Assistant Professor University of Denver Chicago, IL, United States
Abstract Text: Youth with attention-deficit/hyperactivity disorder (ADHD) face high rates of trauma exposure (Lugo‐Candelas et al., 2021), which in turn worsens ADHD symptomology and impairment (Boodoo et al., 2022). ADHD and post-traumatic stress disorder (PTSD) share overlapping symptomology, including inattention, hyperactivity, difficulty with organization, and impulsivity (Szymanski et al., 2011; Dodson, 2023). Yet, no studies to-date have examined how ADHD presentations affect PTSD diagnoses. This study examined which presentations of ADHD are more likely to develop PTSD after trauma exposure. As PTSD and ADHD symptomology overlap in both the inattentive and hyperactive/impulsive presentations (Dodson, 2023), we predict that combined presentation is likely to have the highest rates of PTSD after trauma exposure.
Participants were Black and/or Latiné youth (mage = 14.62, range 11-18 years old) who received a culturally responsive assessment for ADHD. Trauma exposure was measured using the Adverse Childhood Experience Questionnaire, Community Experiences Questionnaire, Everyday Discrimination Scale, and the Adolescent Discrimination Distress Index. Eighteen participants met criteria for combined presentation, 23 for predominantly inattentive presentation, and 1 for predominantly hyperactive/impulsive presentation. All participants were trauma exposed (n = 42). Analysis consisted of calculating the distribution of PTSD diagnosis among the main three ADHD presentations.
One hundred percent of participants in the study, which was focused on providing ADHD assessments for Black and/or Latiné youth, experienced at least one trauma exposure. Those with combined presentation had the highest percentage of PTSD diagnosis after trauma exposure (27%). Both combined and inattentive ADHD presentations were more likely to develop PTSD after trauma exposure (combined presentation 27%, predominantly inattentive presentation 17%) than the general population (4%, Kessler et al., 2017). Due to low sample size, we are unable to report the likelihood of PTSD diagnosis with the predominantly hyperactive/impulsive presentation of ADHD.
Importantly, all youth in this study experienced some aspect of trauma exposure despite this study focusing on ADHD. Results indicate that Black and/or Latiné youth with ADHD are at heightened risk for PTSD, especially those with the combined presentation of ADHD. Rates of PTSD for youth in this sample were much higher than the general population. Thus, Black and/or Latiné youth with ADHD should receive trauma screening in pediatrician's offices, psychology clinics, and at school to tailor support. Screening should include ACEs as well as exposure to discrimination and community violence. Clinicians working with Black and/or Latiné youth with ADHD should include not only trauma screening, but trauma informed interventions, particularly for complex trauma and discrimination (i.e., EMBRace intervention, Anderson et al., 2018).
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