Class Notes (810,488)
Canada (494,139)
Psychology (6,045)


9 Pages
Unlock Document

Western University
Psychology 2042A/B
Jeff St.Pierre

Ch5: ADHD Description and History Description - Attention-deficit/hyperactivity disorder (ADHD): persistent age-inappropriate symptoms of inattention, hyperactivity, and impulsivity that are sufficient to cause impairment in major life activities - Inattentive: not focusing on mealtime demands and behaving carelessly - Impulsive: acting without thinking - ADHD: no distinct physical symptoms, identified by varying characteristic behaviors History - 1798: “the fidgets” - 1902: believed symptoms arose from poor “inhibitory volition” and “defective moral control” - Early 1900s: wide-spread compulsory education = self-controlled behavior = focus on ADHA - 1917-1926: encephalitis (brain inflammation) & brain injuries = brain-injured child syndrome - 1940s-1950s: no evidence of brain damage = minimal brain damage and brain dysfunction (MBD) - 1950s: ADHD referred as hyperkinesis: poor filtering of stimuli entering the brain o Led to hyperactive child syndrome - 1970s: argued that hyperactivity, deficits in attention and impulse control were also primary symptoms Core Characteristics - Key symptoms fall under two categories: o Inattention o Hyperactivity-impulsivity - Categories are oversimplification: o each dimension includes many distinct processes, two dimensions are closely connected Inattention (IA) - Difficultly during work/play, cannot focus on task/follow instructions - Deficits may be seen in one or more types of attention o Attention capacity: amount of information we can remember & attend to for a short time  ADHD children can remember the same amount of info for the time as other children o Selective attention: ability to concentrate on relevant stimuli and not be distracted by task- irrelevant stimuli in the environment o Distractibility: deficit in selective attention  More likely to be distracted by stimuli that are highly outstanding and appealing o Sustained attention (vigilance): ability to maintain a persistent focus over time/when tired  Cannot persist at tasks even when they want to  Alerting: initial reaction to stimulus & ability to prepare for future 1. ADHD may respond too quickly to situations requiring slow and care Hyperactivity-Impulsivity (HI) - Strong link between hyperactivity and impulsivity: both fundamental in regulating behavior - Hyperactivity: o Inability to voluntarily inhibit dominant or ongoing behavior in order to meet ongoing situational demands - Impulsivity: o Hard for them to stop an ongoing behavior /regulate behavior  Cannot think before they act o Difficult resisting temptations and delaying gratification  Cognitive Impulsivity: disorganization, hurried thinking, need for supervision  Behavioral impulsivity: acting without considering consequences, difficulty with inhibition  Emotional impulsivity: impatience, low frustration tolerance, hot temper, quickness to anger, irritable Subtypes - Subtype: group with something in common that makes them distinct from other groupings - DSM specifies 3 subtypes of ADHD: o Predominantly inattentive type (ADHD-PI): inattention  Inattentive and drowsy, daydreaming, spacey, easily confused o Predominantly hyperactive-impulsive type (ADHD-HI): hyperactive-impulsivity (rarest) o Combined Type (ADHD-C): both inattention and hyperactivity-impulsivity (most referred for treatment)  ADHD-HI & ADHD-C: 1. more likely to display problems in inhibiting behavior and in behavioral persistence o aggressive, defiant, rejected by peers, and suspended from school or placed in special education classes Additional DSM Criteria - To diagnose ADHD using DSM, the behaviors must also: o Appear before age 7 o Occur more often and with greater severity than in other children of same age & sex o Continue for more than 6 months o Occur across several settings o Produce significant impairments in the child’s social or academic performance o Not be due to another disorder or serious life stressors - Important to assess both the child’s symptoms and impairment in functioning What DSM Criteria Don’t Tell Us - Number of limitations with DSM criteria o Developmentally insensitive: number of symptoms needed to make a diagnosis is not adjusted for age or level of maturity - Categorical view of ADHD o Children who fall just below the cut-off for ADHD are not necessarily different from children just above the cut-off o ADHD is dimensional rather than categorical - Requirement of an onset of symptoms before age 7 is arbitrary and overly restrictive o Littler difference between children with an onset of ADHD before or after age 7 Associated characteristics - Delaying gratification: o Walter Mischel’s marshmallow experiment (1 now, 2 later) Cognitive Deficits - Executive Functions o Executive Functions: cognitive processes in the brain that activate, integrate and manage other brain functions  Cognitive processes: i.e working memory, planning (calling upon info we know for future)  Language processes: i.e verbal fluency & self-directed speech  Motor processes: i.e response inhibition, motor coordination  Emotional processes: i.e self-regulation & tolerating frustration o Executive functioning deficits occur in only 50% of ADHD  Those with executive functioning deficits have lower IQ (lower grades) - Intellectual Deficits o not lack of intelligence but difficulty applying intelligence to everyday life situations - Impaired Academic Functioning o Low productivity, grades on achievement tests o Academic skills of children with ADHD are impaired before they enter 1 grade - Learning Disorders o Trouble with reading, spelling, math o Show distinct patterns of cognitive deficits o Different pathways may underlie association between ADHD and learning disorders  i.e ADHD=conduct problems=poor academic performance - Distorted Self-Perceptions o Positive Illusory Bias: exaggeration of one’s competence  Self-esteem vary with: subtype, accompanying disorders & assessed area of performance 1. Inattentive/depressive/anxious: lower self-esteem 2. Hyperactivity-impulsivity/conduct problems: exaggerated self-worth  Explanation for positive illusory bias: 1. Self-protective function 2. Diminished self-awareness 3. Not knowing what constitutes successful vs unsuccessful o ADHD also distorts perceptions of quality of life  ADHD rate own quality of life more positively Speech and Language Impairments - About 30%-60% of ADHD also have speech and language impairments - Hard to comprehend children with ADHD Developmental Coordination and Tic Disorders - 30%-50% display motor coordination difficulties - Overlap with ADHD: o Developmental coordination disorder (DCD): motor incoordination and delays in achieving motor milestones o Tic Disorders: sudden, repetitive, nonrhythmic motor movements/ sounds (20% with ADHD) Medical and Physical Concerns - Health-Related Problems: o Sleep problems: may be related to meds - Accident-Proneness and Risk Taking o 3 times more likely for serious accidental injuries (i..e broken bones) o Higher risk of traffic accidents, early initiation of smoking, substance use, risky sexual behaviors Social Problems - Family Problems - Peer Problems Accompanying Psychological Disorders and Symptoms Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) - 50% of children with ADHD meet criteria for oppositional defiant disorder (ODD) o ODD: lash out, overreact, stubborn, short-tempered, argumentative, defiant - 30%-50% eventually develop conduct disorder (CD) – more severe that ODD - ADHD leads to ODD and CD not vice versa b/c of variation of specific gene Anxiety Disorders - 25% with ADHD experience excess anxiety Mood Disorders - ADHD @ age 4-6 = greater chance of future depression/suicidal behavior - Pediatric Bipolar increases ADHD not vice versa Prevalence and course - 6%-7% ADHD in North America, 5% worldwide Gender - ADHD more frequent in boys (6%-9%) than girls (2%-4%) - Clinical samples = 6:1 ratio b/c referred more often than girls b/c of boys natural behavior - Girls with ADHD referred younger & also understudied Socioeconomic Status and Culture - ADHD all socio class but more in low SES b/c of conduct problems (conduct related to SES) - Uniform diagnostic method = similar rates worldwide Course and Outcome - Infancy: o Likely signs of ADHD present at birth (but no evidence) - Preschool o Increasingly visible and significant problem o Persist for at least 1 yr = future problems in middle & adolescence - Elementary o Especially evident during grade school, usually identified as ADHD during this time o 8-12yrs: defiance and hostility start to form - Adolescence o Many do not outgrow ADH
More Less

Related notes for Psychology 2042A/B

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.