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Part 1- L4.docx

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Gareth Treharne

Part 1- L4 ADHD Subtypes - 3 types o Predominantly Inattentive o Predominantly Hyperactive/Impulsive o Combined Behavioural symptoms - Need to have 6. - If have 6 of each then you are combined. - If 6 in one 3 in other then its predominantly that ADHD sub-group - hyperactivity o Squirms and fidgets o Can’t stay seated o Runs/climbs excessively o Can’t play/work quietly o On the go/“Driven by a motor” o Talks excessively - Impulsivity o Blurts out answers o Can’t wait turn o Intrudes/interrupts others o Urge to act out is not inhibited - Inattentive o Careless o Doesn’t listen o No follow through o Forgetful in daily activities o Can’t organize o Avoids/dislikes tasks requiring sustained mental effort o Loses important items o Difficulty sustaining attention in activity o Easily distractible o Not able to focus on something to be able to focus on something. o This is an inability to focus whereas defiant disorder is because they don’t want to. o Difficulty with working memory. o Lack of self-control. o Can’t control cognition or regulate emotions. o With game it’s externally regulating your attention. o Games capture your attention, so it’s doing the work for you. o Studying is internal regulation of attention. Classified under neurodevelopment disorder Symptoms must be: - Present before 12years of age o Used to be 7y/o in DSM 4 - Occur across two or more settings - Maladaptive/interfere and inconsistent with developmental level (social, academic, occupational) o If you are quite happy and bubbly and it doesn’t affect your life in a negative way then you will not be ADHD - Not better explained by another disorder - Need to rule out anxiety, something in environment and other things Aetiology - Highly Heritable o 60-80% chances that 1 or more of their child will have ADHD. o 70-80% heritability in twins with ADHD. o Doesn’t imply its genetic, it could be through modelling. o Adoptive- 3 times higher than biological. o 51% concordance MZ twins; 31% DZ twins o 58-83% MZ; 31-47% DZ - Biological o Hypo (below norm) activity in frontal lobe, basal ganglia thalamus, parietal cortex o Lack of dopamine o Lower than normal norepinephrine activity in PFC - Begins in childhood o 3-6% children are diagnosed as having ADHD o Some but not all symptoms abate (decrease as ADHD patient gets older o 40% children with ADHD continue to have problems into late adolescence o 10% children with ADHD continue to have problems into adulthood o 1-6% adults meet ADHD criteria  Most know how to control their symptoms - Developmental in Nature - Difficulties in: o Behaviour o Cognitive functioning  Lagging by 1/3 of their peers. They’re still learning as others are stopping.  25% have come sort of learning difficulty  Neurotransmitter dysfunction- lower dopamine. Ritalin*
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