(248 words)Objective: ADHD is a prevalent and highly heritable mental disorder associated with significant impairment, morbidity and increased rates of mortality. This combination of high prevalence and high morbidity/mortality seen in ADHD and other mental disorders presents a challenge to naturalselection-based models of human evolution. Several hypotheses have been proposed in an attempt to resolve this apparent paradox. The aim of this study was to review the evidence for these hypotheses.
Methods:We conducted a systematic review of the literature on empirical investigations of naturalselection-based evolutionary accounts for ADHD in adherence with the PRISMA guideline. The PubMed, Embase, and PsycINFO databases were screened for relevant publications, by combining search terms covering evolution/selection with search terms covering ADHD.
Results:The search identified 790 records. Of these, 15 full-text articles were assessed for eligibility, and three were included in the review. Two of these reported on the evolution of the seven-repeat allele of the ADHD-associated dopamine receptor D4 gene, and one reported on the results of a simulation study of the effect of suggested ADHD-traits on group survival. The authors of the three studies interpreted their findings as favoring the notion that ADHD-traits may have been associated with increased fitness during human evolution. However, we argue that none of the three studies really tap into the core ADHD phenotype, and that their conclusions therefore lack validity for ADHD.
Conclusions:This review indicates that the natural-selection-based hypotheses for ADHD have not been subjected to empirical test and therefore remain entirely speculative.
Keywords:Attention Deficit Disorder with Hyperactivity; Biological Evolution; Selection, genetic; Adaptation, Biological.
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Summations-The search conducted for our systematic review of empirical investigations of natural-selectionbased evolutionary accounts for ADHD identified 790 records. Of these, 15 full-text articles were assessed for eligibility, and only three were included in the review.-The authors of the three studies included in this review interpreted their findings as favoring the notion that ADHD-traits may have been associated with increased fitness during human evolution. However, we argue that none of the three studies really tap into the core ADHD phenotype, and that their conclusions therefore lack validity for ADHD.-This review indicates that the natural-selection-based hypotheses for ADHD have not been subjected to empirical test and therefore remain entirely speculative. We suggest that this gap in knowledge should be addressed in future studies.
Considerations-Publications relevant for this topic may have gone undetected in our search.-It is noteworthy that there are more publications raising hypotheses for the evolutionary background for ADHD than there are studies testing them empirically.