectual disorders, influencing both diagnosis and treatment strategies.
Behavioral Therapy: Behavioral therapy is a type of psychotherapy that focuses on changing maladaptive behaviors through various techniques based on learning principles. This approach aims to reduce symptoms and improve functioning by reinforcing desired behaviors and eliminating undesired ones. It often involves structured interventions, such as reinforcement strategies, which can be particularly effective in addressing behavioral issues seen in certain conditions.
Classroom accommodations: Classroom accommodations refer to modifications and adjustments made in the educational environment to support students with disabilities or learning challenges, ensuring they have equal access to learning opportunities. These accommodations can vary widely, from changes in teaching strategies and assessment methods to physical alterations in the classroom layout. The goal is to provide an inclusive educational setting that caters to diverse learning needs, particularly for those with Attention-Deficit/Hyperactivity Disorder (ADHD), who may struggle with traditional teaching methods.
Combined Type: Combined Type refers to a subtype of Attention-Deficit/Hyperactivity Disorder (ADHD) that exhibits symptoms of both inattention and hyperactivity-impulsivity. This classification is significant as it highlights the complexity of ADHD, where individuals demonstrate a mix of behavioral patterns that can affect their functioning in various settings. Understanding Combined Type is essential for accurate diagnosis and effective treatment strategies, as it underscores the need for tailored interventions addressing both sets of symptoms.
Conners Rating Scale: The Conners Rating Scale is a widely used assessment tool designed to evaluate behaviors associated with Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. It provides standardized questionnaires that help parents, teachers, and clinicians assess the severity of ADHD symptoms and their impact on functioning in various settings, allowing for a comprehensive understanding of the child's behavior across different environments.
Diagnostic assessment: Diagnostic assessment is a systematic process used to identify and evaluate an individual's psychological or behavioral conditions, providing a comprehensive understanding of their mental health status. This assessment typically involves gathering information through various methods such as interviews, questionnaires, and standardized tests, helping clinicians determine the presence of disorders like Attention-Deficit/Hyperactivity Disorder (ADHD). Effective diagnostic assessment is crucial for developing tailored treatment plans and interventions.
Differentiated instruction: Differentiated instruction is an educational approach that tailors teaching methods and resources to accommodate the diverse needs, learning styles, and interests of students. This method is particularly crucial for supporting learners who may struggle with traditional teaching techniques, ensuring all students have the opportunity to succeed academically and socially.
DSM-5 Criteria: The DSM-5 criteria are a set of standardized guidelines used to diagnose mental disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. These criteria provide specific symptoms and duration requirements for each disorder, helping clinicians determine the appropriate diagnosis and treatment plans for individuals experiencing psychological distress.
Executive Function Theory: Executive Function Theory refers to the cognitive processes that enable individuals to plan, focus attention, remember instructions, and juggle multiple tasks successfully. This theory is particularly relevant in understanding how individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) may struggle with self-regulation, impulse control, and organizational skills, impacting their daily functioning and academic performance. Essentially, it highlights the role of the brain's executive functions in managing thoughts and behaviors, which is crucial for those experiencing ADHD-related challenges.
Hyperactivity: Hyperactivity is a behavioral condition characterized by excessive movement, impulsiveness, and difficulty in maintaining attention or sitting still. It is often seen as one of the core symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), where individuals may struggle with self-control and can be easily distracted. This condition can affect various aspects of life, including academic performance, social interactions, and overall functioning.
Impulsivity: Impulsivity refers to a tendency to act on a whim, displaying little forethought or consideration of the consequences of actions. This trait can lead to hasty decisions, risky behaviors, and challenges in self-regulation. It is often linked to various psychological disorders and can significantly impact emotional regulation, social interactions, and overall mental health.
Inattention: Inattention refers to a difficulty in maintaining focus or attention on tasks or activities, leading to careless mistakes, missed details, and a lack of sustained effort. This inability to concentrate can significantly impact daily functioning and academic performance, particularly in individuals diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). Inattention can manifest in various ways, including forgetfulness, disorganization, and difficulty following through on instructions or completing tasks.
Learning Disabilities: Learning disabilities refer to a range of neurological disorders that impact an individual's ability to acquire, process, or use information effectively. These disabilities can affect various areas such as reading, writing, math, and executive functions, leading to challenges in academic performance and daily living activities. Understanding learning disabilities is crucial, especially when examining their relationship with other conditions like attention-deficit/hyperactivity disorder (ADHD), as they often co-occur and can influence each other significantly.
Medication Management: Medication management refers to the systematic approach to prescribing, administering, and monitoring medication to ensure optimal therapeutic outcomes while minimizing risks and side effects. This process is crucial for treating various psychological conditions, as it involves not just the administration of medication but also ongoing assessment of its effectiveness, adjustments to dosage, and monitoring for potential interactions with other treatments or medications.
Neurodevelopmental Model: The neurodevelopmental model is a framework that emphasizes the role of biological and environmental factors in the brain's development and their influence on mental disorders. This model suggests that disruptions during critical periods of brain maturation can lead to various psychological issues, highlighting the interaction between genetic predispositions and external stressors. Understanding this model helps explain how conditions like schizophrenia and ADHD emerge from complex neurobiological processes.
Predominantly Hyperactive-Impulsive Type: The predominantly hyperactive-impulsive type is a subtype of Attention-Deficit/Hyperactivity Disorder (ADHD) characterized primarily by hyperactive and impulsive behaviors, rather than significant inattention. Individuals with this type often display excessive fidgeting, difficulty remaining seated, and impulsive decision-making. This subtype highlights the importance of recognizing the diverse manifestations of ADHD, emphasizing the behavioral patterns that can interfere with daily functioning.
Predominantly inattentive type: Predominantly inattentive type is a classification of Attention-Deficit/Hyperactivity Disorder (ADHD) characterized primarily by difficulties in sustaining attention, following through on tasks, and organizing activities. Individuals with this type tend to struggle with completing assignments and often appear to be daydreaming or not listening when spoken to. This subtype highlights the importance of attention-related symptoms without the hyperactive or impulsive behaviors commonly associated with other ADHD types.
Russell Barkley: Russell Barkley is a prominent clinical psychologist known for his extensive research and contributions to the understanding of Attention-Deficit/Hyperactivity Disorder (ADHD). His work focuses on the nature, assessment, and treatment of ADHD, highlighting the disorder's impact on executive functioning and self-regulation. Barkley has developed key models that explain how ADHD affects behavior and cognitive processes, making him a central figure in the field of abnormal psychology as it relates to this condition.
William Pelham: William Pelham is a notable figure in the field of psychology, particularly recognized for his research on Attention-Deficit/Hyperactivity Disorder (ADHD). His work has contributed significantly to understanding ADHD's assessment, diagnosis, and treatment, particularly focusing on behavioral interventions and the impact of parenting styles on children with ADHD. Pelham's insights have influenced both clinical practices and educational strategies for addressing the challenges faced by individuals with ADHD.