To date no single factor has been identified as the cause of ADHD. Rather, as is the case for other psychopathologies (e.g., schizophrenia, autism, PTSD, bipolar disorder), ADHD is thought to be the result of complex interactions between genetic, environmental, and neurobiological factors (Kieling, Goncalves, Tannock, & Castellanos, 2008; Mick & Faraon, 2008; Shastry, 2004; Spencer, Biederman, Wilens, & Farone, 2002). Specifically, it appears that the genetic and environmental etiologies of ADHD lead to the neurobiological differences, which in turn manifest as ADHD symptoms (Biederman & Faraone, 2002). These hypothetical relationships are illustrated in Fig. 2.1, which suggests that genetic and neurobiological variables appear to be the greatest contributors to ADHD symptoms (Barkley, 2006). Further, it is clear that environmental variables play a less significant role in the development of most cases of ADHD and it is not known if environmental insults are required for ADHD to emerge (Das Banerjee, Middleton, & Faraone, 2007). To the extent they are involved it seems likely that they contribute to ADHD symptoms by interacting with genetic predispositions. However, in a few cases (i.e., significant neurological injury) ADHD can arise without genetic predisposition (Max et al., 2005a, 2005b). While psychosocial factors do not appear to cause ADHD per se, they clearly have the potential to effect symptom expression (Barkley, 2006).
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Brock, S.E., Jimerson, S.R., Hansen, R.L. (2009). Causes. In: Identifying, Assessing, and Treating ADHD at School. Developmental Psychopathology at School. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-0501-7_2
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