3.13 Associations Between Adverse Childhood Experiences and Self-Reported ADHD Diagnosis During Young Adulthood: Findings From the National Longitudinal Study of Adolescent to Adult Health

ObjectivesPast studies have shown associations between adverse childhood experiences (ACEs) and ADHD diagnosis in childhood; however, few examined how ACEs relate to ADHD diagnosis in adults. This study investigates the associations between ACEs and self-reported ADHD diagnoses during young adulthood using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health (Add Health).MethodsIn Waves I (1994) to IV (2008), Add Health data were assessed, and young adult participants who responded to wave IV questions regarding ADHD diagnosis were included. Nine ACEs and sociodemographic variables including sex, race/ethnicity, educational attainment, frequency of receiving welfare, and childhood residential urbanity were evaluated. Sample-weighted frequencies of ADHD diagnosis reported at different age groups (before 12 years, 12-18 years, 18 years or after) were used to obtain national prevalence estimates. With a survey-based logistic regression model adjusted by sociodemographic factors, specific ACEs associated with adult ADHD diagnosis were identified, and risk analysis of ADHD diagnosis for age groups was performed. A χ2 test was conducted to examine associations of age groups with diagnosis and with ACE scores.ResultsOur sample consisted of 9416 participants, of whom 117 reported an ADHD diagnosis at age 18 or after. It represented 17,781,588 US young adults (49% male, 51% female; 65% White, 15% Black, 12% Hispanic, 7% Other), with the national prevalence of adult ADHD diagnosis at 1.44%. Three ACEs—mental illness or suicide in household (OR = 3.71; 95% CI, 1.82-7.56), physical abuse (OR = 2.81; 95% CI, 1.57-5.01), and emotional abuse (OR = 2.43; 95% CI, 1.39-4.25)—were associated with increased odds of adult ADHD diagnosis. ACE scores considering these 3 ACEs had a graded relationship with the age of diagnosis (p < .001). Male (OR = 0.25; 95% CI, 0.12-0.51) and one-time welfare recipient (OR = 0.26; 95% CI, 0.09-0.76) were associated with lower odds of adult ADHD diagnosis, whereas postsecondary education (OR = 2.39; 95% CI, 1.21-4.74) was associated with higher odds.ConclusionsThese results suggest significant roles of specific ACEs in ADHD development, leading to diagnosis during adulthood. In addition to elucidating these roles, further research is needed to address the diagnostic disparities of ADHD.ADHD, TRA, EPI ObjectivesPast studies have shown associations between adverse childhood experiences (ACEs) and ADHD diagnosis in childhood; however, few examined how ACEs relate to ADHD diagnosis in adults. This study investigates the associations between ACEs and self-reported ADHD diagnoses during young adulthood using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Past studies have shown associations between adverse childhood experiences (ACEs) and ADHD diagnosis in childhood; however, few examined how ACEs relate to ADHD diagnosis in adults. This study investigates the associations between ACEs and self-reported ADHD diagnoses during young adulthood using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). MethodsIn Waves I (1994) to IV (2008), Add Health data were assessed, and young adult participants who responded to wave IV questions regarding ADHD diagnosis were included. Nine ACEs and sociodemographic variables including sex, race/ethnicity, educational attainment, frequency of receiving welfare, and childhood residential urbanity were evaluated. Sample-weighted frequencies of ADHD diagnosis reported at different age groups (before 12 years, 12-18 years, 18 years or after) were used to obtain national prevalence estimates. With a survey-based logistic regression model adjusted by sociodemographic factors, specific ACEs associated with adult ADHD diagnosis were identified, and risk analysis of ADHD diagnosis for age groups was performed. A χ2 test was conducted to examine associations of age groups with diagnosis and with ACE scores. In Waves I (1994) to IV (2008), Add Health data were assessed, and young adult participants who responded to wave IV questions regarding ADHD diagnosis were included. Nine ACEs and sociodemographic variables including sex, race/ethnicity, educational attainment, frequency of receiving welfare, and childhood residential urbanity were evaluated. Sample-weighted frequencies of ADHD diagnosis reported at different age groups (before 12 years, 12-18 years, 18 years or after) were used to obtain national prevalence estimates. With a survey-based logistic regression model adjusted by sociodemographic factors, specific ACEs associated with adult ADHD diagnosis were identified, and risk analysis of ADHD diagnosis for age groups was performed. A χ2 test was conducted to examine associations of age groups with diagnosis and with ACE scores. ResultsOur sample consisted of 9416 participants, of whom 117 reported an ADHD diagnosis at age 18 or after. It represented 17,781,588 US young adults (49% male, 51% female; 65% White, 15% Black, 12% Hispanic, 7% Other), with the national prevalence of adult ADHD diagnosis at 1.44%. Three ACEs—mental illness or suicide in household (OR = 3.71; 95% CI, 1.82-7.56), physical abuse (OR = 2.81; 95% CI, 1.57-5.01), and emotional abuse (OR = 2.43; 95% CI, 1.39-4.25)—were associated with increased odds of adult ADHD diagnosis. ACE scores considering these 3 ACEs had a graded relationship with the age of diagnosis (p < .001). Male (OR = 0.25; 95% CI, 0.12-0.51) and one-time welfare recipient (OR = 0.26; 95% CI, 0.09-0.76) were associated with lower odds of adult ADHD diagnosis, whereas postsecondary education (OR = 2.39; 95% CI, 1.21-4.74) was associated with higher odds. Our sample consisted of 9416 participants, of whom 117 reported an ADHD diagnosis at age 18 or after. It represented 17,781,588 US young adults (49% male, 51% female; 65% White, 15% Black, 12% Hispanic, 7% Other), with the national prevalence of adult ADHD diagnosis at 1.44%. Three ACEs—mental illness or suicide in household (OR = 3.71; 95% CI, 1.82-7.56), physical abuse (OR = 2.81; 95% CI, 1.57-5.01), and emotional abuse (OR = 2.43; 95% CI, 1.39-4.25)—were associated with increased odds of adult ADHD diagnosis. ACE scores considering these 3 ACEs had a graded relationship with the age of diagnosis (p < .001). Male (OR = 0.25; 95% CI, 0.12-0.51) and one-time welfare recipient (OR = 0.26; 95% CI, 0.09-0.76) were associated with lower odds of adult ADHD diagnosis, whereas postsecondary education (OR = 2.39; 95% CI, 1.21-4.74) was associated with higher odds. ConclusionsThese results suggest significant roles of specific ACEs in ADHD development, leading to diagnosis during adulthood. In addition to elucidating these roles, further research is needed to address the diagnostic disparities of ADHD.ADHD, TRA, EPI These results suggest significant roles of specific ACEs in ADHD development, leading to diagnosis during adulthood. In addition to elucidating these roles, further research is needed to address the diagnostic disparities of ADHD.