Attention-Deficit/Hyperactivity Disorder and Childhood Trauma: Implications for Differential Diagnosis Among Adult Clinical Patients
Kellye Winbush-Fairley, Hailey G. Kinzer, Briana N. Galindo, John-Christopher A. Finley, Aubry Wood, Megan Wintrode, Gabrielle Nabity, Aaliyah Henderson, Malorie E. Watson, Brian M. Cerny, Jason R. Soble, Matthew S. PhillipsBackground
Attention-deficit/hyperactivity disorder (ADHD) and psychological effects of childhood trauma overlap in symptom presentation. Given this symptom overlap, this study investigated the relationship between childhood trauma and ADHD diagnostic status in a sample of adult clinical patients.
Methods
A cross-sectional design analyzed data from 603 adult patients. Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Participants were classified into non-ADHD (n = 257) and ADHD (n = 346) groups. Specific trauma symptoms and exposure levels, as well as sex-based differences were then analyzed for each group.
Results
The non-ADHD group had more traumatic experiences related to emotional abuse, emotional neglect, and sexual abuse compared to the ADHD group. No significant group differences were observed for physical abuse or physical neglect. Within the non-ADHD group, males reported higher levels of sexual abuse, and females reported higher levels of emotional abuse and emotional neglect. Sex differences were not found within the ADHD group.
Conclusions
Patients who experienced childhood emotional trauma may report higher rates of attentional complaints in adulthood which may resemble ADHD symptoms but are inconsistent with ADHD diagnostic criteria. Findings highlight the importance of trauma-informed assessment practices to improve diagnostic accuracy and guide treatment recommendations for adults presenting with attentional concerns.