Psychology 2042A/B Chapter Notes - Chapter 8: Autism Spectrum, Melchior Adam, Sust
30 Apr 2018
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Chapter 8- Attention-Deficit/ Hyperactivity Disorder (ADHD):
Description and history:
Description:
• Attention-deficit/ hyperactivity disorder (ADHD)- display persistent age-inapprop
symptoms inattention, hyperactivity and impulsivity suff cause impairment in major life
activities
• ADHD no distinct physical symptoms can be seen x-ray/ lab test- can only be ident by
characteristic behavs vary considerably child to child (blanket term describe several dif
patterns behav likely have dif causes)
• Increased effort and stricter rules usually don’t help b/c already trying hard- may not
know why things went wrong/ how might do things dif
• Feelings frustration, being dif, not fitting in and hopelessness may overwhelm child w
ADHD- personal suffering and exposure stigmatizing att by others and societal costs high
(highest costs rel health care and edu)- adults= productivity and income losses
History:
• Symptoms ADHD first described 1775 medical textbook by Melchior Adam Weikard
• 1798 described syndrome sim ADHD included early onset, restlessness, inattention and
poor school perf- individs described selves having fidgits and severe prob attending no
matter how hard tried
• 1902 symptoms overactivity and inattention described George Still believed symptoms
arose out poor inhibitory volition and defective moral control
• Early 1900s, compulsory edu demanded self-controlled behav group setting, further
focused attention kids w symptoms ADHD
• 1917-1926 kids dev encephalitis and survived exp multiple behav probs and those
suffered birth trauma, head injury/ exposure toxins displayed behav probs= brain-injured
child syndrome, ass w intellectual disability
• 1950s and 60s erroneously applied to children displaying sim behavs, but w no evidence
brain damage/ intellectual disability- led terms minimal brain damage and minimal brain
dysfunction (MBD)- convenient way attribute behav probs to physical cause
• Certain head injuries can explain some cases ADHD, brain damage theory eventually
rejected b/c didn’t explain majority cases
• Late 1950s, ADHD ref hyperkinesis= attributed poor filtering stimuli entering brain
• Led to def hyperactive child syndrome- motor overactivity considered main feature
ADHD- soon realized hyperactivity not only prob, also failure regulate motor activity in
relation situational demands
• 1970s argued addition hyperactivity, deficits in attention and impulse control also
primary symptoms ADHD- widely accepted and lasting impact DSM for def ADHD
• 1980s interest children w ADHD increased dramatically and sharp rise in use stimulants
gen controversy cont today
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• More recently, in addition inattention and hyperactivity-impulsivity, problems poor self-
regulation, dif inhibiting behav and reward and motivational deficits been emph central
impairments disorder
• Multipathway models emerged include attention-rel and motivation-rel theories- propose
dif pathways to ADHD may have dif reasons for their behav
• Growing agreement nature ADHD, views cont evolve new findings and discoveries
Core characteristics:
• Included in DSM-5 as neurodev disorder b/c early onset and persistent course, ass w
lasting alterations neural dev and often accompanied by subtle delays and probs lang,
motor and social dev overlap w other neurodev disorders such as autism spectrum
disorder and specific learning disorder
• Dev DSM-5 criteria after reviewing research, re-analyzing data, conducting field trials w
children throughout NA and receiving several rounds public feedback
• 2 lists key symptoms ident def ADHD and disting other rel probs- inattention and
hyperactivity-impulsivity
• Quantitative studies support model ADHD consisting unitary ADHD component w two
separable specific dimension- well documented research w dif age, ethnic and cult groups
• Highly correlated but don’t predict dif behav and cog impairments and likely have dif
neural correlates- inattention= academic probs and peer neglect and hyperactivity-
impulsivity= agg behav and peer rejection, among other probs
• Define 2 core dimensions= oversimplifies disorder- each dimension includes many
distinct processes been def and measured various ways and although discuss separately=
closely connected dev- attention helps reg behav, emotions and impulses
Inattention:
• Inattention- inability sustain att/ stick to tasks/ play activities, remember and follow
through on instructions/ rules and to resist distractions- difs planning, org and timeliness
and probs staying alert
• May attend automatically enjoyable things but have great dif focusing less enjoyable
tasks
• Inattention can result failure 1/more cog processes control attention not suff say has
attention deficit- could have deficit only 1 type/ more one type
• Attentional capacity- amount info can remember and attend to for short time- can
remember same amount info short time as do other kids
• Selective attention- ability concentrate relv stimuli and ignore task-irrelv stimuli in env
• Distractibility- used indicate deficit selective att- kids w ADHD more likely others be
distracted by stimuli highly salient and appealing
• Sustained attention/ vigilance- ability maintain persistent focus over time on
unchallenging, uninteresting tasks/ activities/ when fatigued
• Primary att deficit ADHD seems be sust att- assigned uninteresting/ repetitive task, perf
poor= may not be able persist tasks even if want to (deficits sust att core feat ADHD)
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• Children w ADHD may show perf deficits from v beginning task/ response, not just
decline over time- att probs may also be alerting and preparing for task from outset not
only sustaining att during task
• Alerting- initial reaction stimulus, involves ability prep what about to happen- helps
achieve and maintain optimally alert attentional state
• Alerting deficit respond too quickly in sits requiring slow and careful approach and too
slowly sits requiring quick response
Hyperactivity-impulsivity:
• Hyperactivity-impulsivity- undercontrol motor behav, poor sustained inhibition of behav,
inability delay response/ defer gratification/ inability inhibit dom responses in relation to
ongoing situational demands (usually display both)
• Strong link b/w suggests deficit in regulating behav= dif reasons for
Hyperactivity:
• Activity excessively energetic, intense, inapprop and not goal-directed- extremely active
but accomplish v little (even when asleep display more motor activity)
Impulsivity:
• Seem unable brindle immediate reactions/ think before act, hard stop ongoing behav/
regulate sit/ wishes others= blurt out inapprop comments/ quick, incorrect answers qs not
completed
• Interrupt convos, intrude others activities and lash out frustration when upset
• Dif resisting immediate temptations and delaying gratification- minor mishaps common
but more serious accidents/ injuries can result reckless behav
• Cognitive impulsivity- disorg, hurried thinking and need supervision and impulsive
decision making
• Behav impulsivity- dif inhibiting responses sit requires (rule-breaking behav, increased
risk conduct probs)
• Cog and behav impulsivity (and inattention) predict probs w academic achievement, part
in reading
• Emotional impulsivity- impatience, low frustration tolerance, hot temper, quickness anger
and irritability (may be imp component cont poor edu, occ and other adult outcomes
beyond those ass w inattention and hyperactivity-impulsivity)
• Children w ADHD display unique constellation and severity symptoms but may not
differ from comparison children all types and measures inatt and HI
Presentation type:
• Presentation type- group individs w something in common- symptoms, etiology, prob
severity/ likely outcome- makes distinct other groupings
• DSM specifies 3 presentation types ADHD based primary symptoms:
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