ADHD
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by symptoms of inattention, hyperactivity, impulsivity, and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and developmentally inappropriate. ADHD symptoms arise from executive dysfunction.
Impairments resulting from deficits in self-regulation such as time management, cognitive inhibition, task initiation, and sustained attention can include poor professional performance, relationship difficulties, and numerous health risks, collectively predisposing to a diminished quality of life and a reduction in life expectancy. It is associated with other mental disorders as well as non-psychiatric disorders, which can cause additional impairment.
While ADHD involves a lack of sustained attention to tasks, inhibitory deficits also can lead to difficulty interrupting an already ongoing response pattern, manifesting in the perseveration of actions despite a change in context whereby the individual intends the termination of those actions. This symptom is known colloquially as hyperfocus and is related to risks such as addiction and types of offending behaviour. ADHD can be difficult to tell apart from other conditions. ADHD represents the extreme lower end of the continuous dimensional trait (bell curve) of executive functioning and self-regulation, which is supported by twin, brain imaging and molecular genetic studies. ADHD treatment is most effective when medications (primarily stimulants like methylphenidate or amphetamines, as well as non-stimulants such as atomoxetine or alpha-2 agonists) are used, often in combination with psychotherapy; exercise and dietary modifications have no proven benefit.
The precise causes of ADHD are unknown in most individual cases. Meta-analyses have shown that the disorder is primarily genetic with a heritability rate of 70–80%, where risk factors are highly accumulative. The environmental risks are not related to social or familial factors; they exert their effects very early in life, in the prenatal or early postnatal period. However, in rare cases, ADHD can be caused by a single event including traumatic brain injury, exposure to biohazards during pregnancy, or a major genetic mutation. As it is a neurodevelopmental disorder, there is no biologically distinct adult-onset ADHD except for when ADHD occurs after traumatic brain injury.
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