Liam Davenport

June 05, 2015

GLASGOW, Scotland — Children with ADHD have an increased risk for affective comorbidities if their mother suffered abuse as a child, Spanish researchers report.

Presenting their findings here at the 5th World Congress on Attention Deficit Hyperactivity Disorder (ADHD), the team notes, however, that the relationship, which may be mediated by difficulties with maternal attachment, was not replicated in fathers who reported childhood abuse.

They suggest that if their results are confirmed in further studies, special clinical attention should be paid to women with a history of child abuse who have children with ADHD.

Previous studies have indicated that parental psychopathology and parenting behavior are associated with developmental outcomes for children with ADHD and that abuse is linked to ongoing problems in adulthood, including problems with parenting.

To examine the associations between abuse suffered by parents during childhood and the presence of affective disorders in their offspring with ADHD, the team studied 107 children (aged 7 to 18 years), 107 mothers, and 75 fathers. They excluded patients with intellectual difficulties, autism spectrum disorders, or neurologic damage.

Attachment Difficulties

The Childhood Trauma Questionnaire was used to assess parental childhood experiences of abuse, which included physical and emotional neglect and sexual, physical, and emotional abuse. The Mini Kid interview was used to evaluate the presence of affective comorbidities in the ADHD children.

The presence of affective comorbidities was significantly associated on the Mann-Whitney U test with a reported history of childhood emotional neglect (P = .004), physical abuse (P = .020), and sexual abuse (P = .03) in mothers.

There was no relationship between affective comorbidities and a history of abuse in fathers, which the researchers believe may be affected by the smaller number of fathers included in the study.

Coauthor Dr Adela Masana-Marin, Hospital Universitari Institut Pere Mata, Reus, Spain, explained that their first hypothesis was that psychiatric symptoms in mothers would affect the severity of ADHD symptoms, "but that was not the case."

Speaking to Medscape Medical News, she said that they believe that the association between a history of child abuse in mothers and comorbidities in children with ADHD may be mediated by difficulties for the mothers with regard to attachment and depression.

Dr Masana-Marin believes the findings may assist in identifying families in which there is an increased risk for comorbidities in a child with ADHD.

Dr Adela Masana-Marin

"Our interest is to help mothers with child abuse history, for example, by identifying some of those mothers with a high risk of having children with problems," she said.

Support for Moms

However, she acknowledged that on the basis of their study, they cannot say that mothers with a history of child abuse have an increased risk of having children with ADHD.

"Our results don't support this, but they do help support [the idea that] they will be children with more problems, and it is important to help mothers with this history," said Dr Masana- Marin.

Pamelynn Esperanza, MD, assistant professor of psychiatry in the Division of Child and Adolescent Psychiatry at New York–Presbyterian Hospital and Weill Cornell Medical College, in New York City, welcomed the study.

"While the relationship between maternal trauma and the children's comorbid affective disorders was found to be significant, it does not necessarily indicate a causal relationship, as it remains unclear whether affective disorders stem from the mother's abuse or the comorbidity with ADHD," she told Medscape Medical News.

Dr Esperanza suggested that further investigations should be undertaken into the relationship between maternal abuse and non-ADHD children, as well as between ADHD children and nonabused mothers.

"This would provide additional insight into this issue," she concluded.

The authors and Dr Esperanza report no relevant financial relationships.

5th World Congress on Attention Deficit Hyperactivity Disorder (ADHD). Abstract P-04-007. Presented May 29, 2015.

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