Isaksson Johan, Sukhodolsky Denis G, Koposov Roman, Stickley Andrew, Ramklint Mia, Ruchkin Vladislav
Uppsala University, Uppsala, Sweden.
Karolinska Institutet, Stockholm, Sweden.
JAACAP Open. 2024 Feb 16;3(1):126-136. doi: 10.1016/j.jaacop.2024.01.006. eCollection 2025 Mar.
Aggression is a multifaceted behavior that involves cognitive, behavioral, and affective components. Although aggressive behaviors are commonly observed among individuals with attention-deficit/hyperactivity disorder (ADHD), potential sex-specific aspects of the association between ADHD symptoms and different components of aggression need to be evaluated, while also controlling for comorbid problems.
In the present cross-sectional study, self-reported data were collected from 2,838 adolescents (mean age = 14.89 years) from Russia on ADHD symptoms and cognitive (anger rumination, aggressive beliefs), behavioral (physical, verbal, social, proactive), and affective (trait anger) aspects of aggression as well as comorbid emotional and conduct problems. Generalized linear model analyses were used to examine the associations between ADHD symptoms and aggression and to explore sex differences, while also adjusting for comorbid problems.
Clinically significant levels of ADHD symptoms were associated with all components of aggression, and the associations remained significant after adjusting for emotional and conduct problems. Overall, females had higher levels of trait anger and anger rumination, whereas males had higher levels of aggressive beliefs, proactive aggression, and physical and verbal aggression. There was also a sex-specific association, where males with ADHD symptoms reported higher levels of social aggression. Conduct problems moderated the association between ADHD and aggression, increasing the likelihood of trait anger and social aggression in adolescents without ADHD symptoms.
Clinically significant levels of ADHD symptoms seem to impact all components of aggression independent of comorbidity. It is therefore important to consider aggression when evaluating and treating ADHD.
攻击行为是一种多方面的行为，涉及认知、行为和情感成分。尽管在注意力缺陷多动障碍（ADHD）患者中普遍观察到攻击行为，但ADHD症状与攻击行为不同成分之间潜在的性别特异性关联需要在控制共病问题的同时进行评估。
在本横断面研究中，从俄罗斯的2838名青少年（平均年龄=14.89岁）收集了关于ADHD症状以及攻击行为的认知（愤怒反刍、攻击信念）、行为（身体、言语、社交、主动）和情感（特质愤怒）方面以及共病的情绪和行为问题的自我报告数据。使用广义线性模型分析来检验ADHD症状与攻击行为之间的关联并探索性别差异，同时对共病问题进行调整。
具有临床意义的ADHD症状水平与攻击行为的所有成分相关，在对情绪和行为问题进行调整后，这些关联仍然显著。总体而言，女性的特质愤怒和愤怒反刍水平较高，而男性的攻击信念、主动攻击以及身体和言语攻击水平较高。还存在性别特异性关联，即有ADHD症状的男性报告的社交攻击水平较高。行为问题调节了ADHD与攻击行为之间的关联，增加了无ADHD症状青少年出现特质愤怒和社交攻击的可能性。
具有临床意义的ADHD症状水平似乎独立于共病影响攻击行为的所有成分。因此，在评估和治疗ADHD时考虑攻击行为很重要。
