Researchers at Adelphi University say children with attention deficit hyperactivity disorder (ADHD) experience higher incidences of chronic stress, and suffer disruptions in their attachment relationships.

In a study published earlier this year in the Journal of Infant, Child and Adolescent Psychotherapy a team led by Francine Conway, PhD found a definite relationship between ADHD and complex trauma among a group of children in an urban psychiatric hospital.

The researchers reviewed the charts of 79 children and adolescents who were receiving treatment at the hospital. For each, the Hospitalized Child and Adolescent Trauma and Psychopathology Questionnaire was completed as well.

Findings showed that ADHD children “experience higher incidences of chronic stress, termed… as enviromental trauma, and disruptions in attachment relationships, referred to… as attachment trauma.

The authors of the study theorized that the “chronic adverse situations during childhood” — referred to as “complex trauma” — were integrated together with the ADHD symptoms in such a way as to make it impossible to separate the two.

Moreover, said the researchers, the complex trauma of the children was strongly correlated with behavior among children who have deficits in “mentalization” – the ability to understand the mental state of oneself and others that underlies one’s behavior.

Mentalization can be described as a form of imaginative mental activity, allowing people to perceive and interpret human behavior in the environment in terms of its intentional mental states – the needs, desires, feelings, beliefs, goals, purposes and reasons behind the behavior.

The ability to “walk a mile in another’s shoes” and to have some sense of what he or she might be thinking or feeling not only impacts neurodevelopment, but psychopathology as well. Individuals who have difficulty with attachment in their early years also are seen to have problems with the ability to mentalize – to formulate an understanding of their own and other peoples’ minds.

This difficulty is seen more often in ADHD children than in their peers from the general population, researchers suggest, due to their higher incidence of chronic stress.

Conway F, Oster M, Szymanski K. (2011) ADHD and Complex Trauma: A Descriptive Study of Hospitalized Children in an Urban Psychiatric Hospital, J. Infant, Child Adolesc. Psychother., 10:60-72