1. Running Head: LITERARY REVIEW 1
Literary Review
Frances Carpenter
PSY 302
Argosy University

2. 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:

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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

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(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

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(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

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(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).

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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.

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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

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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.