The Relationship Between Attentiondeficit/hyperactivity Hyperactivity Disorder and Adverse Experiences in Childhood

Abstract

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is currently the most commonly diagnosed psychiatric disorder among school aged children. Various studies have found an association between ADHD and adversive childhood experiences. However, there are many conflicting hypotheses about the nature and direction of this relationship. The first aim of the study was to establish whether there is a relationship between adversive childhood experiences and the symptoms, and diagnoses, of ADHD, Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), and Post Traumatic Stress Disorder (PTSD). Secondly, the study aimed to determine whether there is a group of children/adolescents with symptoms of ADHD that constitute a 'complicated ADHD' group. The study aimed to investigate whether this 'complicated ADHD' group had higher rates of adversive childhood experiences, higher rates of diagnostic co-morbidity, and more serious externalizing symptoms. Methodology: The clinical records of 217 consecutively admitted clients of a New Zealand Child and Adolescent Mental Health Service (CAMHS) were read in their entirety. Information regarding diagnoses, symptomology, and adversive childhood experiences was recorded and analysed. Latent class analysis was used to group children and adolescents into homogenous groups based on their profiles of ADHD, ODD and CD symptoms. Results: The study found significant associations between adversive childhood experiences and the symptoms of ADHD, PTSD, and other disruptive behavioural disorders. Latent class analysis revealed a group of children and adolescents who had more serious externalizing symptoms (a high number of ADHD, ODD and CD symptoms) and a high rate of diagnostic co-morbidity. This group had a higher average rate of adversive childhood events, physical abuse, and exposure to domestic violence, compared to the other children and adolescents with symptoms of ADHD. Conclusions: The findings from this study confirm other findings that early adversive childhood experiences place children and adolescents at significant risk of developing ongoing issues with inattentiveness, hyperactivity and impulsivity. Furthermore, the study provides tentative evidence that early adversive experiences may create a more complicated profile of ADHD symptoms and perhaps impact the way that ADHD symptoms manifest.