What is the link between childhood adversity and ADHD?

The relationship is complex and indirect but it seems like self-compassion and emotion regulation strategies are a critical piece of this puzzle.

In my 2025 article “ADHD is not a trauma response”, I made the case that the development of ADHD does not require trauma, and that there is a large and substantial genetic component to ADHD. However, I didn’t ignore the role of the environment, noting the complex interplay between genetic predispositions and our environment:

“Chaotic and stressful early family environments can exacerbate ADHD-related traits. ADHD-related traits existing in unsupportive environments or without resources and help can certainly be a traumatic experience. But this is not the same thing as saying that ADHD-related traits are primarily the result of trauma in childhood. Just because trauma can cause lasting problems in our lives does not mean that ADHD (or any mental health problem) is caused by childhood trauma. For those with a different genetic proclivity, trauma may affect them differently. You tend to break in ways that you’re genetically prone to break.”

Since I wrote that article, I’ve been going down the rabbit hole looking at studies on the link between early childhood adversity and ADHD and I have to say: there really is a significant effect. While it’s well known that adverse childhood experiences (ACEs) such as household dysfunction, abuse, exposure to violence, emotional neglect, and maltreatment can put someone at risk of developing many disorders as an adult, there is growing evidence that early environmental adversity does contribute specifically to the persistence or severity of ADHD symptoms such as impulsivity, inattention, and hyperactivity into adulthood despite ADHD being a neurodevelopment disorder with strong genetic roots (see here, here, here, and here).

Importantly, it seems that the link between childhood adversity and adulthood ADHD symptoms is especially pronounced among those with emotional dysregulation difficulties and the absence of early interventions. Indeed, the field of emotion regulation is one of the fastest growing areas of psychology and one set of researchers argued that emotion dysregulation is a core symptom of ADHD.

While cumulative exposure to early adversity negatively affects brain regions responsible for executive functioning, emotional regulation, and the ability to focus attention, there are protective factors that make it more likely that the adversity will not have such a strong effect. People with neurodevelopmental conditions such as ADHD often are less likely to use adaptive emotion regulation strategies such as cognitive reappraisal or problem solving to cope with a difficult situation due to their greater impulsivity and inattention. Instead, they tend to use more maladaptive strategies such as rumination, avoidance, or emotional suppression, often making things worse. These difficulties are often seen across multiple areas of their life, such as at work, in peer relationships, in family relationships, and in terms of academic success.

Another factor that seems to serve as a protective factor is self-compassion. Self-compassion is the practice of being kind toward oneself during difficult times, recognizing our shared human experiences, and maintaining a balanced awareness of painful thoughts and feelings. It consists of three elements: self-kindness, common humanity, and mindfulness.

While emotion regulation is about how we manage our emotions, self-compassion is about how we relate to ourselves during challenging situations. Research shows that higher self-compassion is associated with a greater use of adaptive emotion regulation strategies.

Self-compassion has also been shown to promote resilience and well-being specifically for those who have faced adversity. Since ACEs tend to increase the risk for greater self-criticism and shame, self-compassion helps to have a gentler attitude toward oneself that is more nurturing and constructive. People high in self-compassion are less likely to engage in self-criticism and negative self-talk, which can lead to feelings of shame, guilt, and inadequacy. Self-compassion allows for the ability to reframe stressful experience and respond with equanimity. It’s becoming quite clear that self-compassion is an important factor in the mental health of adults with ADHD.

Tying all of this research together in a new study, Fikriye Karacul and Gökmen Arslan examined the protective roles of self-compassion and emotional regulation, looking at the link between ACEs and young adult ADHD symptoms. Their sample consisted of 442 young adults aged between 18 and 29 years of age from a public university in Türkiye. A benefit of this sample is that it included a non-Western population (most prior research on the link between early childhood adversity and ADHD have come from Western populations). What did they find?

Consistent with prior research, they found that adverse childhood experiences significantly predicted ADHD symptoms. The researchers also found that emotion regulation accounted for the adverse impact of ACEs on ADHD symptoms. Put the other way, people with strong emotion regulation skills were less likely to experience ADHD symptoms despite adverse childhood experience.

Finally, the findings indicated that adverse childhood experiences were associated with emotional regulation and ADHD symptoms through self-compassion. Self-compassion not only directly explained the relationship between ACEs and ADHD symptoms, but also indirectly enhanced emotion regulation.

Therefore, it seems that cultivating self-compassion not only addresses emotion regulation difficulties but can also provide a foundational resource for young adults managing ADHD symptoms, especially those with histories of adversity. Self-compassion can help ease the burden for these individuals.

Programs such as mindfulness-based self-compassion and emotion regulation training could be tailored to address the specific needs of people who have experienced childhood adversity. Additionally, trauma-informed approaches in educational settings could help identify and support students at risk for ADHD symptoms resulting from early childhood adversity, which could significantly increase their health and well-being.

Something that I think is really important to distinguish in this line of research is between PTSD and ADHD. The study I just mentioned did not examine PTSD specifically but focused on ADHD symptoms. While people with PTSD often display a lot of ADHD-related traits, such as hyper-vigilance, intrusive thoughts, and avoidance behaviors, the underlying mechanism differs between PTSD and ADHD: PTSD-related inattention tends to be trauma-driven whereas inattentive symptoms in ADHD tend to stem from neurodevelopment deficits in executive functioning.

What does this all mean? Well, for most people, ADHD is not the result of trauma. ADHD doesn’t require trauma to develop. With that said, exposure to childhood adversity is a significant environmental risk factor for the development and persistence of ADHD symptoms across the lifespan, especially for those who already have a genetic predisposition toward ADHD-related symptoms.

The promising news is that interventions that target emotion regulation strategies and self-compassion can significantly reduce the impact of early childhood adversity on the exacerbation of ADHD-related symptoms that can cause a significant disruption in a person’s life.

This stuff sure is complex! Which is why you should always be skeptical when you hear any extreme claims about ADHD in the media. There is never one and only one pathway to ADHD-related traits, and ADHD doesn’t require adversity. Many people develop ADHD-related symptoms in a wonderfully supportive environment. But for those with a predisposition for ADHD living a challenging life, there is also hope that they can overcome and live the life they truly want to live.