DOCSLIB.ORG

Diagnosing and Differentiating ADHD and the Bipolar (And Some Other Stuff)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Diagnosing and Differentiating ADHD and the Bipolar (And Some Other Stuff) Diagnosing and Differentiating ADHD and The Bipolar (and some other stuff) ADAM ANDREASSEN, PSY.D. Objectives of Presentation Experience a more comprehensive conceptualization of research-relevant symptoms related to both ADHD and Bipolar Disorder as well as PTSD that goes beyond the narrow framework of the DSM Improve clinical interviewing skills in order to focus on asking the questions that most likely illicit relevant information Become more familiar with the assets and limitations of inventories and psychological testing results. Become more competent in ruling in or ruling out other co-morbid conditions. May I have fries with that Ritalin? 700% increase of Ritalin prescribed in the US since 1995 Everyone Thinks They Are Knowledgeable About Each Disorder Common Overlapping Symptoms in Medical Field Appendicitis Fever Strep Throat Geller & DelBello, 2008 Common Overlapping Symptoms in Psychological Symptoms Irritability and Hyperactivity Mania (elated mood and grandiosity) Major ADHD Depressive (no Disorder cardinal (low mood symptoms) and anhedonia) Autism (communication and social deficits) Geller & DelBello, 2008 A 2012 New York Times Article Suggested: An estimated 3 Million children in the U.S. take drugs for problems focusing. Twentyfold increase in use of ADHD drugs over last 30 years Where are we heading? Prevalence Rates 1% 8% Barkley, 2006 Comorbidity with ADHD Anxiety disorder: 10-50% MDD: 15-75% Bipolar I: 6-27%; (BAD I carries a very high risk for comorbid ADHD, even though ADHD carries a low risk for BAD I) ODD: Up to 85% Conduct Disorder: 15-56% (worse prognosis) PTSD may be circular with ADHD: 1-6% Tourette syndrome or tick disorder: 12-34% PDD: Up to 26% (Barkley, 2006) History and Features of ADHD Around WWI ADHD symptoms were often associated with an outbreak of encephalitis Clinicians began to see similar symptoms in other organic based disorders (brain injured child, MBD) Also “spoiled child” syndrome 1930’s began to notice improved effects with amphetamine use to control headaches Barkley 2006 History and Features of ADHD 1950’s movement to hyperkinetic impulse disorder Later in the decade more specific learning problems were identified rather than generalizing MBD 1970’s began to focus on impulsivity as well 1980’s focus on attention problems Later focus on educational needs 21st century continues to look at further subtypes Barkley 2006 The word “manic” traces back to Ancient Greek. Mania and melancholia have been tied together for centuries Biphasic Mental Illness causing recurrent oscilliations between mania and depression (1854 Jules Baillarger). Emil Kraepelin coined term manic depressiion (1900’s) 1952 placed in the Diagnostic Manual History and Features of Bipolar Disorder No early differentiation between unipolar and bipolar Both were considered manic-depressive illness More recent research has also noted some differences in the energy components between unipolar and bipolar depressed patients Bipolar disorder has been seen to have a greater genetic link than unipolar depression However, conflicting results have been found with relatives of “well- defined” unipolar depressives rarely exhibiting bipolar disorder Could occur on a polygenic or continuous spectrum: Unipolar Bipolar Adams and Sutker (2001) History and Features of Bipolar Disorder Cyclicity can range from less than 48 hours to several years High degree of inter-individual variability Typical cycle length of Bipolar disorder is less than in unipolar major depression 13-20% rapid cycling (≥4 depressed or manic episodes per year) Adams and Sutker (2001) History and Features of Bipolar Disorder Rapid cycling is more common among women Initial mood episode is usually depressive Rapid cycling generally develops later Later age of manic onset may be an indication of secondary mania and can be indistinguishable from patients with primary mania Can also occur during schizoaffective disorder Difficulty in distinguishing from Borderline Personality disorder Some view BPD as subsyndromal mood disorder and some assert they can coexist, data is unclear due to overlapping symptom presentation Adams and Sutker (2001) Features of Bipolar I Disorder Approximately 10-15% of adolescents with recurrent MDE will develop Bipolar, mixed episodes may be more likely in adolescents and young adults First episode in males more likely to be manic and in females depressed Completed suicide occurs in 10-15% More likely to occur in mixed or depressive state APA 2000 Features of Bipolar Onset after 40 should alert that there may be a general medical condition or substance issue Bipolar II may be more common in women Cyclothymic disorder usually begins in adolescence or early adult life APA 2000 Neurobiological Aspects of Bipolar Disorder Theory of kindling Somewhat controversial Important to assumptions of early psychosocial interventions First applied to seizure disorders Combination of stress and genetic vulnerability leads to greater destabilization until full onset Brain becomes further sensitized with each episode until spontaneous occurrence without stressors Will result in less inter-episodic recovery time and treatment resistance Geller & DelBello, 2008 History and Features of Bipolar Disorder Unipolar depression is more prevalent among women but Bipolar is more evenly distributed by gender However, a major Amish study found no gender differences Age and hospitalization trends 1. First unipolar hospitalization tends to occur between 40 and 49 2. First bipolar hospitalization tends to occur between 20 and 29 According to NIMH: 1. Median age of onset for unipolar depression is 25 2. Median age of onset for bipolar is 19 Adams and Sutker (2001) Deception in Assessing Children and Adolescents Historically children have been viewed as honest reporters However, most clinicians have encountered children who deny disruptive behaviors or claim mental illness contrary to findings Rogers (2008) Prevalence of Child and Adolescent Deception Study of 53 dually diagnosed offenders found malingering to be 15%, similar to adult offenders Other studies have found 8% of children have engaged in acquiescence and 10% in nay-saying during psychological assessment 8% attempted to please the interviewer 14% provided guarded responses 12% of 6 to 8-year-olds presented a socially desirable set of responses Assessment must discern minimal denial and "white lies” from exaggerated reporting and extreme denial Rogers (2008) Reasons for Types of Deception in Children and Adolescents Children (and their parents on their behalf) may be motivated to malinger symptoms to gain external incentives or deny symptoms to avoid consequences Conduct Disorder adolescents may feign ADHD to obtain medication May feign symptoms to avoid school work or avoid peer difficulty Influence custody decisions Avoid juvenile justice system Gain academic accommodations Gain money and services Manage peer status Unintentional parent and child misrepresentation Rogers (2008) ADHD and Bipolar ADHD has a small risk for Bipolar Disorder (6-27%) Children with early-onset Bipolar Disorder have a very high probability (91-98%) of meeting the criteria for ADHD HOWEVER, once subtracting out symptom overlap only about ½ of ADHD and Bipolar children retained the Bipolar Diagnosis 6-10% of children may have legitimate comorbidity Follow-up studies have also been inconclusive (Barkley, 2006) Manic Episode Distinct period of abnormally and persistently elevated, expansive, or irritable mood for 1 week (unless hospitalization is necessary) Three or more (4 if just irritable) and PRESENT TO A SIGNIFICANT DEGREE 1. Inflated self-esteem or grandiosity 2. Decreased NEED for sleep 3. More talkative than USUAL 4. Flight of ideas or racing thoughts 5. Distractibility 6. INCREASE in goal-directed activity or psychomotor agitation 7. Excessive involvement in pleasurable activities with a high potential for painful consequences Not a MDE Marked impairment or hospitalization Not due to drugs or GMC Where are we heading? Conceptual Features of ADHD Fidgety Phil- Hoffman 1865 Still and Tredgold were the first to focus clinical attention on the condition in the turn of the 20th century Still noticed problems with attention and impulsivity, and noted relationships with defiance and delinquency Believed they were driven by immediate gratification and many were insensitive to punishment “defect in moral control” Considered that some of the problem may be a secondary response to an acute brain disease that may remit, and noted it affected mentally retarded as well as typical intellect (Barkley, 2006) Conceptualizing ADHD In infancy: 1. Exhibit poor and irregular sleep 2. Colic 3. Feeding problems 4. Dislike being cuddled or held still for long Toddler: 1. Driven to run rather than walk 2. Driven to handle everything Major problems as adults: 1. Low self-esteem 2. Poor social skills Kolb & Whishaw (2003) Distinctive ADHD Features Elementary school: 1. Demanding 2. Oppositional 3. Do not play well with others 4. Poor tolerance of frustration, high level of activity, poor concentration, and poor self-esteem may lead to a referral Adolescence: 1. May be failing school 2. 25-50% have encountered legal problems 3. Withdraw from school 4. Fail to develop social relations and maintain steady employment Kolb & Whishaw (200) Different Types of ADHD ADHD, Inattentive Type ADHD, Sluggish Cognitive Tempo ADHD, Hyperactive-Impulsive Type ADHD, Combined
Load more

Recommended publications
  • The Effect of White Noise on Short- and Long-Term
    THE EFFECT OF WHITE NOISE ON SHORT- AND LONG-TERM RECALL IN HYPERACTIVE BOYS by Norma Jean Arbuckle Dissertation submitted to the Faculty of the Graduate School of the University of Maryland in partial fulfillment of the requirements for the degree of Doctor of Philosophy 1977 ABSTRACT Title of Dissertation: The Effect of White Noise on Short- and Long-Term Recall in Hyperactive Boys Norma Jean Arbuckle, Doctor of Philosophy, 1977 Dissertation directed by: Marie S. Davidson, Assistant Professor, Institute for Child Study The purpose of this research investigation was to determine whether an auditory arouser in the form of 2-minute bursts of 75 decibels of white noise (WN) might be used to facilitate short- and long-term re- call for hyperactive boys. An attempt was made to determine whether the stimulus was most effective if it was presented (a) before acquisi- tion, (b) before the recall tests, or (c) both before acquisition and before the recall tests. Hyperactivity was operationally defined as a score of eight or more on the Conners' Teacher's Questionnaire. The subjects for the study were 36 boys who had received the criterion score or more on the Ques- tionnaire which had been completed by the regular classroom teacher of each child. The boys were between the ages of 8.50 and 12.75 years. Ten hypotheses were tested using two types of tasks. A silently read paragraphs task consistently preceded a tape-recorded paragraphs task. Each task was followed by the administration of two halves of a test. The first half of the test for each task was given at a 2- minute interval and the second half of the test for each task was given at a 24-hour interval.
    [Show full text]
  • Fact Sheet: Attention Deficit Hyperactivity Disorder (ADHD) Topics
    Fact Sheet: Attention Deficit Hyperactivity Disorder (ADHD) Topics MAJOR CHARACTERISTICS OTHER CHARACTERISTICS ADULT OUTCOME SUBTYPES PREVALENCE ETIOLOGIES TREATMENT MORE INFORMATION - SUGGESTED READINGS MORE INFORMATION - SUGGESTED READINGS FOR TEACHERS Attention-deficit hyperactivity disorder (ADHD) is the current term for a specific developmental disorder seen in both children and adults that is comprised of deficits in behavioral inhibition, sustained attention and resistance to distraction, and the regulation of one’s activity level to the demands of a situation (hyperactivity or restlessness). This disorder has had numerous different labels over the past century, including hyperactive child syndrome, hyperkinetic reaction of childhood, minimal brain dysfunction, and attention deficit disorder (with or without hyperactivity). MAJOR CHARACTERISTICS The predominant features of this disorder include: 1. Impaired response inhibition, impulse control, or the capacity to delay gratification. This is often noted in the individual’s inability to stop and think before acting; to wait one’s turn while playing games, conversing with others, or having to wait in line; to interrupt their responding quickly when it becomes evident that their actions are no longer effective; to resist distractions while concentrating or working; to work for larger, longer-term rewards rather than opting for smaller, more immediate ones; and inhibiting the dominant or immediate reaction to an event, as the situation may demand. 2. Excessive task-irrelevant activity or activity that is poorly regulated to the demands of a situation. Individuals with ADHD in many cases are noted to be excessively fidgety, restless, and “on the go.” They display excessive movement not required to complete a task, such as wriggling their feet and legs, tapping things, rocking while seated, or shifting their posture or position while performing relatively boring tasks.
    [Show full text]
  • Distinguishing Originality from Creativity in ADHD: an Assessment
    E.H. Butler Library at Buffalo State College Digital Commons at Buffalo State Creative Studies Graduate Student Master's Theses International Center for Studies in Creativity 5-2015 Distinguishing Originality from Creativity in ADHD: An Assessment of Creative Personality, Self-Perception, and Cognitive Style among Attention-Deficit/Hyperactivity Disorder Adults Jean-Pierre J. Issa Buffalo State College, [email protected] Advisor Gerard J. Puccio, Ph.D. First Reader Gerard J. Puccio, Ph.D. Second Reader Selcuk Acar, Ph.D. Department Chair Gerard J. Puccio, Ph.D. To learn more about the International Center for Studies in Creativity and its educational programs, research, and resources, go to http://creativity.buffalostate.edu/. Recommended Citation Issa, Jean-Pierre J., "Distinguishing Originality from Creativity in ADHD: An Assessment of Creative Personality, Self-Perception, and Cognitive Style among Attention-Deficit/Hyperactivity Disorder Adults" (2015). Creative Studies Graduate Student Master's Theses. Paper 25. Follow this and additional works at: http://digitalcommons.buffalostate.edu/creativetheses Part of the Clinical Psychology Commons, Cognitive Psychology Commons, Disability and Equity in Education Commons, Gifted Education Commons, Industrial and Organizational Psychology Commons, Mental Disorders Commons, Other Psychiatry and Psychology Commons, Other Psychology Commons, Personality and Social Contexts Commons, Psychiatry Commons, and the Theory and Philosophy Commons Abstract of Thesis Debates over whether Attention-Deficit/Hyperactivity Disorder (ADHD) relates to high levels of creativity have been hampered by a lack of rigor when defining creativity. The purpose of the present study was to go beyond the rhetoric by empirically investigating creative personality, creative self-perception, and cognitive style among 49 ADHD adults.
    [Show full text]
  • The Influence of Fidgeting on Test Results
    The influence of fidgeting on test results By Ali Al Kaabi, Enzo Keuning and Luc van Noort 09-02-2018 R.S.G. Slingerbos Levant, 6V 1 Abstract In schools, fidgeting might be popular behaviour. In order to decide where certain students should be located inside a classroom when doing a test and how to deal with these “fidgeters”, it can be important to look at how fidgeting influences the test results of students. From studying literature, the hypothesis was that fidgeting would improve test results, however having somebody that fidgets audibly in your area was expected to be negative for the test results. A hypothesis was also formed about students with an attention disorder, people with an attention disorder were expected to have a bigger positive effect from fidgeting. To check these hypotheses, an experiment was set up, using a total of 76 students who were asked to fill in a test, under different conditions. Half of these students were asked to perform a regular experiment, where everybody was allowed to fidget if they wanted. The other half of the class was put in a different classroom and was not allowed to fidget at all. After studying the results gathered during these tests, the results showed the best results in the group of people that were not fidgeting in the room where fidgeting was allowed, the next best results were from the group of people that were fidgeting in this room and the worst results were from the group that took part in the control experiment and were not allowed to fidget at all.
    [Show full text]
  • The Impact of Psychological Theory on the Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Adults: a Scoping Review
    The Impact of Psychological Theory on the Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Adults: A Scoping Review Author Rebecca E. Champ University of Huddersfield Huddersfield, UK Supervision Marios Adamou University of Huddersfield Huddersfield, UK Barry Tolchard University of Huddersfield Huddersfield, UK The Impact of Psychological Theory on the Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Adults: A Scoping Review Abstract Psychological theory and interpretation of research are key elements influencing clinical treatment development and design in Attention Deficit Hyperactivity Disorder (ADHD). Research-based treatment recommendations primarily support Cognitive Behavioural Therapy (CBT), an extension of the cognitive behavioural theory, which promotes a deficit-focused characterisation of ADHD and prioritises symptom reduction and cognitive control of self-regulation as treatment outcomes. A wide variety of approaches have developed to improve ADHD outcomes in adults, and this review aimed to map the theoretical foundations of treatment design to understand their impact. A scoping review and analysis were performed on 221 documents to compare the theoretical influences in research, treatment approach, and theoretical citations. Results showed that despite variation in the application, current treatments characterise ADHD from a single paradigm of cognitive behavioural theory. A single theoretical perspective is limiting research for effective treatments for ADHD to address ongoing issues such as
    [Show full text]
  • University of Southampton Research Repository
    University of Southampton Research Repository Copyright © and Moral Rights for this thesis and, where applicable, any accompanying data are retained by the author and/or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This thesis and the accompanying data cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder/s. The content of the thesis and accompanying research data (where applicable) must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holder/s. When referring to this thesis and any accompanying data, full bibliographic details must be given, e.g. Thesis: Author (Year of Submission) "Full thesis title", University of Southampton, name of the University Faculty or School or Department, PhD Thesis, pagination. Data: Author (Year) Title. URI [dataset] UNIVERSITY OF SOUTHAMPTON FACULTY OF FACULTY OF SOCIAL, MATHEMATICAL, AND HUMAN SCIENCES Psychology INVESTIGATING THE FRONTO-LIMBIC AND HYPOTHALAMIC-PITUITARY-ADRENAL AXIS SYSTEMS IN CONDUCT DISORDER by Karen Denise González-Madruga Thesis for the degree of Doctor of Philosophy March 2018 UNIVERSITY OF SOUTHAMPTON ABSTRACT FACULTY OF SOCIAL, MATHEMATICAL, AND HUMAN SCIENCES Psychology Thesis for the degree of Doctor of Philosophy INVESTIGATING THE FRONTO-LIMBIC AND HYPOTHALAMIC-PITUITARY-ADRENAL AXIS SYSTEMS IN CONDUCT DISORDER Karen Denise González-Madruga In this thesis, I report studies investigating the neurobiology of conduct disorder (CD) – a disorder diagnosed in children and adolescents who display a persistent pattern of disruptive and aggressive behaviour. My particular focus is on the role of frontal, limbic and hypothalamic-pituitary-adrenal (HPA) axis systems, and especially whether CD-related alterations in these systems differ between males and females.
    [Show full text]
  • The Evolution of Human Risk Tolerance Through ADHD and Its Impacts on Socioeconomic Activity
    The Evolution of Human Risk Tolerance Through ADHD and its Impacts on Socioeconomic Activity Nasir Ahmed Rajah Submitted in accordance with the requirements for the degree of Doctor of Philosophy The University of Leeds Leeds University Business School September 2019 The candidate confirms that the work submitted is his own and that appropriate credit has been given where reference has been made to the work of others. This copy has been supplied on the understanding that it is the copyright material and that non quotation from the thesis may be published without prior acknowledge- ment. The right of Nasir Ahmed Rajah to be identified as Author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988. 2 Acknowledgements Throughout my PhD I have received great support, encouragement and assistance from a number of people. I invariably will do an injustice to the immeasurable input they have had on me personally and academically by writing a short acknowledgement prefacing this document. Though, I believe they know me well enough to know that I am indebted to them for their support, encouragement and assistance. I would like to express my sincere appreciation for the feedback and support provided by my PhD supervisors, Professor Nicholas Williams and Professor Vassiliki Bamiatzi. Their support and countless reading of drafts throughout the PhD has improved my writing and wider academic skills. My thanks to the participants and organisers of the British Cohort Study and the Na- tional Child Development Study. Their continued participation and effort has allowed me to test hypotheses that would not have otherwise been possible.
    [Show full text]
  • Adam Andreassen, Psy.D.  Become More Familiar with the Assets and Limitations of Inventories and Psychological Testing Results
    2/5/2014 Experience a more comprehensive conceptualization of research-relevant symptoms related to both ADHD and Bipolar Disorder as well as PTSD that goes beyond the narrow framework of the DSM Improve clinical interviewing skills in order to focus on asking the questions that most likely illicit relevant information Adam Andreassen, Psy.D. Become more familiar with the assets and limitations of inventories and psychological testing results. Executive Director Heart of America Psychology Training Consortium Become more competent in ruling in or ruling out other co- morbid conditions. President Midwest Assessment & Psychotherapy Solutions (MAPS) 1 2/5/2014 Appendicitis Fever Strep Throat Geller & DelBello, 2008 Irritability and Hyperactivity Mania (elated mood and grandiosity) Major ADHD Depressive (no Disorder cardinal (low mood symptoms) and anhedonia) Autism (communication and social deficits) Geller & DelBello, 2008 1% 8% Barkley, 2006 2 2/5/2014 Anxiety disorder: 10-50% Around WWI ADHD symptoms were often MDD: 15-75% associated with an outbreak of encephalitis Bipolar I: 6-27%; (BAD I carries a very high risk for Clinicians began to see similar symptoms in comorbid ADHD, even though ADHD carries a low risk for BAD I) other organic based disorders (brain injured child, MBD) ODD: Up to 85% Conduct Disorder: 15-56% (worse prognosis) Also “spoiled child” syndrome PTSD may be circular with ADHD: 1-6% 1930’s began to notice improved effects with Tourette syndrome or tick disorder: 12-34% amphetamine use to control headaches PDD: Up to 26% (Barkley, 2006) Barkley 2006 1950’s movement to hyperkinetic impulse disorder The word “manic” traces back to Ancient Later in the decade more specific learning Greek.
    [Show full text]
  • The Medicalization of Hyperactivity and Inattentiveness : a Social History and Theoretical Perspectives on ADHD
    Marshall University Marshall Digital Scholar Theses, Dissertations and Capstones 1-1-2010 The edicM alization of Hyperactivity and Inattentiveness : A Social History and Theoretical Perspectives on ADHD Justin Douglas Brock Follow this and additional works at: http://mds.marshall.edu/etd Part of the Medicine and Health Commons, Other Mental and Social Health Commons, and the Psychiatric and Mental Health Commons Recommended Citation Brock, Justin Douglas, "The eM dicalization of Hyperactivity and Inattentiveness : A Social History and Theoretical Perspectives on ADHD" (2010). Theses, Dissertations and Capstones. Paper 512. This Thesis is brought to you for free and open access by Marshall Digital Scholar. It has been accepted for inclusion in Theses, Dissertations and Capstones by an authorized administrator of Marshall Digital Scholar. For more information, please contact [email protected]. THE MEDICALIZATION OF HYPERACTIVITY AND INATTENTIVENESS: A SOCIAL HISTORY AND THEORETICAL PERSPECTIVES ON ADHD A Thesis submitted to The Graduate College of Marshall University In partial fulfillment of the Requirements for the degree of Master of Arts In Sociology By Justin Douglas Brock Approved by Dr. Fredrick Roth, Ph.D., Committee Chairperson Dr. Richard Garnett, Ph.D. Dr. Kimberly DeTardo-Bora, Ph.D. Marshall University May 2010 ABSTRACT This study investigates the rise of the Attention-Deficit/Hyperactivity Disorder diagnosis. It approaches the topic from a medicalization perspective and frames it under the therapeutic state as proposed by
    [Show full text]
  • Potential Effect of Pharmacotherapy on Sympathetic
    16 ACTA MEDICA MARTINIANA 2017 17/3 DOI: 10.1515/acm-2017-0013 POTENTIAL EFFECT OF PHARMACOTHERAPY ON SYMPATHETIC AROUSAL IN AUTISM BUJNAKOVA I1,2, ONDREJKA I4, MESTANIK M1, FLESKOVA D4, SEKANINOVA N1,2, FARSKY I3,4, TONHAJZEROVA I1,2 1Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia, 2Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia, 3Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia, 4Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Slovakia Abstract Background: Autism spectrum disorder (ASD) is a serious neurodevelopmental disorder associat- ed with autonomic nervous system (ANS) abnormalities. Moreover, at least 50% of children with ASD suffer from other comorbid diseases such as anxiety, depression, and attention deficit hyperactivity disorder (ADHD) associated with receiving psychotropic medication. From this context we aimed to evaluate changes in sympathetic arousal using analysis of electrodermal activity (EDA) as an index of sympathetic cholinergic activity in treated and non-treated autistic children under resting conditions. Methods: We examined 23 children with ASD and 14 healthy age- and gender- matched children at the age of 7–15 years. The ASD patients were divided into ASD non-treated group (n=12) and ASD treated group (n=11). The EDA was continuously monitored during resting phase in a supine posi- tion. The EDA amplitude (µS) was computed as an average of 5 min baseline period. Results: We found significantly lower EDA in ASD non-treated subgroup compared to controls indi- cating subtle abnormalities in the regulation of the sympathetic nervous system.
    [Show full text]
  • Managing Attention Deficit in Adults in Your Office
    Managing attention deficit in adults in your office Nick Kates MB.BS FRCPC MCFP(hon) Chair, Dept. of Psychiatry, McMaster University Cross Appointment, Dept. of Family Medicine, McMaster University Quality Improvement Advisor, Hamilton Family Health Team No funding or support from Industry for any aspect of this presentation or my work Except my lifelong commitment to Self-referred - concerned about his mood Recent life stresses Inconsistent work and relationship history Met criteria for ADD + PHQ score was 14 Was also depressed – poor response to Buproprion Seen a year later – mood was brighter and wanted to start a stimulant Positive response to Methylphenidate Referral for assessment of Bipolar Affective Disorder Mood swings consistent with cyclothymia Consistent history of problems with attention, distractibility, academic underachievement Two diagnoses eventually established Some overall improvement with Lithium Reluctant to start Ritalin 6 - 9 % of all children 25-78% continue to have problems as adults 4-5% of all adults Could be third most prevalent psychiatric disorder ? 50 – 60 adults in an average family practice Democratic Male : female 2:1 ◦ Self-perception Changing prevalence with age 70 adults in your practice 20% of mothers, 25-30% of fathers have ADHD 20-45% co-morbid depression (genetic link) 25% have alcohol and drug problems 0-27% Bipolar affective disorders (one way co-morbidity) 10-40% have anxiety disorders Significant increases in incarceration rates Increased likelihood of being
    [Show full text]
  • Behavioral Health Professional Breakout Track Slide Deck
    SCHOOL CLIMATE YOUTH MENTAL HEALTH A Whole-School Approach AMY HILL, SYSTEM DIRECTOR OF SCHOOL BASED SERVICES SHELLY FARNAN, SYSTEM DIRECTOR OF DIVERSITY AND INCLUSION WHAT IS SCHOOL CLIMATE? Generally, school climate represents the shared norms, beliefs, attitudes, experiences, and behaviors that shape the nature of interactions between and among students, teachers, and administrators- PBIS Technical Brief School climate refers to the quality and character of school life. School climate is based on patterns of students', parents' and school personnel's experience of school life and reflects norms, goals, values, interpersonal relationships, teaching and learning practices, and organizational structures. –National School Climate Center YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH 4 KEY COMPONENTS • 1. Safety • 2. Relationships • 3. Teaching and Learning • 4. External Environment • Positive School Climate = Academic Achievement and Positive Youth Development YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH SAFETY • Rules- Clear communication about harassment, bullying, physical violence and adult intervention • Sense that students feel physically safe • Sense that students feel emotionally safe YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH RELATIONSHIPS • Connection with adults, engagement, high expectations • Respect for student diversity • Relationship with peers, friendships, involvement YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH TEACHING AND LEARNING • Academic learning- individualized learning, varied ways to show achievement, academic
    [Show full text]