背景:注意缺陷/多动障碍(ADHD)具有遗传和环境病因。关于环境因素的出版物很少。这篇综述的目的是介绍心理社会逆境在ADHD的病因和过程中的作用。
方法:在以下数据库中进行了搜索:PubMed,ScienceDirect,SciELO,ClinicalKey,EMBASE,丁香花,OVID,APA和PsycNET。选择英语和西班牙语,不受研究类型或出版年份的限制。最后,进行了定性合成。
结果:ADHD的发展可能与家庭中的不良因素有关,学校或社会环境。已经提出逆境与遗传变异相互作用并导致神经生物学变化的解释机制。也可能存在基因-环境相关性,即个体遗传特征增加了暴露于逆境的风险,并间接增加患多动症的概率。对心理社会逆境的研究是一个巨大的挑战,不仅由于其结构的复杂性,而且对给定事件的主观感知也有影响。
结论:ADHD病因复杂,涉及遗传和环境因素的相互作用,这些因素相互关联并导致疾病。研究心理社会逆境在多动症中的作用是至关重要的,但这仍然是一项需要很大困难的任务。
BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) has genetic and environmental aetiological factors. There are few publications on the environmental factors. The objective of this review is to present the role of psychosocial adversity in the aetiology and course of ADHD.
METHODS: A search was carried out in the following databases: PubMed, ScienceDirect, SciELO, ClinicalKey, EMBASE, Lilacs, OVID, APA and PsycNET. English and Spanish were selected without being limited by type of study or year of publication. Finally, a qualitative synthesis was conducted.
RESULTS: ADHD development could be related to exposure to adverse factors in the family, school or social environment. It has been proposed as an explanatory mechanism that adversity interacts with genetic variants and leads to neurobiological changes. There may also be a gene-environment correlation whereby individual hereditary characteristics increase the risk of exposure to adversity, and indirectly increase the probability of developing ADHD. Research on psychosocial adversity represents a big challenge, not only due to the complexity of its construct, but also to the effect of subjective perception of a given event.
CONCLUSIONS: ADHD aetiology is complex and involves the interaction of both genetic and environmental factors, in which these factors correlate and cause the disorder. The study of the role of psychosocial adversity in ADHD is fundamental, but it remains a task that entails great difficulties.