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Trauma exposure in children with and without ADHD: prevalence and functional impairment in a community-based study of 6–8-year-old Australian children

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Abstract

Both ADHD and trauma exposure are common childhood problems, but there are few empirical data regarding the association between the two conditions. The aims of this study were to compare lifetime prevalence of trauma exposure in children with and without ADHD, and to explore the association between trauma exposure and outcomes in children with ADHD. Children aged 6–8 years with ADHD (n = 179) and controls (n = 212) recruited from 43 schools were assessed for ADHD, trauma exposure and comorbid mental health disorders using the Diagnostic Interview Schedule for Children IV. Outcome data were collected by direct child assessment, parent report and teacher-report, and included ADHD symptom severity, internalizing and externalizing problems, quality of life, and academic functioning. Logistic and linear regression models were used to examine differences adjusted for child and family socio-demographics. Children with ADHD were more likely than controls to have ever experienced a traumatic event (27 vs 16%; OR: 1.99; 95% CI 1.21, 3.27). This difference remained significant in the adjusted model (OR: 1.76, 95% CI 1.03, 3.01) accounting for child factors (age and gender) and family socio-demographic factors (parent age, parent high school completion and single parent status). Among those with ADHD, trauma-exposed children had higher parent-reported ADHD severity and more externalizing problems than non-exposed children, however, this effect attenuated in adjusted model. Children with ADHD were more likely to have experienced a traumatic event than controls. The high prevalence of trauma exposure in our sample suggests that clinicians should evaluate for trauma histories in children presenting with ADHD.

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Acknowledgements

This study was funded by the Australian National Health and Medical Research Council (NHMRC; project Grant No. 1008522), the Collier Foundation and the Murdoch Childrens Research Institute. Dr Sciberras’ position is funded by an NHMRC Early Career Fellowship in Population Health 1037159 (2012–2015) and an NHMRC Career Development Fellowship 1110688 (2016-2019). Dr Alisic’s position is funded by an NHMRC Early Career Fellowship 1090229 (2015-2019). Professor Anderson is funded by an NHMRC Senior Practitioner Fellowship 607333 (2010–2014). Professor Nicholson is supported by the Australian Communities Foundation through the Roberta Holmes Chair for the Transition to Contemporary Parenthood Program (Coronella sub-fund). This research was supported by the Victorian Government’s Operational Infrastructure Support Program to the MCRI. Dr Efron’s position is funded by a Murdoch Childrens Research Institute Clinician Scientist Fellowship. We would like to acknowledge all research assistants, students and interns who contributed to data collection for this study. We would also like to thank the many families, teachers, and schools for their participation in this study. Some study data were collected and managed using REDCap electronic data capture tools hosted at MCRI. REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies.

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Correspondence to Elizabeth J. Schilpzand.

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Dr. Hazell or his employer has received payment from Shire for participation in advisory boards; Eli Lilly and Shire for speaker’s bureau. Drs. Efron, Sciberras, Anderson, Alisic, Jongeling and Nicholson, and Ms Schilpzand report no biomedical financial interests or potential conflicts of interest.

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Schilpzand, E.J., Sciberras, E., Alisic, E. et al. Trauma exposure in children with and without ADHD: prevalence and functional impairment in a community-based study of 6–8-year-old Australian children. Eur Child Adolesc Psychiatry 27, 811–819 (2018). https://doi.org/10.1007/s00787-017-1067-y

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