ADHD Linked to Trauma in Kids

Attention-deficit/hyperactivity disorder (ADHD) may be associated with trauma in children.

New research reveals that many kids with the mental disorder are also exposed to hardships like poverty, divorce, neighborhood violence and drug addiction among family members.

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

The latest study involved data from 65,680 children between the ages of six and 17 who participated in the 2011 National Survey of Children's Health. Parents of the children had answered questions regarding their children's ADHD diagnosis, severity and medication use as well as nine traumatic childhood experiences: poverty, divorce, death of a parent/guardian, domestic violence, neighborhood violence, substance abuse, incarceration, familial mental illness and discrimination.

Study results revealed that 12 percent of the children were diagnosed with ADHD, and parents of children diagnosed with the learning disorder reported a higher prevalence of all the traumatic events examined in the study. Parents of children diagnosed with ADHD also reported a higher number of traumatic childhood experiences compared to those without ADHD. The findings revealed that 17 percent of children with ADHD experienced four or more traumatic events compared to 6 percent of those without ADHD.

Further analysis revealed that children exposed to four or more adverse experiences were nearly three times more likely to use ADHD medications compared to those who experienced three or fewer adverse experiences. Exposure to traumatic events was also linked to ADHD severity. Researchers found that children with four or more negative experiences also were more likely to have a parent rate their ADHD as moderate to severe compared to children exposed to three or fewer traumatic events.

"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," said Brown, assistant professor of pediatrics, Division of General Pediatrics, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, New York.

"Pediatric providers should consider screening for adverse childhood experiences in children who they suspect may have ADHD and/or those who carry the diagnosis, and initiate evidence-based treatment/intervention plans for children who screen positive for ACEs," she added.

The findings will be presented May 6 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

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