Attention-Deficit/Hyperactivity Disorder Symptoms and Child Maltreatment: A Population-Based Study

Objective To examine whether symptoms of attention-deficit/hyperactivity disorder (ADHD) during childhood are associated with child maltreatment. Study design The study sample consisted of 14 322 participants in the National Longitudinal Study of Adolescent Health. We used logistic regression and propensity score matching to examine the relationship, adjusting for demographic, socioeconomic, and familial risk factors for child maltreatment. Results Inattentive type, by criteria of Diagnostic and Statistic, Manual of Mental Disorders Fourth Edition, was significantly associated with the likelihood of supervision neglect (odds ratio [OR]: 1.6; 95% confidence interval [CI]: 1.2-2.2), physical neglect (OR: 2.1; 95% CI: 1.4-3.1), physical abuse (OR: 1.6; 95% CI: 1.1-2.3), and contact sexual abuse (OR: 2.6; 95% CI: 1.5-4.5). To a lesser extent, hyperactive type was associated with the likelihood of supervision neglect (OR: 1.5; 95% CI: 1.1-2.0) and physical abuse (OR: 1.3; 95% CI: 1.0-1.6). The association between hyperactive type and physical neglect or contact sexual abuse was not significant. The results from the propensity score matching were similar. Conclusions Childhood ADHD symptoms were associated with self-reported child maltreatment. Health care providers should be alert to the potential for child maltreatment among children with ADHD symptoms, especially those with inattentive symptoms. (J Pediatr 2008;153:851-6)