Comparison of exposure to trauma and attention deficit/hyperactivity disorder in children

Research suggests that children who have experienced trauma are often more likely to be diagnosed with ADHD than PTSD (Famularo et al., 1996). It has been suggested that many children who have experienced trauma may actually be misdiagnosed with ADHD, due to the overlap between ADHD and symptoms of trauma (Weinstein et al., 2000). The goal of this clinical exploratory study was to examine the comorbid features and to compare the behavioural and neuropsychological profiles of children with symptomatic trauma and children with ADHD. This goal was accomplished through three objectives: to determine the proportion of children with symptomatic trauma who also meet diagnostic criteria for ADHD; to compare children with symptomatic trauma with children with ADHD who have not experienced trauma on measures of intelligence, academic achievement, attention, memory, and executive functioning; and to compare the severity of the behavioural and emotional symptoms between these groups. Initial results revealed few significant differences on cognitive and behavioural variables between the two groups, which was believed to be associated with a 67% comorbidity of ADHD within the Trauma group. Thus, the Trauma group was subdivided into the Trauma only and ADHD/Trauma groups for further analyses. Overall, there were no significant differences between the ADHD and ADHD/Trauma groups on any of the cognitive or behavioural measures. The Trauma only group demonstrated very little impairment on cognitive and behavioural measures, with the exception of significantly lower performance on a memory composite score as compared to the normative sample. When compared to the two ADHD groups, the Trauma group demonstrated significantly higher scores on an executive functioning composite, and significantly fewer elevations on BASC parent, teacher, and self-report measures of Behavioural Symptoms, Externalizing Problems, School Problems, Adaptive Skills, Locus of Control and Depression. These findings suggest that children with symptomatic trauma are at risk for developing behavioural symptoms similar to those seen in ADHD, as well as similar cognitive and behavioural profiles to children with ADHD without exposure to trauma