Hyperactivity in Children: Differentiating the Etiology of Trauma from ADHD

Principal Investigators: Annaclare van Dalen, Ph.D. (JBFCS); Bessel van der Kolk, MD (JBFCS); Bruce Grellong, Ph.D. (JBFCS); Robert Abramovitz, MD (JBFCS)

Funding: Center for the Study of Social Work Practice

Hyperactivity is a frequent symptom of children brought by their parents to mental health clinics. These referrals often come with a demand for Ritalin, in circumstances where the child’s school placement can be influenced by the medication decision. The clinician must assess etiology as the behavioral manifestations of the physiological consequences of trauma are identical to the behavioral hallmarks of Attention Deficit Hyperactivity Disorder (ADHD). Although outward behavior appears identical, the treatment of ADHD is significantly different from the treatment of trauma.

This study will investigate the comorbidity of ADHD and Post Traumatic Stress Disorder (PTSD) among hyperactive children in an effort to improve differential diagnoses, treatment planning and treatment outcomes. The subjects will be children 6-11 at the Pelham and Co-op City offices of JBFCS. The necessary data will be obtained only from their caretakers, and not from the children directly. All protocols will be part of the routine diagnostic assessment employed to provide the best possible treatment for hyperactive children. In addition, consenting caretakers will be asked to complete the Achenbach Child Behavior Checklist while their child is being seen individually during the consultation.

The results of this study could provide an important contribution toward understanding the impact of trauma on children as well as understanding hyperactivity. Moreover, differentiating ADHD and trauma induced hyperactivity may illuminate or alter prominent elements in our current understanding of ADHD. Finally, the study can also contribute to generic research design issues regarding hyperactivity. By including a question on temperament, this study will offer a potentially efficient way to detect ADHD at the same time as it highlights the absence of such data in the research to date on ADHD.