Attention-Deficit/Hyperactivity Disorder (ADHD) symptom severity and gut microbiome dysbiosis: an aetiological perspective on an emerging relationship
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Date
2021-07
Authors
Van Zyl, Katrien
Journal Title
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Publisher
University of the Free State
Abstract
Attention deficit/hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder in the world with a range of adverse outcomes. Collaboration between researchers, healthcare practitioners and families to enhance preventative- and treatment strategies informed by aetiological conceptualisations is key to its management. ADHD presents a complex clinical picture. Genetic heredity and known environmental risk factors do not account for the full spectrum of presenting cases, and many children do not respond to psychopharmaceutical treatments. The role of the gut microbiome in psychiatric disorders has been receiving exponential research interest, radically reconfiguring conceptualisations of mental health. Gut microbiome research beyond microbial analyses is in its infancy, especially with children diagnosed with ADHD. This study is the first focused specifically on the overlapping aetiological factors involved through a clinical psychological lens. A quantitative dominant mixed methods research (MMR) approach was the most appropriate to address this complex, multifaceted research inquiry comprehensively. Consequently, a total of 197 research participants were selected on the basis of being the biological parent of a child between the age of 6 and 12 who has been formally diagnosed with ADHD in South Africa. Each participant completed the following online surveys: the ADHD Rating Scale-IV, the 6-Item Gastrointestinal Severity (GIS) Index and a self-compiled biographical questionnaire. The relationship between symptoms of gut dysbiosis and ADHD symptom severity was explored from a quantitative perspective. A statistically significant correlation was found between GIS Index total score and ADHD Inattention subscale (p = 0.026). Four independent variables were found to make significant contributions (i.e., maternal prenatal smoking, mode of delivery, breastfeeding, and maternal prenatal obesity), although no substantial mediating role by GIS Index symptoms were found. The qualitative results elicited parents’ observations of the influence of specific factors (e.g., gastrointestinal symptoms, diet, probiotic supplements, worm/parasite treatment) on ADHD symptoms. General concerns regarding children’s gut health and the adverse side-effects experienced from psychopharmaceutical treatments were also elicited. This study provides future researchers with a general overview of the overlap between the risk/protective factors involved in ADHD and gut dysbiosis, whilst elucidating the various bidirectional pathways involved in the intricate, emerging relationship between the gut microbiome and mental health.
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Keywords
Dissertation (M.Soc.Sc. (Clinical Psychology))--University of the Free State, 2021, ADHD aetiology, Gut microbiome dysbiosis, Risk/protective factors, South Africa