O transtorno de déficit de atenção e hiperatividade como um transtorno de funcionamento executivo: contribuições da psicologia histórico-cultural

Abstract

This dissertation aims to understand Attention Deficit Hyperactivity Disorder (ADHD) through the lens of the Cultural-Historical Theory (CHT), with its two main authors, L. S. Vygotsky and A. R. Luria, as the theoretical and conceptual foundation to achieve this objective. The study is structured in six chapters. The first chapter presents a historical review of the disorder, from its earliest descriptions to its major changes and clinical validations up to the DSM-5. The second chapter discusses current issues regarding the definition and diagnosis of ADHD, focusing on the validity of its diagnostic criteria and assessment processes. The third chapter examines the relationship between ADHD, executive functions, and emotional regulation through a systematic literature review following the PRISMA protocol. The fourth chapter addresses the concepts of executive functions and their implications for understanding ADHD, highlighting some issues with the dominant definitions of executive functions. The fifth chapter analyzes social and cultural aspects in the origin of the disorder, considering both individual development and the sociogenesis of symptoms. Finally, the sixth chapter presents, synthesizes, and applies the concepts of CHT to construct an explanatory model of the disorder from this theoretical perspective. Among the study's objectives is the hypothesis that ADHD is an Executive Function disorder, supported by the systematic review, which shows significant associations between ADHD, executive functions, and emotional regulation. The study presents an integrated explanatory model for ADHD based on the concepts and applications of CHT, linking L. S. Vygotsky’s notion of psychological systems with A. R. Luria’s idea of a functional system, as described in the theory of three functional units of the brain. Additionally, the concepts of higher psychological functions, self-regulation of behavioral processes, and CHT’s laws of development were used for the elaboration of the explanatory model. Based on this research, there is sufficient evidence to understand ADHD as an executive function disorder, and CHT offers a broad theoretical framework capable of providing a more comprehensive and satisfactory explanatory model for the condition.