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Inborn error of metabolism is not implicated in ADHD pathogenesis. Metabolic disorders such as phenylketonuria cause cognitive impairment but do not specifically produce ADHD. ADHD is linked to neurotransmitter dysregulation, not metabolic enzyme defects. Metabolism and enzyme are irrelevant.

Dopamine neurotransmitter deficit is a neurochemical factor, not strictly genetic. While dopamine dysregulation contributes to symptoms, it represents biochemical imbalance rather than inherited etiology. The stem specifies genetic basis, making this option incorrect. Dopamine and neurochemical are contributory, not genetic.

Arrested id development is a psychodynamic concept without biological evidence. ADHD is not explained by Freud’s structural theory of personality. Neurodevelopmental abnormalities, not unconscious conflict, underlie the disorder. Psychodynamic and id are scientifically invalid here.

Inconsistent parental discipline may exacerbate behavioral symptoms but does not cause ADHD. Parenting style influences symptom severity and management but lacks neurobiological causation. ADHD originates from neurodevelopmental abnormalities, not discipline patterns. Parenting and environment are contributory, not causal.

Exposure to stressful school environments may worsen inattention and hyperactivity but is not etiologic. Environmental stressors influence symptom expression but do not explain pathogenesis. ADHD develops from genetic and neurochemical abnormalities. Stress and school factors are secondary.

Delayed toilet training during toddlerhood is unrelated to ADHD. Toilet training reflects developmental readiness and parental guidance, not neurobiological dysfunction. ADHD symptoms are linked to cortical and neurotransmitter dysregulation, not toileting milestones. Toilet and development are irrelevant.

Withdrawal into self describes autism spectrum disorder, not ADHD. ADHD involves externalizing behaviors such as distractibility and hyperactivity, not social withdrawal. Autism and withdrawal are distinct from ADHD pathology.

ADHD is not diagnosed before 2 years of age. Symptoms must be present before age 12, but reliable diagnosis typically occurs during school years. Age and diagnosis criteria exclude toddlers.

ADHD occurs more commonly in males than females, with a ratio of approximately 2:1 in childhood. Females often present with inattentive subtype, but prevalence is not equal. Gender and prevalence differ.

Recurrent intrusive thoughts are characteristic of obsessive-compulsive disorder, not ADHD. They involve unwanted, repetitive cognitions leading to compulsions. ADHD symptoms are attentional and behavioral, not intrusive thought patterns. Obsessions and compulsions are distinct.

Physical aggression is not a DSM-5-TR criterion for ADHD. Aggression may occur as a comorbidity with oppositional defiant disorder or conduct disorder but is not diagnostic. ADHD criteria focus on attention and activity regulation. Aggression and conduct are separate.

Anxiety and panic attacks are diagnostic of anxiety disorders, not ADHD. While ADHD may coexist with anxiety, panic attacks are not part of ADHD criteria. ADHD is defined by attentional and behavioral dysregulation. Anxiety and panic are unrelated.