Hostname: page-component-7dd5485656-7jgsp Total loading time: 0 Render date: 2025-10-25T15:54:25.728Z Has data issue: false hasContentIssue false
  • English
  • Français

Evolutionary perspectives on ADHD

Published online by Cambridge University Press:  27 August 2025

Gurjot Brar Open the ORCID record for Gurjot Brar [Opens in a new window] ,
Annie Swanepoel Open the ORCID record for Annie Swanepoel [Opens in a new window] ,
Henry O’Connell  and
John McFarland
Gurjot Brar*
Affiliation:
Trinity College Dublin, Dublin, Ireland School of Medicine, University of Limerick, Limerick, Ireland
Annie Swanepoel
Affiliation:
North East London NHS Foundation Trust, London, UK
Henry O’Connell
Affiliation:
School of Medicine, University of Limerick, Limerick, Ireland Laois-Offaly Mental Health Service, Triogue Community Mental Health Centre, Portlaoise, Ireland
John McFarland
Affiliation:
School of Medicine, University of Limerick, Limerick, Ireland
*
Corresponding author: Gurjot Brar; Email: gurjotbrarmd@proton.me
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

This study explores psychiatrists’ perceptions of Attention-Deficit Hyperactivity Disorder (ADHD) through the lens of evolutionary psychiatry, a growing field that reframes mental disorders in the context of adaptation and survival. Evolutionary theories suggest that traits associated with ADHD, such as impulsivity, hypercuriosity and novelty-seeking, may have been adaptive in ancestral environments, though they manifest as maladaptive in structured modern contexts.

Method:

A bespoke 10-item questionnaire was developed to assess psychiatrists’ attitudes following a presentation on evolutionary perspectives of ADHD by an expert. The questionnaire allowed rating in 5-point Likert fashion and was followed by a free text box for qualitative analysis. Basic descriptive statistics and One-Way ANOVA pairwise comparisons between groups was used to test for statistical significance. A p value of <0.05 was deemed statistically significant.

Results:

Forty-two participants, including 21 consultants and 19 psychiatry trainees completed the questionnaire. All participants rated their comprehension of the presentation as high/very high. Most strongly agreed that the information presented could improve psychiatry and therapeutic outcomes. However, consultants with more than 10 years of experience were less likely than trainees to report optimism about the practical applications of evolutionary frameworks. Qualitative feedback emphasized the relevance of evolutionary perspectives in clinical practice, particularly in reducing stigma and enhancing therapeutic engagement with patients and families.

Conclusions:

While the results from this study were positive, limitations include the small sample size and lack of prepresentation baseline data. However, this study has formed part of the first step in investigating the perceptions and attitudes of psychiatrists on evolutionary perspectives on ADHD.

Keywords

ADHDevolutionperceptionspsychiatrystigma

Information

Type
Short Report
Information
Irish Journal of Psychological Medicine , First View , pp. 1 - 5
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of College of Psychiatrists of Ireland

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Abed, R, Ayton, A, St John-Smith, P, Swanepoel, A, Tracy, DK (2019). Evolutionary biology: an essential basic science for the training of the next generation of psychiatrists. The British Journal of Psychiatry : The Journal of Mental Science 215, 699–701. doi:10.1192/bjp.2019.123.CrossRefGoogle ScholarPubMed
Abed, R, St John-Smith, P (2022). Evolutionary Psychiatry: Current Perspectives on Evolution and Mental HeAlth. Cambridge University Press. doi:10.1017/9781009030564 Google Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edn. American Psychiatric Publishing. doi:10.1176/appi.books.9780890425596.CrossRefGoogle Scholar
Ayano, G, Demelash, S, Gizachew, Y, Tsegay, L, Alati, R (2023). The global prevalence of attention deficit hyperactivity disorder in children and adolescents: An umbrella review of meta-analyses. Journal of Affective Disorders 339, 860–866. doi:10.1016/j.jad.2023.07.071.CrossRefGoogle ScholarPubMed
Baptista, T, Aldana, E, Angeles, F, Delgado, H (2012). Teaching evolution to psychiatrists in Venezuela: comparison with medical students and other medical specialists: a pilot study. Canadian Medical Education Journal 3, e127–e137.10.36834/cmej.36586CrossRefGoogle ScholarPubMed
Belsky, J, Hartman, S (2014). Gene-environment interaction in evolutionary perspective: differential susceptibility to environmental influences. World Psychiatry 13, 87–89.10.1002/wps.20092CrossRefGoogle ScholarPubMed
Belsky, J, Schlomer, GL, Ellis, BJ (2012). Beyond cumulative risk: distinguishing harshness and unpredictability as determinants of parenting and early life history strategy. Developmental Psychology 48, 662–673.10.1037/a0024454CrossRefGoogle ScholarPubMed
DeJong, M (2010). Some reflections on the use of psychiatric diagnosis in the looked after or “in care” child population. Clinical Child Psychology and Psychiatry 15, 589–599.10.1177/1359104510377705CrossRefGoogle ScholarPubMed
Ersche, KD, Turton, AJ, Chamberlain, SR, Müller, U, Bullmore, ET, Robbins, TW (2012). Cognitive dysfunction and anxious-impulsive personality traits are endophenotypes for drug dependence. American Journal of Psychiatry 169, 926–936.10.1176/appi.ajp.2012.11091421CrossRefGoogle ScholarPubMed
Faraone, SV, Doyle, AE (2001). The nature and heritability of attention-deficit/hyperactivity disorder. Child and Adolescent Psychiatric Clinics of North America 10, 299–ix.10.1016/S1056-4993(18)30059-2CrossRefGoogle ScholarPubMed
Gavin, B, McNicholas, F (2018). ADHD: science, stigma and service implications. Irish Journal of Psychological Medicine 35, 169–172. doi:10.1017/ipm.2018.20.CrossRefGoogle ScholarPubMed
Godfrey, E, Fuermaier, ABM, Tucha, L, Butzbach, M, Weisbrod, M, Aschenbrenner, S, Tucha, O (2021). Public perceptions of adult ADHD: indications of stigma? Journal of Neural Transmission 128, 993–1008. doi:10.1007/s00702-020-02279-8.CrossRefGoogle ScholarPubMed
Grunspan, DZ, Nesse, RM, Barnes, ME, Brownell, SE (2017). Core principles of evolutionary medicine: a Delphi study. Evolution, Medicine, and Public Health 2018, 13–23. doi:10.1093/emph/eox025.CrossRefGoogle ScholarPubMed
Harold, GT, Leve, LD, Barrett, D, Elam, K, Neiderhiser, JM, Natsuaki, MN, Shaw, DS, Reiss, D, Thapar, A (2013). Biological and rearing mother influences on child ADHD symptoms: revisiting the developmental interface between nature and nurture. Journal of Child Psychology and Psychiatry 54, 1038–1046.10.1111/jcpp.12100CrossRefGoogle ScholarPubMed
Hidaka, BH, Asghar, A, Aktipis, CA, Nesse, RM, Wolpaw, TM, Skursky, NK, Bennett, KJ, Beyrouty, MW, Schwartz, MD (2015). The status of evolutionary medicine education in North American medical schools. BMC Medical Education 15, 38. doi:10.1186/s12909-015-0322-5.CrossRefGoogle ScholarPubMed
Kennedy, M, Kreppner, J, Knights, N, Kumsta, R, Maughan, B, Golm, D, Rutter, M, Schlotz, W, Sonuga‐Barke, EJS (2016). Early severe institutional deprivation is associated with a persistent variant of adult attention-deficit/hyperactivity disorder: clinical presentation, developmental continuities and life circumstances in the English and Romanian adoptees study. Journal of Child Psychology and Psychiatry 57, 1113–1125.10.1111/jcpp.12576CrossRefGoogle Scholar
Kim, P, Evans, GW, Angstadt, M, Ho, SS, Sripada, CS, Swain, JE, Liberzon, I, Phan, KL (2013). Effects of childhood poverty and chronic stress on emotion regulatory brain function in adulthood. Proceedings of The National Academy of Sciences of The United States of America 110, 18442–18447.10.1073/pnas.1308240110CrossRefGoogle ScholarPubMed
Kretschmer, L, Dyble, M, Chaudhary, N, Bann, D, Salali, GD (2025). Patterns of physical activity in hunter-gatherer children compared with US and UK children. Scientific Reports 15, 1495. doi:10.1038/s41598-024-81326-w.CrossRefGoogle ScholarPubMed
Le Cunff, A-L (2024). Distractibility and impulsivity in ADHD as an evolutionary mismatch of high trait curiosity. Evolutionary Psychological Science 10, 282–297. doi:10.1007/s40806-024-00400-8.CrossRefGoogle Scholar
Lindell-Innes, R, Phillips-Hughes, AL, Bartsch, D, Galletly, C, Ludbrook, C (2023). Attitudes of psychiatry trainees towards patients with borderline personality disorder: does the stigma begin during training? Personality and Mental Health 17, 387–395. doi:10.1002/pmh.1587.CrossRefGoogle Scholar
Matthews, LJ, Butler, PM (2011). Novelty-seeking DRD4 polymorphisms are associated with human migration distance out-of-Africa after controlling for neutral population gene structure. American Journal of Physical Anthropology 145, 382–389.Google Scholar
Mischel, W (2014). The Marshmallow Test: Understanding Self-control and How to Master It. Random House.Google Scholar
Nesse, RM (2022). Anxiety disorders in evolutionary perspective. In Evolutionary Psychiatry: Current Perspectives on Evolution and Mental Health (ed. Abed, R. T. and St John-Smith, P.), pp. 101–116. Cambridge University Press.10.1017/9781009030564.009CrossRefGoogle Scholar
Nesse, RM, Schiffman, JD (2003). Evolutionary biology in the medical school curriculum. BioScience 53, 585. doi:10.1641/0006-3568(2003)053[0585:EBITMS]2.0.CO;2 CrossRefGoogle Scholar
Noble, KG, Norman, MF, Farah, MJ (2005). Neurocognitive correlates of socioeconomic status in kindergarten children. Developmental Science 8, 74–87.10.1111/j.1467-7687.2005.00394.xCrossRefGoogle ScholarPubMed
Pappa, I, Mileva-Seitz, VR, Bakermans-Kranenburg, MJ, Tiemeier, H, van IJzendoorn, MH (2015). The magnificent seven: a quantitative review of dopamine receptor D4 and its association with child behavior. Neuroscience & Biobehavioral Reviews 57, 175–186.10.1016/j.neubiorev.2015.08.009CrossRefGoogle Scholar
Polanczyk, G, de Lima, MS, Horta, BL, Biederman, J, Rohde, LA (2007). The worldwide prevalence of ADHD: a systematic review and metaregression analysis. American Journal of Psychiatry 164, 942–948.10.1176/ajp.2007.164.6.942CrossRefGoogle ScholarPubMed
Porter-Stransky, KA, Gallimore, RM (2022). Medical student attitudes and perceptions on the relevance of neuroscience to psychiatry: a mixed methods study. Academic Psychiatry : The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry 46, 128–132. doi:10.1007/s40596-021-01525-9.CrossRefGoogle Scholar
Roskam, I, Stievenart, M, Tessier, R, Muntean, A, Escobar, MJ, Santelices, MP, Juffer, F, Van Ijzendoorn, MH, Pierrehumbert, B (2014). Another way of thinking about ADHD: the predictive role of early attachment deprivation in adolescents’ level of symptoms. Social Psychiatry and Psychiatric Epidemiology 49, 133–144.10.1007/s00127-013-0685-zCrossRefGoogle ScholarPubMed
Sander, L, Amadei, G, Bianchi, I (2012). Living Systems, Evolving Consciousness, and the Emerging Person: A Selection of Papers From the Life Work of Louis Sander. Routledge.10.4324/9780203837580CrossRefGoogle Scholar
Swanepoel, A (2024). ADHD and ASD are normal biological variations as part of human evolution and are not “disorders” | clinical neuropsychiatry. https://www.clinicalneuropsychiatry.org/download/adhd-and-asd-are-normal-biological-variations-as-part-of-human-evolution-and-are-not-disorders/.Google Scholar
Swanepoel, A, Music, G, Launer, J, Reiss, MJ (2017). How evolutionary thinking can help us to understand ADHD. BJPsych Advances 23, 410–418. doi:10.1192/apt.bp.116.016659.CrossRefGoogle Scholar
Swanepoel, A, Reiss, MJ, Launer, J, Music, G, Wren, B (2022). Evolutionary perspectives on neurodevelopmental disorders. In Evolutionary Psychiatry: Current Perspectives on Evolution and Mental Health (ed. Abed, R. and St John-Smith, P.), pp. 228–243. Cambridge: Cambridge University Press.10.1017/9781009030564.017CrossRefGoogle Scholar
Thapar, A (2018). Discoveries on the genetics of ADHD in the 21st century: new findings and their implications. American Journal of Psychiatry 175, 943–950.10.1176/appi.ajp.2018.18040383CrossRefGoogle ScholarPubMed
Tronick, E (2007). The Neurobehavioral and Social-emotional Development of Infants and Children. WW Norton & Company.Google Scholar
Windhorst, DA, Mileva‐Seitz, VR, Linting, M, Hofman, A, Jaddoe, VWV, Verhulst, FC, Tiemeier, H, van IJzendoorn, MH, Bakermans‐Kranenburg, MJ (2015). Differential susceptibility in a developmental perspective: DRD4 and maternal sensitivity predicting externalizing behavior. Developmental Psychobiology 57, 35–49.10.1002/dev.21257CrossRefGoogle Scholar
Supplementary material: File

Brar et al. supplementary material

Brar et al. supplementary material
Download Brar et al. supplementary material(File)
File 449.1 KB