Exploring the effect of ADHD traits on the moment-to-moment interplay between provocation and aggression: evidence from dynamic structural equation modelling

The relation between ADHD symptoms and aggression has been well documented; however, the processes that account for higher levels of aggression associated with ADHD ‘in the moment’ in the course of daily life interactions have been little researched. The current study used ecological momentary assessment (EMA) to explore how ADHD traits might relate to individual differences in provocations, aggression, and the strengths of the links between provocation and aggression in the flow of daily life. We used dynamic structural equation modelling (DSEM) fit to data from the D2M study (n=254 adults aged 20; 35% male from the longitudinal z-proso study) which collected provocation and aggression data at four quasi-random time periods per day over a 14-day period. We found that individuals with higher ADHD trait levels reported higher instances of provocation and aggression, with ADHD traits significantly moderating aggression inertia such that those with higher levels of ADHD traits showed greater persistence of aggressive behaviour across time points. However, ADHD trait levels did not significantly moderate any of the observed cross-lagged effects. Our findings suggest that individuals with higher levels of ADHD traits are at greater risk of exposure to interpersonal interactions involving provocation, show higher levels of aggressive behaviour in daily life, and find it more difficult to reduce their aggression once triggered. These findings support the importance of targeting factors such as social skills and emotion regulation that may underpin the increased difficulties in interpersonal interactions often experienced by individuals with high levels of ADHD symptoms.