Post-traumatic Stress Disorders and ADHD

Studies suggest a bidirectional association between the diagnoses of ADHD and post-traumatic stress disorders (PTSD). Multiple DSM-5 symptoms of PTSD (e.g., avoidance of stimuli, as well as alterations in cognitions, mood, arousal, and reactivity) overlap with symptoms of ADHD (e.g., inattention, hyperactivity, and impulsivity), as well as with other internalizing or externalizing disorders that may also be comorbid with ADHD. A careful assessment is needed for an accurate diagnosis and proper treatment. There are now multiple evidence-based psychotherapies for childhood PTSD and for ADHD, some potential useful for both conditions. There are many medications approved by the Food and Drug Administration (FDA) for pediatric and adult ADHD, and some for adult PTSD, but none for pediatric PTSD. Clinical practice guidelines are also available for ADHD and for PTSD, but not for when they co-occur. As such, clinical judgment and patient and family preferences must guide treatment decisions. In this chapter, we review the etiological aspects, assessment strategies, and psychosocial and pharmacological treatment approaches for patients with co-occurring ADHD and PTSD. We also highlight the need for more research within the field to inform better assessment and treatment of this comorbid combination in clinical practice.