
Contents
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Key Points Key Points
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Introduction Introduction
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What Is ADHD? What Is ADHD?
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Diagnostic Approaches Diagnostic Approaches
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Historical Roots Historical Roots
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Current Diagnostic Approaches Current Diagnostic Approaches
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Alternative Models and Future Directions Alternative Models and Future Directions
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ADHD as a Mental Disorder ADHD as a Mental Disorder
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Does the ADHD Syndrome Have Validity? Does the ADHD Syndrome Have Validity?
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What Sort of Mental Disorder Syndrome Is ADHD—Category or Dimension? What Sort of Mental Disorder Syndrome Is ADHD—Category or Dimension?
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The Challenge of Comorbidity and Heterogeneity The Challenge of Comorbidity and Heterogeneity
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Comorbidity Comorbidity
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Heterogeneity Heterogeneity
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What Causes ADHD? What Causes ADHD?
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Etiology Etiology
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Genetic Factors Genetic Factors
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Environmental Factors Environmental Factors
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Interaction Between Genetic and Environmental Factors Interaction Between Genetic and Environmental Factors
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Pathophysiology Pathophysiology
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Brain Structure Brain Structure
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Neurochemistry Neurochemistry
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Brain Function and Neuropsychology Brain Function and Neuropsychology
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Cognitive Deficits Cognitive Deficits
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The State-Dependent and Dynamic Nature of Impairment in ADHD The State-Dependent and Dynamic Nature of Impairment in ADHD
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From a Single Core to Multiple Deficit Models From a Single Core to Multiple Deficit Models
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Developmental Considerations Developmental Considerations
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The Development of ADHD Across the Lifespan The Development of ADHD Across the Lifespan
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Developmental Continuities and Discontinuities in the Clinical Phenotype Developmental Continuities and Discontinuities in the Clinical Phenotype
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Age-Related Changes Taken by the Clinical Phenotype Age-Related Changes Taken by the Clinical Phenotype
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Developmental Continuities and Age-Related Changes in the ADHD Endophenotype Developmental Continuities and Age-Related Changes in the ADHD Endophenotype
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Toward a Developmental Synthesis of Research on the Causes and Course of ADHD Toward a Developmental Synthesis of Research on the Causes and Course of ADHD
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Nosological and Diagnostic Implications Nosological and Diagnostic Implications
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Future Directions Future Directions
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Conclusion Conclusion
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Questions for Future Research Questions for Future Research
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References References
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22 Attention-Deficit/Hyperactivity Disorder: Toward a Developmental Synthesis
Get accessEdmund J. S. Sonuga-Barke, Institute for Disorders of Impulse and Attention, Developmental Brain Behaviour Laboratory, University of Southampton, Southampton, UK; Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
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Published:16 December 2013
Cite
Abstract
In this chapter I review the literature on attention-deficit/hyperactivity disorder (ADHD) with the aim of providing a developmental synthesis. In the first section I ask: What is ADHD? I conclude that it is a relatively broad construct that, although having validity as a mental disorder dimension and utility as diagnostic category, is frequently comorbid with, but can be distinguished from, other disorders, and is highly heterogeneous. In the second section I ask: What causes ADHD? I conclude that ADHD has a complex set of causes implicating multiple genetic and environmental risks (and their interaction) reflected in alterations in diverse brain systems. The causal structure of ADHD is heterogeneous, with different children displaying different etiological and pathophysiological profiles. In the third section I reflect on developmental considerations. I conclude that ADHD-type problems present in different forms throughout the lifespan from the preschool period to adulthood and that existing data suggest patterns of continuity and discontinuity that support a lifespan perspective both at the level of clinical phenotype and underlying pathophysiology. In the light of this I argue for a developmental reconceptualization of the disorder, grounded in a biopsychosocial framework that would allow the complexity and heterogeneity of the condition to be understood in terms of risk, resilience, and protective factors, as well as mediating and moderating processes. I review the implications of the developmental perspective for nosological and diagnostic formulations of the condition. In the last section I set out priorities for future research in the genetics, imaging, neuropsychology, and treatment of the condition.
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