Background:

An association between child sexual abuse (CSA) and attention deficit hyperactivity disorder (ADHD) has been documented. However, the temporal relationship between these problems and the roles of trauma-related symptoms or other forms of maltreatment remain unclear. This review aims to synthesize available research on CSA and ADHD, assess the methodological quality of the available research, and recommend future areas of inquiry.

Methods:

Studies were searched in five databases including Medline and PsycINFO. Following a title and abstract screening, 151 full texts were reviewed and 28 were included. Inclusion criteria were sexual abuse occurred before 18 years old, published quantitative studies documenting at least a bivariate association between CSA and ADHD, and published in the past 5 years for dissertations/theses, in French or English. The methodological quality of studies was systematically assessed.

Results:

Most studies identified a significant association between CSA and ADHD; most studies conceptualized CSA as a precursor of ADHD, but only one study had a longitudinal design. The quality of the studies varied greatly with main limitations being the lack of (i) longitudinal designs, (ii) rigorous multimethod/ multiinformant assessments of CSA and ADHD, and (iii) control for two major confounders: trauma-related symptoms and other forms of child maltreatment.

Discussion:

Given the lack of longitudinal studies, the directionality of the association remains unclear. The confounding role of other maltreatment forms and trauma-related symptoms also remains mostly unaddressed. Rigorous studies are needed to untangle the association between CSA and ADHD.

中文翻译：

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理清注意力缺陷多动障碍与儿童性虐待之间的关联：系统评价

背景：

儿童性虐待 (CSA) 与注意力缺陷多动障碍 (ADHD) 之间的关联已被记录在案。然而，这些问题与创伤相关症状或其他形式的虐待之间的时间关系仍不清楚。本综述旨在综合有关 CSA 和 ADHD 的现有研究，评估现有研究的方法学质量，并推荐未来的研究领域。

方法：

在包括 Medline 和 PsycINFO 在内的五个数据库中搜索了研究。在标题和摘要筛选之后，审查了 151 篇全文，并收录了 28 篇。纳入标准是性虐待发生在 18 岁之前，发表的定量研究至少记录了 CSA 和 ADHD 之间的双变量关联，并且在过去 5 年内以法语或英语发表了论文/论文。系统地评估了研究的方法学质量。

结果：

大多数研究发现 CSA 和 ADHD 之间存在显着关联；大多数研究将 CSA 概念化为 ADHD 的先兆，但只有一项研究采用纵向设计。研究质量差异很大，主要局限性在于缺乏 (i) 纵向设计，(ii) 对 CSA 和 ADHD 进行严格的多方法/多信息评估，以及 (iii) 控制两个主要混杂因素：创伤相关症状和其他形式虐待儿童。

讨论：

由于缺乏纵向研究，关联的方向性仍不清楚。其他虐待形式和创伤相关症状的混杂作用也大多未得到解决。需要进行严格的研究来弄清 CSA 和 ADHD 之间的关联。