The relationship between inattentive and hyperactivity symptoms and child maltreatment was studied among a sample of 14,322 participants in the National Longitudinal Study of Adolescent Healh at the Centers for Disease Control and Prevention, Atlanta, GA. The weighted percentage of respondents reporting ADHD symptoms was 8.3%. Self-reported rates of child maltreatment were 40.5% for supervision neglect, physical neglect (11.6%), physical abuse (28.4%), and contact sexual abuse (4.5%). Forty six percent reported no child maltreatment. The age of subjects sampled was 18 to 28 years (average 21.8 years). Type of maltreatment was not correlated with age. Respondents with ADHD symptoms were more likely to report maltreatment. Compared with non-ADHD subjects, those with ADHD of any type reported all 4 types of child maltreatment. The inattentive type was associated with elevated risks of all 4 types of maltreatment whereas the hyperactive/impulsive type was associated only with an increased likelihood of supervision neglect and physical abuse. The combined type was associated with elevated risks of physical neglect and contact sexual abuse, and a significant risk of supervision neglect. The number of reported ADHD symptoms was also associated with the severity of child maltreatment. Each additional inattentive symptom was significantly associated with elevated risks of more severe child maltreatment of all 4 types. Each additional hyperactive/impulsivity symptom was associated with an increased likelihood of more severe supervision neglect or physical abuse. [1]

COMMENT. Physicians should be alerted to the potential for child maltreatment in children with ADHD. Those with the inttentive type of ADHD are particularly vulnerable. The more severe the ADHD, the greater is the likelihood of child maltreatment.