Adverse Childhood Experiences Linked to ADHD Symptoms

Research from the University of Bordeaux uncovers how adverse childhood experiences increase the likelihood of ADHD symptoms in French students.

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A new article in the Journal of Child and Adolescent Trauma finds that Adverse Childhood Experiences (ACE) are linked to ADHD symptoms in French college students. The current research, led by Ashlyn Schwartz from the University of Bordeaux, also finds that ADHD symptoms are more likely with exposure to multiple types of ACE. Sexual abuse, emotional neglect, physical neglect, and bullying were the ACEs most associated with ADHD symptoms.

“After controlling for potential confounders, every increase in ACE exposure heightened the risk of ADHD symptoms,” the authors write. “Findings suggest that ACEs heighten the risk for developing ADHD symptoms among college students and bear important implications for prevention and clinical practice.”

This research connecting ADHD symptoms to ACEs challenges the view of ADHD as a purely neurobiological disorder requiring pharmacological intervention. By demonstrating that ADHD symptoms can be significantly influenced by trauma, this study challenges the notion that these symptoms are purely biologically driven and unchangeable. Furthermore, the findings complicate some principles of the neurodiversity movement, which advocates for the acceptance of neurological differences without necessarily addressing the impact of environmental factors like trauma.

Instead, the research strengthens psychological perspectives that understand ADHD symptoms as neurodevelopmental, arising from a complex interplay between individual neurological predispositions and their relational and social environments. This perspective underscores the importance of addressing social determinants and trauma in the assessment and treatment, advocating for a more holistic approach and integrative approach.

The goal of the current research was to investigate the link between ACE and ADHD symptoms in college students. The authors also wanted to explore the association between exposure to multiple ACEs and ADHD symptoms, as well as associations between specific types of ACE and ADHD symptoms.

The current work used data from the Students Health Research Enterprise (i-Share), an online self-report survey available to French college students. I-Share collects data on ACE, mental health, substance use, risk behaviors, and demographic information. Students take a baseline assessment when registering for i-Share and are invited to complete annual follow-ups.

To be eligible for i-Share, students must be enrolled in a French college or higher education institution, be at least 18 years old, and be able to read French. The current study used baseline data collected between September 2018 and October 2021.

The authors created nine yes/no categories of ACE, including emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, parental divorce, parental substance use, parental mental illness, and bullying. They then separated participants into four groups: no ACE, 1 type of ACE, two types of ACE, and three or more types of ACE.

ADHD symptoms were measured using the World Health Organization’s Adult Self Report Scale (ASRS). This consists of 6 questions: 4 measuring how often the participant engages in inattentive behaviors and 2 measuring hyperactive/impulsive behaviors. Participants respond to each question on a 5-point scale, where 0 = never and 4 = often. A score between 18 and 24 represents a clinically relevant cut-off.

The researchers also examined data on variables other than ACE that could contribute to the development of ADHD symptoms. These variables included sex, how long they had attended a university, socioeconomic status during adolescence, whether they had ever consumed tobacco, whether they had ever used illicit drugs, whether they had ever used cannabis, and whether they had a history of depression or anxiety.

The authors used data from 1,062 participants in the current research. The majority of participants were female (81.4%). 30.6% reported no ACE, 29.6% reported 1 type of ACE, 19.2% reported two types of ACE, and 20.6% reported three or more kinds of ACE. 38.3% of participants reported parental mental illness, and 32.5% reported parental divorce.

All other types of ACE had significantly lower numbers reported as follows: bullying (18.5%), emotional neglect (14.6%), emotional abuse (12.8%), sexual abuse (11.6%), physical abuse (10.8%), parental substance use (9.1%), and physical neglect (6.7%). 5.13% reported ADHD symptoms. 12.4% reported a depressive disorder diagnosis, and 14.1% reported an anxiety disorder diagnosis.

ACEs were significantly associated with ADHD symptoms. After adjusting for sociodemographic, mental health, and substance use variables, participants who endorsed 1 ACE type were 2.1 times as likely as those who had no ACE to report ADHD symptoms. Those who endorsed 2 ACE types were 4.5 times more likely to report ADHD symptoms, and those who endorsed three or more ACE types were 5.2 times as likely to report ADHD symptoms.

Participants endorsing three or more ACE types were also significantly more likely to report a depression (4.9 times as likely) or anxiety (3.7) diagnosis. The individual ACEs most associated with ADHD symptoms were sexual abuse (2.3 times more likely), emotional neglect (2.5), physical neglect (2.5), and bullying (2.5).

The authors acknowledge several limitations to the current work. The participant sample was not representative of the population, and some groups most at risk for ADHD (males and those from low socioeconomic backgrounds) were underrepresented. The ASRS only measures ADHD symptoms and is not the same as an ADHD diagnosis. Several “overwhelmingly stressful” events that likely should be considered ACE were not examined in the current work, including severe economic hardship, parental intimate partner violence, parental incarceration, chronic disabilities, exposure to war/migration, and racial discrimination.

The self-report nature of the data also means the researchers were not able to determine if ADHD symptoms were present before the ACEs. The authors note that while the findings here could point to ACE causing ADHD symptoms, it is equally likely that children who exhibit ADHD symptoms are more likely to have ACE. For example, children lacking self-control may be more likely to experience bullying and harsh punishments from adults.

The authors conclude:

“Findings suggest that college students with ACE exposure have a heightened risk of ADHD symptoms and certain ACE types (sexual abuse, emotional neglect, physical neglect, and bullying) may contribute greater risk. More longitudinal research is needed to understand the temporality of the association between ACEs and ADHD symptoms to best identify factors to improve intervention and prevention efforts.”

Previous research has found that ACE can have lifelong health consequences. Exposure to ACE likely increases the risk of depression, psychosis, and suicide. ACE has been linked to poor sleep, lower academic achievement, and emotional/behavioral problems. Some research has found that childhood adversity can even change stress-related gene expression.

At present, no biomarkers can be reliably identified for ADHD, meaning researchers are unable to point to anything that can be objectively tested with biomedical measures. Previous research has found that ADHD is likely overdiagnosed, needlessly exposing service users to drugs that have been linked to cardiovascular disease. One piece of research found that children who exhibited identical symptoms had very different outcomes depending on whether they received an ADHD label, with those given a diagnosis having a worse quality of life and an increased risk of self-harm.

 

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Schwartz, A. et. al. (2023). Adverse Childhood Experiences and ADHD Symptoms Among French College Students. Journal of Child and Adolescent Trauma 16 1109-1117. (Link)

6 COMMENTS

  1. Is there any of the “invalid” “mental illnesses” that is not linked to ACEs or trauma?

    https://www.madinamerica.com/2016/04/heal-for-life/
    https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
    https://psychrights.org/2013/130429NIMHTransformingDiagnosis.htm

    It seems the answer to that question is NO. And all this ACEs covering up is by DSM design, since the “mental health” workers can’t even honestly bill to help child abuse survivors.

    https://www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1

    But since almost all children on the planet were abused with the Covid measures (masks, etc.), it sure does seem that we need a whole lot of caring people, who actually want to honestly help child abuse survivors heal. Instead of the “mental health” industries continuing to profiteer off of silencing child abuse and rape survivors which, of course, also aids and abets the child abusers … to the point we are here:

    https://www.amazon.com/Pedophilia-Empire-Chapter-Introduction-Disorder-ebook/dp/B0773QHGPT

    It’s not time to “maintain the status quo.” It’s time for a paradigm change, “mental health” industries, including the child abuse covering up and abusing, Child Protective Services (CPS) industry.

    https://parentalrights.org/child_protective_services/

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  2. Most of the so-called psychiatric diagnoses are simply different manifestations of trauma and adversity, but unlike actual medical professions, psychiatry has never been interested in causes, only “symptoms” that need to be done away with and as such they can justify their existence.

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  3. As long as we consider “ADHD” as a neurodevelopmental disorder with biological underpinnings, we do not have to take accountability for the circumstances children are raised in or what they are exposed to. Very convenient for parents, foster parents, group homes, child protection agencies, schools, etc.

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  4. The American medical journalist Arthur Firstenberg, “The invisible Rainbow”, has a completely different view of ADHD. Our nervous system is electrical and what causes illness in us is, in his opinion, induced by electricity from the environment. He describes the history of electricity and the development of illnesses.
    A very interesting aspect, in my opinion.

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  5. There is no “ADHD.” There are any number of reasons why a given child might have problems with distraction or inattention. Far better t identify the source of a child’s problems and address that, than to attribute those problems to some mythical disease entity, the existence of which has never been demonstrated.

    https://www.amazon.com/Obedience-Pills-ADHD-Medicalization-Childhood/dp/1989963242/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=

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    • Thank you for writing this much needed book Patrick!

      To piggy back to my general comment:

      In last weeks New Yorker, the article “The Battle for Attention” cites a medical software company (Epic), writing that the ADHD diagnosis “tripled between 2010 and 2022”, “the biggest uptick being elementary school children”. I mention this because its utterly impossible for a psychiatric diagnosis supposedly originating from ones bio-physiology, and from which effectively doesn’t have (“actual”) environmental causes (psychiatry’s platitudes notwithstanding), to triple in 12 years. ADHD can’t be both an individual “medical” problem and a social phenomena.

      Though this statistic didn’t surprise me in the least, it did lead me to think that the ADHD diagnosis (including self diagnosis viz the growing linguistic colonization, etc.) is becoming so saturated in our world-while continuing unabated, that at some point the acronym ADHD won’t mean anything… I can more than imagine this scenario coming to fruition, including the backlash at its 50 year con job.

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