Abnormal Child and Adolescent Psychology, 8th, Chapter (9).doc

CHAPTER 9 ATTENTION-DEFICIT HYPERACTIVITY DISORDER TRUE OR FALSE There is cross cultural agreement on a two factor model of ADHD. The DSMIV permits diagnosticians to assign people with attention-deficit hyperactivity disorder to three subgroups based on two behavioral factors. Children with ADHD are unable to pay attention even when a task is interesting and they are motivated. Selective attention is the ability to continue to focus on a task over time. Dane, Schacher and Tannock (2000) found that in school, children with ADHD were as active as their peers in the morning but became significantly more active and fidgety in the afternoon. The stop-signal task has been used to assess deficits in inhibition. Children with ADHD are more likely to experience motor incoordination. 8. Kent and colleagues (2011) found that adolescents with ADHD were 8 times more likely to drop out of high school than teens without ADHD. 9. Approximately 10-35 percent of students with ADHD fail to graduate high school. 10. Barkley et al., 2002 notes that ADHD is often a disorder where children fail to perform a task even though they have learned how to do it. 11. Children with ADHD-combined type often underestimate their social competence. 12. Research indicates that parents and teachers tend to be more controlling and directive with ADHD children than with normal children. 13. Children with ADHD are at higher risk for accidents and injuries. 14. It is unusual for parents to report sleep problems in children with ADHD. 15. Older youth with ADHD are at greater risk for automobile accidents. 16. Maternal smoking is correlated to ADHD-C but not ADHD-I. 17. The case study of Tim (the young male with ADHD-I) reported in the textbook indicates that academic problems appear to worsen as these children move to higher grades. 18. Research indicates that the presence of ADHD can lead to the development of a reading disability in a child. 19. ADHD often co-occurs with oppositional and conduct-disordered behavior, but it appears to protect children from anxiety and depression. 20. ADHD co-occurs with bipolar disorder in 50-75 percent of cases. 21. Research by Miller, Nigg and Miller (2009) indicates that African American youth have fewer ADHD symptoms than Caucasian youth which is why they are less likely to receive treatment. 22. Most cases of ADHD are diagnosed during the elementary school years. 23. Follow-up studies of ADHD indicate that a sizable percent of children exhibit heterotypic continuity of symptoms. 24. Barkley believes that the basic deficit in the predominantly inattentive type of ADHD is an inability to inhibit behavior. 25. Children with ADHD often underestimate the passage of time. 26. The part of the brain most strongly implicated in the etiology of ADHD is the frontal-striatal area. 27. Research indicates that the brains of children diagnosed with ADHD are overaroused. 28. Stimulant medications often work by blocking the reuptake of dopamine and norepinephrine. 29. Shaw and colleagues (2011) demonstrated that the rate of cortical thinning, a sign of brain maturation, was delayed for children with ADHD, particularly when the symptoms were severe. 30. Research into the genetic etiology of ADHD has revealed that heritability rates are in the .25 to .35 range. 31. Recent genome research by Williams et al., (2010) found no difference in the frequency of copy number variations between ADHD samples and healthy controls. 32. Most researchers believe that psychosocial influences are the primary cause of ADHD. 33. Prenatal influences and birth complications are certain causes of ADHD. 34. From the research evidence it can be concluded that sugar and other components of diet, along with exposure to environmental lead, account for a large percent of cases of ADHD. 35. When a parent suspects that a child might have ADHD, it has been found that home and/or school observations are ineffective assessment tools. 36. Tutoring, parent training and social skills training are all noted as possible methods of prevention of the impairment associated with ADHD. 37. Once medication for ADHD is discontinued, improvements generally continue. 38. As many as 45% of children with ADHD do not take their medication as prescribed. 39. Approximately 10-20 percent of children medicated for ADHD show no improvement when they are on medication. 40. Among children medicated for ADHD, there is evidence that stimulant use causes later drug abuse . 41. Medication use increased in adolescent and young adult ADHD populations between 2000 and 2007. 42. Reich and colleagues found that 35% of their sample received stimulant medication even though they did not meet the diagnostic criteria for ADHD. 43. Token economies, daily report cards and written contracts are all classroom management techniques that are effective and recommended in ADHD interventions. 44. One result of the MTA study was that children in the combined medication and treatment group took lower doses of medication than children in the medication only group. MULTIPLE CHOICE 45. Which of the following terms have historically been used to refer to ADHD? a. Cognitive Impairment b. Hyperkinetic Syndrome c. Diffuse Morality Deficit d. Impulsivity Disorder 46. DSM-IV subtyping of ADHD is based on evidence that the major behavioral manifestations of ADHD fall into which two factors? a. Hyperactivity and inattention b. Impulsivity and hyperactivity c. Hyperactivity-impulsivity and inattention d. Inattention-hyperactivity and impulsivity 47. According to the DSM-IV, which of the following is a criterion for the diagnosis of attention-deficit/hyperactivity disorder? a. Occurrence of symptoms before age 18 b. Occurrence of symptoms in at least two settings c. Deficits on the stop-signal task d. Clear family history of the disorder 48. With regard to attention processes and ADHD, a. evidence for deficits in sustained attention is stronger than for selective attention. b. children with ADHD perform as well as non-ADHD children on tests of attention. c. deficits in attention are most obvious on tasks that appear exciting and stimulating. d. executive attention is impaired in children with ADHD. 49. The motor activity problems displayed by children diagnosed with attention-deficit hyperactivity disorder a. are excessive but goal-directed. b. are highly consistent across settings. c. are best measured with the Matching Familiar Figures Test. d. are most likely to be displayed in highly structured situations. 50. Which is the clearest example of impulsive behavior? a. Nicky talks incessantly. b. John is unable to concentrate on school lessons. c. Sarah often cuts into others’ conversations. d. Leah easily forgets what she has just learned in school. 51. With regard to intellectual/academic performance, youngsters with ADHD a. usually progress in school similarly to typical children, despite behavioral problems. b. are at risk for specific learning disabilities. c. as a group, perform higher than average on tests of general intelligence. d. as a group, perform much lower than average on tests of general intelligence. 52. The stop-signal task is used primarily to evaluate a. impulsivity. c. selective attention. b. sustained attention. d. hyperactivity. 53. When children are presented with the stop-signal task, they are instructed to a. select a letter that matches a standard letter. b. press a button to identify a stimulus on a screen, but sometimes, to inhibit this response. c. signal the researcher when they feel restless. d. signal the researcher when they feel anxious. 54. Executive functions include a. planning and organizing. b. respiration. c. heart rate. d. hunger and thirst. 55. Which of the following is true concerning the social behavior of youngsters with ADHD? a. Children with combined type ADHD may overestimate their social acceptance. b. The youngsters who display only inattention do not have social difficulties c. There is evidence suggesting children with ADHD have more conflict with their fathers than their mothers. d. ADHD behavior does not appear to have much impact the child-teacher relationship. 56. Based on the case study of Jimmy reported in the textbook, children with ADHD-C a. will excel in sports. b. will more than likely achieve their potential without intervention, particularly if they are bright. c. will likely be ignored by their parents and teachers. d. will likely be disliked by peers and experience peer rejection. 57. Which subtype of ADHD is characterized by lethargic, daydreamy behavior? a. Predominantly inattentive b. Predominantly hyperactive c. Predominantly impulsive d. Combined type 58. Which is true of ADHD-I compared to ADHD-C? a. ADHD-I has earlier onset. b. ADHD-I is more associated with conduct disorder. c. ADHD-I is more prevalent in females. d. ADHD-I may be more strongly associated with externalizing problems. 59. Compared to conduct disorder, ADHD is more strongly linked to a. psychosocial disadvantage. c. child maltreatment. b. adverse family variables. d. cognitive deficits. 60. Youth with co-occurring ADHD and conduct/oppositional symptoms, compared to youth with only ADHD, a. display less severe ADHD symptoms. b. have earlier onset of symptoms. c. have experienced more positive parenting. d. have families of higher social class. 61. Which is true with regard to the co-occurrence of ADHD and internalizing disorders? a. Having comorbid depression actually improves outcomes in children with ADHD. b. Children with ADHD and anxiety may show less hyperactivity and impulsivity than children with only ADHD. c. Children with ADHD and anxiety tend to have families with poor supervision. d. There is little evidence that children with ADHD are at higher risk for internalizing disorders. 62. The prevalence of ADHD a. is estimated to be between 3 and 7 percent of the school-age children in the U.S. b. is higher in girls than boys. c. increases with age from childhood to adolescence. d. is remarkably consistent across cultures. 63. According to the trajectories of children with ADHD as calculated by Shaw, Lacourse & Nagin (2005), what percentage of children have a chronic course? a. 5-7 b. 20 c. 27 d. 47 64. About what percent of children with ADHD have symptoms that persist into adolescence and/or adulthood? a. 5-25 c. 40-80 b. 25-50 d. 75-100 65. Which is true with regard to the continuity of childhood ADHD into adolescence/adulthood? a. Childhood ADHD does not always continue into adolescence/adulthood. b. For those teens who do not meet criteria any longer, adjustment is indistinguishable from peers with no history of ADHD. c. Female teens with a history of ADHD who no longer meet criteria are as well adjusted as peers with no history of an ADHD diagnosis. d. Young men with a history of ADHD were more likely than young women with a history of ADHD to exhibit major depression in adulthood. 66. Brad, age 17, has difficulty refraining from swearing in front of his grandparents. He enjoys swearing in everyday life where he gets a positive response from his peers when he swears. According to Barkley’s model this is an example of a. an inability to inhibit competing stimuli. b. an inability to interrupt a behavior that is already underway. c. an inability to inhibit a prepotent response. d. an inability to exert motor control. 67. Some investigators suggest that deficits in motivation are central in ADHD. Relevant to this position is evidence suggesting that children with ADHD a. are not very interested in rewards. b. require strong incentives for behavioral control. c. perform well under partial schedules of reinforcement. d. prefer delayed over immediate reinforcement. 68. The triple pathway model of ADHD includes which of the following constructs? a. Delay aversion b. Reward focus c. Underarousal d. Hyperactivity 69. Which of the following has been shown regarding brain structure/functioning in ADHD? a. Reduction in total volume estimated at 5-10% b. Larger than average size of the frontal area c. High levels of metabolism in the frontal-striatal area d. Rapid brain waves 70. In the research by Shaw and colleagues (2007) which part of the brain demonstrates the most delayed maturation in children with ADHD? a. Corpus callosum c. Occipital lobes b. Prefrontal region d. Brain stem 71. The DRD4 and DAT1 genes that have been linked to ADHD are known to be involved with which neurotransmitter? a. Epinephrine c. Serotonin b. Norepinephrine d. Dopamine 72. Investigations into the causes of attention-deficit hyperactivity disorder have revealed a. a strong association with a high-sugar diet. b. evidence that cigarette smoking and drinking while pregnant increases the risk of ADHD in offspring. c. no evidence of gene-environment interaction. d. no link to low birth weight or prematurity. 73. Which of the following statements best describes the influence of psychosocial factors on ADHD? a. Psychosocial factors play no role in etiology. b. Psychosocial factors influence the nature and severity of ADHD. c. Psychosocial school factors are more important than family factors. d. Psychosocial factors play a strong role in etiology. 74. Which of the following is a Conner’s Third Edition scale? a. Depression b. Anxiety c. Executive Functions d. Obsessions 75. The continuous performance task measures a. inattention. b. problem solving. c. intellectual abilities. d. motivation. 76. Which class of medications is most commonly used in treating attention-deficit hyperactivity disorder? a. Antidepressants c. Tranquilizers b. Antipsychotics d. Stimulants 77. About what percentage of children with attention-deficit hyperactivity disorder benefit from treatment with stimulant medications? a. 35 c. 75 b. 55 d. 90 78. Which of the following is a reported side effect of stimulant medications prescribed for ADHD? a. Sleepiness c. Jitteriness and irritability b. Increased appetite d. Weight gain 79. The goals of the Summer Treatment Program include a. improving executive functions. b. finding the correct combination of medications. c. intensive parent training. d. improving peer relationships. 80. The MTA study was designed to evaluate the effectiveness of a. combined stimulant and behavioral intervention. b. assessment techniques for identifying ADHD. c. treatments for ADHD-C compared to ADHD-I. d. parental management of ADHD children in single-parent versus two-parent families. 81. Findings from the MTA include which of the following? a. The combined treatment was more effective than the medication only treatment on all outcome measures. b. Families with the least education benefitted the most from the combined treatment. c. The results were not maintained at follow up. d. The medication and combined treatments were not more effective than other treatments for addressing the core problems of ADHD. BRIEF ESSAY QUESTIONS 82. What are some of the issues or concerns reported for the DSM conceptualization of ADHD? 83. What are the DSM-IV criteria for attention-deficit hyperactivity disorder? 84. List the component of executive functions. 85. Describe the clinical features displayed by children diagnosed with ADHD, Predominantly Inattentive Type; ADHD, Predominately Hyperactive-Impulsive Type; and ADHD, Combined Type. Be sure to include a definition/description of sluggish cognitive tempo. 86. Summarize findings about the developmental course of ADHD. 87. List at least five of the variables that may predict outcome for adolescents and adults with ADHD. 88. Describe the concept of behavioral inhibition and executive functions relevant to Barkley’s model of ADHD. 89. Describe two of the five proposed explanations of ADHD presented in the textbook: arousal level, sensitivity to reward, Barkley’s model of inhibitory deficits, temporal processing and delay aversion, or multiple pathway. 90. Summarize the major findings concerning neurobiological causation of ADHD. 91. What role, if any, do psychosocial variables play in the etiology of attention-deficit hyperactivity disorder? It may help to include the gene-environment model of multiple pathways to ADHD (Taylor, Sonuga-Barke, 2008) in your discussion. 92. Give 3 examples of questions one might ask a child when evaluating him/her for ADHD (per Barkley and Edwards, 2006). 93. Review the pros and cons of using medication as a treatment for ADHD. 94. Describe behavioral interventions for ADHD that include parents and teachers. 95. Describe the steps used in parent training for ADHD intervention. 96. Describe the MTA study of treatment. Be sure to describe the participants, design, procedures, and results. What can be concluded from that study? Answer Key 1. T, p. 220, conceptual 2. T, p. 220, conceptual 3. F, p. 222, factual 4. F, p. 222, factual 5. T, p. 222 (Figure 9.1), factual 6. T, p. 222-223, applied 7. T, p. 223, factual 8. T, p. 223, factual 9. T, p. 223, factual 10. T, p. 224, factual 11. F, p. 225, conceptual 12. T, p. 225, factual 13. T, p. 226, factual 14. F, p. 226, factual 15. T, p. 226 (Accent), factual 16. F, p. 227, factual 17. T, p. 228 (Tim Case Study), applied 18. T, p. 229, factual 19. F, p. 229, factual 20. F, p. 230, factual 21. F, p. 231 (Accent), applied 22. T, p. 232, factual 23. T, p. 233, factual 24. F, p. 234, (Figure 9.5), factual 25. T, p. 235, factual 26. T, p. 236, factual 27. F, p. 236, factual 28. T, p. 236, factual 29. T, p. 237 (Accent), factual 30. F, p. 237, factual 31, F, p. 237, factual 32. F, p. 238, factual 33. F, p. 238, factual 34. F, p. 238, factual 35. F, p. 240, factual 36. T, p. 241, factual 37. F, p. 242, factual 38. T, p. 242 (Accent), conceptual 39. T, p. 242 (Accent), factual 40. F, p. 243, factual 41. T, p. 243, factual 42. T, p. 243, factual 43. T, pp., 244-246, factual 44. F, pp. 247-248, factual 45. B, p. 220, factual 46. C, p. 220, factual 47. B, pp. 220-221, factual 48. D, p. 222, conceptual 49. D, p. 222, factual 50. C, p. 222, applied 51. B, p. 223, factual 52. A, p. 223, applied 53. B, p. 224, applied 54. A, p. 224, conceptual 55. A, p. 225, factual 56. D, p. 227 (Case study), applied 57. A, p. 227, conceptual 58. C, p. 227, factual 59. D, p. 229, factual 60. B, p. 229, factual 61. B, pp. 229-230, factual 62. A, pp. 230-231, factual 63. B, p. 232 (Figure 9.3), factual 64. C, p. 233, factual 65. A, p. 233, factual 66. C, p. 234, applied 67. B, p. 235, factual 68. A, p. 235, factual 69. A, p. 236, factual 70. B, pp. 236-237, factual 71. D, p. 237, factual 72. B, p. 238, factual 73. B, pp., 238-239, factual 74. C, p. 241 (Table 9.4), factual 75. A, p. 241, factual 76. D, p. 241, factual 77. C, p. 242, factual 78. C, p. 242, factual 79. D, p. 246 (Accent), factual 80. A, p. 247, factual 81. C, pp. 247-248, factual 82. p. 200, factual 83. p. 221 (Table 9.1), factual 84. p. 224, factual 85. pp. 226-228, conceptual 86. pp. 232-234, factual 87. p. 234 (Table 9.2), factual 88. pp. 234-235, factual 89. pp. 234-237, conceptual 90. pp. 235-237, factual 91. pp. 238-239 (Figure 9.7), conceptual 92. p. 240 (Table 9.3), applied 93. pp. 241-243, factual 94. pp. 243-247, factual 95. p. 244 (Table 9.6), factual 96. pp. 247-248, conceptual 107