Attention-Deficit/Hyperactivity Disorder,Trait Impulsivity,and Externalizing Behavior in a Longitudinal Sample

Attention-deficit/hyperactivity disorder (ADHD) is highly comorbid with and predictive of externalizing behavior, yet is most often examined categorically, not dimensionally. We tested a recently proposed trait impulsivity model by dimensionally examining measures of childhood inattention and hyperactivity/impulsivity separately as predictors of later externalizing behavior in an all-female longitudinal sample of 228 young women. We also examined influences of parenting and peer relations, given the transactional nature and importance of environmental factors. We analyzed the relative contribution of hyperactive/impulsive (HI) and inattentive (IA) symptoms of girls with and without childhood-diagnosed ADHD (M age?=?9.5; 140 ADHD and 88 Comparison) to the development of externalizing behaviors in adolescence (M age?=?14.2) and early adulthood (M age?=?19.6). Authoritarian parenting was examined as a moderator and adolescent externalizing behavior as a mediator of the relation between childhood HI and later externalizing behavior. Childhood HI symptoms significantly predicted multiple externalizing behaviors in adolescence and early adulthood, after accounting for IA and covariates (ΔR ² ranged from 2.6 to 7.5 %). Mother’s authoritarian parenting moderated this relation. Adolescent externalizing behavior mediated the relation between childhood HI symptoms and early adult externalizing behavior. In no case did childhood IA significantly predict externalizing behavior after accounting for HI symptoms. Findings support a trait impulsivity model, as HI symptoms, but not IA symptoms, significantly predicted later externalizing behavior. Results support the importance of dimensional predictors of developmental trajectories. We discuss implications for assessment, intervention, and future research.     

Few Preschool Boys and Girls with ADHD are Well-Adjusted During Adolescence

To estimate the prevalence of being well-adjusted in adolescence, boys and girls with (n = 96) and without (n = 126) attention-deficit/hyperactivity disorder (ADHD) were assessed seven times in eight years starting when they were 4–6 years of age. Symptoms of ADHD, ODD/CD, and depression/anxiety in addition to social skills and social preference were gathered using multiple methods and informants. Being well-adjusted was defined by surpassing thresholds in at least four of the five domains. At the 7- and 8-year follow-up, when youth were 11–14 years old, probands were significantly less likely to be well-adjusted relative to age- and ethnicity-matched control children. Only a minority of children with ADHD was well-adjusted in adolescence when emotional, behavioral, and social domains were considered simultaneously. Even when their ADHD symptoms improved over time, most probands exhibited significant impairment 7–8 years after their initial assessment.     

Confirmation of an Inhibitory Control Deficit in Attention-Deficit/Hyperactivity Disorder

The objective of this study was to determine whether deficient inhibitory control distinguishes children with a diagnosis of attention-deficit/hyperactivity (ADHD) disorder, conduct disorder (CD), and comorbid ADHD + CD from normally developing children. Participants were rigorously diagnosed children (age 7 to 12 years) with ADHD (N = 72), CD (N = 13) or ADHD + CD (N = 47) and 33 control children (NC). We studied inhibitory control using the stop-signal paradigm, a laboratory task that assessed the ability to inhibit an ongoing action. The ADHD group had significantly impaired inhibitory control compared to NC, CD, and ADHD + CD children. These results indicate that children with ADHD have deficient inhibition as measured in the stop-signal paradigm and that ADHD occurring in the presence of ADHD + CD may represent a phenocopy of CD rather than a variant of ADHD.     

Negative Halo Effects in Parent Ratings of ADHD,ODD, and CD

Attention-deficit/hyperactivity disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) are highly comorbid, with symptoms that share some similarities. The evidence-based diagnostic process for these disorders includes ratings from adults in the child’s life to assess behavior across settings, so it is important to understand how these raters think about potentially overlapping symptoms. Researchers have identified negative halo effects in ratings of ADHD and ODD symptoms, but ratings of CD have not been examined in these prior studies. Thus, the current study extended past research to examine negative halo effects in parent ratings of the predominantly hyperactive-impulsive presentation of ADHD (i.e., ADHD/HI), ODD, and CD. Parent participants read one of four vignettes that portrayed an 11-year-old boy displaying symptoms of ADHD/HI, ODD, CD, or typical development, and then completed a disruptive behavior scale. The general trend we found was that the presence of a relatively more severe disorder (i.e., CD) artificially inflated ratings of - or showed a negative halo effect for - the relatively less severe disorder (i.e., ADHD/HI), but with some nuance as discussed in the paper. These findings explain and validate how important it is that clinicians conduct evidence-based psychological assessments to decrease the chance of misdiagnosis.

     

Preliminary evidence for reduced posterror reaction time slowing in hyperactive/inattentive preschool children

Background: Attention deficit/hyperactivity disorder (ADHD) has been associated with deficits in self-regulatory cognitive processes, some of which are thought to lie at the heart of the disorder. Slowing of reaction times (RTs) for correct responses following errors made during decision tasks has been interpreted as an indication of intact self-regulatory functioning and has been shown to be attenuated in school-aged children with ADHD. This study attempted to examine whether ADHD symptoms are associated with an early-emerging deficit in posterror slowing. Method: A computerized two-choice RT task was administered to an ethnically diverse sample of preschool-aged children classified as either “control” (n = 120) or “hyperactive/inattentive” (HI; n = 148) using parent- and teacher-rated ADHD symptoms. Analyses were conducted to determine whether HI preschoolers exhibit a deficit in this self-regulatory ability. Results: HI children exhibited reduced posterror slowing relative to controls on the trials selected for analysis. Supplementary analyses indicated that this may have been due to a reduced proportion of trials following errors on which HI children slowed rather than due to a reduction in the absolute magnitude of slowing on all trials following errors. Conclusions: High levels of ADHD symptoms in preschoolers may be associated with a deficit in error processing as indicated by posterror slowing. The results of supplementary analyses suggest that this deficit is perhaps more a result of failures to perceive errors than of difficulties with executive control.     

The Factor Structure of ADHD – Different Models,Analyses and Informants in a Bifactor Framework

The methodological approach of exploratory structural equation modelling (ESEM) has only been applied once to the construct of Attention-deficit/hyperactivity disorder (ADHD). We decided to compare bifactor models based on confirmatory factor analyses (Bi-CFA) and exploratory equation modeling (Bi-ESEM) only, as there is a growing support of a bifactor structure of ADHD. To examine the factorial validity of the construct we compared three possible bifactor models. One model with two specific factors (inattention and hyperactivity/impulsivity), another model with three specific factors (inattention, hyperactivity and impulsivity) and an alternative, incomplete model with one general ADHD and two specific factors (inattention and impulsivity). We used parent- (N = 1386; Age: M = 11.70, SD = 3.18; Sex: 74.5 % male) and teacher-ratings (N = 110; Age: M = 11.27, SD = 3.04; Sex: 77.5 % male) from clinically referred children between the age of 6 and 18. The results indicate that both methods lead to equally good model fit and for both informants the reliable variance of the specific factor hyperactivity is almost completely explained by the general factor. However, in the teacher condition cross-loadings seem to be of particular importance. Across both methods and informants covariation among ADHD symptom items can be in most part attributed to a general ADHD factor as well as to three (inattention, hyperactivity and impulsivity) or two (inattention and impulsivity) weakly defined specific factors. Further research regarding associations between the specific factors of ADHD and other disorders (e.g. conduct disorder) should be conducted.     

Institutional care and iron deficiency increase ADHD symptomology and lower IQ 2.5–5 years post‐adoption

Increased ADHD symptomology and lower IQ have been reported in internationally adopted (IA) children compared to non‐adopted peers (Hostinar, Stellern, Schaefer, Carlson & Gunnar, 2012; Kreppner, O'Connor & Rutter, 2001). However, it is unclear whether these outcomes are due to institutional deprivation specifically or to co‐occurring micronutrient deficiencies that disrupt brain development (Fuglestad, Rao & Georgieff, 2008b). In this study, IA children were compared to children raised in their biological families to examine differences in ADHD symptomology and IQ 2.5–5 years post‐adoption and to assess the contributions of iron deficiency (ID) and duration of deprivation to these cognitive outcomes. ADHD symptoms (parent‐ and experimenter‐reported) and IQ were evaluated in 88 IA (M = 62.1 months, SD = 2.4) and 35 non‐adopted children (M = 61.4 months, SD = 1.6). IA children were assessed 29–64 months post‐adoption (M = 41.9 months, SD = 10.2). ID was assessed during the initial post‐adoption medical visit in 69 children, and children were classified into four groups by iron status, ranging from normal to ID anemia (most severe). IA children had greater ADHD symptomology, p < .01, and lower IQ, p = .001, than non‐adopted children. Within the IA group, children with more severe ID at adoption had greater ADHD symptomology, r(69) = 0.40, p = .001, and lower IQ, r(68) = −0.28, p < .05. Duration of institutional care was positively correlated with ADHD symptoms, r(86) = .28, p < .01, but not IQ, r(85) = −.08, p = .52. Longitudinal results indicate improvement in IQ from 12 months post‐adoption to age 5 for children with greater ID severity at adoption and longer duration of institutional care but no improvement in ADHD symptoms. These results signify continuing effects of early deprivation and ID on ADHD symptoms and IQ years after adoption. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=vUFDAS3DD1c     

Behavioral Characteristics of DSM-IV ADHD Subtypes in a School-Based Population

From an ethnically diverse sample of 2,744 school children, 221 attention deficit hyperactivity disorder (ADHD) [123 (4.5%) predominantly inattentive (IA), 47 (1.7%) predominantly hyperactive/impulsive (HI), and 51 (1.9%) combined type (C)] were identified using teacher ratings on a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) symptom checklist. Subjects were compared to 221 controls on teacher ratings of behavioral, academic, and social functioning. The results revealed relatively independent areas of impairment for each diagnostic group. The IA children were impaired in all areas, but were rated as displaying more appropriate behavior and fewer externalizing problems than HI or C children. The HI group displayed externalizing and social problems, but was rated as no different than controls in learning or internalizing problems. The C group demonstrated severe and pervasive difficulties across domains. These findings support the validity of the DSM-IV ADHD subtypes; all ADHD groups demonstrated impairment relative to controls, but show different patterns of behavioral characteristics.     

Emotion Regulation Mediates the Association Between ADHD and Depressive Symptoms in a Community Sample of Youth

The purpose of this study was to examine the longitudinal relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms, emotion regulation (ER) ability, and depressive symptoms within a diverse community sample of 277 youth, ages 9–12 (56 % male). Participants were drawn from a larger study examining adolescent risk behaviors, and completed annual assessments over 3 years. Youth ADHD symptoms were assessed at Time 1 (T1) using the parent-reported Disruptive Behavior Disorders Rating Scale, ER was assessed with the parent-reported Emotion Regulation Checklist at Time 2 (T2), and youth depressive symptoms were assessed using the self-reported Revised Child Anxiety and Depression Scales at Time 3 (T3). Analyses examined T2 ER as a mediator between T1 ADHD symptoms (including the unique contributions of inattentive [IA] versus hyperactive/impulsive [HI] symptoms) and T3 depressive symptoms. Structural equation modeling (SEM) indicated the path model specified provided an excellent fit to the data. Tests of indirect effects suggested that T2 ER appears to be a significant mechanism that underlies the relationship between T1 ADHD and T3 depression, even when accounting for T1 oppositional defiant and depressive symptoms. Furthermore, while both T1 IA and HI symptoms had significant indirect effects on T3 depression through the mechanism T2 ER, HI proved a more robust predictor of T2 ER than IA. Results of this prospective study support cross-sectional findings pointing to ER as a potential mechanism linking ADHD and depressive symptoms in youth. Clinical implications and future directions are discussed.     

Attention-Deficit/Hyperactivity Disorder symptoms in an adult sample: Associations with Cloninger’s temperament and character dimensions

Relationships between C.R. Cloninger’s temperament and character dimensions and the Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms of inattention (IA) and hyperactivity/impulsivity (HI) were examined in 231 adults from the general population. Regression analyses that predicated overall ADHD, IA and HI by the seven temperament/character dimensions revealed: IA was predicted positively by Harm Avoidance and negatively by Self-Directedness; HI was predicted positively by Persistence; and overall ADHD was predicted negatively by Self-Directedness. These findings are also interpreted in terms of current theories of ADHD, and the related original and revised versions of Gray’s reinforcement sensitivity theory (RST) of personality.     

Young adult follow-up of hyperactive children: self-reported psychiatric disorders,comorbidity, and the role of childhood conduct problems and teen CD

We report on the psychiatric disorders present at young adult follow-up (Mean age 20–21 years; 13 + year follow-up) and the comorbidity among them for a large sample of hyperactive (H; N = 147) and community control (CC; N = 71) children. The H group had a significantly higher risk for any nondrug psychiatric disorders than the CC group (59% vs. 36%). More of the H group met criteria for ADHD (5%); major depressive disorder (26%); and histrionic (12%), antisocial (21%), passive–aggressive (18%), and borderline personality disorders (14%) at follow-up than the CC group. Severity of childhood conduct problems contributed to the risk for passive–aggressive, borderline, and antisocial personality disorders. But it only affected risk for antisocial personality after controlling for severity of teen conduct disorder (CD), which also contributed to the risk for these same 3 disorders. Examination for comorbidity among these disorders indicated that presence of either borderline or antisocial personality disorder significantly increased the risk for major depression and the other significant personality disorders. More of the hyperactive group had received various forms of mental health treatment during and since leaving high school than the control group. Results suggest that hyperactive children are at significant risk for at least 1 nondrug disorder in young adulthood, principally major depression and several personality disorders, and that this risk is largely mediated by severity of CD at adolescence.     

Association between Inhibitory Control Capacity and Body Weight in Overweight and Obese Children and Adolescents: Dependence on Age and Inhibitory Control Component

It has been assumed that overweight individuals show weak inhibitory control capacity leading to a failure to resist external cues for palatable food and that this deficit underlies the recently reported empirical association between obesity and attention deficit/hyperactivity disorder (ADHD). In childhood and adolescence, empirical research on this issue is scarce. Here, the hypothesis is tested that high body weight is associated with weak inhibitory control performance and that this association is moderated by age.

The sample included 177 overweight and obese children and adolescents (BMI: M = 29.2, SD = 4.33; BMI-SDS: M = 2.45, SD = 0.43) between 8 and 15 years. Inhibitory control was assessed by a Go/No-Go task and an Interference Task. A principal component analysis yielded two components: impulsivity (fast but invalid responses) and inattention (highly variable reaction times).

While controlling for age, gender, and maternal education level, we found that more obese children/adolescents showed more inattention. As indicated by a significant interaction effect, exclusively at younger ages, high impulsivity was associated with high body weight.

The results thus confirm a link between low inhibitory control capacity and high body weight and might point to a developmental period with heightened significance of impulsivity for weight gain.     

Agreement of adolescent ratings with mother ratings and teacher ratings of ADHD symptom groups: A correlated trait-correlated method minus one analysis

This study examined the level of agreement of adolescent ratings with mother ratings, and adolescent ratings with teacher ratings of the inattention (IA) and hyperactivity/impulsivity (HI) symptom groups of ADHD. A total of 214 adolescents provided self-ratings of IA and HI, and their IA and HI were also rated by their mothers and teachers. The correlated trait-correlated method minus one model was applied, with adolescent ratings as the reference method, and the other two ratings as the non-reference methods. The findings indicated no additional variance in adolescent ratings for IA and HI that could not be accounted by mother ratings of IA and HI, respectively. In contrast, there was additional variance in adolescent ratings for IA and HI that could was not accounted by teacher ratings of IA and HI, respectively. The findings suggest that when diagnosing ADHD in adolescents, their reports of their own ADHD behaviors are not needed when mother reports of such behaviors are used.     

Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD)

Although parents and teachers are valid informants in the assessment of childhood attention-deficit/hyperactivity disorder (ADHD), there is relatively little systematic research on how these ratings should be optimally combined. We compared four methods of ADHD assessment to determine how well they identified impaired children: (1) parent only, (2) teacher only, (3) parent or teacher (‘or rule’), and (4) parent and teacher (‘and rule’). We obtained parent and teacher ratings of ADHD from the Disruptive Behavior Disorder Rating Scale on 232 5- to 10-year-old children (69% male; 47% Caucasian) with (n = 121) and without (n = 111) ADHD. We used receiver operating characteristic curves (ROC) and seemingly unrelated regression analyses (SUR) to evaluate how accurately each method identified categorically- and dimensionally-defined measures of functional impairment. Parent ratings of ADHD optimally identified globally impaired children based on categorical and dimensional measures. However, teacher ratings of ADHD most accurately identified children who were negatively regarded by peers using categorical, but not dimensional, measures. No ADHD assessment method effectively identified children with academic difficulties. Although multiple informants are valuable in the assessment of ADHD, no single method was consistently superior in identifying impaired children across domains. We consider alternative assessment strategies in ADHD as well as other potential factors that may contribute to modest agreement among informants.     

Pragmatic aspects of communication and language comprehension in groups of children differentiated by teacher ratings of inattention and hyperactivity

Children with attention‐deficit hyperactivity disorder (ADHD) experience pragmatic language deficits, but it is not known whether these difficulties are primarily associated with high levels of inattention, hyperactivity, or both. We investigated pragmatic aspects of communication and language comprehension in relation to poor attention and/or high hyperactivity in a nondiagnosed population of 7‐ to 11‐year olds. Classroom teachers rated their pupils' attention and hyperactivity/impulsivity on the ADD‐H Comprehensive Teacher Rating scale (ACTeRS). Three groups were formed: children with poor attention and low hyperactivity (poor attention group), children with good attention and high hyperactivity (high hyperactivity group), and children with both poor attention and high hyperactivity (poor attention/high hyperactivity group). Their performance was compared with that of same‐age controls in two studies: Study 1 (N = 94) investigated the comprehension of figurative language in and out of context and Study 2 (N = 100) investigated the pragmatic aspects of communication using the Children's Communication Checklist – Second Edition. Two groups, the poor attention and the poor attention/high hyperactivity groups, were impaired in both their comprehension of figurative language and their communication skills. The high hyperactivity group was impaired in their comprehension of figurative language but they did not exhibit communication impairments. The findings extend work with clinical populations of children with ADHD: even in a nondiagnosed sample of children, poor attention and elevated levels of hyperactivity are associated with pragmatic language weaknesses.     

ADHD Symptoms in Middle Adolescence Predict Exposure to Person-Related Life Stressors in Late Adolescence in <Emphasis Type="Italic">5-HTTLPR</Emphasis> S-allele Homozygotes

Literature suggests that life stressors predict attention-deficit/hyperactivity disorder (ADHD) symptoms and that this relationship is moderated by the serotonin transporter polymorphism (5-HTTLPR). It is less clear whether, on reverse, ADHD symptoms may influence the risk of exposure to life stressors. Furthermore, the role of life stressors may vary across development depending on the type of life stressor. We used threewave longitudinal data of 1,306 adolescents from the general population and clinicreferred cohort of the TRacking Adolescents’ Individual Lives Survey. The 5-HTTLPR genotype (SS, LS, LL), parent-reported ADHD symptoms at three time points (T1: Mage?=?11.2; T2: Mage?=?13.5; T3: Mage?=?16.2 years), and the number of personrelated (‘dependent’) and environment-related (‘independent’) life stressors occurring between measurements (T1-T2, T2-T3) were assessed. Using path analyses, we examined bidirectional relations between exposure to these life stressors and ADHD symptoms between the separate waves moderated by 5-HTTLPR status. Exposure to life stressors did not predict ADHD symptoms. Rather, we found that in 5-HTTLPR Sallele homozygotes, ADHD symptoms in middle adolescence (T2) predicted exposure to the number of person-related life stressors later in adolescence (T2-T3, p?=?0.001). There was no relation with environment-related life stressors. Our study suggests that S-allele homozygotes with higher levels of ADHD symptoms in middle adolescence are more vulnerable to becoming exposed to person-related (‘dependent’) life stressors in late adolescence. Findings emphasize the need to be aware of social-emotional adversities that may occur in genetically vulnerable adolescents with ADHD symptoms in the transition into adulthood.     

The Accuracy of Retrospective Recall of Childhood ADHD: Results from a Longitudinal Study

Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset condition that may continue into adulthood. When assessing adult patients, clinicians usually rely on retrospective reports of childhood symptoms to evaluate the age-of-onset criterion. Since inaccurate symptom recall may impede the diagnosis and treatment of ADHD, knowledge about the factors influencing retrospective reports is needed. This longitudinal study investigated (a) the accuracy of retrospective symptom ratings by adult participants with a childhood diagnosis of ADHD (self-ratings) and parents or significant others (proxy ratings), and (b) the influence of current ADHD symptom severity and ADHD-associated impairments on retrospective symptom ratings. Participants (N =?55) were members of the Cologne Adaptive Multimodal Treatment (CAMT) study who had been referred and treated for ADHD in childhood and were reassessed in adulthood (average age 27 years). Participants’ retrospective self-ratings were substantially lower than, and did not correlate with, parents’ ADHD symptom ratings provided at study entry, while retrospective symptom ratings provided by proxy respondents correlated moderately with parents’ childhood ratings. In addition, participants were more likely to underreport childhood symptoms (79%) and more frequently denied the presence of three or more childhood symptoms (17%) compared to proxy respondents (65% underreporting, 10% false-negative recall). Proxy respondents’ symptom recall was best predicted by childhood ADHD, while participants’ symptom recall was best predicted by current ADHD symptom severity. ADHD-associated impairments were not correlated with symptom recall after controlling for childhood ADHD. Together, these findings suggest a recall bias in adult patients and question the validity of retrospective reports, even in clinical samples.

     

Adult ADHD and/or Sleep Apnea? Differential Diagnostic Considerations with Six Case Studies

An increased interest in the persistence of attention-deficit hyperactivity disorder (ADHD) into adulthood brings concern that adult ADHD may become overdiagnosed. As with ADHD in childhood, various other adult psychological and medical disorders may be associated with ADHD in adulthood, and these related disorders may be mislabeled and mistreated as simple ADHD. One such medical condition is sleep apnea. This paper reviews similarities and differences between ADHD and sleep apnea and presents case histories of six adult patients diagnosed with ADHD who were subsequently found to have at least comorbid obstructive sleep apnea (OSA). Clinicians who diagnose and treat patients with ADHD are advised to become familiar with sleep apnea as a life-threatening condition that presents with overlapping symptoms.     

Predicting ADHD Symptoms in Adolescence from Early Childhood Temperament Traits

Extreme levels of certain temperament traits can be early markers of different developmental pathways of attention-deficit/hyperactivity disorder (ADHD). However, the long-term utility of using these traits as predictors of ADHD is not fully known. This study includes 64 male adolescents (M age = 13.5), who have been followed since birth as part of a longitudinal study. The primary aim was to test effortful control (EC), activity level, and anger, measured in early childhood – both with mother’s reports and laboratory assessments –as predictors of ADHD symptoms in adolescence. Further, we investigated the specificity of this prediction to the different ADHD symptom domains. The results demonstrated that early temperament dimensions of EC and activity level were predictive of ADHD symptoms about 10 years later, when the participants reached adolescence. Moreover, activity level showed specificity only to hyperactivity-impulsivity symptoms whereas EC was a predictor of the two symptom domains. Anger had a predictive correlation with ADHD symptoms; however, it did not have a unique predictive contribution. These results emphasize the relevance of EC and activity level in the developmental course of ADHD. Identification of early risk factors can lead to more efficient design and implementation of intervention programs.     

Childhood Attention-Deficit/Hyperactivity Disorder Predicts Intimate Partner Victimization in Young Women

Attention-deficit/hyperactivity disorder (ADHD) is associated with interpersonal dysfunction during childhood and adolescence, yet little is known about the romantic relationships of young women with childhood ADHD. In the present study, we draw from a longitudinal sample of girls followed prospectively into young adulthood, comparing those with (n?=?114) and without (n?=?79; comparisons) childhood ADHD in terms of their risk for physical victimization by an intimate partner (physical IPV; e.g., slapping, punching) by 17–24 years of age. We examined ADHD both diagnostically and dimensionally, at the same time establishing reliable indicators of young adult physical IPV. Externalizing and internalizing problems, and academic achievement during adolescence, were tested as potential mediators. Overall, participants with a childhood diagnosis of ADHD experienced more physical IPV than did comparisons (30.7 % vs. 6.3 %). In parallel, IPV was associated with higher levels of childhood ADHD symptomatology (d?=?0.73). Young women with persistent ADHD stood the highest risk of experiencing IPV (37.3 %), followed by those with transient ADHD (19.0 %) and those never-diagnosed (5.9 %). Academic achievement measured during adolescence was a significant partial mediator of the childhood ADHD symptomatology-young adult IPV relationship, even with control of sociodemographic, psychiatric, and cognitive factors, including childhood reading and math disorders. Findings indicate that in young women, childhood ADHD is a specific and important predictor of physically violent victimization in their intimate relationships. This vulnerable population requires IPV prevention and intervention, with academic empowerment as a key target.