Week 5
ADHD is a neurodevelopmental disorder characterized by developmentally inappropriate levels
of inattention, disorganization, hyperactivity, and impulsivity (Children and Adults with
Attention-Deficit/Hyperactivity Disorder
Without early identification and proper treatment, ADHD can cause disruptions in academic
performance, family stress, difficulties in social relationships, and accidental injuries.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) (American Psychiatric
Association [APA], 2022) identifies three clinical presentations of ADHD based on symptom
profiles: predominately inattentive presentation, predominantly hyperactive-impulsive
presentation, and combined presentation.
To make an informed diagnosis, it is essential to gather data from multiple sources, including the
client, parents, and teachers of children and adolescents. Screening tools are available to assist
in diagnosis.
Over two-thirds of children diagnosed with ADHD have at least one coexisting psychiatric
condition (CHADD, n.d.). Common co-occurring conditions include learning disabilities, conduct
disorders, tics, anxiety, depression, and language disorders; adolescents are at increased risk of
substance use disorders (CHADD, n.d.).
Medication options for the treatment of ADHD include both stimulant and non-stimulant
medications (Buckstein, 2021). Stimulant medications are effective for 70-80% of clients with
ADHD and are typically the medications of choice for children (Centers for Disease Control and
Prevention ).
Several stimulant medications are classified as Schedule II medications indicating that they have
a high potential for abuse. The psychiatric mental health nurse practitioner (PMHNP) must
adhere to federal and state-specific guidelines for prescribing these medications.
Psychotherapeutic interventions for ADHD may include cognitive-behavioral therapy (CBT),
social and organizational skill training, and family therapy.
Disruptive, impulse-control, and conduct disorders (also called DBDs) are a group of disorders
that involve problems with emotional and behavioral regulation.
The hallmark characteristics of oppositional defiant disorder (ODD) include persistent angry and
irritable mood, argumentative and defiant behavior, and vindictiveness
Conduct disorder is characterized by severe behaviors that violate societal norms or the rights
of others and may involve aggression towards others, animals, theft, and/or the destruction of
property.
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The essential features of intermittent explosive disorder are frequent impulsive or anger
outbursts that often include temper tantrums, verbal assaults, or physical assaults towards
others, animals, or property.
Treatment for DBDs usually consists of a combination of the following interventions based on
the unique needs of the individual and family.
FASD is an umbrella of terms that describes the physical, mental, behavioral, and/or learning
disabilities that can occur in an individual who was prenatally exposed to alcohol.
FASD is a lifelong disability that may require support from a variety of disciplines based on the
degree of impairment.
There is no specific test for FASD. Because symptoms resemble those of other diagnoses such as
ADHD, ODD, or conduct disorder, children may be misdiagnosed leading to delays in appropriate
treatment. Diagnosis is based on confirmation of maternal alcohol consumption.
FASD treatment is based on the severity of symptoms and developmental impact. Prognosis is
best if children receive a diagnosis and begin treatment before the age of six
Week 6
Anorexia nervosa is an eating disorder characterized by restrictive eating patterns, extremely
low body weight, and an intense fear of gaining weight
The weight loss and malnutrition caused by anorexia nervosa can lead to medical complications
that impact most major organ systems (Mehler, 2021).
Bulimia nervosa is characterized by recurrent episodes of eating unusually large amounts of
food paired with a feeling of lack of control of eating behaviors. To compensate for overeating,
individuals with bulimia nervosa engage in behaviors to prevent weight gain, including self-
induced vomiting, excessive use of laxatives or diuretics, excessive exercise, fasting, or a
combination of these behaviors
Like anorexia nervosa, bulimia nervosa is associated with multiple medical complications that
can impact almost all parts of the body.
Binge eating disorder (BED) entails recurrent episodes of binge eating, along with distress or
secrecy about eating or eating when not hungry.
Pica disorder is characterized by the persistent ingestion of nonfood items that do not contain
nutritional value for at least one month.
Untreated, pica can cause intestinal obstruction, poisoning, and other medical emergencies.
Pica can be fatal depending on the substances ingested.