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Child Psychiatry: Attention Deficit Hyperactivity Disorder

ADHD and Environmental Factors

Attention Deficit Hyperactivity Disorder (ADHD) is a childhood disruptive behavioral disorder that manifests in “inattention, impulsivity, and hyperactivity” and can persist into adulthood (Perese, 2012, p. 657). ADHD is supposed to originate from developmental deviations in the prefrontal lobe area, which are likely to be the result of genetic influences (Perese, 2012, p. 658). However, there is some evidence of environmental factors also contributing to the issue, even though it is relatively inconsistent (Sciberras, Mulraney, Silva, & Coghill, 2017).

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In the uterus, a child is believed to be put at the risk of ADHD if they are exposed to toxic substances (including drugs, alcohol, and tobacco), stress, or insufficient diet. Various birth complications are also described as risk factors by Perese (2012). However, the evidence for these suggestions is rather inconsistent. A very recent review by Sciberras et al. (2017) points out that rigorous studies (which take into account multiple factors) are not likely to show a significant relationship between in-utero environmental factors and ADHD development and tend to specifically state that causal relationships are not evident from their findings (p. 6). Thus, more rigorous research may be required for definite conclusions. After birth, extended exposure to television as well as low “socioeconomic status” tend to be regarded as contributors (Perese, 2012, p. 658). Finally, the family climate is of importance: Perese (2012) states that “parental discord” and “disorganized attachment patterns” are typically viewed as risk factors.

Apart from the negative factors, several environmental forces can affect the expression of ADHD by contributing to its treatment. There exists a variety of treatment methods, including stimulant and non-stimulant medication, psychological interventions, and cognitive training (Brahmbhatt et al., 2016). Brahmbhatt et al. (2016) report that stimulant medication is typically regarded as the primary method of treatment and others can be supplementary (p. 5). Moreover, according to Perese (2012), the interventions that target developmental processes, which might predict and grow into ADHD, may prevent the disorder. Finally, Perese (2012) and Brahmbhatt et al. (2016) mention the significance of parental engagement, indicating that support and relationships with other people modify the course of ADHD. Thus, the environmental factors that might influence ADHD are numerous, even though the extent of their influence is not established yet.

Parental and Other Forms of Support and ADHD

According to Johnston and Chronis-Tuscano (2014), relationship with parents can have a notable effect on the course of ADHD in their children. It is clear that some family interactions are regarded as harmful (Perese, 2012), and Johnston and Chronis-Tuscano (2014) admit this fact, but they also suggest that the relationships between children and parents are complex and reciprocal. Among other things, they report that parental support and positive (but realistic) attitude can foster a child’s autonomy, improve their task performance, decrease frustration, and increase satisfaction and quality of life in children as well as parents, all of which contributes to ADHD treatment (p. 195-196). They also state that the satisfaction with parental roles is harder to achieve in the case of ADHD, which, along with other disorders, might manifest in several members of the family because of its genetic roots. However, this satisfaction is beneficial for parental contribution to the resolution of ADHD-related issues.

Thus, Johnston and Chronis-Tuscano (2014) highlight the fact that parental support is crucial for ADHD treatment and the quality of life of the entire family. The authors conclude that clinicians need to foster parental support. Similarly, Brahmbhatt et al. (2016) mention the practice of involving parents in psychological treatments that are typically regarded as supplementary to medical ones. Also, Brahmbhatt et al. (2016) and Perese (2012) consider the opportunity of educating parents about ADHD and children’s needs to foster parental support. Still, Brahmbhatt et al. (2016) point out that low parental warmth is not unusual for ADHD children (p. 4), which is why it might not always be available. Substitutions for it can include other social support (Perese, 2012, p. 160), but parental support is valued by specialists, and they strive to foster it.


Brahmbhatt, K., Hilty, D., Hah, M., Han, J., Angkustsiri, K., & Schweitzer, J. (2016). Diagnosis and treatment of attention deficit hyperactivity disorder during adolescence in the primary care setting: A concise review. Journal Of Adolescent Health, 59(2), 135-143. Web.

Johnston, C., & Chronis-Tuscano, A. (2014). Families and ADHD. In R. A. Barkley (Ed.), Attention-Deficit hyperactivity disorder: A handbook for diagnosis and treatment (pp. 191-209). New York, NY: Guilford Publications.

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Perese, E. (2012). Psychiatric advanced practice nursing. Philadelphia, PA: F.A. Davis.

Sciberras, E., Mulraney, M., Silva, D., & Coghill, D. (2017). Prenatal risk factors and the etiology of ADHD—Review of existing evidence. Current Psychiatry Reports, 19(1), 1-8. Web.

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StudyCorgi. 2020. "Child Psychiatry: Attention Deficit Hyperactivity Disorder." December 16, 2020.


StudyCorgi. (2020) 'Child Psychiatry: Attention Deficit Hyperactivity Disorder'. 16 December.

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