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Lecture 17 Attention – Deficit / Hyperactivity Disorder
3-5% of American Children
3 boys for every girl
3 cardinal symptoms:
Inattention not being able to keep their mind on a single problem for an extended time. They become easily bored
within a few minutes.
Difﬁculty in sitting still, will not remain seated for
Hyperactivity more than a few minutes if allowed. Fidget in their
seats, etc. They appear in adults to be very restless Impulsivity blurting out inappropriate comments, sudden
aggressive behavior, not being able to "take
turns", etc. Attention – Deficit / Hyperactivity Disorder
Have to have all the symptoms starting at 3-4
years of age
Have to have all the symptoms all the time.
Should rule out other things that look the
same (learning disability, stress, abuse etc.) Oppositional Defiant Disorder Approx. ! have this: fighting, punching, etc. Emotional Disorders: Anxiety, Depression
It is characterized by aggression and violence, commonly resulting in
punching playmates when they get frustrated Oppositional Defiant Disorder Emotional Approx. ! have this: fighting, punching, etc. about 1/4 feel anxious, which is tremendous worry, tension and uneasiness even
though there is nothing in their environment to fear. About a similar number will have
episodes of depression, which goes beyond ordinary sadness. Depression Anxiety What doesn t cause it: Stimulants are an effective
treatment for ADHD But that is not without controversy Why in the world would you give this: Impulse control centers in the frontal
lobe are not active enough a stimulant? The stimulant increases activity all over, but it
increases it in the frontal lobe enough to
allow better impulse control. Side effects of Ritalin? Everything that you expect from a stimulant:
fast heart rate Behavior modification can also work: Break things into
manageable chunks. Obsessive – Compulsive Disorder Obsessive-Compulsive Disorder:
You obsess about something, which compels you to do something that you
know is irrational. One of the more common things is the obsession about germs Which compels you to wash your hands.
20 or 50 or 200 times a day.
That makes it tough to have a normal life. They know that this is irrational behavior, they just can t help themselves. this is different than other addictions: Obsessive-Compulsive Disorder: 2-3% of Americans have it.
Likely an underestimate since many will not seek treatment.
Treatments are Drugs and Therapy: tricyclic antidepressants:
affect the re-uptake of
serotonin selective serotonin re-uptake
inhibitor (SSRI) Therapy: Exposure and Response Prevention Manic Depressive Illness (also called bipolar disorder) Depression is by far the more
common. If an individual suffers
only from depression it is
considered unipolar. If the person
experiences episodes of both
mania and depression, or mania
alone, it is considered bipolar. 1-2% of population Manic episodes are often rewarded: William Blake
Winston Churchill Virginia Woolf Buzz Aldrin Marlon Brando antidepressants
work best for
depressive state Lithium (Li+) works
well to control both
the mania and
How it works is
unclear. T his drug is considered a SSRI, or selective serotonin reuptake
inhibitor SSRIs also work (Prozac), and seem to work about the best.
Many are championing it s virtues, but you must be careful as there is
a long history of well-renowned psychologists/psychiatrists that have
touted the virtues of drugs we now know are not that good for you. Electroconvulsive Shock Therapy Checkered history Still used today for
severely depressed patients
with high suicide risk.
Now do under anesthesia
with paralytics. Works much faster than
It generates a generalized
seizure for 30 – 60 seconds,
and somehow that helps. Anxiety Nervosa 2 Forms:
Panic Attacks Generalized anxiety is less
severe, but constitutes a
continuous feeling of
anxiety, fear, and
apprehension. This will of
course cause irrational
behavior making it very
difﬁcult to maintain a
fulﬁlling relationship, hold
down a job Drug treatments are the benzodiazapams
Panic Attacks One of the most overprescribed medications of the
late 1960s and early 1970s Side effects include: Drowsiness
Affective Disorders (euphoria)
Benzodiazapams mimic GABA
and bind to a specific GABA
Benzodiazepines mimic GABA and cause an increase in the inhibition of neurons in the cortex. The anticonvulsants that are used in the treatment of epilepsy also mimic GABA. However, these anti-convulsants
do not work well to alleviate the symptoms of anxiety, and the benzodiazepines do not prevent epileptic
seizures. This is because there is more than one type of GABA receptor, and so far the two most common
are the GABA-A and GABA-B receptors GABA-B receptor also binds GABA but it activated a G-protein and works via a
second messenger. Anti-epileptic drugs work on the GABA-B receptor and don t
help with anxiety. Psychoactive Drugs should be able
to treat most mental illnesses
Patients often don t like the side
effects (remember Lecture 16?)
so they stop taking the drugs
once they feel normal
Once they are ill again they
don t know to take the medicine,
stay mentally ill, with bad
consequences. Dissociative Disorders I m not crazy and neither am I These disorders cover a wide range, from perfectly normal
Disorder to post-traumatic stress disorder Post-Traumatic Stress Disorder
Estimated at 10-15% of the population at one time or another.
Is triggered by an extremely stressful event. It could be an acute event. Or a longer period of constant stress Post-Traumatic Stress Disorder has two general types:
Flashbacks or Amnesias Flashbacks are when the person experiences the event in a very vivid way.
It is much more than a memory, the person feels that they are actually there again.
This is the intrusion type as the thoughts of those events continually intrude in
The amnesia type is the opposite, you simply don t remember what happened to
you. Which type you get generally depends on what happens after the event. If you
have the chance to talk about it ( reporting live from New Orleans I m standing with
a man who lost everything " ) you get the intrusion type.
If you are told to keep it quiet, which commonly happens to children that are
physically or sexually abused, you get the amnesia type. Why did the Vietnam War veterans get PTSD more often that soldiers from
previous wars? average age: 19 vs. 26 Three days and a wake-up call More effort is now made to treat people with PTSD, including
group therapy, virtual reality, and medications. Dissociative Identity Disorder The person adopts a different personality. Sometimes they know about each other and
are able to switch from one personality to
the other. The cause is child abuse, either physical,
sexual or (in most cases) both.
This usually occurs only after repeated
incidences of abuse. ...
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- Fall '11