Childhood trauma, dissociative experiences and ADHD symptoms in youth

Abstract

Background: Trauma exposure and dissociative experiences can resemble attentiondeficit/ hyperactivity disorder (ADHD) symptoms in adolescence, but it is unclear whether dissociation explains trauma-related attentional symptoms by diagnostic status. Methods: We enrolled 108 youth aged 12-18 years (54 with ADHD; 54 controls) from a child and adolescent psychiatry outpatient service in Türkiye. Youth completed the Childhood Trauma Questionnaire (CTQ) and Adolescent Dissociative Experiences Scale (A-DES); parents completed the Conners Parent Rating Scale-Revised Short Form (CPRS-RS). We estimated a multigroup path model (ADHD vs control) testing CTQ→A-DES (path a), A-DES→CPRSRS (path b), and CTQ→CPRS-RS (path c′), with 1000-draw bootstrap confidence intervals, adjusting for sex, internalizing symptoms, socioeconomic status, and number of children in the household. Indirect effects were interpreted as associational. Results: In controls, higher trauma was associated with higher dissociative experiences (a=0.529, p=0.005), and higher dissociative experiences were associated with ADHD-like symptoms (b=0.292, p<0.001). The indirect effect was significant (a×b=0.155, 95% CI 0.035-0.306; p=0.019). In the ADHD group, path a (0.163, p=0.153), path b (0.107, p=0.230), and the indirect effect (0.017, 95% CI -0.022 to 0.061; p=0.380) were not significant. Indirect effects differed between groups (Wald χ²(1)=4.54, p=0.033). Conclusions: Dissociative experiences were associated with trauma-related ADHD-like symptoms in adolescents without ADHD, but this pathway was not statistically supported in diagnosed ADHD, supporting trauma-informed assessment when attentional complaints arise without confirmed ADHD.