Attention deficit hyperactivity disorder as a response to traumatic stress

Abstract

The subject of Attention Deficit Hyperactivity Disorder (ADHD), and Ritalin as a method of treatment, has received a lot of media attention in recent years as it appears to be the most “popular” diagnosis for children who are difficult, who struggle to pay attention and who are impulsive and hyperactive. Some medical professionals are of the opinion that incidences of the disorder are increasing, while others believe that the disorder is being misdiagnosed. There is a significant overlap in the symptoms of ADHD and those of Post-traumatic Stress Disorder (PTSD). In South Africa, where many children are exposed to traumatic stimuli on a regular and ongoing basis, health care professionals cannot afford to overlook the possibility that children exhibiting symptoms of ADHD may, in fact, be traumatised. However, when examining the criteria for PTSD we find that the DSM-IV (Diagnostic and Statistical Manual IV) does not adequately describe the differences between adult and childhood PTSD and also does not adequately account for children who may be in an almost continuous state of traumatic stress. Since there is increasing evidence of the interaction between mind/emotions and body, it is plausible that the emotions of children with ADHD play an important role in their condition, particularly if the child has suffered traumatic stress. The researcher believes that children who experience continuous traumatic stress may develop maladaptive responses which may eventually become traits, and that ADHD may be one such response. The goal of this exploratory study was to gain insight into the thoughts and feelings of a few children (case studies) who have been diagnosed with ADHD and who are in the middle childhood phase of development. The first objective was to gather knowledge regarding ADHD, traumatic stress, biological responses to trauma and to describe middle childhood and gestalt play therapy. In the empirical study, gestalt play therapy techniques were used to assess whether children with ADHD had suffered traumatic stress (particularly the loss of safety and security) prior to the diagnosis and whether they are able to express their thoughts and emotions appropriately. Since the study was qualitative, the researcher made use of observation and unstructured interviews (including play therapy sessions) to obtain background information from the parents and to explore the thoughts, feelings and behaviours of children with ADHD from their perspective. This study falls under applied research, undertaken with a view to creating preventative measures and improving interventions for children with ADHD and children who have suffered traumatic stress. The final objective of the study was to draw conclusions and make recommendations in order to promote awareness of the likelihood of traumatic stress in children with ADHD in South Africa. The researcher concluded that the respondents in this study have indeed suffered traumatic stress in the form of loss of safety and security, related to an inadequate bond with a responsive, nurturing caregiver. In addition, they have difficulty expressing their thoughts and emotions.