What is the prevalence of ADHD?
According to estimates, ADHD affects around 8% of children and adolescents (Ayano et al., 2023) and 2.5% of adults globally (Song et al., 2021). In Australia, prevalence rates are similar, with around 6-10% of children and adolescents and 2-6% of adults (Graetz et al., 2001; Sawyer et al., 2018). Therefore, prevalence rates among adults may vary but are generally lower than in children.
What is the prevalence of PTSD?
Around the world, an estimated 3.9% of people have experienced PTSD at some point in their lives (Koenen et al., 2017). In Australia, estimates vary depending on the population studied and criteria for diagnosis. Though some estimates suggest that up to 5.6% of Australians have experienced PTSD in the last year and 11% in their lifetime (Australian Bureau of Statistics., 2022). Higher rates may be observed in specific groups such as veterans, emergency service workers, and survivors of abuse or trauma.
How do the two co occur?
Research suggests that individuals with ADHD may be at higher risk for experiencing traumatic events and developing PTSD, although the exact prevalence of co-occurrence is not well-documented research studies have found overlap between those who met the criteria for PTSD and ADHD (Adler et al., 2004; Biederman et al., El Ayoubi et al., 2020; Gurvits et al., 2000). These include estimates of up to 36% of veterans who met criteria for PTSD and co-occurring ADHD (Adler et al., 2004).
Vulnerability of co-occurring ADHD and PTSD
Individuals with Attention Deficit Hyperactivity Disorder (ADHD) and Post-Traumatic Stress Disorder (PTSD) may be more vulnerable due to a combination of factors inherent to each condition:
Attentional Difficulties:
ADHD is characterized by difficulties in attention, concentration, and impulse control. These challenges can make it harder for individuals to stay focused on tasks, regulate their emotions, and manage stress effectively. In the context of PTSD, where intrusive thoughts and memories are common, the attentional difficulties associated with ADHD can exacerbate symptoms, making it harder for individuals to regulate their emotions and cope with distressing memories.
Impulsivity:
Impulsivity, a hallmark symptom of ADHD, can lead individuals to engage in risky behaviours or make impulsive decisions, increasing their exposure to potentially traumatic events. In individuals with PTSD, impulsivity can also manifest as reckless behaviour or self-destructive tendencies, further complicating their ability to cope with and recover from trauma.
Emotional Dysregulation:
Both ADHD and PTSD are associated with difficulties in regulating emotions. Individuals with ADHD may experience heightened emotional reactivity and have trouble managing their feelings, while those with PTSD often struggle with intense emotions such as fear, anger, or sadness. The combination of these emotional dysregulation challenges can make it harder for individuals to cope with stressors and regulate their responses to triggers, increasing their vulnerability to re-traumatization or exacerbation of PTSD symptoms.
Executive Functioning Deficits:
ADHD is characterized by deficits in executive functions such as planning, organization, and problem-solving. These cognitive challenges can interfere with individuals’ ability to effectively navigate daily tasks, manage responsibilities, and cope with stressful situations. In the context of PTSD, executive functioning deficits can further impair individuals’ ability to engage in adaptive coping strategies, leading to increased vulnerability to the impact of trauma.
Interpersonal Difficulties:
Both ADHD and PTSD can impact individuals’ relationships and social interactions. ADHD-related impulsivity and inattention can lead to difficulties in forming and maintaining relationships, while PTSD symptoms such as hypervigilance and emotional numbing can create barriers to trust and intimacy. These interpersonal difficulties can exacerbate feelings of isolation and loneliness, further increasing vulnerability to stress and trauma.
Summary
Overall, the combination of ADHD and PTSD presents unique challenges that can increase vulnerability to stressors and traumatic experiences. It’s essential for individuals with co-occurring ADHD and PTSD to receive comprehensive assessment as in some cases, the overlap in symptoms can lead to an incorrect diagnosis (Szymanski., 2011). Tailored interventions can address the specific needs associated with each condition.
Your mental health is just as important as your physical health. If you’re struggling with a ADHD or PTSD or both, don’t hesitate to seek help. Book an appointment with our experienced psychologists at the Centre for Clinical Psychology in Melbourne by calling 03 9077 0122. We’re here to support you on your journey to better mental health.
References
Australian Bureau of Statistics. (2020-2022). National Study of Mental Health and Wellbeing. ABS. https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/latest-release.
Ayano, G., Demelash, S., Gizachew, Y., Tsegay, L., & Alat, R. (2023). The global prevalence of attention deficit hyperactivity disorder in children and adolescents: An umbrella review of meta-analyses. Journal of affective disorders.
Graetz, B. W., Sawyer, M. G., Hazell, P. L., Arney, F., & Baghurst, P. (2001). Validity of DSM-IV ADHD subtypes in a nationally representative sample of Australian children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 40(12), 1410-1417
Koenen KC, Ratanatharathorn A, Ng L, McLaughlin KA, Bromet EJ, Stein DJ, et al. Posttraumatic stress disorder in the World Mental Health Surveys. Psychol Med. 2017 Oct;47(13):2260–74. doi:10.1017/S0033291717000708.
Sawyer MG, Reece CE, Sawyer ACP, et al. (2018) Has the prevalence of child and adolescent mental disorders in Australia changed between 1998 and 2013 to 2014? Journal of the American Academy of Child and Adolescent Psychiatry 57: 343–350.
Song, P., Zha, M., Yang, Q., Zhang, Y., Li, X., & Rudan, I. (2021). The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis. Journal of global health, 11.
Szymanski, K., Sapanski, L., & Conway, F. (2015). Trauma and ADHD–association or diagnostic confusion? A clinical perspective. Attention Deficit Hyperactivity Disorder, 51-59.
