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Psychology /Psychotherapy: 104b - ADHD

Psychotherapy: 104b - ADHD

Psychology18 CardsCreated about 5 hours ago

This content summarizes the key brain regions involved in ADHD, focusing on the prefrontal cortex, striatum, and cerebellum. It also explains the mechanism of action of atomoxetine, a selective norepinephrine reuptake inhibitor used to treat ADHD, and highlights important comorbidities such as behavioral problems and anxiety often seen in children with ADHD.

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Which areas of the brian are affected by ADHD?

  • Prefrontal cortex

    • Executive function and planning

  • Striatum

    • Reward, reinforcement

    • Motivation for behavior and activities

  • Some cerebellum

  • Overall brain volume

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Key Terms

Term
Definition

Which areas of the brian are affected by ADHD?

  • Prefrontal cortex

    • Executive function and planning

  • Striatum

    • Reward, reinforceme...

What is the mechanism of action of atomoxetine in the treatment of ADHD?

In which patients is it indicated?

Selective norepinephrine reuptake inhibitor

Works as an antidepressant to treat ADHD + anxiety

<...

What comorbididities should we be aware of in children with ADHD? (4)

  • Behavior or conduct problem

  • Anxiety

  • Depresssion and othe rmood diso...

What environemtal exposures contribute to risk of ADHD?


  • Smoking, alcohol, drugs during pregnancy

  • Lead exposure

  • Brain injury

  • Premature delivery + l...

What causes ADHD?

Strong genetic component

(multiple genes + gene-environment interaction)

Environmenta...

What is the role of therapy in the treatment of ADHD?

Therapy alone is less affective than medication alone

However, combination treatment may be good for other areas of ...

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Psychotherapy: 104b - ADHD
TermDefinition

Which areas of the brian are affected by ADHD?

  • Prefrontal cortex

    • Executive function and planning

  • Striatum

    • Reward, reinforcement

    • Motivation for behavior and activities

  • Some cerebellum

  • Overall brain volume

What is the mechanism of action of atomoxetine in the treatment of ADHD?

In which patients is it indicated?

Selective norepinephrine reuptake inhibitor

Works as an antidepressant to treat ADHD + anxiety

Black box warning: increased suicidal thoughts in teenagers

What comorbididities should we be aware of in children with ADHD? (4)

  • Behavior or conduct problem

  • Anxiety

  • Depresssion and othe rmood disorders

  • Autism spectrum disorder

  • Learning and/or speech disorders

  • Tourette syndrome

  • Substance use disorder

  • Obesity

What environemtal exposures contribute to risk of ADHD?


  • Smoking, alcohol, drugs during pregnancy

  • Lead exposure

  • Brain injury

  • Premature delivery + low birth weight

What causes ADHD?

Strong genetic component

(multiple genes + gene-environment interaction)

Environmental risk factors

  • Smoking, alcohol, drugs during pregnancy

  • Lead exposure

  • Brain injury

  • Premature delivery + low birth weight

    • May confound with other factors

What is the role of therapy in the treatment of ADHD?

Therapy alone is less affective than medication alone

However, combination treatment may be good for other areas of functioning

  • Anxiety

  • Academic performance

  • Parent-child relationships

  • Social skills

What is the mechanism of action of stimulant medications in the treatment of ADHD?

Stimulants = methyphenydate, amphetamine

  • Stimulate portions of the brain that are underactive

  • Increase available dopamine and norepinephrine by blocking reuptake, facilitating release into the synapse

Amphetamine specifically gets into the presynaptic neuron and increases vesicle release

What is the most effective treatment for ADHD?

Medical management

Stimulants are first line

(Atomoxetine, alpha-2 blockers 2nd line)

What is the mechanism of action for guanfacine in the treatmnet fo ADHD?

What are the indications and side effects?

Alpha-2 agonist; reduces CNS activation

Helps with sympathetic overdrive, reduction of fight/flight response

Can be used in conjunction of stimulants

May cause sedation, drowsiness, depression, low BP, dizziness, fainting

What is the DSM-5 criteria for ADHD?

Persistent patern of inattention and/or hyperactivity-impulsivity that interferes with function or development, persisting for at least 6 months

  • Requires 6+ symptoms in either category

  • (Or 6+ in each category for mixed)

  • In at least 2 settings

In how many settings do ADHD symptoms ahve to occur in order to diagnose ADHD?

At least 2

What are the contrindications to stimulants for the treatment of ADHD?

Significant cardiac history

Before what age must ADHD symptoms present to meet criteria for formal diagnosis?

Before age 12

What are the side effects of stimulants to watch out for in the treatment of ADHD?

  • Decreased appetite

  • Insomnia

  • Headache

  • Nausea

  • Less common

    • Irritability

    • Lability

    • Tics

    • Heart racing

    • Emotional blunting

    • Hallucinations

What is the prevalence of ADHD?

3-11% of school-aged children

M>F

F more likely to have the inattentive type

Which medications are used to treat ADHD?

  • Stimulants (first line)

    • Methylphenidate

    • Amphetamine

  • Non-stimulants (if stimulants are not tolerated, or co-occuring symptoms are present)

    • Atomoxetine (ADHD + Anxiety)

    • Alpha-2 agonists (Guanfacine, clonidine)

Which medications are first line for ADHD?

Stimulants

  • Methylphenidate

  • Amphetamine

List some possible consequence of untreated ADHD (4)

  • Difficulties in interpersonal relationships

  • Difficulties at school and work

  • Increased likelihood of accidents and injuries

  • Higher rates of substance abuse