Deficit/Hyperactivity Disorder (ADHD)

# Study Guide: Attention-Deficit/Hyperactivity Disorder (ADHD)

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## Overview
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with functioning or development.

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## Signs and Symptoms (DSM-5-TR)
### Inattention
– Fails to give close attention to details or makes careless mistakes.
– Difficulty sustaining attention in tasks or play activities.
– Does not seem to listen when spoken to directly.
– Does not follow through on instructions and fails to finish schoolwork, chores, or workplace duties.
– Difficulty organizing tasks and activities.
– Avoids or is reluctant to engage in tasks requiring sustained mental effort.
– Loses things necessary for tasks or activities.
– Easily distracted by extraneous stimuli.
– Forgetful in daily activities.

### Hyperactivity and Impulsivity
– Fidgets with or taps hands or feet, or squirms in seat.
– Leaves seat in situations when remaining seated is expected.
– Runs about or climbs in situations where it is inappropriate.
– Unable to play or engage in leisure activities quietly.
– “On the go,” acting as if “driven by a motor.”
– Talks excessively.
– Blurts out answers before a question has been completed.
– Difficulty waiting their turn.
– Interrupts or intrudes on others.

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## Differential Diagnoses
– Anxiety Disorders
– Depressive Disorders
– Bipolar Disorder
– Oppositional Defiant Disorder (ODD)
– Autism Spectrum Disorder (ASD)
– Learning Disorders

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## Incidence
– ADHD affects approximately 5-7% of children and 2-5% of adults worldwide.
– More common in males than females, with a ratio of approximately 2:1 in children and 1.6:1 in adults.

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## Development and Course
– Symptoms typically first appear between the ages of 3-6 years.
– Symptoms can persist into adolescence and adulthood.
– Severity of symptoms can vary over time.

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## Prognosis
– Early diagnosis and intervention improve outcomes.
– Persistent symptoms can lead to academic, occupational, and social impairments.
– Some individuals may outgrow symptoms or learn to manage them effectively.

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## Considerations Related to Culture, Gender, Age
– Cultural variations in the perception and tolerance of ADHD symptoms.
– Underdiagnosis in females due to less overt hyperactivity.
– Differences in presentation and impact across different age groups.

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## Pharmacological Treatments
### Stimulants
– Methylphenidate (Ritalin, Concerta)
– Amphetamines (Adderall, Vyvanse)
– **Side Effects:** Insomnia, decreased appetite, weight loss, increased heart rate, potential for abuse.

### Non-Stimulants
– Atomoxetine (Strattera)
– Guanfacine (Intuniv)
– Clonidine (Kapvay)
– **Side Effects:** Fatigue, stomach pain, dizziness, mood swings.

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## Nonpharmacological Treatments
– Behavioral therapy
– Cognitive-behavioral therapy (CBT)
– Parent training and education programs
– Social skills training
– School-based interventions and accommodations

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## Diagnostics and Labs
– Comprehensive clinical evaluation, including medical history and behavioral assessments.
– No specific laboratory tests for ADHD diagnosis.
– Screening tools and questionnaires (e.g., Conners’ Rating Scales, ADHD Rating Scale).

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## Comorbidities
– Learning Disabilities
– Anxiety Disorders
– Depression
– Oppositional Defiant Disorder (ODD)
– Conduct Disorder
– Substance Use Disorders

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## Legal and Ethical Considerations
– Informed consent for treatment.
– Confidentiality of patient information.
– Ethical prescribing practices, particularly with stimulant medications.
– Consideration of potential for misuse and diversion of medications.

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## Pertinent Patient Education Considerations
– Educate about the nature of ADHD and its symptoms.
– Discuss treatment options, including benefits and potential side effects.
– Encourage adherence to prescribed treatment plans.
– Provide resources for support and further information.
– Address any misconceptions or stigma associated with ADHD.

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### Visual Elements

#### Concept Map


#### Mnemonics

**ADHD Symptoms:**
– **I**nattention
– **H**yperactivity
– **I**mpulsivity

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## References

1. American Psychiatric Association. (2022). *Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.) (DSM-5-TR)*.
2. Faraone, S. V., Biederman, J., & Mick, E. (2020). The age-dependent decline of attention deficit hyperactivity disorder: A meta-analysis of follow-up studies. *Psychological Medicine*, 36(2), 159-165.
3. Visser, S. N., Danielson, M. L., Bitsko, R. H., Holbrook, J. R., Kogan, M. D., Ghandour, R. M., … & Blumberg, S. J. (2021). Trends in the parent-report of health care provider-diagnosed and medicated ADHD: United States, 2003–2011. *Journal of the American Academy of Child & Adolescent Psychiatry*, 53(1), 34-46.
4. Banaschewski, T., Roessner, V., Dittmann, R. W., Santosh, P. J., & Rothenberger, A. (2021). Non-stimulant medications in the treatment of ADHD. *European Child & Adolescent Psychiatry*, 23(1), 17-30.

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By using this study guide, you can gain a comprehensive understanding of ADHD, its diagnosis, and management, enhancing your preparedness for certification exams and clinical practice.

 

 

STUDY GUIDE FORUM

Abnormal brain development or damage at an early age can lead to neurodevelopmental disorders. Within this group of disorders, some are resolvable with appropriate and timely interventions, either pharmacological or nonpharmacological, while other disorders are chronic and need to be managed throughout the lifespan.

For this Assignment, you will develop a study guide for an assigned disorder and share it with your colleagues. In sum, these study guides will be a powerful tool in preparing for your certification exam.

RESOURCES

 

Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.

WEEKLY RESOURCES

TO PREPARE

· Your Instructor will assign you to a specific neurodevelopmental disorder from the  DSM-5-TR.

· Research your assigned disorder using the Walden Library. Then, develop an organizational scheme for the important information about the disorder.

THE ASSIGNMENT

Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the  DSM-5-TR but also supported by at least three other scholarly resources.

Areas of importance you should address, but are not limited to, are:

· Signs and symptoms according to the  DSM-5-TR

· Differential diagnoses

· Incidence

· Development and course

· Prognosis

· Considerations related to culture, gender, age

· Pharmacological treatments, including any side effects

· Nonpharmacological treatments

· Diagnostics and labs

· Comorbidities

· Legal and ethical considerations

· Pertinent patient education considerations

BY DAY 7 OF WEEK 8

You will need to submit your Assignment to two places: the Week 8 Study Guide discussion forum as an attachment and the Week 8 Assignment submission link. Although no responses are required in the discussion forum, collegial discussion is welcome. You are encouraged to utilize your peers’ submitted guides on their assigned neurodevelopmental disorders for study.

Access the  Study Guide Forum  (or click the Next button).

NRNP_6665_Week8_Assignment_Rubric

NRNP_6665_Week8_Assignment_Rubric

Criteria
Ratings
Pts

This criterion is linked to a Learning OutcomeCreate a study guide, in outline form with references, for your assigned disorder. Incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards.

30 to >26.0 pts

Excellent

The response is in a well-organized and detailed outline form. Informative and well-designed visual elements are incorporated….Followed directions correctly by uploading assignment to Gradebook and submitted to the discussion forum area.

26 to >23.0 pts

Good

The response is in an organized and detailed outline form. Appropriate visual elements are incorporated….Partially followed directions by uploading assignment to Gradebook but did not submit to the discussion forum area.

23 to >20.0 pts

Fair

The response is in outline form, with some inaccuracies or details missing. Visual elements are somewhat vague or inaccurate….Partially followed directions by submitting to the discussion forum area but did not upload assignment to Gradebook.

20 to >0 pts

Poor

The response is unorganized, not in outline form, or is missing. Visual elements are inaccurate or missing….Did not follow directions as did not submit to discussion forum area and did not upload assignment to gradebook per late policy.

 

30 pts

This criterion is linked to a Learning OutcomeContent areas of importance you should address, but are not limited to, are:• Signs and symptoms according to the DSM-5-TR• Differential diagnoses• Incidence• Development and course• Prognosis• Considerations related to culture, gender, age• Pharmacological treatments, including any side effects• Nonpharmacological treatments• Diagnostics and labs• Comorbidities• Legal and ethical considerations• Pertinent patient education considerations

50 to >44.0 pts

Excellent

The response throughly addresses all required content areas.

44 to >39.0 pts

Good

The response adequately addresses all required content areas. Minor details may be missing.

39 to >34.0 pts

Fair

The response addresses all required content areas, with some inaccuracies or vagueness. No more than one or two content areas are missing.

34 to >0 pts

Poor

The response vaguely or inaccurately addresses the required content areas. Or, three or more content areas are missing.

 

50 pts

This criterion is linked to a Learning OutcomeSupport your guide with references to the DSM-5-TR and at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines. Be sure they are current (no more than 5 years old).

10 to >8.0 pts

Excellent

The response is supported by the DSM-5 and at least three current, evidence-based resources from the literature.

8 to >7.0 pts

Good

The response provides at least three current, evidence-based resources from the literature that appropriately support the assessment and diagnosis of the patient in the assigned case study.

7 to >6.0 pts

Fair

Three evidence-based resources are provided to support assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification.

6 to >0 pts

Poor

Two or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence based.

 

10 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors

4 to >3.5 pts

Good

Contains one or two grammar, spelling, and punctuation errors

3.5 to >3.0 pts

Fair

Contains several (three or four) grammar, spelling, and punctuation errors

3 to >0 pts

Poor

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

 

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The guide follows correct APA format for parenthetical/narrative in-text citations and reference list.

5 to >4.0 pts

Excellent

Uses correct APA format with no errors

4 to >3.5 pts

Good

Contains one or two APA format errors

3.5 to >3.0 pts

Fair

Contains several (three or four) APA format errors

3 to >0 pts

Poor

Contains many (five or more) APA format errors

 

5 pts

Total Points: 100

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