Commentary: ADHD and social disadvantage: an inconvenient truth? --a reflection on Russell et al. () and Larsson et al. ().
In the 1950's, many experts believed hyperkinesis was a neurotic reaction to inner conflicts arising from early family experiences. In the 1990's, many experts believed ADHD to be 'genetic' (without a mechanistic explanation of what that meant). Both views appear naïve today in a scientific world grappling with the complexity of highly plastic gene expression, gene x environment interplay, and epigenetic, context-dependent emergence of psychopathology. Both views also fail to account for the uncomfortable fact that ADHD is also associated with social disadvantage - a level of analysis required in a developmental psychopathology approach. That developmental psychopathology approach, pioneered a generation ago, initially emphasized the accumulation of risk and protective factors, and emerged in a contemporary systemic approach that seeks to determine whether it is risk accumulation (e.g., allostatic load) or specific risk factors (e.g., family process) that mechanistically shape psychopathology. Despite the prominence of the developmental psychopathology perspective, the social context of ADHD is surprisingly neglected today. Both Russell et al. (this issue, 2014) and Larsson et al. (this issue, 2014) take strides toward remedying this state of affairs.
Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.
Joel T
JT
Nigg
Lindsay
L
Craver
D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data*
ADHD; epigtenetics; social disadvantage