Aug 2026· European Journal of Psychotraumatology· Vol 17· 0 citations· 35 references
Medicine
TL;DR
The need for trauma-informed ADHD care that addresses internalising symptoms within relevant familial and cultural contexts is highlighted, as trauma responses are closely associated with comorbid anxiety and depression.
Abstract
ABSTRACT Background: Adolescents with attention-deficit/hyperactivity disorder (ADHD) may be particularly vulnerable to trauma; however, patterns of trauma exposure and psychological responses in East Asian contexts remain underexplored. Objective: To examine associations among ADHD, trauma exposure, and psychological outcomes, and to differentiate trauma-specific reactions from broader internalising symptoms. Methods: This cross-sectional study included 295 adolescents aged 12–18 years (149 with ADHD and 146 controls). Adolescents and their caregivers completed validated measures of trauma exposure (Trauma Exposure Experience Questionnaire), trauma reactions (Revised Child’s Reaction to Traumatic Events Scale), anxiety (Multidimensional Anxiety Scale for Children), depression (Centre for Epidemiological Studies Depression Scale), and self-esteem (Rosenberg Self-Esteem Scale). All measures demonstrated excellent internal consistency (Cronbach’s α = .92–.95). Intergroup differences were examined using chi-square tests and t-tests. Hierarchical regression models incorporating ADHD × trauma exposure interaction terms, along with sex-stratified analyses, were used to evaluate associations. Results: Adolescents with ADHD reported stronger trauma reactions (p = .039), greater depressive symptoms (p = .032), and lower self-esteem (p = .002) than controls. Logistic regression analyses indicated that physical assault (odds ratio = 3.11) and threats of violence (odds ratio = 3.77) were significantly associated with ADHD. Trauma reactions were strongly predicted by anxiety, depression, and trauma exposure across the sample. The interaction between ADHD and trauma exposure was not significant in the total sample (p = .600) or in stratified analyses. Conclusion: Adolescents with ADHD in Taiwan are highly vulnerable to interpersonal trauma. Although ADHD does not moderate the association between trauma exposure and subsequent reactions, trauma responses are closely associated with comorbid anxiety and depression. These findings highlight the need for trauma-informed ADHD care that addresses internalising symptoms within relevant familial and cultural contexts.
Background: Adolescent major depressive disorder (MDD) is heterogeneous, with diverse and frequently co-occurring psychopathological manifestations. Although family-related experiences, childhood trauma, rumination, and psychological resilience have each been linked to adolescent mental health, less is known about how they are interrelated and jointly associated with distinct psychopathological domains. This study examined these associations within an integrative framework. Methods: This cross-sectional study included 80 adolescents with MDD and 53 healthy controls. Family functioning, parenting, childhood trauma, rumination, psychological resilience, and four clinical domains, including affective distress, suicidal ideation, the non-suicidal self-injury (NSSI) spectrum, and self-regulation difficulties, were assessed using validated instruments. Partial least squares structural equation modeling (PLS-SEM) examined their multivariate associations. Sensitivity analyses restricted to the MDD sample and covariate-adjusted regression models assessed the robustness of the findings. Results: The four clinical domains showed high reliability and acceptable discriminant validity. Family dysfunction was associated with maladaptive parenting and childhood trauma, and maladaptive parenting was associated with childhood trauma (beta = .383-.600; all p < .001). Childhood trauma was associated with greater rumination (beta = .625) and lower psychological resilience (beta = -.405; both p < .001). Rumination and psychological resilience showed opposing associations with all four domains (rumination: beta = .280-.559; resilience: beta = -.265 to -.399; all p <= .006). Family dysfunction, maladaptive parenting, and childhood trauma showed significant total indirect associations with each domain (all p < .001). The model explained 53%-85% of the variance across the four domains. The MDD-only analysis reproduced the principal associations observed in the combined sample and additionally showed direct associations between maladaptive parenting and all four clinical domains. Covariate-adjusted analyses retained all principal associations except the resilience-NSSI association. Conclusions: The findings support a multidimensional characterization of adolescent MDD comprising distinguishable yet interrelated domains of affective-psychosomatic distress, suicidal ideation, the NSSI spectrum, and self-regulation difficulties. The partly shared and partly distinct associations of these domains with family-related adversity, rumination, and psychological resilience support considering domain-level psychopathology alongside diagnostic status and global depression severity in research on adolescent MDD.
P. Wang, Y. Zhang, X. Wang et al.· medRxiv· 0 citations
Examining the associations between childhood trauma and non-suicidal self-injury (NSSI) among adolescents suffering depressive disorders, and the statistical mediating roles of self-efficacy, psychological resilience, and depression. The Children's Depression Inventory (CDI), the Childhood Trauma Questionnaire (CTQ), the Connor-Davidson Resilience Scale (CD-RISC), the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire (ANSAQ), and the General Self-Efficacy Scale (GSES) were used to assess 201 adolescents aged 10-19 years with depressive disorders who attended a psychiatric hospital in Zhejiang Province from September 2024 to March 2025. After excluding outliers (calculated using Mahalanobis distance), data analysis was conducted on 200 patients. Childhood trauma was positively associated with NSSI and depression, and inversely linked to adolescents' self-efficacy and psychological resilience. NSSI was positively associated with depression. Childhood trauma showed a parallel and serial mediation with NSSI through self-efficacy, psychological resilience, and depression. Childhood trauma showed direct and indirect associations with NSSI, with self-efficacy, psychological resilience, and depression statistically accounting for the indirect association. These findings highlight the key role of psychosocial mechanisms in understanding NSSI and suggest that interventions for adolescents with childhood trauma may benefit from prioritizing screening, enhancing self-efficacy and resilience, and managing depressive symptoms.
Background: Adult Attention-Deficit/Hyperactivity Disorder (ADHD) is often associated with complex psychosocial impairments that extend beyond core neurodevelopmental symptoms. This study investigated the differences in self-esteem, retrospective reports of childhood adversity, perceived parenting styles, and personality traits between adults with and without ADHD in an Indian clinical context.
Methods: A retrospective observational design was employed, utilizing deidentified clinical data from 98 adults [ADHD group (n = 28); non-ADHD control (n = 70)] from a psychology outpatient clinic in Chennai. Psychometric evaluation included the Rosenberg Self-Esteem Scale (RSES), the Parenting Scale, and the International Personality Disorder Examination (IPDE) Screening Questionnaire. Data were analyzed using independent samples t-tests, chi-square tests, and one-way ANOVA.
Results: Adults with ADHD showed significantly lower self-esteem (p < 0.001) and reported a higher exposure to childhood physical abuse, sexual abuse, and bullying compared to the control group (p < 0.01). Perceptions of early parenting experiences significantly differed; the ADHD group reported lower rates of authoritative parenting and higher rates of neglectful parenting from both mothers and fathers. The ADHD cohort demonstrated a significantly higher prevalence of schizoid, impulsive, and borderline traits (surviving Bonferroni correction), with anxious and dependent traits significant at the unadjusted level. Within the ADHD group, borderline traits were significantly more common among females, while the schizoid trait was associated with lower self-esteem.
Conclusion: The findings suggest that the diagnosis and management of adult ADHD should take into account environmental vulnerability and maladaptive personality development. These results highlight the need for trauma-informed, integrated clinical interventions that address core symptoms alongside self-concept and interpersonal functioning to optimize long-term psychosocial outcomes.
A. P. Porrselvi, C. Sneha· Journal of Indian Federation...· 0 citations
Background: Emotion dysregulation and internalizing symptoms are increasingly recognized as central features of attention-deficit/hyperactivity disorder (ADHD), yet substantial emotional heterogeneity exists among affected adolescents. This study aimed to identify distinct emotional profiles in adolescents with ADHD by integrating emotion regulation difficulties, resilience, and internalizing symptoms using a person-centered, data-driven approach. Methods: This multicenter, cross-sectional study included 109 clinically referred adolescents aged 11–18 years with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnosis of ADHD. Adolescents completed self-report measures of emotion regulation difficulties (Difficulties in Emotion Regulation Scale–16; DERS-16), resilience (Connor–Davidson Resilience Scale; CD-RISC-25), and internalizing symptoms (Revised Child Anxiety and Depression Scale; RCADS). Parents completed parent-report measures of their child’s ADHD symptom severity (Swanson, Nolan, and Pelham Rating Scale; SNAP-IV) and perceived competence, as well as self-report measures of their own emotion regulation difficulties and resilience. Clinicians rated global severity using the Clinical Global Impression–Severity scale (CGI-S). K-means clustering was applied to standardized adolescent emotional variables to identify distinct profiles, which were evaluated using internal validation indices and clinical correlates. Between-cluster comparisons were conducted across demographic, clinical, and psychosocial variables. Correlation and mediation analyses were performed to examine associations among resilience, emotion regulation difficulties, and internalizing symptoms. Results: Four distinct emotional profiles were identified: (1) Low Emotion Dysregulation / High Resilience / Low Internalizing, (2) Moderate Emotion Dysregulation / Moderate Resilience / Moderate Internalizing, (3) Low-to-Moderate Emotion Dysregulation / Low Resilience / Low-to-Moderate Internalizing (descriptively labeled as “Low-resilience silent” profile), and (4) High Emotion Dysregulation / Low Resilience / High Internalizing. Emotional profiles differed significantly in emotion regulation difficulties, resilience, and internalizing symptom severity (all p < 0.001), but not in parent-reported ADHD symptom dimensions or clinician-rated severity. Perceived social competence, gender distribution, internalizing comorbidity, and medication patterns varied across profiles, whereas parental emotion regulation difficulties and resilience did not. Emotion regulation difficulties showed a significant indirect effect in the association between resilience and internalizing symptoms, such that lower resilience was associated with greater emotion regulation difficulties, which in turn were associated with higher internalizing symptom severity. Conclusions: Adolescents with ADHD exhibit clinically meaningful emotional profiles that are largely independent of core ADHD symptom severity. Emotion regulation difficulties represent a key mechanism linking resilience and internalizing symptoms. Profile-informed assessment incorporating brief measures of emotion regulation, resilience, and internalizing symptoms may enhance clinical formulation and help identify adolescents with silent emotional vulnerability who may otherwise be overlooked in routine care.
Background Childhood traumatic experiences are known to have profound and lasting effects on mental health; however, there are limited data on the relationship between types of childhood trauma and social anxiety in non-clinical populations. Aim This study aimed to explore the associations between types of childhood trauma and social anxiety symptoms in non-clinical young adults. Setting The study was conducted at the Faculty of Health Sciences of a university in Istanbul, Turkey. Methods This cross-sectional study included 486 university students. Sample size was determined via G*Power analysis to ensure statistical power. Participants completed the Liebowitz Social Anxiety Scale (LSAS) and the Childhood Trauma Questionnaire (CTQ) to assess childhood trauma types and social anxiety symptoms. Data were analysed using stepwise multiple regression. Results The mean age of the participants was 21.8 ± 4.0 years, and 81% were female, with emotional abuse and neglect scoring highest in both genders. The sample’s LSAS total mean score was 63.87 ± 11.68. When the subscales were compared by gender, females had significantly higher mean fear and avoidance scores than males (p < 0.05). The results show that childhood abuse and neglect were significant predictors of social anxiety and explained 23% of the social anxiety variance. Conclusion Childhood abuse and neglect are clearly associated with social anxiety symptoms. Interventions and treatments for individuals with social anxiety should incorporate a detailed assessment of childhood trauma history, with a particular focus on emotional abuse and neglect. Contribution This study contributes to the literature by clarifying the associations between specific types of childhood trauma and social anxiety symptoms in a non-clinical young adult population.
Ayfer Ekim-Günaydın, Mazlum Çöpür· South African Journal of Psy...· 0 citations
ABSTRACT Somatic symptom disorder (SSD) is increasingly prevalent in youth and is associated with impaired later health and social functioning. SSD in youth is linked to emotional awareness and mentalising deficits; however, these factors, together with parental mentalising, have rarely been examined together. This cross‐sectional case–control study aims to investigate these key factors in early adolescents with SSD and their mothers, compared with a community sample. The sample included 360 participants: a clinical group (n = 112) of 56 adolescents with SSD (Mage = 12.98, SD = 1.72) and their mothers, recruited from two paediatric hospitals; and a comparison group (n = 248) of 124 adolescents (Mage = 13.04, SD = 1.21) and their mothers from the general population. The adolescents completed the Emotional Awareness Questionnaire (EAQ) and the Reflective Functioning Questionnaire for Youth (RFQ‐Y), and their mothers completed the Parental Reflective Functioning Questionnaire for Adolescents (PRFQ‐A). A logistic regression predicting clinical (vs. comparison) group membership (R 2 = 0.24; p < 0.001) revealed that greater adolescent verbal emotion sharing (OR = 0.41, p = 0.015), higher RFQ‐Y curiosity (OR = 0.45, p = 0.014) and higher RFQ‐Y certainty (OR = 0.53, p = 0.011) were associated with reduced odds of belonging to the clinical group. Additionally, higher maternal PRFQ certainty was linked to lower odds of clinical group membership (OR = 0.56, p = 0.003). These findings inform interventions to enhance mentalising and emotional awareness in adolescents with SSD and their mothers, particularly deficits concerning others' mental and affective states.
L. Buratta, Gaetano Maria Sciabica, Rosanna Martin et al.· Clinical Psychology and Psyc...· 0 citations
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