Attention-Deficit Hyperactivity Disorder and Intimate Partner Violence Perpetration: Sex Differences and Subtype-Specific Associations in a Population-Based Study

Background: Attention-deficit hyperactivity disorder (ADHD) has been linked to interpersonal violence, but its relationship with intimate partner violence (IPV) perpetration, particularly in women and across symptom subtypes, remains underexplored. This study examines associations between ADHD and IPV perpetration in a nationally representative sample, with a focus on sex differences and ADHD symptom dimensions. Methods: Data were drawn from the 2014 Adult Psychiatric Morbidity Survey (APMS), a cross-sectional household survey of adults aged 16+ in England. Positive screen for ADHD was assessed using the 6-item Adult ADHD Self-Report Scale (ASRS), with subscale scores for inattentiveness and hyperactivity/impulsivity calculated. IPV perpetration was measured via four self-completed items capturing psychological, physical, and sexual violence. The inclusion criteria for the analysis were adults who had been in a relationship. Logistic regression models estimated associations between ADHD and IPV perpetration, adjusting sequentially for sociodemographic, trauma, behavioural, and psychiatric covariates. Marginal effects of interaction terms between sex and ADHD symptoms were used to model predicted probabilities across symptom severity. Results: ADHD was associated with increased odds of IPV perpetration (OR 2.70, 95% CI: 2.12 - 3.44). This association attenuated after adjustment for covariates. Inattentiveness remained associated with IPV perpetration after full adjustment; hyperactivity/impulsivity was marginal. The ADHD-IPV relationship differed by sex: across all ADHD subtypes, predicted probabilities of IPV perpetration increased with symptom severity in women but not in men. Conclusions: ADHD may contribute to risk of IPV perpetration, with stronger effects among women. These findings highlight the importance of dimensional ADHD assessments, sex-specific analyses, and tailored intervention approaches for IPV prevention among individuals with neurodevelopmental and mental health needs.