Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Faculty of Social Sciences, Social and Public Policy Unit, University of Helsinki, Helsinki, Finland.
Psychol Med. 2023 Mar;53(4):1510-1517. doi: 10.1017/S0033291721003093. Epub 2021 Sep 1.
Neurodevelopmental disorders (NDs) are associated with experiences of victimization, but mechanisms remain unclear. We explored sex differences and the role of familial factors and externalizing problems in the association between several NDs and violent victimization in adolescence and young adulthood.
Individuals born in Sweden 1985-1997, residing in Sweden at their 15th birthday, were followed until date of violent victimization causing a hospital visit or death, death due to other causes, emigration, or December 31, 2013, whichever came first. The exposures were diagnoses of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual disability (ID) and other NDs. We used three different Cox regression models: a crude model, a model adjusted for familial confounding using sibling-comparisons, and a model additionally adjusted for externalizing problems.
Among 1 344 944 individuals followed, on average, for 5 years, 74 487 were diagnosed with NDs and 37 765 had a hospital visit or died due to violence. ADHD was associated with an increased risk of violent victimization in males [hazard ratio (HR) 2.56; 95% confidence interval (CI) 2.43-2.70) and females (HR 5.39; 95% CI 4.97-5.85). ASD and ID were associated with an increased risk of violent victimization in females only. After adjusting for familial factors and externalizing problems, only ADHD was associated with violent victimization among males (HR 1.27; 95% CI 1.06-1.51) and females (HR 1.69; 95% CI 1.21-2.36).
Females with NDs and males with ADHD are at greater risk of being victim of severe violence during adolescence and young adulthood. Relevant mechanisms include shared familial liability and externalizing problems. ADHD may be independently associated with violent victimization.
神经发育障碍（NDs）与受害经历有关，但机制尚不清楚。我们探讨了性别差异以及家族因素和外化问题在几种 NDs 与青少年和年轻成人期暴力受害之间的作用。
1985-1997 年在瑞典出生、15 岁生日时居住在瑞典的个体，随访至发生暴力受害导致住院或死亡、其他原因死亡、移民或 2013 年 12 月 31 日（以先发生者为准）。暴露因素为注意力缺陷多动障碍（ADHD）、自闭症谱系障碍（ASD）、智力残疾（ID）和其他 NDs 的诊断。我们使用了三种不同的 Cox 回归模型：未经调整的模型、使用同胞比较调整家族混杂因素的模型以及另外调整外化问题的模型。
在平均随访 5 年的 1344944 名个体中，74487 人被诊断为 NDs，37765 人因暴力受害而住院或死亡。ADHD 与男性（HR 2.56；95%CI 2.43-2.70）和女性（HR 5.39；95%CI 4.97-5.85）暴力受害风险增加相关。ASD 和 ID 仅与女性暴力受害风险增加相关。在调整家族因素和外化问题后，仅 ADHD 与男性（HR 1.27；95%CI 1.06-1.51）和女性（HR 1.69；95%CI 1.21-2.36）暴力受害相关。
患有 NDs 的女性和患有 ADHD 的男性在青少年和年轻成人期成为严重暴力受害的风险更高。相关机制包括共同的家族易感性和外化问题。ADHD 可能与暴力受害独立相关。
