Purpose Childhood ADHD increases risk for maladaptive adult outcomes, including substance abuse and violence perpetration (Buitelaar et al., 2015). However, ADHD risk for violence victimisation is not well understood. ADHD is cross-sectionally associated with interpersonal victimisation in childhood (Lewis et al., 2015), and longitudinally predicts adult intimate partner victimisation (Wymbs et al., 2016). ADHD may prompt victimisation via impulsive involvement in violence/delinquency (Low & Espelage, 2014), but support for mediation is absent (Gibson, 2011). This study tests: (1) Whether childhood ADHD predicts adult interpersonal victimisation; and (2) Whether aggression/delinquency mediates this association.

Methods Participants were 579 children rigorously diagnosed with ADHD-Combined Type (ages 7–9.9) and 289 age- and sex-matched comparison children from the Multimodal Treatment of ADHD Study (MTA). Prospective assessments followed baseline and a 14 month randomised controlled treatment trial. Six victimisation types (e.g., attacked with weapon; theft) were assessed 12, 14, and 16 years post-enrollment (Mage 20–25) and totaled for analysis. Conduct was assessed with the caregiver-report Aggression and Conduct Problems Scale (Mage 10), and the Self-Reported Delinquency scale (Mage 18).

Results One-third of participants experienced any victimisation as adults. Poisson regression indicated that probands experienced significantly more victimisation types (OR=1.32, p=0.009), controlling for demographics (sex, race, SES, familial psychopathology, grade retention) and neighbourhood quality. Mage 10 aggression predicted more adult victimisation (OR=2.26, p=0.001) and fully mediated the ADHD-victimisation association. Separately, Mage 18 delinquency predicted adult victimisation (OR=1.14, p<0.001), but did not mediate the ADHD-victimisation link. Victimisation did not predict adult alcohol outcomes.

Conclusions Childhood ADHD prospectively forecasts adult victimisation mediated by childhood, but not young-adult, aggression/delinquency.

Significance/contributions to injury/violence prevention science ADHD is a double whammy: it increases risk for both violence perpetration and victimisation, making ADHD a critical violence prevention target. Researchers should elucidate how this risk unfolds developmentally and isolate malleable ADHD-related intervention priorities.