Evidence map›Paper›PMID 41310555›Full record

ArticleBMC psychiatry2025

Adverse childhood experiences mediate the association between ADHD symptoms and severe psychological distress in the Japanese general population: a causal mediation analysis of 29,268 participants.

Keita Tokumitsu, Norio Sugawara, Takahiro Tabuchi, Norio Yasui-Furukori

Abstract read
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Article in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Keita TokumitsuDepartment of Neuropsychiatry, Towada City Hospital, Towada, Aomori, Japan.ORCID 0000-0001-6747-4348
Norio SugawaraDepartment of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, 321-0293, Japan. nsuga3@dokkyomed.ac.jp.ORCID 0000-0001-7058-664X
Takahiro TabuchiDivision of Epidemiology, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.ORCID 0000-0002-1050-3125
Norio Yasui-FurukoriDepartment of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, 321-0293, Japan.ORCID 0000-0002-4414-3770

Funding

Health Labor Sciences Research Grants 22FA1002, 22FA1010, 22FA2001, 23FA1004, 23JA1003, 23EA1009Japan Society for the Promotion of Science 20H00040, 21H03203, 24K13396, 25H01079Japan Society for the Promotion of Science 23K06993, 24K13396, 25K13594Japan Society for the Promotion of Science 24K13396, 25K13594
6 · The paper itself

Abstract

backgroundAdverse childhood experiences (ACEs) include various forms of trauma or chronic stress during childhood, e.g., physical, emotional, and sexual abuse; neglect; and household dysfunction. ACEs have been linked to long-term psychological difficulties. Emerging research suggests that individuals with attention-deficit/hyperactivity disorder (ADHD) may be more frequently exposed to ACEs due to familial conflict or behavioral dysregulation. However, it remains unclear which specific ACE types mediate the association between ADHD symptoms and adult psychological distress.

methodsWe analyzed data from 29,268 adults in a nationwide Japanese internet-based survey. ADHD symptoms were measured using the Adult ADHD Self-Report Scale (ASRS-J-6), and severe psychological distress (SPD) was measured using the Kessler Psychological Distress Scale (K6) scale. Participants reported exposure to ten types of ACEs. Causal mediation analysis was performed to identify ACEs that mediated the ADHD-SPD association, adjusting for demographic variables.

resultsAmong participants, 3.69% screened positive for ADHD symptoms, 12.81% met the criteria for SPD, and 5.09% reported four or more ACEs. Both ADHD symptoms and greater ACE exposure were significantly associated with SPD. Five ACE indicators, including emotional neglect, emotional abuse, physical abuse, household physical violence, and having four or more ACEs, significantly mediated the ADHD-SPD relationship. Emotional neglect had the strongest mediating effect (11.19%).

conclusionsEmotion-related ACEs partially mediate the association between ADHD symptoms and adult psychological distress. While preventing childhood adversity remains essential, addressing ADHD symptoms through psychoeducation and intervention may reduce psychological burden in adulthood. These findings underscore the importance of trauma-informed approaches in the assessment and treatment of individuals with ADHD. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Adverse Childhood ExperiencesAttention Deficit Disorder with HyperactivityPsychological DistressStress, PsychologicalAdultAgedEast Asian PeopleFemaleHumansJapanMaleMediation AnalysisMiddle AgedYoung AdultACEADHDAdverse childhood experienceAttention-deficit/hyperactivity disorderCausal mediation analysisPsychological distress

Identifiers

PMID41310555
PMCPMC12752057

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.