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Understanding ADHD: Diagnosis, Comorbidities, and Cognitive Theories

This comprehensive overview explores Attention Deficit Hyperactivity Disorder (ADHD), including its core symptoms, related conditions such as Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD), and the developmental pathways from childhood to adulthood. It discusses diagnostic measures through questionnaires and structured interviews, as well as cognitive theories like the response inhibition hypothesis and Delay Aversion Theory. Treatment options, including MPH and behavioral interventions, are also examined, highlighting the importance of understanding ADHD's complexities in various contexts.

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Understanding ADHD: Diagnosis, Comorbidities, and Cognitive Theories

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Presentation Transcript

  1. ATTENTION DEFICIT HYPERACTIVITY DISORDER Further explained

  2. Comorbidities • CD • ODD • MMR LD ADHD PDD-NOS HFA • PKU • CHT

  3. Developmental pathway • depression/anxiety • Childhood Adulthood ADHD • impulsivity CD • Core symptoms persist • MPH treatment

  4. DIAGNOSTIC MEASURES • Questionnaires • (Semi) Structured Interviews • DIAGNOSIS BY HEARSAY • PARENT + TEACHER • Third observational condition??

  5. Important cognitive theories

  6. response inhibition hypothesis Barkley (1997) Psychological Bulletin, 121, 65-94 (frontal) paper and pencil tests • delayed responding tests • stop task

  7. Delayed response testProfile control child • trial time in seconds after stimulus 1 2 3 4 5 6 7 8 • 1 x • 2 x • 3 x • 4 x • 5 x • 6 x • 7 x

  8. Profile child with ADHD • trial time in seconds after stimulus 1 2 3 4 5 6 7 8 • 1 x • 2 x • 3 x • 4 x • 5 x • 6 x • 7 x

  9. Delay Aversion Theory Sonuga Barke et al. (1992) - Journal of Child Psychology and Psychiatry, 33, 387-398 Sonuga Barke (2002) - Behavioural Brain Research, 130, 29-36

  10. Performance non-optimal state optimal state Theory of state regulation • Actual state vs. required (target) state – effort allocation extra effort no extra effort

  11. Signal rate

  12. Performance non-optimal state optimal state Theory of state regulation • Actual state vs. required (target) state – effort allocation extra effort no extra effort Physiological costs Heart rate variability P300 amplitude fMRI

  13. Nucleus Reticularis Thalami • NRT is a neural sheet draped over the lateral/anterior aspects of the thalamus • NRT is the functional interface between the arousal and attention systems • Receives axonal collaterals from corticothalamic, thalamocortical and reticular formation projections Portas et al. 1998, J. of Neuroscience, 18

  14. Go No-Go test

  15. ERPs • Tracking of covert information processing • Excellent temporal resolution • More direct assessment of energetic mechanisms

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