Journal of Child and Family Studies

, Volume 3, Issue 3, pp 327–336 | Cite as

Comorbidity of attention Deficit Hyperactivity Disorder and Post-Traumatic Stress Disorder

  • Steven P. Cuffe
  • Elizabeth L. McCullough
  • Andres J. Pumariega
Regular Papers


Attention Deficit Hyperactivity Disorder (ADHD) and Post-Traumatic Stress Disorder (PTSD) show a high degree of comorbidity in traumatized children. Two hypotheses may help explain this relationship: children with ADHD are at higher risk for trauma due to their impulsivity, dangerous behaviors, and parents who may have a genetic predisposition for impairment of their own impulse control; and hyperarousal induced by severe trauma and manifested by hypervigilance and poor concentration may impair attention to create an ADHD-like syndrome. Four illustrative cases are presented, and implications for treatment are discussed.

Key Words

Attention Deficit Hyperactivity Disorder Post-Traumatic Stress Disorder comorbidity hyperarousal treatment 


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  1. American Psychiatric Association (1980).Diagnostic and statistical manual of mental disorders. (3rd ed.). Washington, DC: American Psychiatric Association Press.Google Scholar
  2. American Psychiatric Association (1987).Diagnostic and statistical manual of mental disorders (3rd ed., revised). Washington, DC: American Psychiatric Association Press.Google Scholar
  3. Barkley, R. A. (1990).Attention deficit hyperactivity disorder, New York: Guilford Press.Google Scholar
  4. Bourne, P. G. (1970). Military psychiatry and the Vietnam experience.American Journal of Psychiatry, 127, 123–130.Google Scholar
  5. Guyton, A. C. (1976):Textbook of medical physiology. Philadelphia: W. B. Saunders.Google Scholar
  6. Hunt, R. D., Lau, S. R., & Ryu, J. (1991). Alternative therapies for ADHD. In L. Greenhill & B. Osman (Eds.),Ritalin: Theory and patient management (pp. 75–95). New York: Mary Ann Liebert, Inc.Google Scholar
  7. Kosten, T. R., Mason, J. W., Giller, E. L., Ostroff, R. B., & Podd, L. (1987). Sustained urinary norepinephrine and epinephrine elevation in post-traumatic stress disorder.Psychoneuroendocrinology, 12, 13–20.CrossRefPubMedGoogle Scholar
  8. Lahey, B. B., Schaughency, E. A., Hynd, G. W., Carlson, C. L., & Nieves, N. (1987). Attention deficit disorder with and without hyperactivity: Comparison of behavioral characteristics of clinic-referred children.Journal of the American Academy of Child and Adolescent Psychiatry, 26, 718–723.PubMedGoogle Scholar
  9. Litz, B. T., & Keane, T. M. (1989). Information processing in anxiety disorders: Application to the understanding of post-traumatic stress disorder.Clinical Psychology Review, 9, 243–257.CrossRefGoogle Scholar
  10. Munir, K., Biederman, J., & Knee, D. (1987). Psychiatric comorbidity in patients with attention deficit disorder: A controlled study.Journal of the American Academy of Childrand Adolescent Psychiatry, 26, 844–848.Google Scholar
  11. Ornitz, E. M., & Pynoos, R. S. (1989). Startle modulation in children with post-traumatic stress disorder.American Journal of Psychiatry, 146, 866–870.PubMedGoogle Scholar
  12. Ornitz, E. M. (1991). Developmental aspects of neurophysiology. In M. Lewis (Ed.),Child and adolescent psychiatry: A comprehensive textbook (p. 38–50). Baltimore, MD: Williams and Wilkins.Google Scholar
  13. Peterson, K. C., Prout, M. F., & Schwarz, R. A. (1991).Post-traumatic stress disorder. New York: Plenum Press.Google Scholar
  14. Pitman, R. (1989). Post-traumatic stress disoder, hormones and memory.Biological Psychiatry, 26, 221–223.CrossRefPubMedGoogle Scholar
  15. Szatmari, P., Offord, D. R., & Boyle, M. H. (1989). Ontario child health study: Prevalence of attention deficit disorder with hyperactivity.Journal of Child Psychology and Psychiatry, 30, 219–230.PubMedGoogle Scholar
  16. Terr, L. (1981) Psychic trauma in children: Observations following the Chowchilla school-bus kidnapping.American Journal of Psychiatry, 138, 14–19.PubMedGoogle Scholar
  17. Terr, L. (1991). Childhood traumas: An outline and overview.American Journal of Psychiatry, 148, 10–20.PubMedGoogle Scholar
  18. Zametkin, A. J. (1989). The neurobiology of attention deficit hyperactivity disorder: A synopsis.Psychiatric Annals, 19, 584–586.Google Scholar

Copyright information

© Human Sciences Press, Inc. 1994

Authors and Affiliations

  • Steven P. Cuffe
    • 1
  • Elizabeth L. McCullough
    • 1
  • Andres J. Pumariega
    • 1
  1. 1.School of Medicine, and William S. Hall Psychiatric InstituteUniversity of South CarolinaColumbia

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