# Risk and resilience: adverse and positive childhood experiences and aggression in adults with and without ADHD

## TL;DR

This study explores how childhood experiences affect aggression in adults with and without ADHD, finding that negative experiences strongly predict aggression, especially in those with ADHD.

## Contribution

The study introduces a compensatory resilience model to examine how positive childhood experiences may buffer aggression in adults with and without ADHD.

## Key findings

- Adults with ADHD reported higher adverse childhood experiences and greater aggression compared to non-ADHD individuals.
- Positive childhood experiences reduced aggression in non-ADHD individuals but not in those with ADHD.
- Adverse childhood experiences strongly predict aggression, highlighting their importance in forensic risk assessments.

## Abstract

Identifying risk and protective factors for aggressive behavior is central to effective violence prevention and public safety. In forensic psychiatry, attention-deficit/hyperactivity disorder (ADHD) is common among offenders and is linked to adverse childhood experiences (ACEs) on the one hand and increased aggression on the other hand. Yet, the mechanisms connecting these factors remain insufficiently understood. Evidence on the protective potential of positive childhood experiences (PCEs), particularly when considered alongside ACEs, is also limited.

Guided by resilience theory and a compensatory resilience model, this study analyzed the dynamics among self-reported ACEs, PCEs, and current aggression in an ADHD subsample (n = 154) and a non-ADHD population (n = 205) using hierarchical linear regression analyses.

Compared with the non-ADHD group, adults with ADHD reported higher ACE loads, lower PCE scores, and greater aggressive tendencies. In both subsamples, ACEs significantly predicted higher aggression. Among individuals without ADHD, PCEs demonstrated an independent protective association with aggression after adjusting for ACEs and attenuated the ACE–aggression association. This compensatory effect of PCEs was not observed in the ADHD group. Overall, the harmful influence of ACEs on adult aggression appeared to outweigh any mitigating role of PCEs, particularly among individuals with ADHD.

ACEs emerged as a robust correlate of current aggression in adults with and without ADHD, underscoring the need to systematically integrate developmental adversity into forensic risk assessment. For individuals with ADHD, violence prevention and public safety strategies may particularly benefit from early prevention and reduction of childhood adversity, trauma-focused interventions where indicated, and evidence-based ADHD treatment to limit the impact of ADHD-related impairments on dynamic aggression-related risk factors. For individuals without ADHD, prevention and rehabilitation efforts may be strengthened by simultaneously reducing ACEs and actively promoting PCEs as resilience-enhancing conditions.