Attention Deficit / Hyperactive Disorder (ADHD) ????????

1
Attention Deficit / Hyperactive Disorder
(ADHD)????????
2
??????/???? Attention-Deficit/Hyperactivity
Disorder?

• (1) ?6/9???????(Inattention)??,
• (2) ?6/9??????(Hyperactivity-Impulsivity)??,
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5
ADHD????

• ???
• Inattentive type ???????
• Hyperactive impulsive ?????
• Combined type ??? (12)

6
?????/???? ??????????
5.3, 102 studies, 171,756 children. Africa 8.5,
South America 11.8, Asia 4.0, Europe 4.6,
North America 6.2 Polanczyk et al. The
Worldwide Prevalence of ADHD A Systematic Review
and Metaregression Analysis. Am J Psychiatry
2007 164942948.
7
????

• ??? (2004) 7.5-3.8 in G7-9 ????
• Hou (2003) 6.4 ????
• Tzang (2002) 8.4-11.7 ????
• ??? (1998) 7.5-9 ?? ?????
• Leung (1996) 8.9 ????
• 6-9 US 5-12 y/o children, 60-80 functionally
  impairing symptoms into adolescence and 50 into
  adulthood. Pliszka 2007
• National comorbidity survey, 3199 adults (19-44)
  4.4. Kessler 2006

8
???????
9
ADHD and the Impairment of Social and Emotional
Behaviors
Strengths and Difficulties Questionnaire, based
on the 2003 National Health Information Survey,
USA, Strine et al., 2006, Preventing Chronic
disease, http//www.cdc.gov/pcd/issues/2006/apr/05
_0171.htm
10
Social and Emotional Behavioral Problems in
Children with ADHD
European survey of parents of children with ADHD
(n910) and without ADHD (N995). plt.0001 ,
(Coghill et al., Child and adolescent psychiatry
and mental health, 231,2008)
11
Emotional problems

• Low self-esteem ???
• Self-perception of incompetence ?????
• ??
• 27-30 met criteria for an anxiety disorder
  (Biderman 1991)
• 28 of preschooler, 22 of school-age children
  (Wilens 2002)
• ??
• 25-30 of children with ADHD

12
Peer relation

• More than 50 of children with ADHD have
  significant problems in peer relationship (Pelham
  1982)
• Less knowledge about
• social skills, appropriate behavior with others
  (Grenell 1987)
• More likely to be engage in
• Bullying, Victimized in bullying episode
  (Unnever 2003)
• Children with ADHD are stigmatized by their
  behavior
• Troublemaking
• Excessive talking
• Breaking rules
• Impulsive aggression
  (Barkley 1991)

13
Parent-Child relation

• ADHD affects the interaction of children with
  their parents (especially with mother)
• Greater intrafamily conflicts (Danforth et al.
  1991)
• Children with ADHD (Barkley 1985)
• More talkative, negative, and defiant
• Less compliant and cooperative
• Less able to play and work independently of their
  mother
• Mother of children with ADHD (Hoza et al. 2000)
• Low self-esteem
• Lower parenting efficacy
• Disturbance of interaction
• Stem from the effects of a childs behavior
  rather than parents behavior on the child (
  Fischer 1990)

14
Academic School performance

• Lower academic performance than their classmates
• By 10-30 points on standardized achievement test
• Including reading, spelling, math, and reading
  comprehension
• Disruptive classroom behavior
• Underperforming in school relative to ability
• Repetition of a grade (30 or more)
• Be placed in one or more special education
  programs (30-40)
• Suspended from school (up to 46)
• 
  (Barkely et al. 1990)

15
Impact of ADHD in adolescence
Data from Barkley RA26 (A) Impact at school
(B) impact on health, social, and psychiatric
wellbeing.
16
Antisocial behaviour in adolescents with ADHD
Data primarily represents outcomes in those with
conduct disorder as teenagers
Harpin, V A Arch Dis Child 200590i2-i7
17
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18
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• 4-16????????(???)
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19
?? ADHD ???

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Ingram S. Mental Retardation and Development
Disabilities Research Reviews. 19995243. Weiss
M, Jain U. ADHD Report. 200084-10.
20
?? ADHD ??????

• ?? 50 ADHD ??????????
• 50 ???????? (Oppositional Defiant Disorder)
  ??????? (Conduct Disorder)
• 40 ??
• 20 ??
• 30 ?????? (Substance Use Disorder,????, ??, ??,
  ????)
• ? 50 ADHD ????????

Biederman J et al. Am J Psychiatry.
1991148564-577. Pomerleau OF et al. J Subst
Abuse. 19957373-378.
21
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