DSSSB 12 August 2024
Mental Health Nursing
Easy
ADHD is commonly associated with:
Appeared in: DSSSB 12 August 2024
Explanation
- ADHD is a neurodevelopmental disorder linked to an imbalance or deficit in key brain chemicals called neurotransmitters.
- The primary neurotransmitters implicated are dopamine and norepinephrine, both of which are typically found at lower-than-normal levels in key brain regions like the prefrontal cortex.
- Low levels of dopamine are strongly associated with problems in the brain's reward system, leading to issues with motivation, focus, and executive functions like planning and impulse control.
- While low norepinephrine is also involved, the dopamine deficit is often considered the hallmark neurochemical imbalance in ADHD, making it the best answer.
Why Other Options Were Wrong
- Option A: While a decrease in noradrenaline is a key feature of ADHD pathophysiology affecting attention and arousal, the deficit in dopamine is often considered the primary or hallmark neurochemical imbalance, especially concerning reward and motivation symptoms.
- Option B: ADHD is characterized by a deficit, not an excess, of noradrenaline. Medications for ADHD aim to increase its levels.
- Option C: ADHD is characterized by a deficit, not an excess, of dopamine. The core pathophysiology involves insufficient dopamine signaling.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Neurochemical basis of Attention-Deficit Hyperactivity Disorder (ADHD) as background academic context rather than a clinical decision trigger.
- Understanding this neurochemical deficit is crucial for patient education and explaining why stimulant medications (e.g., methylphenidate, amphetamine) are prescribed. These drugs work by increasing the levels of dopamine and norepinephrine in the brain.
- Nurses must monitor patients on ADHD medications for side effects related to increased catecholamine levels, such as insomnia, decreased appetite, tachycardia, and anxiety.
- What if? If a patient with ADHD also has a significant anxiety disorder, a non-stimulant medication like atomoxetine, which primarily targets norepinephrine, might be considered to avoid exacerbating anxiety through a strong dopamine increase.
How to Approach the Question
- First, identify the core subject of the question: the neurochemical basis of ADHD.
- Recall that ADHD is a disorder characterized by a deficit or imbalance of neurotransmitters, not an excess. This immediately helps eliminate options suggesting 'increased' or 'high' levels (Options B and C).
- You are left with 'Decreased noradrenaline' and 'Low level of dopamine'. Both are technically correct statements about ADHD.
- Recall that while both are involved, dopamine is often highlighted as the primary neurotransmitter linked to the core symptoms of reward dysfunction and inattention. In a 'best answer' scenario, the dopamine deficit is the classic and most emphasized choice.
Concept Tested & Keywords
- Concept Tested: Neurochemical basis of Attention-Deficit Hyperactivity Disorder (ADHD)
- Stem keywords: ADHD, commonly associated with
- Lead-in keywords: commonly associated with
Question ID
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Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 12106-12108, 10126-10128
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 444-446
Practise the full DSSSB 12 August 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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