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Childhood trauma may increase risk for ADHD

Analysis of national data indicated adverse childhood experiences were more common among children with ADHD than those without the developmental disorder.

“There is growing evidence showing that repeated or sustained exposure to adverse childhood experiences — defined as traumatic occurrences before the age of 18 years that are experienced as physically or emotionally harmful or threatening — increases a child’s risk for toxic levels of stress, which in turn might impair neurodevelopment, behavior, and overall physical and mental health. Studies have shown associations between parental psychopathology, marital discord, low socioeconomic status, and presence and severity of ADHD,” Nicole M. Brown, MD, MPH, MHS, of Albert Einstein College of Medicine and Children’s Hospital at Montefiore, Bronx, New York, and colleagues wrote.

To assess associations between adverse childhood experiences (ACEs) and ADHD diagnosis and severity, researchers used the 2011 to 2012 National Survey of Children’s Health to identify children aged 14 to 17 years with parent-reported ADHD and exposure to nine ACEs (n = 76,227).

Prevalence of ACEs was higher among children with ADHD vs. those without.

ADHD was more common among children who experienced socioeconomic hardship (adjusted OR = 1.39; 95% CI, 1.21-1.59), divorce (aOR = 1.34; 95% CI, 1.16-1.55), familial mental illness (aOR = 1.55; 95% CI, 1.26-1.9), neighborhood violence (aOR = 1.47; 95% CI, 1.23-1.75) and incarceration (aOR = 1.39; 95% CI, 1.12-1.72).

Researchers observed a graded relationship between ACE score and ADHD. Children with ACE scores of 2, 3 and 4 or higher had significantly higher risk for moderate-to-severe ADHD.

“Our results suggest that ACEs are prevalent among a large, nationally representative sample of children with ADHD, and that the presence of one or more ACEs increases the likelihood of having a parent report an ADHD diagnosis and moderate-to-severe ADHD. Enhanced efforts to identify ACEs among children who have or who are suspected of having ADHD should be an important component of ongoing efforts to optimize ADHD evaluation methods, diagnosis, and management, and to enhance delivery of care that is sensitive and responsive to the needs of children and families who experience trauma,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.