Attention-deficit hyperactivity disorder risk factors: Difference between revisions

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{{CMG}}; {{AE}} {{KS}}, {{HW}}


{{ADHD}}
==Overview==
==Overview==
Several factors have been implicated in possibly leading to an increased risk of ADHD. Some factors occur in utero, such as tobacco and alcohol exposure, while other possible factors are traumatic head injuries, and social maladjustment.
Common risk factors in the development of attention-deficit hyperactivity disorder (ADHD) are [[child abuse]], [[infections]] of the [[central nervous system]], [[epilepsy]], and [[traumatic brain injury]].


==Risk Factors==
==Risk Factors==
Common risk factors in the development of ADHD are:<ref name= DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref><ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref>
*[[Alcohol]] exposure in utero
*[[Brain injury]]
*[[Child abuse]]
*[[Epilepsy]]
*First-degree biological relative of individuals with ADHD
*Genetic predilection
*[[Infections]] of the [[central nervous system]] (e.g., [[encephalitis]])
*[[Low birth weight]] (less than 1,500 grams)
*Male gender
*Metabolic abnormalities
*Multiple foster placements
*Neglect
*[[Neurotoxin]] exposure in utero or during youth (e.g., lead)
*[[Nutritional deficiencies]]
*Pessimistic outlook
*Reduced behavioral inhibition
*[[Sleep disorders]]
*[[Smoking]] during pregnancy
*Visual and hearing impairments


===Non-Genetic Factors===
==References==
The estimated contribution of non genetic factors to the contribution of all cases of ADHD is 20 percent.<ref>{{PDFlink|1=[http://www.schwablearning.org/pdfs/2200_7-barktran.pdf?date=4-12-05 Barkley presentaiton.]|2=779&nbsp;[[Kibibyte|KiB]]<!-- application/pdf, 798631 bytes -->}} SchwabLearning.org.</ref> The environmental factors implicated are common exposures and include alcohol, ''in utero'' tobacco smoke and lead exposure. Lead concentration below the [[Center for Disease Control]]'s [[action level]] account for slightly more cases of ADHD than tobacco smoke (290 000 versus 270 000, in the USA, ages 4 to 15).<ref name="pmid17185283">{{cite journal |author=Braun JM, Kahn RS, Froehlich T, Auinger P, Lanphear BP |title=Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children |journal=Environ. Health Perspect. |volume=114 |issue=12 |pages=1904–9 |year=2006 |pmid=17185283}}: "''Compared with the lowest quintile of blood lead levels, children with blood lead levels > 2.0 µg/dL were at a '''4.1-fold increased risk of ADHD'''. When we limited the analysis to children with blood lead levels ≤ 5 µg/dL, the association between increased blood lead levels and ADHD remained. These results are consistent with previous reports that have found significant associations between blood or dentin lead levels and behavior problems .... Our results further indicate that blood lead levels below the CDC action level of 10 µg/dL are associated with an increased risk for ADHD in children. This result is consistent with previous studies that have found cognitive deficits in children with blood lead levels < 10 µg/dL.''"</ref> Complications during pregnancy and birth&mdash;including [[premature birth]]&mdash;might also play a role. It has been observed that women who smoke while pregnant are more likely to have children with ADHD.<ref>Kotimaa AJ, Moilanen I, Taanila A, et al. ,"Maternal smoking and hyperactivity in 8-year-old children". 2003,  ''J Am Acad Child Adol Psychiatry'' Jul;42(7):826–33. PMID 12819442</ref>  This could be related to the fact that nicotine is known to cause [[Hypoxia (medical)|hypoxia]] (lack of oxygen) ''in utero'', but it could also be that ADHD women have more probabilities to smoke both in general and during pregnancy, being more likely to have children with ADHD due to genetic factors.
{{Reflist|2}}


===Head Injuries===
{{WH}}
Head injuries can cause a person to present ADHD-like symptoms,<ref>McAvinue L, O'Keeffe F, McMackin D, Robertson IH, et al. "Impaired sustained attention and error awareness in traumatic brain injury: implications for insight"  ''Neuropsychological Rehabilitation''. 2005 Dec;15(5):569–87. PMID 16381141</ref> possibly because of damage done to the patient's frontal lobes. Because these types of symptoms can be attributable to brain damage, one earlier designation for ADHD was "Minimal Brain Damage".<ref>[http://www.add.org/articles/causeadd.html What Causes ADD.] Attention Deficit Disorder Association. Retrieved on 2007-08-13.</ref>
{{WS}}


===Social Causes===
There is no compelling evidence that social factors alone can create ADHD.<ref name="BarkleyContEd"/> Many researchers believe that attachments and relationships with caregivers and other features of a child's environment have profound effects on attentional and self-regulatory capacities. It is noteworthy that a study of foster children found that an inordinate number of them had symptoms closely resembling ADHD.<ref>{{PDFlink|[http://www.vera.org/publication_pdf/169_280.pdf What Keeps Children in Foster Care from Succeeding in School.]|661&nbsp;KiB<!-- application/pdf, 677488 bytes -->}}</ref> An editorial in a special edition of [[Clinical Psychology]] in 2004 stated that "our impression from spending time with young people, their families and indeed colleagues from other disciplines is that a medical diagnosis and medication is not enough. In our clinical experience, without exception, we are finding that the same conduct typically labelled ADHD is shown by children in the context of violence and abuse, impaired parental attachments and other experiences of emotional trauma."<ref>Adam James (2004) [http://www.psychminded.co.uk/news/news2004/august04/Clinical%20psychology%20publishes%20critique%20of%20ADHD%20diagnosis%20and%20use%20of%20medication%20on%20children.htm  ''Clinical psychology publishes critique of ADHD diagnosis and use of medication on children''] published on Psychminded.co.uk Psychminded Ltd</ref> Furthermore, [[Complex Post Traumatic Stress Disorder]] can result in attention problems that can look like ADHD, as can [[Sensory Integration Dysfunction|Sensory Integration Disorders]].


==References==
[[Category:Psychiatry]]
{{Reflist|2}}
[[Category:Pediatrics]]

Latest revision as of 15:10, 14 January 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2], Haleigh Williams, B.S.

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Overview

Common risk factors in the development of attention-deficit hyperactivity disorder (ADHD) are child abuse, infections of the central nervous system, epilepsy, and traumatic brain injury.

Risk Factors

Common risk factors in the development of ADHD are:[1][2]

References

  1. ↑ Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
  2. ↑ National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."

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