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A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/impulsive and combined subtypes

Published online by Cambridge University Press:  07 September 2005

Terje Sagvolden*
Affiliation:
Department of Physiology, University of Oslo, NO-0317Oslo, Norwayhttp://folk.uio.no/terjesa/
Espen Borgå Johansen*
Affiliation:
Department of Physiology, University of Oslo, NO-0317Oslo, Norwayhttp://folk.uio.no/terjesa/
Heidi Aase*
Affiliation:
Norwegian Centre for the Studies of Behavioural Problems and Innovative Practice, Ltd., University of Oslo, NO-0118Oslo, Norway
Vivienne Ann Russell*
Affiliation:
Department of Human Biology, University of Cape Town, ZA-7925South Africahttp://www.uct.ac.za/

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is currently defined as a cognitive/behavioral developmental disorder where all clinical criteria are behavioral. Inattentiveness, overactivity, and impulsiveness are presently regarded as the main clinical symptoms. The dynamic developmental behavioral theory is based on the hypothesis that altered dopaminergic function plays a pivotal role by failing to modulate nondopaminergic (primarily glutamate and GABA) signal transmission appropriately. A hypofunctioning mesolimbic dopamine branch produces altered reinforcement of behavior and deficient extinction of previously reinforced behavior. This gives rise to delay aversion, development of hyperactivity in novel situations, impulsiveness, deficient sustained attention, increased behavioral variability, and failure to “inhibit” responses (“disinhibition”).

A hypofunctioning mesocortical dopamine branch will cause attention response deficiencies (deficient orienting responses, impaired saccadic eye movements, and poorer attention responses toward a target) and poor behavioral planning (poor executive functions). A hypofunctioning nigrostriatal dopamine branch will cause impaired modulation of motor functions and deficient nondeclarative habit learning and memory. These impairments will give rise to apparent developmental delay, clumsiness, neurological “soft signs,” and a “failure to inhibit” responses when quick reactions are required.

A hypofunctioning mesocortical dopamine branch will cause attention response deficiencies (deficient orienting responses, impaired saccadic eye movements, and poorer attention responses toward a target) and poor behavioral planning (poor executive functions). A hypofunctioning nigrostriatal dopamine branch will cause impaired modulation of motor functions and deficient nondeclarative habit learning and memory. These impairments will give rise to apparent developmental delay, clumsiness, neurological “soft signs,” and a “failure to inhibit” responses when quick reactions are required.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2005

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