PATHOPHYSIOLOGY

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. It results from
genetic, neurobiological, and environmental factors that affect brain structure and function, leading to executive dysfunction, emotional dysregulation, and motor restlessness.

Precipitating Factors:
Predisposing Factors: Increased
 Glutamate
Early use of media with excessive
Age: 4 years old Prefrontal
screen Cortex -
time exposure
Gender: Female  Irregular sleep patterns or sleep
 High levels of noise or chaotic
Family History
surroundings
Prenatal exposure to tobacco: Second-hand  Social rejection or difficulty interacting with
smoker peers

Delayed prefrontal cortex maturation Neurotransmitter Imbalance Disrupted Neural Pathways

-Reduced basal ganglia volume Affects motivation, Weak Prefrontal Cortex Basal Ganglia
↓ Dopamine
-Prefrontalattention,
Cortex impulse control Connection
Smaller cerebellum -Prefrontal Cortexfocus, working
Impairs
↓ Norepinephrine Weak connection affects
memory, cognitive flexibility self-regulation
Weak connections in executive function circuits
Weak connection affects self-regulation ↑ Glutamate Causes hyperactivity, Limbic System Heightened emotional
overstimulation Overactivity responses, poor stress
Serotonin management
Dysregulation leads to emotional
dysregulation
Default Mode Increased distractibility,
Network (DMN) excessive daydreaming
Dysfunction

Reduced alertness,
Reticular poor sustained
Activating System attention excessive
(RAS) Impairment daydreaming
 Central Nervous System Cardiovascular System Musculoskeletal System

Impaired Overactive sympathetic

Delayed motor coordination
executive function nervous system

Excessive fidgeting, difficulty

Poor impulse regulation, Sensitivity to stress with fine motor tasks
high distractibility triggers

Poor handwriting, difficulty

gripping objects
Hyperactivity and restlessness
ADHD Symptoms and
Behavioral Manifestations

Easily distracted, trouble following multi-step

Inattention
instructions, forgetfulness

Hyperactivity Constant movement, running excessively, fidgeting

Interrupting, acting without thinking, blurting

Impulsivity
out answers

Emotional Dysregulation Frequent tantrums, mood swings, frustrations

Sleep Problems Difficulty falling asleep, restless sleep, waking

up frequently
 Long-Term Complications

Academic Struggles Social Challenges Increased risk of injuries

Poor performance, difficulty Trouble making/maintaining Impulsivity leads to frequent

adjusting to structured friendships, peer rejection, accidents
learning

Long-Term Complications

-Academic
Long-TermStruggles: Poor performance, difficulty
Complications
adjusting to structured learning
-Academic Struggles: Poor performance, difficulty
-Social Challenges:
adjusting to Trouble making/maintaining
structured learning
friendships, peer rejection,
-Social Challenges: Trouble making/maintaining
Increasedfriendships,
risk of injuries:
peerimpulsivity
rejection, leads to
frequent accidents
Increased risk of injuries: impulsivity leads to
frequent accidents
HF