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Is Violence a Symptom of ADHD?

Attention deficit hyperactivity (ADHD) is characterized by cognitive disorganization, low attention, and impaired focus. Among the many symptoms and behaviors associated with ADHD are excess energy and externalizing behavior. Research has shown that as children with ADHD [1] mature, their symptoms often decrease.

However, some children also exhibit signs of conduct disorder and personality problems, which exacerbate and perpetuate symptoms. This combination of psychological conditions can lead to violent behavior in some individuals. But does ADHD itself cause violent behavior?

That was the question posed by Rafael A. Gonzalez of the Forensic Psychiatry Research Unit at the University of London as the subject of a recent study. Gonzalez and his colleagues wanted to determine if ADHD by itself was linked directly to violent behavior in adults. And if so, what aspects of ADHD were most influential on violence?

To answer this question, Gonzalez reviewed responses from over 7,300 adults in the general population, using the Adult Self-Report Scale for ADHD. He also asked about violence [2], recurrence of violence acts, level of violence, and other comorbid issues. Gonzalez found that ADHD alone was only slightly predictive of violence. More specifically, the hyperactive behavior linked with ADHD, not the inattentive aspect, was the impetus for violence.

When Gonzalez examined levels of ADHD in relation to levels of violence, he discovered that the mild and moderate symptoms of ADHD were most closely related to repeated violent perpetration. However, severe ADHD was only associated with violence in the context of comorbidity. The most common conditions that appeared to be responsible for violent behavior in the adults with severe ADHD were personality problems, anxiety [3], and substance abuse [4].

“We thereby conclude that repetitive violence among persons with severe ADHD is associated with multiple forms of coexisting psychopathology but not ADHD,” said Gonzalez. Therefore, it is imperative that people with ADHD and co-existing psychological problems address the issues that could make them more susceptible to violent behavior. Future research should address the most effective ways to accomplish this.

Reference:
González, R.A., Kallis, C., Coid, J.W. (2013). Adult attention deficit hyperactivity disorder and violence in the population of England: Does comorbidity matter? PLoS ONE 8(9): e75575. doi:10.1371/journal.pone.0075575