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Autonomic Nervous System Functioning in ADHD

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Clinical Handbook of ADHD Assessment and Treatment Across the Lifespan

Part of the book series: Autism and Child Psychopathology Series ((ACPS))

Abstract

In this chapter, we introduce the autonomic nervous system (ANS), discuss the mechanisms underlying arousal regulation in humans, and present theoretical frameworks suggesting that altered autonomic functioning is likely to contribute to behavioral, cognitive, and emotional difficulties experienced by people with attention deficit/hyperactivity disorder (ADHD). The reviewed evidence in this chapter suggests that autonomic hypofunctioning and difficulties in regulating arousal according to situational demands may cause inattention, restlessness, reduced vigilance and cognitive difficulties (especially during monotonous and unrewarding activities), and emotional dysregulation and irritability in people with ADHD. Although the chapter is specifically focused on ADHD, we also provide the reader with an overview of the literature investigating autonomic dysfunction in psychiatric or psychological conditions that often co-occur with ADHD, including oppositional defiant disorder and conduct disorder, mood disorder, and autism spectrum disorder. We discuss the effects of pharmacological and nonpharmacological interventions for ADHD on autonomic functioning, and we propose that ADHD medication and some nonpharmacological interventions may be effective in reducing inattention and hyperactivity, and improving global functioning in people with ADHD, because they normalize activity of the ANS and improve arousal regulation. The concluding sections include a brief discussion about the possible implications of the findings presented in this chapter for clinical and research practice. Specifically, we stress the importance of clarifying, in future research, the role of altered autonomic functioning in ADHD, which could prove helpful for developing more efficient and valid assessment and intervention tools for people with this neurodevelopmental condition.

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Notes

  1. 1.

    Aware of the debate on the use of ‘person-first’ or ‘identity-first’ language to refer to people who received a diagnosis of autism spectrum disorder, we decided to use ‘autistic people’ since this is what the majority of a sample of autistic adults, family members or friends and parents of an autistic person have reported to prefer in an online survey conducted in the United Kingdom (Kenny et al., 2015). We are also aware though that this may not be the case for other countries.

Abbreviations

ACC:

Anterior Cingulate Cortex

ADHD:

Attention Deficit/Hyperactivity Disorder

ANS:

Autonomic Nervous System

CD:

Conduct Disorder

CI:

Confidence Interval

CNS:

Central Nervous System

CSI:

Cardiac Sympathetic Index

CVI:

Cardiac Vagal Index

EDA:

Electrodermal Activity

EEG:

Electroencephalography

ENS:

Enteric Nervous System

fMRI:

Functional Magnetic Resonance Imaging

HF-HRV:

High-Frequency component of Heart Rate Variability

HR:

Heart Rate

HRV:

Heart Rate Variability

LC:

Locus Coeruleus

LC-NE:

Locus Coeruleus-Norepinephrine

LF-HRV:

Low-Frequency component of Heart Rate Variability

NE:

Norepinephrine

ODD:

Oppositional Defiant Disorder

OFC:

Orbitofrontal Cortex

OR:

Odds Ratio

PEP:

Pre-Ejection Period

PFC:

Pre-Frontal Cortex

PNS:

Parasympathetic Nervous System

rMSSD:

Square Root of the Mean of Successive Differences Between Inter-beat Intervals

RSA:

Respiratory Sinus Arrhythmia

SCT:

Sluggish-Cognitive Tempo

SNS:

Sympathetic Nervous System

SRD:

State Regulation Deficit

vmPFC:

Ventro-Medial Pre-Frontal Cortex

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Authors and Affiliations

  1. School of Psychology, University of Nottingham Malaysia, Semenyih, Selangor, Malaysia

    Alessio Bellato

  2. Ghent University, Ghent, Belgium

    Jan R. Wiersema

  3. Academic Unit of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK

    Madeleine J. Groom

  4. Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, Nottingham, UK

    Madeleine J. Groom

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    Johnny L. Matson

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Bellato, A., Wiersema, J.R., Groom, M.J. (2023). Autonomic Nervous System Functioning in ADHD. In: Matson, J.L. (eds) Clinical Handbook of ADHD Assessment and Treatment Across the Lifespan. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-031-41709-2_3

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