Category Archives: Adhd

Can childhood trauma cause ADHD?

Reasons Why ADHD Might Be Being Overdiagnosed.

How Many Young People Are Diagnosed With ADHD?

Statistics reveal around 1 in 7 young people in the United States currently receives a diagnosis of ADHD (the majority of whom are male)) and it is has been argued by many that a large proportion of these diagnoses are incorrect ; in fact, it is quite possible that the number of incorrect diagnoses outweigh the correct ones.

Overdiagnosis ?

The extremely strong suspicion that ADHD is being overdiagnosed in young people in the United Stated is underlined by the fact that The American Psychiatric Association estimates the true number of ADHD sufferers to be around 5% (i.e. a mere third of those who are being diagnosed with the condition – see above) and this figure is generally endorsed as a realistic estimate ny most experts in the field.

Explosion of Diagnoses :

Also, it should be taken into consideration that there has been an absolute explosion in relation to the diagnosis of ADHD in the recent past ; for example, in 1990 only about 1% of young people, at most, had been diagnosed with ADHD.

In the UK, prescriptions of retalin have doubled for children and adolescents between 2003 and 2008 (and, in relation to adults, they have quadrupled).

So, if we accept the ADHD is indeed being overdiagnosed in young people, what are the possible reasons for this unfortunate occurrence?

Possible Explanations For Over-Diagnosis Of ADHD:


One reason that is frequently put forward is that the organizations profiting from selling the drugs that are used to treat ADHD are funding studies, running aggressive campaigns (including campaigns endorsed by celebrities) and hiring physicians who will increase their sales and, of course, their profits.


It is also argued in some quarters that diagnosing a young person with ADHD so that he or she can then be medicated with drugs that have a ‘subduing’ effect may be, at least in part, motivated by a wish of some (e.g. over-stressed teachers) to control disruptive students rather than by a sole inclination to act in the young person’s best interests. Indeed, such motivation may, in some cases, be operating on an unconscious level with the concept of the young person having a genuine clinical need for the medication serving as a convenient rationalization.


Indeed, some researchers have even suggested that the diagnosis of ADHD,and the subsequent administration of medication purpotedly to treat it, represents a cultural intolerance of boys deriving from a perception that their high levels of energy and aggressive tendencies make them hard to keep under discipline. In fact, as long ago as the 1970s, the drug retalin was being described by some as the ‘bahvior drug’ and, more recently, terms like ‘pathologizing boyhood’ and ‘medicating boyhood’ have been suggested in relation to the perceived inappropriate use of the drug (Kindton and Thompson, 1999 :Raising Cain: Protecting the Emotional Life of Boys ).


A very large proportion of children (estimated at around 85 per cent) are diagnosed with ‘mild’ or ‘moderate’ symptoms of ADHD. It is argued that in such cases where symptoms are not severe and dramatically pronounced, the diagnosis is subject to being overly influenced by subjective opinion.


Some individuals may fake ADHD symptoms so that they can gain a prescription for ADHD medication in the hope that it will improve their powers of concentration and attention in a way that helps them to achieve better academic grades. In other words, they treat such medication as ‘performance-enhacing drugs.’


One study conducted in the 1990s (Watson) found that young students who were young for their grade in school were 20 times more likely to receive a diagnosis of ADHD than those who were not in this category (although there was some initial dispute, subsequently resolved, over her findings).

Another study, conducted by Ford-Jones, PhD, found that children born in December (the youngest in their grade) were more likely to receive a diagnosis of ADHD than those born in December (the oldest in their grade).


It is possible that depression is sometimes misdiagnosed as ADHD because of the symptoms the two conditions share in common such as disrupted sleep, irritable mood and problems relating to focus, concentration and attention.


Similarly, it is possible that anxiety is sometimes misdiagnosed as ADHD because of the symptoms the two conditions share in common such as irritable mood, problems relating to focus, concentration and attention, restlessness and difficulties relating to interpersonal relationships due to social anxiety.


See my previously published article : Childhood Trauma : Is PTSD Being Misdiagnosed as ADHD?


It is important to stress, that despite controversy regarding the appropriateness, or otherwise, of many diagnoses of ADHD, it is widely accepted amongst the medical community that a significant quantity of ADHD diagnoses are clinically justifiable and that sometimes the prescribed medication that follows such a diagnoses is beneficial to the individual to whom it is administered.


The UK guidelines (PDF, 217Kb) 


David Hosier BSc Hons; MSc; PGDE(FAHE).

ADHD And Its Link To Childhood Trauma And A Negative Thinking Bias

There is increasing evidence derived from research studies that ADHD is linked to psychosocial stress, particularly childhood trauma which has been established as a major factor putting the child at increased risk of developing ADHD (e.g. Stevens et al., 2007).

Indeed, there is a growing school of thought expressing the view that many individuals are receiving a diagnosis of ADHD which is erroneous (i.e. a misdiagnosis) and, instead, should have received a diagnosis relating to the effects of traumatic stress (such as complex posttraumatic stress disorder – see my article entitled :Childhood Trauma And ADHD : Is PTSD BEING MISDIAGNOSED AS ADHD?

Negative Thinking Styles May Develop As A Result Of Childhood Trauma :

One major effect of childhood trauma can be to cause us to develop a negative thinking style, particularly if we were rejected, constantly criticized, made to feel unsafe, were denied affection or were neglected and / or otherwise abused.

Recent research suggests that the negative thinking resulting from the experience of childhood trauma can contribute to the development of ADHD. (SEE BELOW).


Several studies have focused on a particular type of negative thinking that researchers refer to as : NEGATIVE MEMORY BIAS (this refers to the tendeny to recall and recollect negative memories, rather than positive ones, particular when it comes to memories relevant to oneself, a phenomenon already known to put individuals at risk of developing emotional problems).


A study conducted by Krauel (2009) found that teenagers diagnosed with ADHD displayed less positive memory bias than non-ADHD individuals.

Another study, carried out by d’Acremont and Van der Linden (2007) found that individuals with ADHD symptoms were better able to recall faces with a negative expression (anger) than they were able to remember faces with a positive (happy) expression.

A further study (Vrijsen et al., 2017) suggests that the link between childhood trauma and ADHD symptoms may be, in part, mediated (i.e. brought about) by the negative memory bias caused by the childhood trauma. So, according to this study, the effect of childhood trauma on the development of ADHD symptoms is an indirect one (though more research is needed to investigate this preliminary finding further).

Implications For Treatment :

If, indeed, such negative memory bias contibutes to the development of ADHD, and further research backs up the hypothesis, then this will serve to elucidate understanding about the relationship between psychosocial stressors (particularly childhood trauma), negative memory bias and ADHD, thereby possibly ifluencing the direction of research into therapy for ADHD in the future.


Be Less Negative Pack | Self Hypnosis Downloads


David Hosier BSc Hons; MSc; PGDE(FAHE).


Impulse Control : Study Showing Its Vital Importance

the marshmallow test
impulse control study

We have already seen that those who suffer such severe, protracted childhood trauma that they go on to develop borderline personality disorder (BPD) have very significant problems regarding self-regulation (i.e, controlling intense emotions) and with IMPULSE CONTROL (along with a wide range of other symptoms).

This impaired ability to control impulses, in turn, can have a seriously adverse effect on myriad aspects of the individual’s life, potentially leading to, for example, relationships problems, substance abuse, gambling, compulsive sex, poor financial control due to compulsive shopping, lowered work /academic accomplishments, violent outbursts and many other difficulties.

In this article, I will briefly outline a study that helps to show the relationship between poor impulse control in childhood and later life success :


The study was conducted by Walter Mischel and E.B Ebbeson. A group of children were given two options :

OPTION ONE : They could have one marshmallow immediately.

OR :

OPTION TWO : They could have two marshmallows if they were prepared to wait fifteen minutes for them.

The children were then left alone with the marshmallows.

the marshmallow test


Some children gave in to temptation immediately and some managed to defer gratification for a short amount of time (but not the full fifteen minutes).

HOWEVER : About one third of the children were able to defer gratification for the FULL FIFTEEN MINUTES (in the main they distracted themselves from the temptation to eat the marshmallow by playing or singing to themselves, according to the researchers).

TWELVE  YEARS LATER, a follow-up study was carried out on these same individuals. The results of this follow-up study were :

The individuals’ PERFORMANCE ON THE IMPULSE CONTROL TEST (as described above) was more highly correlated with future life success than any other measure, including socioeconomic status and I.Q.

In other words, on average, the children who managed to wait the full fifteen minutes before eating went on to have significantly more successful lives (as defined and measured by the twelve year follow-up study) than those children who were unable to do so. The fact that the level of an individual’s impulse control appears, according to this particular study, to be a better predictor of that same individual’s future life success than either their socioeconomic status or I.Q. implies that how well we are able to control our impulses is of vital importance.


However, researchers from New York and California Universities have unsuccessfully attempted to replicate the results of the above study to help confirm its reliability. More specifically, their study suggested that differences in levels of impulsivity found in 4 – year – olds had largely disappeared by the time that these same children reached the age of fifteen.once the confounding variable of these children’s parents had been controlled for.

In contrast to Mischell’s and Ebbeson’s study, this second study found that by the time children were fifteen years old, the children of wealthier parents, in general, had better impulse control than fifteen year olds from less wealthy families, irrespective of the level of impulse control the children had (from either wealthy or less wealthy families) at the age of four.

Related Post : Childhood Trauma : Is PTSD Being Misdiagnosed As ADHD?


David Hosier BSc Hons; MSc; PGDE(FAHE)

Childhood Trauma And The Development Of Impulse Control Disorders.

If, as adults, we find we have poor impulse control, this may be, in large part, due to the legacy of a disturbed and traumatic childhood. For example, those who have suffered severe and chronic childhood trauma are more likely to suffer from conditions such as borderline personality disorder (BPD) and anti-social personality disorder (APD) than the average person and both these conditions include impulsiveness  as one of the symptoms.

If a person is impulsive it means s/he often acts prematurely with insufficient planning and lack of thoughtful deliberation; importantly, too, impulsiveness (when it is pathological) involves repeated efforts to make short-term gains but at the expense of long-term gains.

Tell-tale signs that a person may be impulsive:

– frequently making inappropriate comments (speaking without forethought)

– constantly interrupting others during conversations

– often displaying impatience (e.g when having to wait in queues)

Impulse control disorders may involve:

– ‘binge’ shopping for unnecessary items (although many ‘binge’ shoppers indulge in the activity in an attempt to escape from negative emotions such as depression)

– excessive use of alcohol/narcotics (which may themselves increase impulsiveness, thus creating a vicious cycle)

– binge eating (again, though, many indulge in binge eating to  overcome – temporarily, of course – negative emotions)

– dangerous risk taking (such as dangerous overtaking of other vehicles when driving)

– promiscuous, unsafe sex

– kleptomania

– arson

intermittent explosive disorder (I.E.D)

pathological gambling


The Five Main Stages Involved In Impulse Control Disorders:

Research has identified five main stages a person who has pathological problems controlling his/her impulses goes through; these are:

STAGE 1: The experience of a powerful urge

STAGE 2: A failure to resist/inhibit this urge

STAGE 3: A state of high excitement/arousal (with physical and psychological manifestations)

STAGE 4: Giving in to the urge (this usually results in a sense of deep relief from tension)

STAGE 5: Feelings of guilt for having carried out the impulsive act (this feeling of guilt may be very intense and involve profound feelings of self-disgust, self-loathing and self-hatred).

Brain Regions Thought To Be Involved In Impulse Control Disorders:

Although further research is required in order to determine with greater accuracy how certain brain regions are involved in impulse-control disorders, it is currently hypothesized that damage to both the amygdala and orbitofrontal cortex may be relevant (it is also believed that these parts of the brain may be damaged by the experience of significant childhood trauma). Furthermore, it is theorized that the brain’s exexcutive function may also impaired.

Neurochemical Involvement:

Theories also exist that suggest people who suffer from impulse-control disorders are likely to have lower than normal levels of the neurotransmitters dopamine and serotonin in their brains.

The Possible Role Of Genes:

It is also thought that the dopamine receptor and serotonin receptor genes may be involved in impulse-control disorders which would, of course, follow from the above.

Risk Taking And Decision Making :

Below I outline a study that suggests that childhood trauma can impair our ability to make decisions and accurately assess risk, both of which deficits are linked to impulsiveness.

The Study – Part One :

Part One of a study conducted by Professor Seth Pollak (University of Wisconsin-Madison) involving over 50 young people (from a range of backgrounds and all approximately 20 years of age), required the participants to engage in various tasks (for example, simulated gambling) in order to ascertain their behavioral responses reward / punishment and risk-taking.

Results Part One Of The Study :

It was found that those who had experienced trauma / severe stress as children had impaired ability to make good decisions and to accurately assess risk compared to those young people who had not experienced trauma / severe stress while growing up ; especially noteworthy was the finding that, whilst participating in such tasks, those individuals who had experienced trauma / severe stress as children showed a marked inability to learn from their mistakes as well as poor levels of concentration.

Brain Scans :

Whilst the participants were in the ‘decision making’ phase of the task, scans of their brains were taken ; these scans revealed that the individuals who had experienced trauma / severe stress during childhood displayed BELOW NORMAL ACTIVITY in the area of the brain associated with decision making.

childhood trauma and decision making

Part Two Of The Study :

The second part of the study was intended to discover how the same group of over 50 young people behaved in real life in relation to decision making.

This was carried out by giving the participants a questionnaire to fill out which comprised various questions about how much risk they took (e.g. do you wear a seat-belt?).

Results Of Part Two Of The Study :

The results of this part of the study were very similar to those found from the first part of the study, i.e. the participants who had suffered trauma / severe stress during childhood made worse decisions / indulged in riskier behaviors in real life compared to the participants who had not experienced trauma / severe stress during childhood.

Conclusion :

It was inferred from these results that severe stress during childhood adversely affects the way in which the brain functions when making decisions leading to poor judgment and a higher than normal propensity to indulge in  risk-taking behavior in those affected.

It was also found that these deficits in decision-making ability were unrelated to I.Q. or intelligence. Because of this, Pollak alikened such deficits to a specific ‘learning disability’ which impairs individuals’ ability to effectively process information relating to potential loss or risk.

Implications For Youth Justice System :

Pollak also points out that up to 90 per cent of young people who become embroiled with the criminal justice system have experienced childhood trauma, and, if they do indeed have a kind of specific ‘learning disability’ (as described above and as the findings of this study suggest) then, in many cases, punishment is neither appropriate nor a solution.

Instead, Pollak suggests that, when dealing with young offenders, it will often be far better for these individuals to participate in training programs that improve the brain’s decision making capabilities.

Related Post : Is PTSD Being Misdiagnosed As ADHD?

David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma And ADHD : Is PTSD Being Misdiagnosed As ADHD?


This article considers the possible link between childhood trauma and ADHD. However, to clear up any possible misinterpretation of this article, it is important to state at the outset that ADHD is undoubtedly a very real disorder and it is not by any means implied below that all cases involve underlying trauma.

In the USA, about one in every nine children are diagnosed with ADHD; this equates to a total of 6.4 million American youths.

But should many of these young peoples’ primary diagnosis really be one of PTSD, not ADHD?

Many experts think so. In fact, Post Traumatic Stress Disorder (PTSD) may be being misdiagnosed as Attention Deficit and Hyperactivity Disorder (ADHD) in up to a million children per year in the USA.

The psychologist, Brown, an expert in the field, has drawn attention to the fact that many children who have been diagnosed with ADHD have symptoms which one would expect to find in people suffering from PTSD such as : difficulty controlling behaviour / impulsivity, severe mood fluctuations, hypervigilance and dissociation ( or ‘zoning out’).

The confusion may arise when such symptoms are mistaken for those of ADHD. For example:

– difficulty controlling behaviour / mood fluctuations may be seen as wilful disruptiveness.

hypervigilance may be seen as distractability.

dissociation may be seen as deliberate inattention / lack of focus (indeed, I suffered from this when I was eight. I didn’t respond to my name in class, so lost and caught up was I in my own internal distressed thoughts, leading to my teachers actually suspecting that I was going deaf. I was taken for an ear test but there was nothing whatsoever wrong with my hearing – let this serve as a salutary lesson to teachers as to how a child’s distress may manifest itself in unexpected ways and be completely misinterpreted ; indeed, another good example is the possibility that a child’s anger is serving to soothe his / her emotional pain – click here to read my article on this).

Brown’s suspicions that, often, children diagnosed with ADHD should, in fact, have been diagnosed with PTSD were heightened further by the observation that standard ADHD treatment simply did not work for many children.

Perhaps, then, Brown hypothesised, these children were, in facf, ‘acting out’ (what psychologists refer to as ‘externalizing’) their distress caused by living in a dysfunctional family (the children in the study came from low income families and were known to live in environments in which high levels of stress and violence were prevalent).

In order to examine the issue further, Brown set up a study looking at the overlap between the symptoms of ADHD and the effects of traumatic stress on children caused by maltreatment and abuse.

A Closer Look At The Link Between Childhood Trauma And ADHD :

The study was based on a survey of 65,000 children in the USA and the results showed that those who had been diagnosed with ADHD also had a significantly higher than average chance of coming from a background of divorce, poverty, violence and/or families who misused drugs and alcohol.

Indeed, those who had experienced the great stress of 4 or more ADVERSE CHILDHOOD EXPERIENCES (ACEs)  – click here for more information about ACEs – were 3 times more likely to have been diagnosed with ADHD and prescribed medication for it than those who had not experienced any.


The psychologist, Szymanski, derived similar results from a study of 63 children who had been treated by a psychiatric hospital. On average, the children had suffered 3 ACEs yet only 8 per cent had been diagnosed with PTSD whilst 33 per cent had been diagnosed with ADHD.

Another study (Burke et al., 2011) of relevance involved the analysis of 701 children’s medical records. The children involved came from violent and economically deprived neighbourhoods in the Sans Francisco area.

It was found that two thirds of the young people had experienced at least one ACE and 12 per cent had experienced 4 or more ACEs. Further analysis of the data revealed that the more ACEs the children had experienced, the more likely they were display behavioral problems.

Significantly, the researchers involved in the study expressed the concern that many such children may be receiving diagnoses of ADHD when a diagnosis of PTSD, or other stress-induced condition, would be more appropriate. It was suggested that this error may be occurring because symptoms of severe stresss, such as hyperarousal and cognitive dysregulation were being mistaken for symptoms of ADHD.


The above studies suggest that, in some cases, PTSD me be being mistakenly diagnosed as ADHD and that many children could be being mistakenly diagnosed with ADHD whereas, in fact, their primary diagnosis ought to be one of PTSD. Some estimates suggest that up to one million children per year could be being misdiagnosed in this way.

Implications for treatment:

If some children are being treated for ADHD when they should, in fact, be being treated for PTSD, their treatment may be inappropriate.

Indeed, one treatment for ADHD is the prescription of stimulants. However, this could worsen symptoms of agitation (agitation is a symptom of PTSD).

Furthermore, treatment for ADHD does not deal sufficiently with the emotional and psychological distress that the child with PTSD suffers.

Very obviously, the above does not in any way imply that all cases ADHD should in fact have been diagnosed as PTSD and, equally obviously, a child may simultaneously fulfil the diagnostic criteria to be considered to be suffering from both conditions (i.e. justifying a co-morbid diagnosis ; indeed, research suggests the two conditions share familial risk factors) which is why I include the following warning : N.B. Any changes in medication should only be made on the advice of a properly qualified professional who is familiar with the specific case under consideration.

Why might misdiagnosis of ADHD as PTSD be happening?

One reason that has been suggested is that the companies producing the drugs for ADHD use advertising campaigns which, in effect, encourage the diagnosis of ADHD and its treatment, thus increasing their profits.

A second suggestion as to why ADHD may be being misdiagnosed as PTSD is that the assessment of children by clinicians is not extensive or thorough enough due to time and financial restrictions. A fifteen minute or half hour appointment is not enough to evaluate, fully, a child’s mental state and factors related to his / her home life which may be damaging it.

It is also worth reiterating how there exists and overlap between the symptoms of ADHD and the symptoms of PTSD (e.g. Daud, 2009) ; these include, sleep difficulties, giving the impression of not listening in class, restlessness, disorganization, restlessness and easy distractability.

For useful advice about whether a child is suffering from ADHD or the effects of traumatic stress, you may wish to read this (CLICK HERE) useful article from WebMD.


Perhaps the best way to demonstrate how ADHD and complex PTSD differ from one anorher is to list symptoms SPECIFIC to each condition followed by a list of the symptoms that both ADHD and complex PTSD have in common. I do so below, based upon




feelings of shame and guilt

risk taking behaviors

proneness to aggressive behaviors

self – destructiveness


perpetual feelings of being on ‘red alert’ / under threat


avoidance behaviors

outburts of rage / anger



problems following instructions

fidgeting and squirming

poor organizational skills

excessive talking

interrupting or intruding on others

losing items that are necessary for tasks and activities

difficulty concentrating

problems with waiting and turn-taking



sleep problems


giving impression of not listening


problems with concentration

The above lists are based upon research conducted by The National Child Traumatic Stress Network (NCTSN).

For useful advice about whether a child is suffering from ADHD or the effects of traumatic stress, you may wish to read this (CLICK HERE) useful article from WebMD.

For information about complex PTSD from one of the UK’s leading mental health charities (MIND), click HERE


Complex PTSD And Misdiagnosis.

Wrongly Diagnosed With BPD?

Reasons Why ADHD Might Be Being Overdiagnosed.

eBook :

Above eBook now available for immediate download on Amazon. Click here.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Control Impulsive Behavior

Do You Find It Hard To Control Impulsive Behavior?

If we have suffered severe childhood trauma which has led us to develop borderline personality disorder/BPD (click here to read my article on the link between childhood trauma and BPD) one of the most harmful symptoms we suffer may be a grossly impaired ability to control impulsive behavior.

The kinds of self-destructive, impulsive behaviours that an individual suffering from BPD may experience are :

– over-spending

– reckless driving

binge eating

– shop- lifting


– reckless sex (e.g. promiscuous unprotected sex) – click here to read my article on this)

– substance abuse

Often, people with BPD will give in to such impulsive activities in a desperate attempt to fill a profound sense of inner emptiness and desolation.


Three methods often recommended by psychologists to help us control impulsive behavior :




Let’s look at each of these in turn:

1) REFLECTION – often, if we carry out an impulsive act, we deeply regret it the next day and are filled with a deep sense of shame and despair.

We can actually use this to our advantage by reflecting on such feelings we are likely to experience BEFORE we indulge ourselves in the impulsive behaviour; hopefully, through such anticipation of how we will feel later, we are less inclined to go ahead and carry the impulsive behaviour out.

In order to utilize this strategy most effectively, many people find it very helpful to write out the following four questions on a piece of paper and then carry it around with them (e.g. in a wallet or handbag etc.), for instant reference should the need arise!

These four questions are as follows :

a) How important to me is it that I act out this impulsive act in the great scheme of things?

b) How will I feel about having carried it out tomorrow?

c) How will I feel tomorrow if I DO NOT carry out the behaviour?

d) If I indulge in the behaviour, what are the likely long-term consequences?

2) DELAY – an alternative strategy is to DELAY acting upon our impulses. For example, if we have the urge to do something that is likely to be self-destructive, such as gambling, we may experiment by delaying doing it by, say, an hour.

Then, next time, we can delay by an hour and a half, then, the time after that, by two hours…and so on…and so on…

This actually strengthens our ability to delay gratification and resist potentially harmful impulses (by strengthening relevant neurological pathways in the brain).

The goal is to strengthen this ability to such a degree that, eventually, we find it no harder to control our impulses than does the average person.

3) DISTRACTION – the third strategy entails distracting ourselves from our impulsive feelings. This method works best if we plan in advance what we might do to divert ourselves from our potentially self-destructive urges, should they arise.

Of course, chosen distractions will vary from person to person; however, I provide some examples below:

– gym

– jogging

– home exercises

– phoning a friend

– cinema/film

– taking up a hobby which we find both interesting and enjoyable


Some people with BPD are sensation/thrill seekers as they have a need to compensate for inner feelings of emptiness (see above) and this has led to their impulsive, self-destructive behaviours. More healthy (yet still exciting) behaviours which may act as  alternatives (given correct training and supervision) include :

– bungee jumping

– sky diving

– skiing

– mountain climbing

– rock climbing

– extreme sports

Obviously, this list is not exhaustive and different individuals will, no doubt, find activities most appropriate to them.


Impulse Control : Study Showing Its Vital Importance

Childhood Trauma Leading To The Development Pf Impulse Control Disorders


Resource :



David Hosier BSc Hons; MSc; PGDE(FAHE).