Abstract
OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSION: 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.