Trauma-linked ADHD: A Neuroplasticity based REWIRE framework for neuropsychological intervention

Attention-Deficit/Hyperactivity Disorder (ADHD) is traditionally conceptualised as a neurodevelopmental disorder of primarily genetic origin. Emerging evidence from affective neuroscience and developmental psychopathology, however, suggests that ADHD symptoms often overlap with adaptations to chronic stress, attachment disruptions and early trauma. This thesis proposes a trauma-informed reconceptualisation of ADHD as a dynamic, survival-based pattern rooted in altered stress-response and emotion-regulation circuits, and argues that the resulting REWIRE framework can be applied both to trauma-linked and primarily biological or genetically mediated ADHD, where individuals must still learn everyday self-regulation skills alongside any medication. Drawing on an integrative, narrative review of empirical literature on stress physiology, reward pathways, attachment and neuroplasticity, the thesis develops the REWIRE model, a six-phase framework (Recognize, Engage, Witness, Integrate, Recode, Empower) that translates neuroscientific insights into therapeutic practice. A central implication is a shift in clinical questioning from “What is wrong with this person?” to “What has this nervous system learned, and what does it now need?”, inviting clinicians to view hyperactivity, distractibility and impulsivity not only as deficits but also as once-adaptive responses to adversity. This shift may reduce shame, strengthen therapeutic alliance and support more nuanced formulations that integrate biology, attachment and context. The thesis outlines the architecture of trauma-linked ADHD, sketches practical clinical, educational and game-based applications of the REWIRE model, and identifies priorities for future empirical evaluation.