Violence at Home and ADHD

Is there a connection?
Lead study author: Dr. Nerissa Bauer, assistant professor of pediatrics at the IU School of Medicine.
A recent study published in the Journal of the American Medical Association (JAMA) Pediatrics found that children exposed to domestic violence or maternal depression may increase the risk of developing ADHD.

Indiana University School of Medicine researchers examined data from a population of more than 2,000 children. They discovered a link between parents who had reported depression or intimate partner violence and a significantly greater likelihood of their children suffering from ADHD as they grew older.

“It wasn’t surprising, from the lens of me being a behavioral pediatrician,” said Dr. Nerissa Bauer, an assistant professor of pediatrics at the IU School of Medicine and the lead study author. “I routinely encounter mental health and behavioral problems in children, and this supports my initial hunch that I was seeing an increase in that.”

Previous research has demonstrated the same links as the Indiana study. Trauma, whether it is psychological or physical will reshape the brain especially in an area known as the hippocampus which serves as a center for memory and learning. The reshaping or pruning of the hippocampus when exposed to trauma may be a biological trigger to other problems such as ADHD, sleep disorders, etc.

New Study Finds ADHD Rates on Rise

The study, published in Monday’s issue of JAMA Pediatrics, examined health records from California and found that rates of ADHD have jumped by 24% since 2001.

“That is a very significant increase,” says Darios Getahun, a research scientist with the Kaiser Permanente Southern California Medical Group who conducted the study.

Many experts theorize that the rise in diagnoses can possibly be attributed by growing awareness of the condition. If one were cynical, one could also point out the increased rate of marketing for ADHD medications. Let’s not be blind; ADHD is a multi-billion dollar business to the pharmaceutical industry.

Kaiser Permanente reviewed the health records of more than 840,000 children, ages 5-11, and also found that boys were three times more likely to be diagnosed than girls. The cynic might say that boys are more boisterous than girls. They display greater signs of hyperactivity.

“I don’t agree with the language about ‘epidemic’ proportions [in the study] and ‘dramatic’ increases,” says Paul Hammerness, an ADHD expert at Harvard Medical School and Massachusetts General Hospital. “It is my impression that absolute rates are fairly stable over time, from country to country as well.”

One must always question whether we are allowing children to be children or trying to mold them through medication.

Suggested reading: The Last Normal Child: Essays on the Intersection of Kids, Culture, and Psychiatric Drugs (Childhood in America) [Lawrence H. Diller M.D.] on Amazon.com.

Training the ADHD Brain

For years, we at Play Attention, have trained thousands and thousands of people to better pay attention, learn the cognitive skills they need to succeed, and change their behavior. Our results have spoken clearly for us since 1994. Now science is catching up.

Two recent distinct studies validate the brain’s ability to change. While a vast plethora of research confirms these studies’ findings, they are noteworthy. The first study demonstrates the efficacy of skill training, and the second demonstrates how teaching skills rewires the living brain.

The first study, published in the August 25 Journal of the American Medical Association, was performed by researchers from Massachusetts General Hospital (MGH). They utilized cognitive behavioral therapy as a direct intervention for ADHD adults. Cognitive therapy teaches skills for managing life challenges.

The researchers at  MGH found that while medications were the first line of treatment, many patients still persist with underlying symptoms.  While previous studies on cognitive behavioral therapy for ADHD were small and short term, the researchers at MGH claim their study to be the first to conduct full-scale randomized, controlled trial of the efficiency of an individually-delivered, non-medication treatment of ADHD among adults.

“Medications are very effective in ‘turning down the volume’ on ADHD symptoms, but they do not teach people skills,” commented Steven Safren, PhD, ABPP, director of Behavioral Medicine in the MGH Department of Psychiatry, who led the study. “This study shows that a skills-based approach can help patients learn how to cope with their attention problems and better manage this significant and impairing disorder.”

“Sessions were designed specifically to meet the needs of ADHD patients and included things like starting and maintaining calendar and task list systems, breaking large tasks into manageable steps, and shaping tasks to be as long as your attention span will permit,” commented Safren, an associate professor of Psychology in the Harvard Medical School Department of Psychiatry. “The treatment is half like taking a course and half like being in traditional psychotherapy.”

Like Play Attention has been doing since 1994, the researchers provided training sessions mainly that included skills training in filtering of distractions, organization, problem solving, and planning.

Safren’s group receiving cognitive and behavioral training demonstrated advanced control of their symptoms over their control group.  This benefit had persisted when measured three and nine months after the training.

The second study, published in The Journal of Neuroscience (August 25, 2010, 30 34 11493-11500 doi 10.1523 JNEUROSCI.1550-10.2010), examined the brains of rats when they learned to control their impulses.  The researchers documented synaptic changes in the medial prefrontal cortex. They concluded that the rat’s brains rewired themselves to produce the impulse controls necessary to be successful in the tasks the scientists had established for them.

Other past studies have confirmed that the brain will rewire to make changes for skills, impulse control, organization, etc. We’re glad that science is catching up to an learning process that we’ve done at Play Attention for sixteen years now.  That’s beyond cutting edge; it’s leading the way for others.