ADHD is genetic
ADHD / Attention Deficit Hyperactivity Disorder
Metabolic and functional disorders in the brain
The scientifically based explanatory model for the development of ADHD is based on incorrect information processing between certain brain sections, which are responsible for concentration, perception and impulse control. This disorder is in turn caused by an imbalance in the messenger substances (neurotransmitters) in these areas of the brain - especially dopamine and noradrenaline - which play an important role in the transmission of signals from one nerve cell to another. It is assumed, among other things, that in ADHD patients there is not enough dopamine available in the space between two nerve cells, the so-called synaptic gap. The undersupply of this messenger substance leads to a disturbed transmission of information between the nerve cells. Stimuli are only badly and inadequately filtered. This does not prevent the occurrence of new thoughts, with the result that started thoughts cannot be thought through to the end.
With modern imaging methods such as positron emission tomography (PET), which enables the metabolic processes of the brain to be displayed, and single-photon emission computed tomography (SPECT), functional disorders in individual brain sections (basal ganglia and frontal lobe) in ADHD patients ) as well as changes in the "brain architecture" are made visible. In this way it was found that, for example, the anterior lobe of the brain, i.e. the frontal lobe, is smaller in ADHD children and the altered areas of the brain consume less oxygen and glucose than in healthy children.
Permanent overstimulation - disturbed reaction inhibition
Because of the metabolic and functional disorders in their brain, people with ADHD cannot filter the constant new impulses enough, so that information processing is hindered. They are subject to permanent overstimulation. Those affected are therefore only able to concentrate their attention on one thing to a limited extent; they suffer from impaired self-regulation. At the same time, access to existing skills and information is restricted, making it difficult to plan ahead. You can hardly differentiate between important and unimportant perceptions. Since all impressions collapse on them unfiltered, they are constantly under great tension.
A genetic predisposition leads to this neurobiological disorder, as 10 to 15% of the immediate family members of children with ADHD are also affected. Twin studies show that a good 80% of monozygotic and almost 30% of dizygotic have the same symptoms. More recent research results even assume that almost 80% of all ADHD diseases are hereditary.
Several altered genes (polygenic inheritance), which on their own hardly cause any disturbances, are, however, together responsible for the incorrect transmission of information in the brain. This then also explains the broad spectrum of possible accompanying disorders (comorbidity) such as learning deficits or emotional disorders as well as the different responses to the medication.
"Bad upbringing" or "negative childhood experiences" can be ruled out as the actual causes of ADHD. However, unfavorable family relationships can additionally burden the affected children in their personal development and affect the severity, the course of the disease and the development of accompanying disorders (eg aggressiveness, fear) The so-called psychosocial risk factors include, for example:
- Incomplete family, i.e. growing up with a single parent or without parents
- Parent mental illness, particularly father's antisocial personality disorder and family history of alcohol use
- family instability, constant quarrel between parents
- low family income, very cramped living conditions
- Inconsistent upbringing, lack of rules
- frequent criticism and punishment
- unstructured daily routine
Lower intelligence and the child's personality, which is largely due to the unfavorable family circumstances, such as poor social integration and a negative self-image, also play a role in the development of ADHD.
Risk factors in the womb
Nicotine, alcohol, or other drugs during pregnancy, as well as prematurity or a lack of oxygen at birth, increase the child's risk of developing ADHD later.
Some experts suspect that the development of ADHD is also adversely affected by today's modern lifestyle. Instead of walking to school and playing outside every day, the children are brought to school by bus or by their parents, and mostly games are played inside and all too often on the PC. Physical activity, visual and acoustic perception from nature and real "grasping" with the hands take place less and less. The urge to move, excessive energy and curiosity can hardly be lived out. Less authority on the part of parents and teachers nowadays promotes the free development of healthy children, but harms the ADHD child, who needs clear structures, rules and regularity. Large group sizes in kindergartens and schools, which make individual care almost impossible, exacerbate the problem, as does the so-called “open kindergarten”, which hardly provides any structures. So slight behavioral problems are no longer compensated and the children become increasingly conspicuous.
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