This is one reason for why the use of ADHD “subtypes” has been abandoned for the term “predominant presentation” (Roberts et al., 2015). The latter because the predominating presentation may change over time. The former because individual presentations of ADHD are highly heterogenous (Wåhlstedt et al., 2009). The condition is at once resistant to classification by a single persistent characteristic and by multiple subtypes. ADHD as an Executive Function Deficit Disorderĭespite a vast body of research, the delineation of a neural basis for ADHD is beset by several difficulties. In accordance with these characteristics, ADHD has been correlated with a wide array of personal, social, academic, and occupational problems across all age groups (Aduen et al., 2018 see also Barkley, 2015b Bernfort et al., 2008 Brandt & Fischer, 2017 Loe & Feldman, 2007). The main characteristics of ADHD are persistent and maturationally inconsistent patterns of inattention and/or hyperactivity disruptive of social and vocational activities (American Psychiatric Association, 2013, p. It ranges among the most common and most studied neurodevelopmental disorders in children, adolescents, and adults alike (Barkley, 2015a). Rather, talk of deficit and pathology in ADHD must take account of the mismatches occurring in situations constituted across individuals and their socio-cultural context.ĪDHD is a universal condition whose prevalence in all measured populations vary between an average 5–7% in children and 3–5% in adults with geographical variation likely resulting from methodological differences (Polanczyk et al., 2007). This is by no means to render challenges for individuals with ADHD inconsequential. In other words, the neural basis of ADHD is not sufficient for pathology or deficit. This heightened connectivity does, however, not warrant talk of any straightforward intrapersonal functional deficit. It will be argued that what can be measured as executive function deficits in ADHD arises from a heightened connectivity in the inherent temporal organization of brain. A downstream result will be both a deeper understanding of ADHD and of executive function. This will serve to provide a theoretical basis for understanding ADHD in its executive functional aspect without reducing the whole of ADHD to explicit manifestations of behavioral deficit. It therefore seeks to integrate the manifestation of the executive functions with the inherent temporal structure of the brain. In other words, it seeks to understand executive function deficits in ADHD as just one expression of a less straightforwardly pathological phenomenon. The goal of this paper is to remedy the discontinuity between ADHD as understood through its executive functional profile and its general neural profile. The error is not the recognition of a neural component but mistaking this for a full picture. But neither is the intention to rule out a role for executive functioning in characterizing a neurological component of ADHD. Indeed, it will be shown that conceptualizing ADHD in terms of executive function deficits is inadequate-even from a neurological perspective. Despite the deliberately neurological focus of this paper, an implication will be precisely that the pathological status of ADHD cannot be attributed to individual brain function but must be outlined in terms of broader socio-cultural interactions. Alternatives instead appeal to the responsibility of institutions in producing or preventing challenges for people with neurodevelopmental conditions. Medical model approaches interpret normative divergencies in terms of internally pathological deficits. The analyses provided suggest that executive functional deficits in ADHD arise from much broader idiosyncrasies, rooted within the inherent diachronic organization of neurocognitive function, and whose challenges must be understood in conjunction with socio cultural environmental factors.Ī more general criticism has been raised against the application of medical model approaches to neurodevelopmental conditions including ADHD (Bertilsdotter Rosqvist et al., 2020). Analysis of the temporal signature of ADHD provides a potential avenue for integrating different profiles by means of anchoring executive functions within inherent diachronic neurocognitive organization. ResultsĬomparative analyses suggest disparities within executive functional deficit disorder models and discontinuities between executive functional and structural profiles of ADHD. This was followed by an analysis of the temporal profile of ADHD and phase synchronous neural assemblies. MethodsĬomparative theoretical analyses between executive functional deficit disorder models of ADHD and results from default mode network fMRI data. The purpose of this theoretical analysis of current research on ADHD is to provide an account integrating executive functional profiles with its broader structural neurodevelopmental profile.
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