Psychology 2042A/B Lecture Notes - Lecture 3: Attention Deficit Hyperactivity Disorder, Attention, Impulsivity
27 Jan 2020
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Lecture 3 – ADHD
• ADHD is exhibited as persistent age-inappropriate symptoms of inattention, hyperactivity, and
impulsivity that are sufficient to cause impairment in major life activities
o Characteristic behaviours vary considerably from child to child
o Different behaviour patterns may have different causes
History
• Early 1900s
o Children who lacked self-control and showed symptoms of overactivity/inattention in school
were said to have poor "inhibitory volition" and "defective moral control"
• Following worldwide influenza epidemic from 1917-1926
o "brain-injured child syndrome"
• 1940s-1950s
o "minimal brain damage"
o "minimal brain dysfunction"
• Late 1950s
o Hyperkinesis
• Led to the definition of hyperactive child syndrome
• 1970s
o Deficits in attention and impulse control, in addition to hyperactivity, were seen as the
primary symptoms
• 1980s
o Increased interest in ADHD
o Rise in stimulant use generated controversy
Core Characteristics
• Inattention
• Hyperactivity-impulsivity
Inattention
• Inability to sustain attention, particularly for repetitive, structured, and less-enjoyable tasks
• Deficits may be seen in one or more types of attention
o Attentional capacity
o Selective attention
o Distractibility
o Sustained attention/vigilance
Hyperactivity-Impulsivity
• Inability to voluntarily inhibit dominant or ongoing behaviour
• Hyperactivity behaviours include:
o Fidgeting and difficulty staying seated
o Moving, running, touching everything in sight, excessive talking, and pencil tapping
o Excessively energetic, intense, inappropriate, and not goal-directed
• Impulsivity
o Inability to control immediate reactions or to think before acting
o Cognitive impulsivity includes disorganization, hurried thinking, and need for supervision
o Behavioural impulsivity includes impatience, low frustration tolerance, hot temper,
quickness to anger, and irritability
Presentation Types
• Predominantly inattentive presentation (ADHD-PI)
• Predominantly hyperactive-impulsive presentation (ADHD-HI)
• Combined (ADHD-C)
ADHD-PI
• Inattentive, drowsy, daydreamy, spacey, in a fog, and easily confused
• May have learning disability, process information slowly, have trouble remembering things, and
display low academic achievement
• Often anxious, apprehensive, and socially withdrawn, and may display mood disorders
ADHD-HI
• Primarily symptoms of hyperactivity-impulsivity
• Primarily includes preschoolers and may have limited validity for older children
• May be a distinct subtype of ADHD-C
ADHD-C
• Children who have symptoms of both inattention and hyperactivity-impulsivity
• Most often referred for treatment
Additional DSM Criteria
• Appears prior to age 12
• Persists more than 6 months
• Occurs more often and with greater severity than in other children of the same age and sex
• Occurs across two or more settings
• Interferes with social or academic performance
• Not explained by another disorder
• Limitations:
o Developmentally insensitive
o Categorical view of ADHD
Associated Characteristics
• Often display other problems in addition to their primary difficulties
o Cognitive deficits
o Speech and language impairments
o Developmental coordination and tic disorders
o Medical and physical concerns
o Social problems
Cognitive Deficits - Executive Functions
Document Summary
History: early 1900s, children who lacked self-control and showed symptoms of overactivity/inattention in school were said to have poor "inhibitory volition" and "defective moral control" Led to the definition of hyperactive child syndrome: 1970s, deficits in attention and impulse control, in addition to hyperactivity, were seen as the primary symptoms, 1980s. Increased interest in adhd: rise in stimulant use generated controversy. Inability to sustain attention, particularly for repetitive, structured, and less-enjoyable tasks: deficits may be seen in one or more types of attention, attentional capacity, selective attention, distractibility, sustained attention/vigilance. Inability to voluntarily inhibit dominant or ongoing behaviour: hyperactivity behaviours include, fidgeting and difficulty staying seated, moving, running, touching everything in sight, excessive talking, and pencil tapping, excessively energetic, intense, inappropriate, and not goal-directed. Inability to control immediate reactions or to think before acting: cognitive impulsivity includes disorganization, hurried thinking, and need for supervision, behavioural impulsivity includes impatience, low frustration tolerance, hot temper, quickness to anger, and irritability.
