PSYCH 333 1nd Edition Lecture 23 Outline of Last Lecture I. Theories of Histrionic PDII. Cluster C: Anxious/Fearful Personality DisorderIII. General Approach to TreatmentIV. Neurodevelopmental DisordersV. ADHDOutline of Current Lecture II. ADHDIII. Autism Spectrum DisorderIV. Intellectual DisabilityCurrent Lecture- ADHDo Environmental factors. Prenatal/perinatal factors.- Low birth weight.- Maternal tobacco use.o Predicts ADHD diagnoses even after controlling for genetics.o Nicotine may have a direct impact on dopaminergic pathways in the developing brain. Environmental toxins.- NO evidence that food additives/coloring causes ADHD.- Lead poisoning can cause symptoms similar to ADHD, but is rarely a cause.o Psychological factors. Parent-child interactions.- Parents more like to have negative interaction with children with ADHD.- Children less compliant; more negative towards parents. Parental history of ADHD.- Less consistent parenting if one of both parents have ADHD.- This environment may exacerbate ADHD symptoms in children. Treatment.These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.- Parent training and classroom management.o Behavioral interventions.o Behaviors monitored at home and school.o Reinforce positive behaviors through point systems.o Added structure to help with inattention.o Extra physical exercise/exercise breaks for hyperactivity.o ADHD in adulthood. You cannot develop ADHD as an adult, however symptoms can persist from childhood into adulthood. Inattention tends to be more predominant in adults. Other features common in adults with ADHD.- Restless leg syndrome.- Car accidents/speeding tickets.- Problems at work. Treatment for adults.- Accommodations for school/work.- Couples counseling.- Cognitive behavioral therapy.- Stimulant medications.- Autism Spectrum Disorder:o Deficits in social communication/interaction. Problems with nonverbal behaviors. Difficulty developing appropriate peer relationships. Deficits in social/emotional reciprocity.o Restricted, repetitive behaviors, interests, or activities. Stereotyped/repetitive speech, motor movements, or use of objects. Excessive adherence to routines, rituals/extreme resistance to change. Very restricted interests that are abnormal in focus. Hyper- or hyporeactivity to sensor input/unusual interest in sensory environment.o Associated features. More common in males. Comorbid with intellectual disability, learning disabilities, depression, andanxiety. May have delays in language acquisition. Motor impairment.- Odd gait, clumsiness, abnormal motor behavior, catatonia, “freezing.” Self-injury.- Especially when comorbid with intellectual disability.o Theories. Vaccines are not related to increased incidence of autism. Genetics.- Heritability around .80.- Greater concordance rate in MZ twins than DZ twins.- Linked to a spectrum of deficits in communication and social interactions.- Deletion on chromosome 16 associated with autism (but not the cause). Neurobiological factors.- Larger brain volume at ages 2-4.o Inadequate pruning.- Abnormalities in the cerebellum.o Treatments. Behavioral therapy.- Applied behavioral analysis, functional behavior assessment, behavior modification.- Operant conditioning to teach language, social behavior. Pivotal response treatment.- Type of behavioral therapy.- Involve child in selecting focus of treatment and involve parent in providing treatment.- Intervening in one key (or pivotal) area will impact all areas of functioning. Joint attention and play interventions.- Intellectual Disability.o Previously mental retardation.o Deficits in intellectual functions (reasoning, problem-solving, planning, abstract thinking, judgment, academic learning, etc.) confirmed by clinical assessment and intellectual thinking.o Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for independence and social responsibility.o One of symptoms during the developmental period.o Associated features. Very heterogeneous presentation. More commonly diagnosed in males. Comorbid with other neurodevelopmental disorders. Gullibility/lack of awareness of risk may lead to exploitation, victimization,and unintentional criminal activity. Lack of communication skills may increase likelihood of aggressive/disruptive behaviors. Increased risk of suicide.o Theories. Chromosomal abnormalities.- Down syndrome – trisomy 21.- Fragile X syndrome. Genetic diseases.- Phenylketonuria (PKU) deficiency in liver enzyme phenylalanine hydroxylase.- Phenylalanine and phenylpyruvic acid build up in bodily fluids; cause brain damage. Infectious diseases.- Maternal infection with rubella, toxoplasmosis, herpes, HIV, syphilis.- Encephalitis or meningitis after birth. Environmental.- Lead, mercury exposure.o Treatments. Behavioral treatments.- Similar to autism. Residential treatment.- Therapeutic communities; care-takers. Cognitive treatment.- Teach problem-solving skills/ strategies.- Components of behavioral therapy as