Deck 8: Attention-Deficit-Hyperactivity Disorder

Question 1

Which of the following is best supported by the research on the interactions between parents and their children with ADHD?

A) Problematic interactions are often reciprocal.
B) Children's disruptive behavior has been conclusively shown to precede their parents' hostile-intrusive parenting.
C) Female children with ADHD are most likely to experience these negative interactions with parents.
D) Parents of children with ADHD with comorbid conduct disorder tend to get more treatment and hence have better parent-child interactions than the parents of children with ADHD alone.

Answer 1

 Problematic interactions are often reciprocal.

Question 2

The Society of Clinical Child and Adolescent Psychology and the American Academy of Pediatrics has recommended which of the following as the first line treatment for preschoolers with ADHD?

A) medication
B) behavior therapy
C) combined treatment
D) social skills training

Answer 2

behavior therapy

Question 3

Which of the following is true regarding the history of ADHD?

A) This is a new condition that was first recognized only in the 1980s.
B) As early as the first part of the 1930s, this condition was recognized, and stimulant medications were first used.
C) The condition first appeared in DSM-I.
D) The condition was first called ADHD in DSM-II.

Answer 3

As early as the first part of the 1930s, this condition was recognized, and stimulant medications were first used.

Question 4

Adolescents with ADHD are at increased risk for substance use problems.Which of the following is NOT true of research explaining this link?

A) Comorbid conduct problems mediate the association between ADHD and alcohol or drug problems.
B) ADHD is a specific, unique predictor for smoking.
C) The more symptoms of ADHD, the greater the risk of smoking.
D) Stimulant medication makes individuals much more likely to abuse substances.

Question 5

Which of the following is an example of an impulsive symptom?

A) difficulty listening to others
B) difficulty remaining seated
C) difficulty waiting one's turn
D) difficulty making a decision, indecisiveness

Question 6

Comorbidity in those with ADHD ______.

A) is relatively uncommon
B) is common, particularly among youths referred to mental health clinics
C) typically involves schizophrenia
D) typically involves depression

Question 7

Which of the following best reflects common peer relationships for those with ADHD?

A) Children with hyperactive-impulsive symptoms were most likely to be neglected by their peers.
B) Adolescents with hyperactive-impulsive symptoms were most likely to be rejected by their peers, while children with hyperactive-impulsive symptoms were most likely to be neglected by their peers.
C) Children with inattentive symptoms are at risk for being neglected by peers.
D) Children who are controversial with peers are most likely to have their ADHD symptom severity increase and continue to be controversial with peers two years later.

Question 8

Which of the following is true of sleep disorders in ADHD?

A) Dyssomnias, such as problems falling asleep, are typically only seen in youths with ADHD with hyperactive-impulsive symptoms.
B) Movement disorders associated with sleep, such as sleep talking or teeth grinding, account for the vast majority of the excess in sleep disorders between youths with ADHD and youths in the general population.
C) Parasomnias, such as night wakings, nightmares, or night terrors, occur about as frequently in youths with ADHD as in youths with other psychiatric disorders.
D) Sleep disorders are almost never seen in children with inattentive presentation of ADHD.

Question 9

Psychostimulant medications,used to treat ADHD,are most likely to affect which part of the brain?

A) amygdala
B) hippocampus
C) parietal lobe
D) striatum

Question 10

Which of the following best describes the relationship between ADHD and conduct problems?

A) There is a strong comorbidity between oppositional defiant disorder and ADHD, but almost no relationship between conduct disorder and ADHD.
B) The presence of ADHD in childhood makes it twice as likely for an individual to develop a conduct problem.
C) Longitudinal research indicates that ADHD is causally related to the emergence of conduct problems.
D) An ADHD diagnosis includes any conduct and behavioral issues that result, so these conditions cannot be comorbid.

Question 11

Sluggish cognitive tempo is seen primarily in children with ______.

A) a combined presentation of ADHD
B) an inattentive presentation of ADHD who have a moderate (but still subthreshold) number of hyperactive-impulsive symptoms
C) an inattentive presentation of ADHD with no hyperactive-impulsive symptoms
D) a hyperactive-impulsive presentation of ADHD

Question 12

Which of the following is a way in which the diagnosis of ADHD in those over the age of 17 differs from the diagnosis in children?

A) Those over 17 need only show five symptoms of either inattention or hyperactivity/impulsivity to be diagnosed.
B) Those over the age of 17 are excused from the DSM-5 criterion that symptoms must have been present prior to age 12.
C) Those over the age of 17 must endorse at least one hyperactive-impulsive symptom for diagnosis.
D) Those over the age of 17 must show symptoms in at least two settings, whereas this is not a requirement for younger individuals.

Question 13

The most common presentation of ADHD in clinical populations is ______.

A) hyperactive-impulsive
B) hyperactive
C) inattentive
D) combined

Question 14

Which of the following is true concerning the academic performance of those with ADHD?

A) They show significantly lower academic achievement and school performance than their typically developing peers, but this difference disappears when intelligence and socioeconomic background are accounted for.
B) They show significantly lower academic achievement and school performance than their typically developing peers, even when intelligence and socioeconomic background are accounted for.
C) Children with combined presentation are most at risk for negative outcomes such as repeating a grade or not completing high school.
D) Low academic performance of those with ADHD seems to be only found for boys; girls seem to be relatively protected from these effects.

Question 15

How can clinicians determine whether a child's inattentive or hyperactive-impulsive symptoms are developmentally inappropriate or excessive?

A) Clinicians don't need to determine this; they simply need to determine whether the symptoms interfere with the child's everyday functioning.
B) Clinicians can observe the child's classmates; if the child in question is significantly more inattentive or hyperactive-impulsive than his or her classmates on a given day, an ADHD diagnosis would be appropriate.
C) Clinicians can ask children to rate their own behavior; because children are generally credible and valid at self-report, this would be sufficient for diagnosis.
D) Clinicians can administer norm-referenced rating scales to parents and teachers; very high symptom ratings might qualify the child for a diagnosis of ADHD.

Question 16

Lyle,age 10,sometimes forgets about homework he's been assigned or underestimates how long it will take him to complete it and doesn't finish it in time.In class,sometimes he finds himself daydreaming,and one time he even forgot that he had to present his science project that day,so he left it at home,even though it was completed.Which of the following is NOT true of Lyle?

A) He can't have ADHD because he's too young to be diagnosed.
B) We don't know how long these symptoms have lasted, so he can't be diagnosed with ADHD unless they last 6 months or more.
C) We've only really seen problems related to Lyle's school performance; people with ADHD have problems in multiple settings.
D) It doesn't seem that Lyle's symptoms are inconsistent with his developmental level or greatly exceed those shown by other kids his age.

Question 17

Which of the following is NOT a piece of evidence described in the text indicating that sleep problems cause ADHD symptoms?

A) Children with ADHD exhibit more restless, low-quality sleep.
B) Restricting children's sleep, even by 1 to 2 hours per night, makes inattention and hyperactive-impulsive symptoms worse.
C) Sleep problems at 2- to 4 years of age predict the emergence of ADHD symptoms at age 5.
D) Children with persistent sleep problems show more ADHD symptoms in later childhood than children whose early sleep problems subsided.

Question 18

Which is true of children with ADHD,predominantly hyperactive-impulsive presentation?

A) They cannot have any symptoms of inattention.
B) They tend to be older children.
C) If they don't have inattention problems initially, most usually they do not develop these symptoms.
D) They are disproportionately male.

Question 19

Which is true of the predominantly inattentive presentation of ADHD?

A) It is most common in girls.
B) It typically emerges between 5 and 8 years of age.
C) It is typically preceded by hyperactive-impulsive symptoms.
D) It is typically a precursor to combined presentation.

Question 20

How is severity of ADHD determined,according to the DSM-5?

A) based on the number of settings in which symptoms manifest 
B) based on the duration of the disturbance and age of onset
C) based on how many of the three primary symptom classes (hyperactivity, impulsivity, inattention) the child exhibits
D) based on how many symptoms, in excess of the minimum required for diagnosis, the person exhibits and degree of impairment in functioning

Question 21

The hippocampus is part of which neural circuit thought to underlie ADHD?

A) the mesolimbic neural circuit
B) the frontal-striatal neural circuit
C) the dorsolateral prefrontal circuit
D) the default mode network

Question 22

The results of a large scale study to compare the efficacy of pharmacological and psychosocial treatments for ADHD found which of the following?

A) Only the groups whose treatment included methylphenidate showed improvement over the 2 years of the study.
B) Most of the improvement occurred in the latter half of the study.
C) The group that included clinical behavior therapy showed the most improvement at the 2-year follow-up.
D) The addition of psychosocial therapy did not improve the effectiveness of methylphenidate alone.

Question 23

What is the innovation of the Challenging Horizons Program?

A) inclusion classes
B) summer school
C) afterschool program
D) individual peer mentors

Question 24

Which is true about the abnormalities in the frontal-striatal neural circuit in youths with ADHD?

A) A longitudinal study has indicated that the frontal-striatal neural circuit in youths with ADHD develops more slowly, by about 3 years, than it does in typically developing children.
B) By adolescence, the growth of the frontal-striatal neural circuit in those with ADHD has caught up to their peers'.
C) Youths with ADHD show too little dopamine in the striatum and too much dopamine in the right prefrontal cortex compared to typically developing peers without ADHD.
D) There is a hyperconnection between the striatum and right prefrontal cortex in those with ADHD compared to typically developing controls.

Question 25

Which of the following is true of the prevalence of ADHD?

A) It is approximately equal in children and adults.
B) Rates of disorder are approximately equal in every world region studied.
C) Caregiver reports provide the lowest estimated prevalence rate.
D) The largest increase in ADHD diagnoses in the United States has been in African American children and those of low socioeconomic status.

Question 26

Which of the following was NOT a main finding of a study discussed in the text that examined the relationship between exercise and attention (Pontifex et al.,2012)?

A) Children who reported more exercise had greater attentional abilities.
B) Children showed faster reaction times and better response accuracy on a computerized attention test after exercising than after sitting.
C) Children's reading and math scores were higher after exercising than after sitting.
D) EEG showed greater allocation of resources to brain regions responsible for attention and concentration after exercising than after sitting.

Question 27

Studies investigating the behavioral genetics of ADHD have found which of the following?

A) Environment plays a stronger role in the development of the disorder than genetics does.
B) Concordance between twins is higher for inattentive than hyperactive-impulsive symptoms.
C) The siblings of those with ADHD are no more likely to have the disorder than controls.
D) Adopted children are more similar to their biological parents than to their adoptive parents with respect to ADHD symptoms and diagnosis.

Question 28

The environmental risk factors most salient in their relationship to ADHD include all of the following EXCEPT ______.

A) children exposed to cigarette smoke in utero
B) hypoxia at birth
C) high-crime neighborhoods
D) breathing problems during sleep

Question 29

Putting children with ADHD to bed an hour earlier was found to ______.

A) give them an hour more sleep per night
B) give them nearly a half hour more sleep per night and triggered reported improvements in their daytime sleepiness, emotional stability, and restlessness and hyperactivity at school
C) give them nearly an hour more sleep per night and triggered reported improvements in their daytime sleepiness, emotional stability and restlessness and hyperactivity at home
D) produce self-reported benefits in behavior, but these were not confirmed by teachers

Question 30

Which brain region is largely responsible for inhibition and impulse control?

A) globus pallidus
B) orbitofrontal cortex
C) dorsolateral cortex
D) caudate

Question 31

Which of the following best describes the effectiveness of special diets in helping children with ADHD?

A) No reputable study has found a positive effect of special diets on behavioral outcomes for children with ADHD.
B) A subset of children with ADHD seem to show a reduction in symptoms following a change in diet.
C) The most effective special diet for children with ADHD is one in which sugar is strictly limited.
D) The most effective special diet for children with ADHD is one in which salt is strictly limited.

Question 32

Overactivity of the behavioral activation system has been theorized to be most related to which main symptom of ADHD?

A) hyperactivity
B) impulsivity
C) inattention
D) sluggish cognitive tempo

Question 33

Girls are more likely than boys to ______.

A) be diagnosed with ADHD, but only in community samples
B) be diagnosed with ADHD, but only in clinic samples
C) be diagnosed with predominantly inattentive presentation
D) have comorbid ADHD and substance use problems

Question 34

Which of the following is NOT described in the text as one of the four main explanations for the increase in ADHD from 1990 to the present?

A) Those with ADHD symptoms are more likely to reproduce with each other, increasing the proportion of those with ADHD in the population.
B) The fact that the IDEIA recognizes ADHD as a potential disability led more parents to seek out a diagnosis to gain access to services.
C) Low-income children now have greater access to mental health services.
D) Assessment for ADHD has improved, leading to better identification of those with the disorder.

Question 35

According to Barkley's neurodevelopmental model,which of the following is NOT one of the three primary purposes of executive functions?

A) They allow children to make consistent decisions, irrespective of environmental conditions.
B) They allow children to determine their own behavior, rather than be controlled by the environment.
C) They allow delayed reinforcers to influence children, instead of just immediate gratification.
D) They allow children to set long-term goals.

Question 36

Taken together,the findings regarding the effectiveness of various treatments for ADHD suggest which of the following?

A) Medication is an effective treatment; psychosocial therapy is not.
B) Both medications and psychosocial treatments are effective, but generally medication is more effective.
C) Both medications and psychosocial treatments are effective, but generally psychosocial treatment is more effective.
D) Behavior therapy is most effective when used after medication has been deemed ineffective for an individual.

Question 37

Which of the following is NOT part of the default mode network?

A) medial prefrontal cortex
B) medial parietal cortex
C) medial temporal lobes
D) medial occipital lobes

Question 38

The evidence suggests that individuals with ADHD are more sensitive to ______ and less sensitive to ______.

A) dopamine; serotonin
B) serotonin; dopamine
C) immediate rewards; delayed rewards
D) delayed rewards; immediate rewards

Question 39

Problems with the default mode network most likely relate to which of the following primary symptoms of ADHD?

A) impulsivity
B) inattention
C) hyperactivity
D) sluggish cognitive tempo

Question 40

You and your 6-year-old cousin are playing a game where he runs around and tickles you.Then,his mother calls that it's time for dinner.Your cousin wants to keep playing the game.Despite repeated reminders to sit in his chair and eat dinner,he keeps running around.Your cousin's behavior may be related to challenges in what brain region or system?

A) the behavioral inhibition system (BIS)
B) the behavioral activation system (BAS)
C) the default mode network
D) the motor cortex

Question 41

Which of the following is typically a way in which clinicians help teachers change the environment of a child with ADHD with respect to report cards?

A) Clinicians recommend not using report cards until children's treatment is underway.
B) Clinicians encourage the use of only a single report card at the end of the year, to remove the stress of multiple assessments.
C) Clinicians recommend teachers keep daily report cards of children's appropriate behavior.
D) Clinicians recommend teachers provide weekly reports to the parent and the principal to determine whether or not the child should remain in school.

Question 42

Comorbidity in those with ADHD ______.

A) is relatively uncommon for females.
B) is especially common among youths referred to mental health clinics
C) typically involves eating disorders
D) typically involves communication disorders

Question 43

Which is true of communication training for ADHD?

A) It is typically used as the sole therapy for parent-adolescent dyads, when the adolescent has ADHD.
B) It is an effective additional therapy to parent training alone for parents and their adolescents with ADHD.
C) It is not only ineffective, but can worsen family disputes.
D) It allows adolescents to better express their feelings, which has been linked to a decrease in impulsive behaviors.

Question 44

Which of the following is a benefit of using an SNRI instead of a psychostimulant to treat ADHD?

A) SNRIs are more effective.
B) SNRIs produce positive effects more quickly.
C) SNRIs affect more neurological systems.
D) SNRIS have lower potential for misuse.

Question 45

The Multimodal Treatment Study of Children with ADHD showed a modest additional benefit of behavioral therapy when combined with medication.

Question 46

It is possible to be diagnosed with ADHD,even if one has no hyperactive symptoms.

Question 47

Which of the following is NOT a difference between different psychostimulants?

A) method of action
B) binding location
C) method of delivery
D) intended effects

Question 48

Children with ADHD often seem to be focused on the here and now,rather than thinking about past experiences or future goals or consequences.This indicates an impairment in which executive function?

A) working memory
B) internalized speech
C) emotion regulation
D) creative problem solving

Question 49

As discussed in the textbook,direct contingency management has been shown to result in all of the following EXCEPT ______.

A) increasing attention
B) increasing appropriate social behavior
C) reducing disruptive behavior and aggression
D) reducing obedience latency (time to obey a command)

Question 50

Molly has ADHD.Her therapist has just started working with Molly's mom.Which of the following is most likely?

A) The therapist is likely teaching Molly's mom how to discourage undesirable behaviors.
B) The therapist is likely teaching Molly's mom to administer consistent discipline.
C) The therapist is likely teaching Molly's mom to use a token economy.
D) The therapist is likely teaching Molly's mom to reinforce Molly's positive behaviors and obedience.

Question 51

The most commonly prescribed medications for ADHD fall into which two broad classes?

A) psychostimulants and antidepressants
B) psychostimulants and amphetamine
C) psychostimulants and methylphenidate
D) amphetamine and methylphenidate

Question 52

What is the unique aspect of behavioral classroom management?

A) It uses direct reinforcement.
B) It uses delayed reinforcement.
C) It is administered at school.
D) It is administered at a younger age than any other intervention.

Question 53

It seems that there is a bidirectional association between sleep and ADHD.

Question 54

The results of meta-analysis examining the effectiveness of medications to treat ADHD have indicated which of the following?

A) Placebos are as effective as stimulants.
B) For most children, if one stimulant is not effective, no other stimulants will be effective either.
C) Stimulants had larger effects than other ADHD medications.
D) The effects of stimulant medications differed for males and females.

Question 55

Recent research has confirmed that children who take stimulant medications are at increased risk of cardiac events.

Question 56

Which of the following best describes the difference in mechanism of action between methylphenidate and amphetamine?

A) Amphetamine works on dopamine, methylphenidate on norepinephrine.
B) Amphetamine works on norepinephrine, methylphenidate on dopamine.
C) Amphetamine increases the release of dopamine from presynaptic vesicles; methylphenidate slows the dopamine transporter system that removes dopamine from the synaptic cleft.
D) Methylphenidate increases the release of dopamine from presynaptic vesicles; amphetamine slows the dopamine transporter system that removes dopamine from the synaptic cleft.

Question 57

How is response cost implemented in the Summer Treatment Program for ADHD?

A) Counselors don't talk to campers until an inappropriate behavior is replaced by the appropriate behavior.
B) Counselors remove campers' ability to call home when they engage in inappropriate behaviors.
C) Counselors take away tokens or deduct points when campers engage in inappropriate behaviors.
D) To foster interdependence, counselors take away tokens or deduct points from the entire team when one member engages in misbehavior.

Question 58

Which of the following is NOT a component of the Summer Treatment Program for ADHD?

A) group therapy for parents
B) direct contingency management
C) academic instruction
D) social skills training

Question 59

The results of the Preschool ADHD Treatment Study (PATS)indicated which of the following?

A) Low doses of methylphenidate were most effective in treating ADHD.
B) Stimulants are not effective for treating preschoolers with ADHD.
C) Almost all preschoolers experienced complete remission of symptoms when treated with stimulants for ADHD.
D) Most children who took medication did not experience complete symptom remission and many experienced significant side effects.

Question 60

The majority of children whose parents participate in parent training no longer meet diagnostic criteria for ADHD.

Question 61

Describe the evidence that sluggish cognitive tempo is a distinct disorder from ADHD.

Question 62

Blurting out answers is an example of a hyperactive symptom.

Question 63

Most individuals with ADHD receive the recommended first-line treatment.

Question 64

What is the evidence that the dopamine system is involved in ADHD?

Question 65

What do you think might account for the finding that community care was the least effective of all treatment conditions in the MTA study?

Question 66

What are the benefits and drawbacks of adding behavioral therapy to a medication regimen for kids with ADHD?

Question 67

Why might the prevalence rate of the predominantly inattentive presentation of ADHD be higher in the community than in clinic populations?

Question 68

Why might kids with ADHD be able to watch TV for hours but not be able to focus on a writing assignment for more than a few minutes?

Question 69

Your neighbor tells you her 6-year-old son has ADHD,combined presentation,and he's being rejected by peers.She's considering putting him on medication,in part to improve his peer relationships.What does the research have to say about this?

Question 70

Would psychostimulants create any effect for those without ADHD? Why or why not?

Question 71

Describe at least three reasons parents may not wish to use medications to treat their children with ADHD.