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The Deep Mystery of Executive Function: What ADHD Reveals About How Our Minds Work
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by impaired executive functioning, along with symptoms of inattention, hyperactivity, impulsivity, and mood lability. The symptoms are often excessive and pervasive, affecting a wide range of situations and are developmentally inappropriate. The symptoms of ADHD stem from impairment of executive function, and emotional instability is often considered one of its core symptoms.
Deficits in self-regulation, such as deficits in time management, inhibition, and sustained attention, can lead to poor work performance, relationship difficulties, and multiple health risks, which collectively predict a reduced quality of life and directly contribute to The average life expectancy is shortened by about 13 years.
ADHD causes hundreds of billions of dollars in economic losses worldwide each year. The disorder is closely related to other neurodevelopmental and psychiatric disorders, as well as non-psychiatric illnesses, which can lead to additional functional impairment. While people with ADHD often have difficulty initiating work or persisting on delayed tasks, these problems may be less noticeable in situations they find intrinsically interesting and immediately rewarding, which can involve "hyperfocusing" or obsessive responding. This mental state is often difficult to escape and is associated with Internet addiction and certain risks of illegal behavior.
ADHD symptoms and manifestations
Common symptoms of ADHD include inattention, hyperactivity (often manifesting as restlessness in adults), disruptive behavior, and impulsivity. Academic difficulties and interpersonal relationship problems are also common among people with ADHD. Diagnosing ADHD is often challenging because it is difficult to define when normal levels of inattention, hyperactivity, and impulsivity become excessive.
According to the requirements of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), symptoms must persist for more than six months and have a more significant impact on peer norms in at least two situations. exist.
The main manifestations of ADHD can be divided into three types: mainly inattention (ADHD-PI), mainly hyperactivity and impulsivity (ADHD-PH), and mixed manifestations of both (ADHD-PH). ADHD-C). Girls and women tend to show fewer symptoms of hyperactivity and impulsivity but more pronounced symptoms of inattention and distractibility. As we age, the outward manifestations of hyperactivity decrease and are replaced by inner restlessness and difficulty relaxing.
Comorbidities
Approximately two-thirds of children with ADHD also have other psychiatric problems. Autism spectrum disorder (ASD) and learning disabilities are common comorbidities, with the latter affecting approximately 20% to 30% of children with ADHD. Research shows that ADHD is not a learning disability, but it often causes academic difficulties. According to reports, approximately 25% of ADHD patients also experience oppositional defiant disorder (ODD).
ADHD is closely associated with anxiety and mood disorders, and these comorbid conditions often complicate the assessment and treatment of ADHD, particularly with regard to the risk of addictive behaviors.
ADHD may also be significantly associated with trauma and adverse childhood experiences, especially in the overlap of behavioral symptoms in clinical diagnosis and treatment, which may lead to misdiagnosis. This means that the manifestations of ADHD are not limited to attention problems. Some patients will exhibit behaviors similar to ADHD symptoms due to the influence of trauma.
Causes of ADHD
The pathogenesis of ADHD is mainly related to the dysplasia of the prefrontal executive network, which may be due to genetic or acquired factors. According to research, ADHD is 70% to 80% heritable. Additionally, environmental factors may play a role in potential risk, particularly in the prenatal or early postnatal period.
Since ADHD is highly heritable, gene variation and mutation may be the main cause of ADHD. These genes have a direct impact on brain function and neurotransmission.
In most cases, the specific cause of ADHD is unknown. However, there is some evidence that maternal smoking during pregnancy is associated with the development of ADHD. This demonstrates the multiple causes and complexity of ADHD.
SummaryADHD is a profound neurodevelopmental disorder that provides important insights into human thinking and behavior. By understanding the symptoms, manifestations, and mechanisms of ADHD, we can better appreciate the impact of executive function on an individual's life. As we delve deeper into these mysterious workings of the mind, are we also wondering where the boundary between normal and abnormal lies?
