Abstract
PurposeAn emerging body of work suggests a link between childhood maltreatment and attention-deficit hyperactivity disorder (ADHD). However, research examining the role of maltreatment in the early course of the disorder lacks robust evidence from longitudinal studies. Our aim was to examine concurrent and prospective associations between maltreatment experiences and ADHD diagnosis and sex differences, and to estimate the association between repetitive maltreatment exposure and ADHD through childhood and adolescence.MethodsData were obtained from the Boricua Youth Study, a longitudinal study of 2480 children and adolescents of Puerto Rican background. Neglect, physical, emotional and sexual abuse, and foster placement were regressed on ADHD diagnosis measured at each of three waves using the Diagnostic Interview Schedule for Children-IV. Multilevel regressions estimated the effects of exposure on ADHD, adjusted by age, sex, income, household education, parental psychopathology, comorbidity and ADHD medication status.ResultsEmotional abuse and foster placement had robust associations with ADHD diagnosis. For girls, physical abuse had a threefold increase in the odds of having ADHD diagnosis; for boys, associations were observed only for emotional abuse. Prospective models examining the risk of ADHD following maltreatment provided initial evidence for the effects of physical abuse on ADHD, and a linear trend for repetitive exposure suggested increased probability for disorder persistence.ConclusionsAssociations between early maltreatment and ADHD were robust. Different categories of maltreatment increase the likelihood of ADHD for girls and boys. Increased exposure to maltreatment may predict symptom persistence. Interventions addressing ADHD must consider the effects of both sex and family environment.
Highlights
Childhood maltreatment, including physical and sexual abuse and neglect, is a common risk factor associated with long-term psychiatric morbidity and mortality
Physical abuse and foster placement were significantly associated with attention deficit/hyperactivity disorder (ADHD) diagnosis across waves (Table 2)
Emotional abuse and foster placement remained significant with robust associations after adjustments were made for all demographics, any parental psychopathology and ADHD medication
Summary
Childhood maltreatment, including physical and sexual abuse and neglect, is a common risk factor associated with long-term psychiatric morbidity and mortality. There is an emerging body of work linking experiences of childhood maltreatment with attention deficit/hyperactivity disorder (ADHD) [6,7,8,9]. ADHD is a highly heritable disorder relative to other forms of psychiatric morbidity [10]. It is one of the most prevalent psychiatric disorders in children and adolescents, ranging from 2 to 7.1%, based on global meta-analytic rates [11, 12]. Several lines of evidence point to a potential link between maltreatment and ADHD
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