focus and context, part IIa: ADHD and rejection

The following post is in part an answer to a question in a randform comment.

ADHD is a socalled disorder. Among its symptoms are a “unusual way” of focusing/concentrating. The symptoms of ADHD are gradually. Thus weak forms of ADHD may not necessarily be seen as disorder, but as a normal condition.

Although the clinical investigations are not yet sufficient there exist strong indications that neurophysiological components play an imminent role in ADHD. And these may also be play a role in understanding rejection.

In particular the concentration level of a certain neurotransmitter called Dopamine seem to be smaller in ADHD patients than in non-ADHD patients, moreover the reuptake of Dopamine seems to be faster in ADHD patients. Since Dopamine steers the neural activity of a lot of neurons (“dopaminergic neurons”), the faster reuptake (and may be also the general lower level) of Dopamine seems to lead to a faster decrease of neural activity/stimulation (see plasticity). Dopamine is produced in several areas of the brain, including the substantia nigra and the ventral tegmental area (VTA). The production of Dopamine can be influenced by components including genetic disposition and nutrition.

Among others SPECT scans found people with ADHD to have reduced blood circulation (indicating low neural activity), and a significantly higher concentration of dopamine transporters in the striatum. Medications (such as methylphenidate) thus focused on treating ADHD by blocking the dopamine transporter and thus reducing dopamine reuptake in certain areas of the brain, such as those that control and regulate attention. As explained above dopamine is a stimulant, thus methylphenidate increases neural activity.

The level and reuptake of Dopamine seems to be accompagnied by emotional states, such as motivation (ADHD patients can actually “hyperfocus” if motivated), but as it seems also be connected to negative experiences/responses:

In der klinischen Praxis kann in diesem Zusammenhang immer wieder beobachtet werden, dass diese Patienten sich primär an negative und traumatisierende Erlebnisse erinnern. Nur massive Traumata vermögen bei ihnen Spuren im Gedächtnis zu hinterlassen. Fatalerweise sind es dann in erster Linie diese schmerzhaften Erinnerungen, welche das Grundgerüst des Selbstgefühls bilden.
source

translation (without guarantee of correctness):
In the clinical practice one can repeatedly observe, that patients recall primarily negative and traumatising experiences. Only massive Traumata may leave Traces in their memory. Badly enough these painful memories are then predominantly the memories which form the basic framework which forms self-assurance.

As a result ADHD patients have a tendency to easier develop comorbidities such as anxiety disorder, depression etc.

Emotional memories are partially triggered by activity in the Nucleus accumbens.
Major inputs to the nucleus accumbens include prefrontal association cortices, basolateral amygdala, and dopaminergic neurons which are located in the already above mentioned ventral tegmental area (VTA). Due to its role in the development of positive emotions the Nucleus accumbens is also called the “pleasure or reward center” of the brain.

However research suggests that in addition to its prominent role in appetitive learning, the nucleus accumbens (NAC) may also be involved in fear conditioning.

I couldn’t find a study with regard to this, but it is thus not far fetched to assume that a different activation pattern of the Nucleus accumbens may also be due to a different (way of/rate of) change of the dopamine level (this may also be a feedback mechanism). On a first guess this could imply that the positive activation of the Nucleus accumbens may be less easy for people with e.g. a faster/differently changing Dopamine level (such as ADHD patients), in particular this different dopamine regulation may (again this is guessing) even lead to a rather complete inactivation of the Nucleus accumbens and thus enforce negative emotions, like the above mentioned fear conditioning. Moreover if the Nucleus accumbens is inactivated it could be rather resistent to positive stimulation. As a simple reference: It is generally not easy to cheer someone up who is grumpy.

Concluding -it may be at least for a certain group of people very important to avoid negative experiences. This could explain also why some people may appear to “hyperreact” when e.g. being critized or rejected. And – it may be sensible to focus on investigating the mechanisms of rejection as these may dominate the mechanisms of reward. This may also be useful with regard to understanding Traumata which may be the result of a severe form of rejection such as in betrayal and abuse.

In short -it is important to understand why people feel rejected. In particular the experience of rejection is not only an individual feature, but is certainly influenced by other factors, like general societal (e.g. stress) factors, or like cultural conditions, which include religious constructions, conceptions of honor, but also arrangements on how to “institutionally” avoid that people feel rejected. These arrangements may reach as far as from pink slip parties to hospices.

3 Responses to “focus and context, part IIa: ADHD and rejection”

1. Al Aziz Says:

Thank you for interesting explanation. So you say that high-rank officials who does
not like to be critized should better take the pills you mentioned, since they probably have this sickness you describe?

Some say that criminals with hard childhood, who were rejected and sick should be excused. Do you want to say the same? I think murderers shouldn’t be excused.

@Al Aziz

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