Date of Award

Spring 2026

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Jeanie McHugo

Keywords

attention-deficit/hyperactivity disorder, childhood trauma, adverse childhood experiences, trauma-informed screening, pediatric primary care

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood neurodevelopmental disorder with symptoms that significantly overlap with trauma-related behavioral and emotional disturbances, complicating diagnostic accuracy. Childhood trauma and adverse childhood experiences (ACEs) can both mimic and exacerbate ADHD symptoms, increasing the risk of misdiagnosis and inappropriate treatment when trauma exposure is not assessed. This scholarly project examined the relationship between childhood trauma exposure and ADHD diagnosis, symptom severity, and risk for subsequent adversity in children ages 6-12. A literature review of primary studies published between 2020 and 2025 was conducted using PubMed, PsycINFO, EMBASE, and CINAHL databases. Eleven studies met inclusion criteria and were analyzed. Findings demonstrated a consistent association between trauma exposure and increased likelihood of ADHD diagnosis, with a dose-response relationship between cumulative ACEs and ADHD prevalence and severity. Longitudinal evidence supported a bidirectional relationship, in which trauma worsens ADHD symptoms and ADHD increases vulnerability to future adversity. Trauma-informed screening tools improved identification of trauma exposure during ADHD evaluations. Integrating trauma-informed screening into pediatric ADHD assessments may improve diagnostic accuracy and support more comprehensive, individualized care.

Comments

Note: this is a corrected draft of the student work, not the final version

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