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Adult ADHD in Trauma- and Stressor-Related Disorders

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The Burden of Adult ADHD in Comorbid Psychiatric and Neurological Disorders

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Abstract

Among the Trauma- and Stressor-Related Disorders classified in DSM-5, Post-Traumatic Stress Disorder (PTSD) is one of the most frequently reported in people with ADHD and vice versa. As their clinical presentation overlaps for some features, it is very challenging for the clinician to recognize ADHD in individuals suffering from PTSD. PTSD is not so uncommon. In fact, there is evidence indicating a higher likelihood for developing a PTSD after some traumatic life events such as chronic illnesses, relationship problems, and unemployment in respect to after severe traumas such as accidents, physical and sexual assaults, and robbery.

ADHD is a disorder causing great impairment to people affected throughout lifetime, as they experience occupational and relationship problems as well physical accidents/trauma at higher frequency than in general population. Moreover, ADHD symptoms have been found associated with greater sexual victimization during adolescence, and linked with sexual victimization through engagement in risky sexual behavior. Therefore, greater vulnerability to the PTSD onset is expected.

From a neuropsychological point of view, individuals with PTSD suffer from impairment in attentional and memory cognitive domains, but deficits in attentional control and poor response inhibition can also predate the trauma exposure. Studies performed on youth with ADHD have shown a relationship between hyperarousal symptoms of PTSD and inattentive symptoms of ADHD, but no association with hyperactive/impulsive symptoms. However, results from studies on adults with both ADHD and PTSD were slightly different from those found in children and adolescents.

The 50% of people with PTSD do not respond to the main treatment, and this may be due to the presence of comorbid conditions. The vast majority of PTSD interventions are addressed to the re-experiencing and avoidance symptoms, with an absence of interventions focused on the neurocognitive deficits.

There is a paucity of studies investigating the effect of ADHD medication on PTSD symptomatology, but evidence up to date shows that methylphenidate improves not only PTSD symptoms but also depressive and post-concussive symptoms in individuals with PTSD, TBI, or both, and exerts a beneficial effect on cognition.

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    Stefano Pallanti & Luana Salerno

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Pallanti, S., Salerno, L. (2020). Adult ADHD in Trauma- and Stressor-Related Disorders. In: The Burden of Adult ADHD in Comorbid Psychiatric and Neurological Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-39051-8_13

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  • DOI: https://doi.org/10.1007/978-3-030-39051-8_13

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  • Online ISBN: 978-3-030-39051-8

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