When analyzing a given mental disorder, it is important to review all possible coexisting conditions that may be hiding underneath a blanket of other symptoms. While great progress has been made over recent decades to identify which types of conditions commonly overlap, many psychological relationships are still being discovered everyday. A study at UC Berkeley recently found a novel link between Attention deficit hyperactivity disorder (ADHD) and trauma that could have wide implications for injury prevention.
ADHD consists of a triad of major mental and bodily dysfunctions. The first is inattention, which is characterized by an overall difficulty with focus, persistence and organization of one’s thoughts. Second is hyperactivity, which is a physical symptom that is demonstrated by excessive, uncontrollable motor activity, such as fidgeting, tapping or being overly talkative. Last is impulsivity, which refers to hasty or risky actions that occur in the moment without consideration of long-term consequences. Together these symptoms impact a person’s mind and body and can have serious side-effects on their social life.
Previous research in this field has led to similar discoveries. Dr. Nicole Brown, assistant professor of pediatrics at New York’s Albert Einstein College of Medicine, led a review of the 2011 National Survey of Children’s Health for highlighting cases of adverse childhood experiences (ACEs) which include: poverty, divorce, death of a parent/guardian, domestic violence, neighborhood violence, substance abuse, incarceration, familial mental illness and discrimination.
Of the 65,680 children identified with ACEs, approximately 12 percent of them were diagnosed with ADHD. Parents of these children also reported a higher number of adverse childhood experiences compared to children without the disorder, as 17 percent of those with ADHD were diagnosed with four or more ACEs. Furthermore, children with four or more ACEs were deemed to be suffering from a moderate or severe level of ADHD and were almost three times more likely to use medications to treat it. This research points out that an increased awareness of the ACEs children with ADHD are susceptible to should lead to vast improvements in screening, diagnosis and treatment of both the disorder as well as trauma.
Withstanding severe trauma can also lead to problematic patterns of behavior in individuals, including the avoidance of stressful stimuli, difficulty regulating one’s emotions and sometimes developing a full-blown diagnosis of post-traumatic stress disorder (PTSD). In these cases, women have been shown to have a unique set of symptoms in response to personal trauma. Interestingly enough, one of the most noticeable distinctions between males and females who have endured trauma is the lack of noticeable symptoms in women.
Although both genders show significant emotional disruptions, women tend to turn these disturbances inward rather than outward. In fact, women are more likely to blame themselves as the cause of their traumatic experience. Due to these self-destructive thoughts, extreme feelings of anxiety and depression are soon to follow, which puts a person in even greater risk of self-injury and suicide.
Since 1997, the Berkeley Girls with ADHD Longitudinal Study (BGALS) has accumulated a substantial amount of data concerning the development of women with ADHD from childhood to adulthood. The study, fronted by Stephen Hinshaw, a university psychologist involved a pool of 140 participants and was able to distinguish trends in how women with ADHD respond to traumatic experiences. Results showed that about 25 percent of women with ADHD were suffering from trauma before their teens, while only 11 percent of those without the disorder reported similar affliction.
Unfortunately, the prevalence of both ADHD and childhood maltreatment are on a steady rise in the United States. A 2011 survey showed approximately 6.4 million children have been diagnosed with ADHD. Similarly, an estimated 3.4 million referrals of children being abused or neglected was reported in 2012. These parallel trends are disheartening, but they also signify possible overlapping instances.
As for the current research, Hinshaw’s team is aware of the many underlying factors of ADHD, including those that are biological. Maya Guendelman, a UC Berkeley Ph.D. student and colleague of the study explains that it is very vital for clinicians and treatment providers to pay closer attention to the traumatic experiences reported by women with ADHD. She goes on to add, “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’s question is a common one that has been progressively addressed in recent years. The advanced screening process of dual diagnosis has been developed to target hidden factors that could be either causing or strengthening another disorder or condition. Whether this coexisting issue is biological, mental or even substance related, dual diagnosis aims to identify and treat both conditions at once in order to enhance one’s personal management and well-being. Many centers are available that offer these detailed screenings, so if you or anyone you know suffers from trauma or an associated mental condition such as ADHD, please contact Sovereign Health of Arizona online or call us at 866-598-5661.
Written by Lee Yates, Sovereign Health Group writer
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