Specific Adverse Childhood Experiences and Homelessness are Associated with Increased Risk for Attention Deficit Hyperactivity Disorder in a Nationally Representative Sample

Abstract

This study examines associations of homelessness and specific Adverse Childhood Experiences (ACEs) on Attention Deficit Hyperactivity Disorder (ADHD). Unlike prior research focusing on the number of ACEs, our study hypothesized that there are specific types of high-risk ACEs associated with ADHD, and that homelessness further increased such risk association. Data samples obtained from the National Longitudinal Study of Adolescent to Adult Health, and measures of ACEs derived from measures used in the CDC-Kaiser ACE study were used to test the associations. Survey based logistic regression analysis identified which specific high-risk ACES were associated with ADHD. The specific high-risk ACEs were summed, then used with homelessness and demographics as covariates to adjust a survey based logistic regression model for the assessment of relative risk, namely the odds ratios of ACE scores and homelessness associated with ADHD. Three ACEs (sexual abuse, emotional abuse, and mental illness in the household) were associated with increased risk of ADHD by 67%, 76% and 89%, respectively. The addition of homelessness and any one of the identified high-risk ACEs was strongly associated with almost a 5.0-fold risk of lifetime ADHD diagnosis. The assessment of these ACEs and homelessness should be included when screening patients for ADHD.