New research has found that individuals with attention-deficit/hyperactivity disorder (ADHD) are significantly more likely to be involved in violent incidents, either as victims or perpetrators. Specifically, these individuals had approximately 2.5 times higher odds of perpetrating violence and an 80% higher likelihood of being victims of sexual or intimate partner violence compared to those without ADHD. The study was published in Psychological Medicine.
Intimate partner violence is any kind of violence that takes place within a romantic relationship. It includes physical, sexual, or psychological violence. Intimate partner violence is a serious public health concern and is often associated with a range of negative physical and emotional consequences for the victim. Recent estimates indicate that roughly 61 million women and 53 million men in the U.S. have faced psychological aggression from their partners at some point in their lives.
Intimate partner violence is believed to affect women much more often than men. However, intimate partner violence often goes in both directions within a couple. Studies show that the most frequent pattern of intimate partner violence is mutual violence between partners. Not all, but many, individuals who are victims of intimate partner violence have also been its perpetrators.
Sexual violence is defined as any “sexual act that is committed or attempted by another person without the victim’s consent or against someone incapable of giving consent or refusal.” While acts of sexual violence against strangers often garner significant media attention, it also frequently occurs between intimate partners. Data reveals that approximately 4.2% of women and 2.4% of men experienced at least one instance of sexual violence in the past year.
Study author Gonzalo Arrondo and his colleagues wanted to study the association between ADHD, intimate partner violence, and sexual violence in adolescents and adults. ADHD is a neurodevelopmental disorder that manifests in persistent patterns of inattention, hyperactivity, and impulsivity. It commonly begins in childhood and can continue into adulthood, requiring clinical diagnosis and appropriate management.
Childhood ADHD is an important risk factor of antisocial behavior later in life. This is the reason why these researchers believed that people with this disorder might be more often involved in acts of violence either as perpetrators or victims. They were also aware that there are already quite a few studies examining this association, but results were often inconsistent.
The research team executed a meta-analysis, a statistical technique that amalgamates and scrutinizes data from multiple independent studies, aiming to draw broader and more dependable conclusions on a specific research subject. They focused on studies featuring ADHD individuals, analyzing data pertaining to involvement in either sexual or IPV, in the role of either victim or perpetrator.
The search resulted in 14 different studies that met the criteria set by the researchers. All of these studies were published between 2001 and 2021. Ten of these studies were conducted in the United States, while four were from Europe (England, Germany, Denmark, and Sweden).
In total, the studies included 1,111,557 individuals, with the median sample size per study being 14,816 participants. Most of the studies were conducted on young people or adolescents. Seven were on intimate partner violence, five on sexual violence, and two reported both.
The researchers found that individuals with ADHD had 2.5 higher odds of being perpetrators of intimate partner violence compared to individuals without this disorder. When the biggest study was removed from the calculation, odds were 1.87 times higher.
Analysis of studies on sexual violence showed large differences in results of studies, but on average, individuals with ADHD had 2.73 higher odds of being perpetrators of sexual violence compared to individuals without this disorder.
Individuals with ADHD were also more likely to be victims of both sexual and intimate partner violence. Their odds of being a victim of intimate partner violence were 1.78 times higher than those of individuals without ADHD. However, results differed greatly across studies. If some of the studies were excluded from the calculation, the increased odds disappeared. Odds of being victims of sexual violence were 1.84 greater and they remained greater even with exclusion of specific studies.
“Our results are of high clinical and social relevance but could be misinterpreted. On the one hand, we must emphasize that we have presented relative risks of an infrequent event. Therefore, our results should not be used to stigmatize individuals with ADHD, as most individuals with the disorder will not be involved in a case of intimate partner violence or sexual victimization,” the study authors concluded.
“On the other hand, the fact that ADHD is related to a significantly higher risk of perpetrating or of being the victim of violence should not be minimized, as intimate partner violence and sexual violence can have lasting consequences in the person who suffers them.”
The study makes an important contribution to the scientific understanding of specificities of individuals with ADHD. However, it should be noted that most cases of intimate partner violence and sexual violence do not include individuals with ADHD. The majority of individuals diagnosed with ADHD in childhood will also likely not be involved in cases of violence. Additionally, in doing these analyses, the study authors did not control for other mental disorders. It is possible that another mental disorder, something other than ADHD, could be driving the obtained results.
The study, “Attention-deficit/hyperactivity disorder as a risk factor for being involved in intimate partner violence and sexual violence: a systematic review and meta-analysis” was authored by Gonzalo Arrondo, Alfonso Osorio, Sara Magallón, Cristina Lopez-del Burgo, and Samuele Cortese.
