Childhood Stressors Linked to ADHD Diagnosis

Certain stressors may cause children to exhibit behavior similar to symptoms of ADHD.
Published: October 14, 2016

A new study found that children who have been exposed to certain adverse experiences are more likely to be diagnosed with Attention Deficit Hyperactivity Disorder.

For the study researchers analyzed family stressors, environmental stressors and other traumatic experiences in a sample of 76,227 children from the 2011-2012 National Survey of Children’s Health.

Stressors, such as socioeconomic hardship, divorce or familial incarceration, may impair brain development, behavior and overall physical and mental health, although they have not been directly linked to ADHD, according to The report’s authors speculated that doctors unfamiliar with a child’s history may misdiagnose the child.

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“If clinicians aren’t routinely discussing exposure to traumatic experiences and identifying [Adverse Childhood Experiences], particularly among children with behavioral concerns such as ADHD, there may be a heightened risk of missing an underlying trauma history or misattributing some of the symptoms of traumatic stress as solely those of ADHD,” lead author Nicole M. Brown of the Division of Academic General Pediatrics at Children’s Hospital at Montefiore says. “We sought to examine the link between ADHD and ACEs in an effort to improve ADHD assessment and management.”

ADHD is a neurobehavioral disorder that has become far more common in children over the last decade. The study, titled “Associations Between Adverse Childhood Experiences and ADHD Diagnosis and Severity,” looked at ADHD in children four to 17 years old. Other stressors analyzed included children’s exposure to death, domestic violence, neighborhood violence, substance abuse, mental illness and discrimination.

“Our research shows there are significant associations between ACE exposures and having an ADHD diagnosis, and we encourage pediatric providers to more frequently evaluate for ACEs as part of ADHD assessments,” Dr. Brown says. “Ultimately, this may lead to more trauma-informed approaches to care, particularly for children whose response to stimulant medications or targeted behavioral therapies are poor.”

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