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ADHD or Complex Trauma: Untangling the Threads of Diagnosis

Understanding the nuances between ADHD (Attention-Deficit/Hyperactivity Disorder) and complex trauma can be a challenging task for clinicians conducting ADHD assessments. In some instances, the symptoms of ADHD can resemble those of complex trauma, and vice versa. Additionally, these two conditions can co-occur, further complicating the diagnostic process.

In this article, we will explore the difficulties associated with differentiating between ADHD and complex trauma, while also shedding light on the crucial considerations that assessors must keep in mind when making a diagnostic decision.

Overlapping Symptoms

When conducting an ADHD assessment, it is essential to recognise that some symptoms commonly associated with ADHD, such as difficulty concentrating, impulsivity, and restlessness, can also be observed in individuals who have experienced complex trauma. These individuals may display heightened hypervigilance, difficulties with emotional regulation, and impaired executive functioning, which can mimic the symptoms of ADHD. It is crucial for assessors to consider these overlapping symptoms and delve deeper to identify the underlying cause behind these presentations.

Impact of Trauma

Complex trauma, characterised by exposure to prolonged interpersonal trauma, can significantly impact an individual's cognitive and behavioural functioning. Children and adults who have experienced trauma may exhibit ADHD-like behaviors, such as inattention, impulsivity, and hyperactivity, as a result of heightened stress responses and difficulties with emotional regulation. Assessors must consider the possibility that the observed behaviours may stem from the individual's traumatic experiences, rather than a primary diagnosis of ADHD.


In some cases, individuals may present with both ADHD and complex trauma simultaneously. It is essential to recognize that these conditions can co-occur, and each can exacerbate the symptoms of the other. The trauma experienced by individuals with ADHD may intensify their difficulties with attention, impulsivity, and emotional regulation. On the other hand, individuals with complex trauma may find it challenging to manage their symptoms effectively, leading to increased distractibility and restlessness. Assessors must be vigilant and consider the possibility of co-occurring conditions, as this can significantly impact treatment planning and intervention strategies.

Considerations for Diagnostic Decision-Making

When faced with the challenging task of differentiating between ADHD and complex trauma, assessors must take a comprehensive and holistic approach. Here are some important considerations to keep in mind:

  1. Thorough assessment: Conduct a thorough assessment that includes comprehensive interviews, observations, and gathering information from multiple sources. This will help in capturing a complete picture of the individual's symptoms, behaviours, and history, enabling a more accurate diagnosis.

  2. Trauma-informed approach: Adopt a trauma-informed approach that acknowledges the potential impact of trauma on an individual's functioning. Assessors should explore the individual's trauma history, inquire about any potential triggers or traumatic reminders, and be sensitive to the emotional responses during the assessment process.

  3. Collaboration and consultation: Engage in collaboration and consultation with other professionals, such as psychologists, psychiatrists, and trauma specialists. This interdisciplinary approach can provide valuable insights and help in distinguishing between ADHD and complex trauma, ensuring the most accurate diagnosis and appropriate treatment recommendations.

Distinguishing between ADHD and complex trauma during the assessment process can be a complex and intricate task. By understanding the overlapping symptoms, considering the impact of trauma, and recognising the possibility of co-occurring conditions, assessors can navigate the diagnostic challenges more effectively. A thorough assessment, trauma-informed approach, and collaboration with other professionals are key elements to ensure an accurate diagnosis and provide appropriate support for individuals who are grappling with these complexities. At Clinical Therapy, our team of expert clinicians is dedicated to conducting comprehensive assessments and guiding individuals towards the most suitable interventions based on their unique needs and experiences.

Clinical Psychologist

B Psych (Hons), M Psych (Clin), MAPS

Elizabeth Talbot is a Clinical Psychologist and the Principal Psychologist at Clinical Therapy. Whilst Elizabeth enjoys her clinical work, she is also a lover of behavioural science and has a keen research interest in the psychology of decision making, moral reasoning, cognitive biases, magical thinking, and conspiratorial beliefs.

Content note: Unless otherwise labelled, all blog posts are intended as discussion pieces, and are not academic texts. Articles pertaining to research or making an academic argument will be labelled as such and include supporting evidence/references. All examples (including client names) are fictitious, to illustrate a point, and are not based on actual clients.


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