Attention Deficit Hyperactive Disorder
Part One:
Attention Deficit Hyperactive Disorder (ADHD) is defined as a persistent pattern of inattention and/or hyperactivity, characterised by impulsivity, attentional problems, and hyperactivity. The said impulsivity has been found by George Fredric Still (1902) to interfere with the normal functioning and/or development. In terms of its biological basis, ADHD is said to have multiple environmental and genetic factors acting together to form a spectrum in relation to neurobiological liability and often associated to frontal cortex dysfunction (Miller, Sheridan, Cardoos, & Hinshaw, 2013). According to recent brain studies, decreased neural activities and volumetric reductions in the basal ganglia, frontal lobe, limbic system, and the cerebellum have revealed the biological mechanism of ADHD. The studies show that the impairment of the executive functions and the reward systems as well as the dysfunction of the default mode network are some of the notable biological changes that are associated with ADHD development. Additionally, catecholamine- regulated neurotransmission dysfunctions, particularly the dopamine transporters, is biologically linked to the disorder.In ADHD, genetic factors are implicated, despite a poor understanding of its mechanism of action. Candidate gene research in regard to ADHD have generated substantial evidence that have gone on to implicate findings in the etiology of the disorder. The role of the biological basis of ADHD is therefore one that facilitates a better understanding of the underlying factors and the causative issues surrounding the disorder. By having a better understanding of the biological foundations of the disorder, neurologists are better placed to eliminate issues and conditions that may trigger, create, or lead to the development of ADHD.
Biological basis is important for diagnosis, understanding of the condition, and its treatment. To date, researchers have not yet fully agreed on the causes of the disorder. Myths dominate the understanding of ADHD and are, thus, an impediment to proper diagnosis and treatment. By having a clear understanding of the biological basis, proper diagnosis and treatment of ADHD can be attained. For example, biological factors such as individuals with neurological disorders have been scientifically linked to the development of ADHD. Such knowledge is important because it informs the direction of future research and also helps in eliminating a majority of the misconceptions surrounding the disorder. The pathogenesis of ADHD is not well understood. Miller et al. (2013) propose that one of the best ways to arrive to a consensus surrounding the disorder is to understand its biological basis. Today, the milestones reached in understanding how dopamine or issues with the frontal cortex dysfunction, as well as established neurological disorders affect the development of ADHD are all documented, owing to the understanding and studying of biological basis of the disorder. The greatest advantage of having an understanding of the biological basis of ADHD is that it informs further research, helps neuroscientists to narrow down on approaches to the disorder, and leads to an advancement in the establishment of the causative agents and proper diagnosis of the disorder.
Part Two
Research demonstrates that ADHD has a strong neurobiological basis. That said, it is also true that exact causes are yet to be identified. Some studies agree that heredity has the largest contribution in regard to the expression of ADHD in the population (Heal, Cheetham, & Smith, 2009). Although there is the general acceptance and consensus on the contribution of heredity, there are difficulties in explaining how other biological factors may lead to the disorder. For example, difficulties in the pregnancy phase, premature delivery, exposure to tobacco and alcohol, high lead levels in the body, and significantly low weight during birth have all been attributed to contribute somewhat to ADHD development. However, there is a general lack of adequate information regarding how these factors (and many other biological factors) may contribute to an increased risk of developing ADHD to different degrees. There is also a lack of adequate information and research regarding the exact cause of the symptoms of ADHD between the participation of genes and heredity. The gene responsible for creation of dopamine is largely attributed to the irregular maintenance of consistent attention. In other cases, the disorder is said to be passed on from parent to child through hereditary factors.
Low levels of neurotransmitter dopamine are believed to have an active role in displaying ADHD symptoms. The medications used with ADHD, including antidepressants and stimulants are made to correct the dopamine deficit as well as addressing the linked symptoms. For example, addiction, aggression, depression, and anxiety are also addressed. Stimulant as well as non-stimulant medications are given to control ADD symptoms. Although significant steps have been taken in research involving ADHD, a biological explanation of the causes is not always possible because some of the underlying conditions are yet to be fully understood in the confines of research and biological basis. Biological factors are not always accurate and may be confusing. Therefore, there is a need to have alternative explanations, for example those that physical, environmental, or of a chemical nature, to offer alternative explanations. Biological explanations are helpful because they help in understanding the body and how to diagnose ADHD and even how to go about treating it. However, wherever there is controversy or inadequate explanations, then confusion arises or alternative explanations that can be termed as myths. For example, the fear that high intake of sugar or exposure to video games and violence are triggers of ADHD are unfounded. Yet, they have occupied the majority of the explanations available to the public based on the lack of a consensus on the biological causes of ADHD. Therefore, a biological explanation is not always possible, but is very helpful in providing an explanation including diagnosis, treatment, and further research.
Conduct Disorder
Part One
Conduct disorder is described by Fairchild et al. (2019) as a group of persistent and repetitive emotional and behavioural problems amongst youngsters. Adolescents and children with conduct disorder have increased difficulty in following set rules, showing empathy, behaving as per the socially acceptable ways, and respecting the rights of other people. The main symptoms and signs of conduct disorder include aggressive repetitive behaviour, deceitful mannerism, persistent destructive behaviour, and a continued pattern of violation of rules. For example, youngsters with conduct disorder may be bullies, arsonists, vandals, chronic liars, and often in trouble with the law. The biological causes of conduct disorder have been suggested to include injuries and/or defects to some areas of the brain, abnormal development of some parts of the brain responsible for regulation of behaviour, impulsive control and emotions, improper functioning of the nerve cell circuits in the brain, and the presence of other mental illnesses including ADHD, anxiety disorder, and ADD may be contributing factors to the symptoms and signs of conduct disorder. Genetics have also been linked to the development of conduct disorder with a number of teens or children with family members with mental illnesses having behavioural disorders. For example, close family members who have positively been diagnosed with anxiety disorders, personality disorders, mood disorders, and substance abuse disorders are likely to pass these down in the form of conduct disorder. Biological factors and basis point to a likelihood that conduct disorder may be partially inherited or present in the body of a patient due to certain body formations and conditions. This understanding helps to inform the diagnosis, understanding, treatment, and shapes the way for future research.
The understanding of biological basis of conduct disorder has been very helpful in linking how other factors such as genetics, psychological, social, and environmental contribute to the development of conduct disorder. Today, it is possible for researchers to estimate the number of children or teens with conduct disorder and those that are at the highest risk of developing it due to information relating to the biological basis of parents and other important aspects relating to the disorder. The same understanding has helped practitioners to know when to prescribe stimulants such as methylphenidates, dextroamphetamines, amphetamines, and pemoline. Drugs such as Ritalin are prescribed on the basis of a biological understanding of ADHD. Additionally, it is easier to predict frequency and occurrence amongst different lines such as age and gender. Therefore, the role of biological basis in understanding conduct disorder is important in helping to diagnose it early and in offering treatment for the same.
Part Two
Similar to a majority of mental illnesses, the exact biological causes of conduct disorder remain relatively unknown. However, a myriad of combinations of social, biological, genetic, environmental, and psychological factors are linked to the disorder. It is generally thought that the presence of other mental illnesses including ADHD, anxiety disorder, and ADD may be contributing factors to the symptoms and signs of conduct disorder. Other biological factors may be linked to the presence of genes from family members that put a child at a higher risk of developing conduct disorder. However, almost every aspect of conduct disorder, especially the causes and contributing factors, do not have an adequate biological explanation (Fairchild et al., 2019). While there sufficient biological explanation on the symptoms and signs, the causes are not very well defined and leave a lot of room for speculation. As a result, conduct disorder is heavily associated to other social, psychological and environmental factors such as a dysfunctional family, abuse in childhood, traumatic experiences, substance abuse during pregnancy, deficits in cognitive reasoning, low socioeconomic status, and other issues relating to the individual.
It is clear that in defining conduct disorder, a biological explanation is not always possible. Sometimes, it is important to think outside of biological factors into other elements such as the social, the psychological, environmental, and genetics to try get a better picture of the problem. In the case of conduct disorder, the available biological explanations are important in informing the direction of future research, in defining diagnosis, treatment, and further understanding of the disorder.
However, whenever a biological explanation is adequate, this is very helpful to the process of further understanding the disorder and relating it to other conditions that may be present in a patient. In prescribing medication, biological basis helps to identify whether to give lithium, clonidine, methylphenidate, antidepressants like Prozac, and stimulants like Dexedrine. When such explanations are not possible, the speculation that emerges is not helpful in narrowing down a problem to a specific cause or treatment. A lack of adequate biological explanation creates chaos and may lead to the development of myths which are dangerous in the proper diagnosis and treatment of the disorder. Therefore, a biological explanation is not always possible but there is a need to have other alternative explanations that support biological positions in order to understand the entire environment of the disorder.
References
Fairchild, G., Hawes, D. J., Frick, P. J., Copeland, W. E., Odgers, C. L., Franke, B., … & De Brito, S. A. (2019). Conduct disorder. Nature Reviews Disease Primers, 5(1), 1-25.
Heal, D. J., Cheetham, S. C., & Smith, S. L. (2009). The neuropharmacology of ADHD drugs in vivo: insights on efficacy and safety. Neuropharmacology, 57(7-8), 608-618.
Miller, M., Sheridan, M., Cardoos, S. L., & Hinshaw, S. P. (2013). Impaired decision-making as a young adult outcome of girls diagnosed with attention-deficit/hyperactivity disorder in childhood. Journal of the International Neuropsychological Society: JINS, 19(1), 110.
