Dual vulnerability: Trauma type and burden impact behavioral and psychosocial functioning in children with ADHD

Trauma-related symptoms can overlap with core symptoms of ADHD. However, there is limited evidence of exploration of how trauma exposure, particularly trauma burden and trauma type, relates to ADHD and whether these associations differ in their impact on psychosocial functioning compared to neurotypical (NT) children.

To examine the associations between trauma exposure, trauma burden and trauma type and ADHD status and to assess whether these factors are differentially associated with behavioral, psychological and social functioning in children with ADHD compared to NT peers.

Participants (N = 242) comprised of an ADHD (n = 141, 58.26%) and a NT group and were a subset of children whose parents completed the adverse childhood experience questionnaire. Behavioral and psychosocial functions were examined using the child behavior checklist.

Children with ADHD were more likely to be exposed to trauma and to report higher trauma burden. Exposure to a single traumatic event resulted in a higher trauma burden and higher internalizing and externalizing problems in children with ADHD compared to NT children. They also had higher exposure to events related to household dysfunction, compared to NT children, after adjusting for socio-demographic factors. For trauma type, household dysfunction associated with higher internalizing problems and abuse-related trauma associated with higher internalizing and social difficulties in those with ADHD when compared to NT children with similar trauma exposures.

Trauma burden and type can have differential effects on behavioral and psychosocial problems in children with ADHD.