Running Head: LITERARY REVIEW 1

Literary Review

Frances Carpenter

PSY 302

Argosy University

LITERARY REVIEW 2

Literary Review

It was estimated in 2000 that 879,000 children were abused or neglected (Wolf,

Reinhard, Cozolino, Caldwell, & Asamen, 2008). This study will examine the possibility that

children suffering from Posttraumatic Stress Disorder (PTSD) are more likely to experience

Attention-Deficit Hyperactivity Disorder (ADHD). The hypothesis is that ADHD and PTSD are

positively correlated in children aged seven years. The examiners will also be aware of the

questions related to the possibility that some children are misdiagnosed with ADHD when in fact

they have PTSD (Buczynski, 2011).

There have been suggestions of an association between ADHD and PTSD (Wozniak,

Crawford, Biederman, Faraone, Pil et al, 1999). This study will consist of personal interviews

and psychometric testing using the Minnesota Multiphasic Personality Inventory – 2 to ascertain

the presence of either disorder (Wolf, et al, 2008).

The questions this study will answer are: 1.) Is there a correlation between ADHD and

PTSD? 2.) Are children being misdiagnosed with ADHD, when in fact they have PTSD? 3.)

Would treatment for all children be more effective if it targeted only PTSD?

The Diagnostic Statistical Manual, fourth edition, Desk Reference states the criterion

necessary for diagnosing ADHD and PTSD (American Psychiatric Association, 2005). The

symptoms for ADHD are as follows:

A. Either (1) or (2)

1. six (or more) of the following symptoms of inattention have persisted for at

least 6 months to a degree that is maladaptive and inconsistent with

developmental level:

LITERARY REVIEW 3

Inattention

(a) often fails to give close attention to details or makes careless mistakes in

schoolwork, work, or other activities

(b) often has difficulty sustaining attention in tasks or play activities

(c) often does not seem to listen when spoken to directly

(d) often does not follow through on instructions and fails to finish schoolwork,

chores, or duties in the workplace (not due to oppositional behavior or failure

to understand instructions)

(e) often has difficulty organizing tasks and activities

(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained

mental effort (such as schoolwork or homework)

(g) often loses things necessary for tasks or activities (e.g. toys, school

assignments, pencils, books, or tools)

(h) is often easily distracted by extraneous stimuli

(i) is often forgetful in daily activities

(2) six (or more) of the following symptoms of hyperactivity-impulsivity have persisted

for at least 6 months to a degree that is maladaptive and inconsistent with developmental

level:

(a) often fidgets with hands or feet or squirms in seat

(b) often leaves seat in classroom or in other situation in which remaining seated

is expected

(c) often runs about or climbs excessively in situations in which it is inappropriate

LITERARY REVIEW 4

(d) often has difficulty playing or engaging in leisure activities quietly

(e) is often “on the go” or often acts as if “driven by a motor”

(f) often talks excessively

Impulsivity

(g) often blurts out ensures before questions have been completed

(h) often has difficulty awaiting turn

(i) often interrupts or intrudes on others (e.g. butts into conversations or games)

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were

present before age 7 years

C. Some impairment from the symptoms is present in two or more settings (e.g. at

school, [or work], and at home)

D. There must be clear evidence of clinically significant impairment in social, academic,

or occupational functioning

E. The symptoms do not occur exclusively during the course of a Pervasive

Developmental Disorder, Schizophrenia, of other mental disorder (e.g. Mood

Disorder, Anxiety Disorder, Dissociative Disorder, of a Personality Disorder).

The criterion from the DSM-IV-TR (2005) for PTSD are as follows:

A. The person has been exposed to a traumatic event in which both of the following

were present:

(1). The person experienced, witnessed, or was confronted with an event or events

that involved actual or threatened death or serious injury, or a threat to the physical

integrity of self or others

LITERARY REVIEW 5

(2). The person’s response involved fear, helplessness, or horror

B. The traumatic event is persistently re-experienced in one (or more) of the following

ways:

(1). recurrent and intrusive distressing recollections of the event, including

images, thoughts, or perceptions

(2). recurrent distressing dreams of the event

(3). acting or feeling as if the traumatic event were recurring (includes a sense of

reliving the experience, illusions, hallucinations, and dissociative flashback

episodes, including those that occur on awakening or when intoxicated)

(4). intense psychological distress at exposure to internal or external cues that

symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general

responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1). efforts to avoid thoughts, feelings, or conversations associated with the

trauma

(2). efforts to avoid activities, places, or people that arouse recollections of the

trauma

(3). inability to recall an important aspect of the trauma

(4). markedly diminished interest or participation in significant activities

LITERARY REVIEW 6

(5). feeling of detachment or estrangement from others

(6). restricted range of affect (e.g. unable to have love feelings)

(7). sense of a foreshortened future (e.g. does not expect to have a career,

marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma) as indicated

by two (or more) of the following:

(1). difficulty falling or staying asleep

(2). Irritability or outburst of anger

(3). difficulty concentrating

(4). hypervigilance

(5). exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B,C, and D) is more than 1 month

F. The disturbance causes clinically significant distress or impairment in social,

occupational, or other important areas of functioning.

The purpose of the study is to answer the questions about ADHD and PTSD being

related. One thousand seven year old children will be tested. Studies done in the past have had

significantly fewer participants, which means that their findings may not be considered norms of

the general population of the United States (Ford, Racusin, Daviss et al, 2010).

LITERARY REVIEW 7

Stratified random sampling will be used to ensure that this study can be normed to the

population of the United States (Argosy, 2011. Shaughnessy, Zechmeister & Zechmeister,

2012). Percentages of various groups and diversity will be gathered from the United States

Census Report, 2010(www.census.gov, 2010)

The study will also compare and contrast symptoms of ADHD and PTSD and those

children exhibiting signs of either disorder will be categorized using the DSM-IV-TR (American

Psychiatric Association, 2005).

Ethical concerns with this project include the inability to manipulate the variable of

abuse, as it is unethical to cause abuse in order to study it. Parents and children will be informed

of the purpose of the study and the method by which information is to be gathered. There will

be no use of deception in this study. Those children identified as having either disorder will be

treated immediately. There will also be counseling available to all participants at the end of the

study.

LITERARY REVIEW 8

References

American Psychiatric Association (2005). Desk Reference to the DiagnosticCcriteria from

the DSM-IV-TR. American Psychiatric Association. Arlington, VA.

Argosy Online (2011). Retrieved from www.myeclassonline.com (9/27/2011).

Buczynski, R. (2011). PTSD and ADHD: Are we misdiagnosing? (9/27.2011).

Ford, J.D., Racusin, R., Daviss, W.B., Ellis, C.G., Thomas, J., Rogers, K…Senguipa, A.,

(1999). Trauma exposure among children with oppositional defiant disorder and

attention-deficit hyperactivity disorder. Journal of Consulting and Clinical

Psychology. 67 (5). 786-789. doi: 10.637/0022-006X. 67.5.786.

Shaughnessy, J.J., Zechmeister, E.B., Zechmeister, J.S, (2012). Research Methods in

Psychology. (9th ed.). New York. McGraw Hill.

United States Census (2010). Retrieved from www.census.gov (10/2/2011).

Wolf, G.K., Reinhard, M., Cozolino, L.J., Caldwell, A., Asamen, J.K. (2009).

Neuropsychiatric symptoms of complex posttraumatic stress disorder: A

Preliminary Minnesota Multiphasic Personality Inventory scale to identify

adult survivors of childhood abuse. Psychological Trauma Theory: Practice

LITERARY REVIEW 9

and Policy. 1 (1). 49-64. Educational Publishing Foundation.

Wozniak, J., Harding Crawford, M., Biederman, J., Faraone, S.V., Pil, D., Spencer,

T.J…Slier, H.K. (1999). Antecedents and complications of trauma in boys with

ADHD: Findings from a longitudinal study. American Academy of Child and

Adolescent Psychiatry. 38 (1). 48-55.