The Effect of Adverse Childhood Experiences on ADHD Symptom Reporting, Psychological Symptoms, and Cognitive Performance Among Adult Neuropsychological Referrals

Alfonso, Demy; Basurto, Karen; Guilfoyle, Janna; VanLandingham, Hannah B.; Gonzalez, Christopher; Ovsiew, Gabriel P.; Rodriguez, Violeta J.; Resch, Zachary J.; Ulrich, Devin M.; Soble, Jason R.

doi:10.1177/10870547231196326

J Atten Disord

2023

DOI: 10.1177/10870547231196326

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The Effect of Adverse Childhood Experiences on ADHD Symptom Reporting, Psychological Symptoms, and Cognitive Performance Among Adult Neuropsychological Referrals

Demy Alfonso,

Karen Basurto,

Janna Guilfoyle

et al.

Abstract: Objective: Adverse childhood experiences (ACEs) are early life experiences that influence mental health outcomes, though there are mixed findings reported in relation to attention deficit hyperactivity disorder (ADHD) symptoms. The current study compared adults who experienced ACEs on measures of ADHD symptom reporting, psychological symptoms, and neurocognitive test performance. Method: The sample ( n = 115) had mean age of 28.42 ( SD = 6.46); educational attainment of 16.47 years ( SD = 1.99); and was 35% ma… Show more

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2024

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Cited by 4 publications

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Adverse Childhood Experiences and Attention Deficit-Hyperactivity Disorder Diagnosis and Severity: An Update

Crouch,

Boswell

2024

Academic Pediatrics

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Adverse Childhood Experiences and Attention Deficit-Hyperactivity Disorder Diagnosis and Severity: An Update

Crouch,

Boswell

2024

Academic Pediatrics

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The Impact of Adverse Childhood Experiences on Symptom and Performance Validity Tests Among a Multiracial Sample Presenting for ADHD Evaluation

Gonzalez,

Finley,

Khalid

et al. 2024

Archives of Clinical Neuropsychology

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Objective Adverse childhood experiences (ACEs) are commonly reported in individuals presenting for attention-deficit hyperactivity disorder (ADHD) evaluation. Performance validity tests (PVTs) and symptom validity tests (SVTs) are essential to ADHD evaluations in young adults, but extant research suggests that those who report ACEs may be inaccurately classified as invalid on these measures. The current study aimed to assess the degree to which ACE exposure differentiated PVT and SVT performance and ADHD symptom reporting in a multi-racial sample of adults presenting for ADHD evaluation. Method This study included 170 adults referred for outpatient neuropsychological ADHD evaluation who completed the ACE Checklist and a neurocognitive battery that included multiple PVTs and SVTs. Analysis of variance was used to examine differences in PVT and SVT performance among those with high (≥4) and low (≤3) reported ACEs. Results Main effects of the ACE group were observed, such that high ACE group reporting demonstrated higher scores on SVTs assessing ADHD symptom over-reporting and infrequent psychiatric and somatic symptoms on the Minnesota Multiphasic Personality Inventory-2-Restructured Form. Conversely, no significant differences emerged in total PVT failures across ACE groups. Conclusions Those with high ACE exposure were more likely to have higher scores on SVTs assessing over-reporting and infrequent responses. In contrast, ACE exposure did not affect PVT performance. Thus, ACE exposure should be considered specifically when evaluating SVT performance in the context of ADHD evaluations, and more work is needed to understand factors that contribute to different patterns of symptom reporting as a function of ACE exposure.

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Examining the Association Between Adverse Childhood Experiences and ADHD in School-Aged Children Following the COVID-19 Pandemic

Boswell,

Crouch,

Odahowski

et al. 2024

J Atten Disord

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Background: Adverse childhood experiences (ACEs) have long been associated with attention-deficit/hyperactive disorder (ADHD) diagnoses in children; but the data used is now over 6 years old (from 2017 to 2018). Understanding the current landscape of their prevalence and association is needed to capture evolving social, environmental, and economic conditions, and ensure interventions remain relevant to addressing current childhood trauma. Objective: This study provides an updated analysis of the association between ACEs and ADHD using post-acute-COVID-19 pandemic data. Participants and Setting: This cross-sectional study of 10,518 children aged 5 to 17 years old derived data from the 2021 to 2022 National Health Interview Survey (NHIS). Methods: Differences in the prevalence of number (0, 1–3, or 4+) and type of ACEs by ADHD diagnosis were evaluated using Rao-Scott chi-square tests and multivariable logistic regression. All analyses incorporate complex survey weights. Results: In 2021 to 2022, 2,457 (23.3%) of children experienced ACEs and 1,115 (9.9%) had an ADHD diagnosis. Children with ADHD were more likely to experience every type of ACE and were more likely to have 1 to 3 or 4+ ACEs than children without ADHD. Children with 4+ ACEs had higher odds of having an ADHD diagnosis (aOR: 3.44, 95% CI [2.64, 4.49]) than children without ACEs. Male children, children with fair or poor health, and children living in rural counties were more likely to have an ADHD diagnosis, while children of color and uninsured children were less likely. We found the odds ratio of ADHD diagnosis for children with four or more ACEs, compared to those without ACEs, slightly lower than found in Brown et al., 2017’s estimate of 3.97 (CI [3.29, 4.80]). These results suggest a consistent association between ACEs and ADHD when comparing pre-COVID data to our post-acute-COVID results. Conclusions: These findings highlight the need for clinicians to consider traumatic stress in ADHD screening. Policymakers and early childhood organizations should encourage early screening and intervention for ACEs to reduce the impacts of ADHD diagnoses.

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The Effect of Adverse Childhood Experiences on ADHD Symptom Reporting, Psychological Symptoms, and Cognitive Performance Among Adult Neuropsychological Referrals

Cited by 4 publications

References 36 publications

Adverse Childhood Experiences and Attention Deficit-Hyperactivity Disorder Diagnosis and Severity: An Update

Adverse Childhood Experiences and Attention Deficit-Hyperactivity Disorder Diagnosis and Severity: An Update

The Impact of Adverse Childhood Experiences on Symptom and Performance Validity Tests Among a Multiracial Sample Presenting for ADHD Evaluation

Examining the Association Between Adverse Childhood Experiences and ADHD in School-Aged Children Following the COVID-19 Pandemic

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