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Cited by 60Child Abuse and TraumaAttention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional Development

ADHD and risk for subsequent adverse childhood experiences: understanding the cycle of adversity

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Lugo‐Candelas, Claudia, Corbeil, Thomas, Wall, Melanie, Posner, Jonathan, Bird, Hector, Canino, Glorisa, Fisher, Prudence W., Suglia, Shakira F. +1 more·2021·Journal of Child Psychology and Psychiatry
DOI 10.1111/jcpp.13352PMC PMC8169708
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Abstract

Background: Children with adverse childhood experiences (ACEs) are more likely to develop Attention‐Deficit/Hyperactivity Disorder (ADHD). The reverse relationship – ADHD predicting subsequent ACEs – is vastly understudied, although it may be of great relevance to underserved populations highly exposed to ACEs. Methods: Participants were 5‐ to 15‐year‐olds (48% females) with (9.9%) and without ADHD (DSM‐IV criteria except age of onset) in a longitudinal population‐based study of Puerto Rican youth. In each wave (3 yearly assessments, W1‐3), ten ACEs (covering parental loss and maladjustment and child maltreatment) were examined, plus exposure to violence. Logistic regression models examined ADHD (including subtypes) and subsequent risk for ACEs. Also considered were interactions by age, sex, number of W1 ACEs, and recruitment site. Results: Children with W1 ADHD were more likely to experience subsequent adversity (OR: 1.63; 95% CI: 1.12–2.37) accounting for child age, sex, public assistance, maternal education, site, disruptive behavior disorders, and W1 ACEs. Inattentive (OR: 2.00; 95% CI: 1.09–3.66), but not hyperactive/impulsive or combined ADHD, predicted future ACEs. Conclusions: ADHD predicts subsequent risk for ACEs, and the inattentive presentation may confer the most risk. Inattentive presentations could pose a bigger risk given differences in symptom persistence, latency to access to treatment, and treatment duration. The present study suggests a pathway for the perpetuation of adversity, where bidirectional relationships between ADHD and ACEs may ensnare children in developmental pathways predictive of poor outcomes. Understanding the mechanism underlying this association can help the development of interventions that interrupt the cycle of adversity exposure and improve the lives of children with ADHD.

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Authors
Lugo‐Candelas, C., Corbeil, T., Wall, M., Posner, J., Bird, H., Canino, G., Fisher, P. W., Suglia, S. F., & Duarte, C. S.
Affiliations
  • New York State Psychiatric Institute Columbia University Irving Medical Center New York NY USA
  • Columbia University Irving Medical Center (US)
  • University of Puerto Rico System (PR)
  • Emory University (US)
ORCID
Venue
Journal of Child Psychology and Psychiatry
Publisher
Wiley
Published
2020-12-02
Volume
62
Issue
8
Pages
971-978
ISSN
  • 0021-9630 (ISSN-L)
  • 1469-7610
DOI
10.1111/jcpp.13352
PMC
PMC8169708
OpenAlex
W3109083401
Cited by
60
References
39
Citations by year
2026: 12 · 2025: 13 · 2024: 7 · 2023: 19 · 2022: 5 · 2021: 3
FWCI
2.69
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Child Psychology and Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Drug Abuse (R01‐DA033172)
  • National Institutes of Health (UH3‐OD023328)
  • National Institute of Mental Health (R01‐MH56401;K08‐MH117452)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
attention deficit hyperactivity disorder, adverse childhood experiences, child abuse, parental loss, violence exposure, bidirectional relationship, Puerto Rican children, disruptive behavior disorders, social assistance, maternal education
MeSH terms
Adverse Childhood Experiences, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Child Abuse, Family, Female, Humans, Male, Attention Deficit and Disruptive Behavior Disorders

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