Childhood Disorders 665
with ADHD than in control families (Pressman et al., 2006). However, do family
environments that are higher in conflict contribute to ADHD in those who are
vulnerable? Or do the symptoms of the disorder—inattention, hyperactivity, or
impulsivity—create more tension in the family? Or do diffi culties associated with the
disorder, such as diffi culty in recognizing angry or sad facial expressions, increase
family tension? It may be that all these possible infl uences occur.
Figure 14.4g44
Affect
Stressful Life Events Family
NeuroPsychoSocial NeuroPsychoSocial
Easily
distressed
Mental Processes and
Mental Contents
Difficulty focusing and
sustaining attention
Low self-esteem
Difficulty recognizing
facial expression of
anger and sadness
Maladaptive
attributional style
Family conflict
Gender/Culture
No known major
contribution
Behavior
Impulsive and/or
hyperactive
behaviors
NeuroPsychoSocial
Genetics
Inherited vulnerability
for ADHD and related
temperaments
Brain Systems
Frontal lobes
Abnormalities that
arise from exposure
to teratogens
Underresponsive
autonomic nervous
system
Neural Communication
Dopamine
Multiple neurotransmitters
Interpersonal problems
14.4 • Feedback Loops in Action: Attention-Defi cit/Hyperactivity Disorder