Traumatic Experiences Often Associated with ADHD

Attention-deficit/hyperactivity disorder (ADHD) in children often goes hand in hand with traumatic life events, according to research presented May 6 at the Pediatric Academic Societies annual meeting in Vancouver, British Columbia, Canada.

A collaborative research team examined data from the 2011 National Survey of Children’s Health, looking at the prevalence of adverse childhood experiences (ACEs) in a national sample of 85,637 children between the ages of 2 and 17, both with and without ADHD. More specific data was collected via surveys filled out by parents of children in the sample group of 65,680 children ages 6 to 17 years.

The 9 ACEs were defined as poverty, divorce, death of a parent/guardian, domestic violence, neighborhood violence, substance abuse, incarceration, familial mental illness, and discrimination. The researchers wanted to determine the possible association and correlation between ACEs and ADHD diagnosis, severity, and medication use.

Of the children studied, 6,758 (7.9%) had a current ADHD diagnosis. Of those with ADHD, 42.6% reported exposure to 2 or more ACEs compared to only 19.6% of children without ADHD diagnoses.

“Our findings suggest that children with ADHD experience significantly higher rates of trauma than those without ADHD,” said lead author Nicole M. Brown, MD, MPH, MHS. “Providers may focus on ADHD as the primary diagnosis and overlook the possible presence of a trauma history, which may impact treatment.”

Researchers also found that children who experienced 4 or more ACEs were nearly 3 times more likely to use ADHD medications compared with children experiencing 3 or fewer ACEs. Parents were more likely to rate their child’s ADHD as moderate to severe if the child experienced 4 or more ACEs compared to children with 3 or fewer ACEs.

“Knowledge about the prevalence and types of adverse experiences among children diagnosed with ADHD may guide efforts to address trauma in this population and improve ADHD screening, diagnostic accuracy and management,” Brown said.

She suggested that pediatric providers screen for adverse experiences in children they suspect may have ADHD.

“An enhanced understanding of the prevalence and types of ACEs among children diagnosed with ADHD may inform efforts to develop trauma-informed care delivery systems and improve ADHD screening, diagnostic accuracy, and management,” the authors concluded.