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Chapter 8

Psychology 2320A/B Chapter Notes - Chapter 8: Mood Disorder, Dont, Stimulant


Department
Psychology
Course Code
PSYCH 2320A/B
Professor
Elizabeth Hayden
Chapter
8

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Chapter 8 ADHD
Description
Display persistent age inappropriate symptoms of inattention, hyperactivity, and
impulsivity that are sufficient to cause impairment in the major life activities
Heirih Hoffa, rote i hild’s storook oe of the first ko aouts of
hyperactivity
Symptoms usually include
o Inattentive
o Hyperactive
o Impulsive
ADHD has become a blanket term used to describe several different patterns of
behaviour that likely have different causes
Usually frustrated because of their inability to focus etc
Serious economic impact, 2-3x higher for adults than young people
History
The symptoms were first described in 1775 textbook by Melchior Weikard
In 1798, Sir Alexander Crichton described a syndrome similar to ADHD that included
early onset, restlessness, inattention and poor school performance
o Desried theseles as haig the fidgets ad displaed a seere prole
attending no matter how hard they tried
In the early 90s, the onset of widespread compulsory education demanded self
controlled behaviour in a group setting, which further focused attention on children
with symptoms of ADHD
Brain injured syndrome: when an epidemic arose number of children developed
encephalitics and those who survived experienced multiple behaviour problems,
including irritability, impaired attention and hyperactivity
o Labeled as having brain injured syndrome which was associated with intellectual
disability
In 40-50s this label was applied to children displaying similar behaviours, but with no
evidence of brain damage or intellectual disability, and led to terms minimal brain
damage and minimal brain dysfunction (MBD)
o Provided way to attribute behaviour problems to physical cause
50s, ADHD was referred to as hyperkinesis
o attributed to poor filtering and stimuli entering the brain
led to definition of hyperactive child syndrome
o in which motor activity was not only problem; also hild’s failure to regulate
motor activity in relation to situational demands
70s argued in addition to hyperactivity, deficits in attention and impulse controlled were
also primary symptoms of ADHD
o widely accepted view, had impact of DSM
increasingly, ultipatha odels hae eerged that ilude oth attetio-related
and motivation-related theories
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o these propose different pathways to ADHD with different neural substrates,
meaning that different children with ADHD may have different reasons for their
behaviour
Core Characteristics
ADHD is in DSM 5 as neurodevelopmental disorder
o Because it has early onset and persistent course
o Associated with lasting alterations in neural development and often
accompanied by subtle delays and problems in language, motor and social
development that overlap with other neurodevelopmental disorders like ASD
Diagnostic Criteria
1. Iattetio: 6+ sptos that hae persisted for 6 oths or loger, that’s
inconsistent with developmental level and negatively impacts
2. Hyperactivity and Impulsivity: 6+ symptoms that have persisted for at least 6 months
to a degree that’s iosistet ith deelopetal leel ad that egatiel ipats
directly on social and academic activities
Specify whether
o Combined presentation (inattention and hyperactivity/impulsivity) are met
o Predominantly inattentive presentation: inattention but not other
o Predominantly hyper active impulsive presentation
Specify if:
o In partial remission: when full criteria were previously met, fewer than the full
criteria have been met for past 6 months, and symptoms still result in
impairment in social, academic or occupational functioning
Specify current severity
o Mild
o Moderate
o Severe
Two dimensions are highly correlated but do predict different behavioural and cognitive
impairments and likely have different neural components
Inattention
Inability to sustain attention or stick to tasks or play activities, to remember or follow
through instructions and to resist distractions
Also involves difficulties in planning and organization and in timeliness and problems
staying alert
Attentional capacity is the amount of information we can remember and attend to for a
short time
o Children with ADHD DON’T hae a defiit i attetioal apait
Selective attention is the ability to concentrate on relevant stimuli and ignore task
irrelevant stimuli
Distractibility is a term commonly used to indicate a deficit in selective attention
o More likely than others to be distracted by stimuli that are highly salient and
appealing
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Sustained attention (vigilance) is the ability to maintain a persistent focus over time on
unchallenging, uninteresting tasks or activities or when fatigued
o Primary deficit is a core feature
o Attentional problems may also be in alerting and preparing for task from outset
and not only in sustaining attention during the task
Alerting refers to an initial reaction to a stimulus; involves the ability to prepare for
whats about to happen
o Helps achieve and maintain optimally alert attentional state
Hyperactivity-Impulsivity
Involves the under control of motor behaviour, poor sustained inhibition of behaviour,
the inability to delay a response or defer gratification, or an inability to inhibit dominant
responses in relation to ongoing situational demands
These symptoms are best viewed as a single dimension of behaviour called
hyperactivity-impulsivity
Strong link suggest a deficit in regulating behaviour
Hyperactivity
Activity is excessively energetic, intense and inappropriate and not goal directed
Even when they are asleep, children with ADHD display more motor activity
Largest differences are found in situations requiring child to inhibit moto activity to
slow down or sit still in response to the structured task demands of the classroom
Impulsivity
Seem unable to bridle their immediate reactions or think before they act
Hard to stop ongoing behaviour or to regulate their behaviour in accordance with the
demands of the situation or wishes of others
Cognitive impulsivity: reflected in disorganization, hurried thinking and need for
supervision
Behavioural impulsivity: impulsively calling out or acting without consideration of
consequences
Emotional impulsivity: impatience, low frustration tolerance, hot temper
o May be important component for ADHD that contributes to poor educational,
occupational and other adult outcomes
Primary attention deficit in ADHD is an inability to engage and sustain attention and to
follow through on directions or rules while resisting salient distractions
Primary impairment in hyperactivity-impulsivity involves under control of motor
behaviour, poor sustain inhibition of behaviour
Presentation Type
Refers to group of individuals with something in common symptoms, etiology,
problem severity, or likely outcome
DSM specifies three presentation types of ADHD based on the individuals primary
symptoms
o Predominantly inattentive presentation (ADHD-PI): who met symptom criteria
for inattention but not hyperactivity-impulsivity
Most common presentation, less referred to than those with C
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