PSYCH 270 Study Guide - Midterm Guide: Methylphenidate, Attention, Substance Abuse
CH 14: Neurodevelopmental Disorders
What is normal? What is abnormal?
- Developmental perspective→ Absence of early, meaningful social relationships= BAD
- Changes @ biological level or at psychosocial level could change impact of disorder
ADHD
- ADHD→ Two categories subtypes:
1. Inattention
2. Hyperactivity & impulsivity
- May have common bio cause
Statistics
- Found in 5.2% of children pop in the world
- Some people believe children are falsely diagnosed
- Children in US more likely to receive diagnosis than anywhere else
- Raises question: is ADHD just a Western cultural construct?
- 5-7% of children worldwide have ADHD; 3-5% have sx that significantly interfere
with quality of life
- Boys are 2-3x more likely to be diagnosed
- Girls need to be studied more→ Girls sx are very different from boys
- Children first diagnosed around 3-4 y/o
- About ½ of ADHD kids have ongoing problems into adulthood
- Impulsivity decreases, but inattention persists
- Adults with AD(D→ Worked lower jobs, less education
- More likely to be divorced, have substance abuse, antisocial pers disorder
- Diagnosing in children is difficult
- Several disorders overlap→ Oppositional defiant, Conduct, Bipolar disorders
Causes
- Genetics
- More likely to have it if family member has it
- Mutations: Make extra copies of gene on chromosome OR deletion of genes
- Dopamine→ Ritalin inhibits gene & increases dopamine
- Gene-Environment
- Children w/ mutation involving dopamine system MORE likely to exp ADHD sx if
mother smoked during pregnancy
- Other factors: Maternal stress/alc use, marital instability
- Unfortunately, this is confounded (Moms who smoke are prob lower class)
- Brain
- Brain is 3-4% smaller ni ADHD kids
- Medication can stimulate brain growth
- Toxins & Additives
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- Little support for this
- Environment
- Negative responses from parents, teachers, peers→ Can lower self-esteem
Treatment of ADHD
- Treatment
1. Psychosocial→ FOCUS: broader issues, improving academics & social skills
2. Biological→ GOAL: reduce childs impulsivity/hyperactivity, improve attention
Psychosocial
- Behavioral interventions at home and in school
- Set goals→ EX: increase time child remains seated, # of math problems done, etc.
- Reinforcement→ Reward for improvement, punish misbehavior
Biological
- Stimulant meds→ reduce hyperactivity, impulsivity
- Controversial→ abused
- Use of drug tx is trial & error:
- Tried at certain dosage, if it doesnt work change dosage
- Some children do not respond to meds
- Bad side effects: insomnia, irritability
Combined Approach to Treatment
- 14-month study of 579 children in 4 groups
- Meds, behavioral tx, combo, or nothing
- May have slight advantages, but answer is unclear
Specific Learning Disorder
- SLD→ Performance that is substantially below what would be expected given persons age,
IQ, and education
Clinical Description
- Unexpected underachievement → + standard deviations betw. Achievement & )Q
- Criticism: Delay betw. when learning problems occur & when they finally result in a
large enough difference betw. IQ and achievement scores
- Alternate approach: Response to intervention
- Identifying child as having SLD when response to known effective intervention is
significantly inferior to performance by peers
Statistics
- SLD in about 5-15% of youth
- Frequency increases in wealthier regions
- Racial differences: 1% of white children, 2.6% black
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- Boys may be more likely to have reading disorder
- Students with SLD more likely to drop out, be unemployed, commit suicide
- Having positive relationships can mitigates these effects
Autism Spectrum Disorder
- Autism→ affects how one perceives/socializes with others
- Aspergers, autistic disorder, and childhood disintegrative disorder all included
- Autistic kids have difficulty learning social rules
Clinical Description
- Two major characteristics:
1. Impairments in social communication/interaction
2. Restricted, repetitive patterns of behavior, interests, or activities
- Degree of sx→ distinguishes individuals previously diagnosed w/ separate
disorders
- Three levels of severity: (qualitative, no quant. element)
(1) Requiring Support
(2) Requiring Substantial Support
(3) Requiring Very Substantial Support
Impairment in Social Communication and Social Interaction
- Three problems: (all must be present)
1. Social reciprocity
a. Inability to engage in joint attention
b. May not be interested in social interactions
2. Nonverbal communication
a. May lack appropriate facial expressions/tone of voice (prosody); awkward
3. Initiating & maintaining social relationships
a. 25% of individuals w/ ASD do not develop sufficient speech proficiency
Restricted, Repetitive Patterns of Behavior, Interests, or Activities
- )ntense preference for things to stay the same→ Maintenance of sameness
- Spend hours on stereotyped & ritualistic behaviors (i.e. spinning in circles)j
- People w/ less severe ASD→ Can take form of obsession w/ specific subjects ex:
memorizing zip codes)
Statistics
- More prevalent than previously thought→ -in-68 of 8 year olds in US
- Gender differences
- Male:female = 4.5:1
- Range of IQ scores
- 31% of ASD people have <70 IQ
- )Q scores determine prognosis→ higher )Q=need less support
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Changes @ biological level or at psychosocial level could change impact of disorder. Developmental perspective absence of early, meaningful social relationships= bad. Adhd two categories (cid:523)subtypes(cid:524): inattention, hyperactivity & impulsivity. Found in 5. 2% of children pop in the world. Children in us more likely to receive diagnosis than anywhere else. 5-7% of children worldwide have adhd; 3-5% have sx that significantly interfere. More likely to be divorced, have substance abuse, antisocial pers disorder. Boys are 2-3x more likely to be diagnosed. About of adhd kids have ongoing problems into adulthood with quality of life. Girls need to be studied more girls sx are very different from boys. Adults with ad(d worked lower jobs, less education. Several disorders overlap oppositional defiant, conduct, bipolar disorders. Dopamine ritalin inhibits gene & increases dopamine. More likely to have it if family member has it. Mutations: make extra copies of gene on chromosome or deletion of genes.
