Attention Deficit/Hyperactive Disorder; ADD no longer exists. To become diagnosed, one must display 6 of the 9 symptoms displayed in either inattention or hyperactivity.
Common with ADHD, have the ability to get deeply focused and tune everything out. Can occur with extremely unproductive activities such as video games.
A. Fails to pay attention to DETAILS or making careless mistakes when doing schoolwork. Missing key words like NOT in test questions, or missing signs in math problems. B. Trouble keeping focused during play or tasks. C. Does not seem to listen when spoken directly to. D. Difficulty organizing tasks or activities E. Avoid tasks requiring high amount of mental effort and organization F. Frequently looses items needed to complete tasks G. Excessive Distractability H. Forgetfullness
A. Fidgets with hands or feet or squirming in seat B. Leaves seat often, even when inappropriate C. Runs or Climbs at inappropriate times D. Difficulty in quiet lay E. Often "on the go" or "driven by a motor" F. Talks excessively G. Blurts out answers before the are asked. H. Has difficulty awaiting turn I. Interrupts or Intrudes on others
Diagnosis of ADHD
1. Must have 6 or more of the symptoms of inattention or hyperactivity. 2. Onset by age 7 3. Has to be functionally impairing to everyday life
Prevalence of ADHD
8% in school age population, 4% in adult population 2:1 (male:female)
Causes of ADHD
1. Frontal Cortex (impulse control, attentional focus) 2. Reward/Pleasure Circuits 3. Heritability (50%) 4. Dopamine Function (DRD2, DBH genes) -Dopamine is a main neurotransmitter in reward circuit and frontal cortex -These genes regulate dopamines activity in the reward center 5. Omega-3, Zinc Deficiency -ADHD has huge deficiency in these -Kids with low levels can be dramatically improved with Omega-3 supplements
-Physiological dependence; cannot function without drug in the body. Functional impairment, can't function with drug, can't function without it. -Drugs of addiction light up reward circuits and brains craving -To beat the addiction, you must beat the craving.
Ventral Tegmental Area (VTA)
-In brainstem, neurons which project dopamine. -Hippocampus: memory storage of the brain -Nucleus Accumbens: ground zero for you
-Less severe than Substance Dependence -Use is sporadic, but causes some functional impairment.
Lifetime Prevalence of Drugs
Nicatine: Most prevalent, 24%, second-hand smoke as child increases chance of addiction. Alcohol: 14%, highly toxic to organs. Illicit Drugs: 6%
Alcohol Effects on Brain
-Effects three main neurotransmitters in the brain. 1. GABA (puts break on neural firing) 2. Dopamine (reward center) 3. Glutamate (major excitement transmitter, increases activity) -When drinking, your frontal cortex goes offline, which is the part of the brain which affects all of your behavioral decisions.
Alcohol Dependence Subtypes
Type I: Socially anxious; drinking to meditate Type II: Antisocial
Causes of Alcoholism
Biological Factor: Alcohol can be reinforcing to some individuals. Low levels of D2 receptors cause you to not be able to get "high on life" so you look for other means.
Sociocultural Factor: Cultures vary dramatically in % alcohol use problems
Personality Factors: Antisocial or Neurotic
Treatments for Alcohol Abuse
Pharmacology: prescriptions such as Antabuse, Naltrexone, Prometa
AA: Alcoholics Anonymous
Marijuana vs Alcohol
-FDA has to decided too ban a drug which is more destructive to your body or those around you.
-Means "split mind" -Psychosis: a split with reality. Delusions and Hallucinations are the two varieties.
-Beliefs that don't conform with reality -"Delusions of Grandeur" man that Dr. Illardi met who believed he was traveling backward through time, and that he was Abe Lincoln.
-Perceptions that do not conform to reality. (All 5 primary senses can be affected) -most universal among those who get the diagnosis
-Disorganized speech, neologisms.
Diagnostic Criteria for Schizophrenia
-Must have two of the following.. 1. Delusions 2. Hallucinations 3. Disorganized speech 4. Grossly disorganized behavior 5. Stupor/flat effect ***ONLY ONE OF THE ABOVE IS REQUIRED IF AUDITORY HALLUCINATIONS!!!
Prevalence of Schizophrenia
1% of adults
Causes of Schizophrenia: Medical Model
1. Genetic Evidence 2. Disordered Brain Development 3. Hypofrontality 4. Dopamine Hypothesis 5. Disordered Lipid Metabolism in Brain 6. Medical Treatment
-Individuals with disorder have key regions of frontal cortex which are misfiring -Logical sequencing circuits dormant or not acting in coordinating fashion with the rest of the brain.
-Increased cerebral dopamine activity -All anti-psychotics block DA (dopamine) transmission -Amphetamines increase DA transmission (and can cause psychosis at high levels) EVIDENCE -Parkinson patients do not get schizophrenia, low DA transmission -Model is helpful but too simple
Causes of Schizophrenia: Psychoanalytical Model
-weakly developed ego, psychosis= invasion of the id and superego
-Enduring and pervasive pattern of behavior, thoughts, and feelings.
-Personality causes significant functional impairment and/or distress -In order to get the diagnosis, one must be this way since adolescence.
Characteristics of Personality Disorder
-Onset by late adolescence -Prevalence of 10-15% of population -People do not seek help because they are unaware -Disorder is dimensional NOT categorical Dimensional: you are somewhere on a continuum Categorical: you either have it or you dont
Schizotypal: odd perceptions and beliefs, social discomfort Paranoid: mild delusional disorder, tends to be an unpleasant person. Schizoid: looks like asbergers syndrom, little/no desire for social interaction.
Histrionic: craves attention, loud, must be in spotlight, even if it is negative. Narcissistic: sense of entitlement, self-absorbed, crave admiration, one ups people, manipulator Borderline: intense emotions, self mutilation, fear of abandonment. ends up hospitalized Antisocial: Violates others rights, violent behavior, lack of remorse, commits crimes, really smart ones end up in business or politics.
Obsessive Compulsive: perfectionist, overly high standards, PROCRASTINATORS, NOT OCD Dependent: Feels like needs significant other to function, low self-esteem, clings to abusers. Avoidant: low grade social phobics, anxious about negative judgement from others, feels like they are ugly, always anxious in social situations.
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