Young women with attention deficit hyperactivity disorder (ADHD) who experienced trauma such as abuse or neglect as children are at a higher risk of developing serious mental disorders, says a study by the University of California Berkley (UC Berkeley). Girls with ADHD who were mistreated are more likely to attempt suicide, develop eating disorders, and self-injure. The study was announced on March 3, 2015, and was published in the journal Development and Psychophathology.
ADHD is a neurodevelopmental disorder with symptoms such as inattention, poor concentration, hyperactivity, impulsiveness, and being easily distracted. The condition affects at least six million children and teens in the U.S.
“In the United States, we have a large contingent of kids being diagnosed with ADHD. At the same time, 10 to 20 percent of U.S. kids are abused or neglected, but we have very limited understanding of the overlap between these two groups,” said Maya Guendelman, a Ph.D. student in psychology at UC Berkeley, and lead author of the study. There is growing evidence that childhood maltreatment and other environmental factors have a significant impact on the psychosocial outcomes associated with ADHD.
“While ADHD is clearly a heritable and biologically based disorder, and can be treated with medications, it is very important for clinicians and treatment providers to pay close attention to the trauma experiences of individuals, particularly women with ADHD,” said Guendelman. “What if, in some portion of cases, we as clinicians, parents, and teachers are superficially seeing and diagnosing and treating symptoms of hyperactivity and inattention, but it is really trauma experiences that underlie some of those overt manifestations of ADHD?”
Guendelman and her team used data from the Berkeley Girls with ADHD Longitudinal Study which tracked more than 140 girls with ADHD from childhood to adulthood since the year 1997. The participants were a diverse group of girls in the San Francisco Bay area who were tracked during summer camp participation in childhood, adolescence and into adulthood. The study compared the emotional, academic, and behavioral development of the girls with ADHD to a group of 88 girls without ADHD.
The study showed that girls with ADHD tend to suffer this condition in more hidden ways than boys and are more likely to internalize their struggles as they mature into their teens and young adulthood. Girls have a greater tendency to suffer from depression, eating disorders, self-mutilation, and attempt suicide as they become adults.
Researchers looked at how many of the women with ADHD reported neglect, physical abuse, or sexual abuse during childhood or adolescence. Nearly one in four women in this group reported experiencing some type of trauma by adolescence compared to 11 percent of the control group who did not have ADHD. The maltreated ADHD group were more likely to experience anxiety, depression, and manifest self-destructive behavior than girls with ADHD who were not maltreated and girls in the non-ADHD group.
“Our findings clearly support the contention that child or adolescent maltreatment specifically is an important risk factor for maladaptive functioning in young adulthood among women with childhood ADHD, particularly with respect to depression, anxiety, and suicidal behavior,” Guendelman said. “This is not to say that all ADHD is due to social adversity rather than biological factors – rather, it suggests that we must consider the contribution of factors such as severe social stress and trauma in our understanding of how children with ADHD develop.”
“Across a range of mental disorders, from schizophrenia to depression and bipolar disorder, scientists are realizing that, despite the undisputed biological underpinnings of these conditions, key life experiences, including trauma, are essential forces related to long-term outcomes,” said UC Berkeley psychologist Stephen Hinshaw.