Childhood Adversity and Adult Outcomes in Women with and without Childhood ADHD: A Comparison of Effects Between Threat and Deprivation Dimensions

Childhood adversity is linked to a variety of negative physical and mental outcomes. Women, especially those with neurodevelopmental conditions like attention-deficit/ hyperactivity disorder (ADHD), are at heightened risk for greater adversity exposure and more severe long-term outcomes. A key dimensional model of adversity differentiates threat-related (e.g., abuse, violence) from deprivation-related (e.g., neglect, household dysfunction) factors, with potentially distinct developmental impacts. Through a longitudinal cohort of women with and without childhood ADHD, we examine whether adverse childhood experiences (ACEs) can form threat and deprivation dimensions, which may differentially predict young-adult outcomes. Participants are a diverse sample of 228 girls (140 with carefully diagnosed childhood ADHD; 88 neurotypical comparisons). In young adulthood (mean age ~26), participants reported retrospectively on 10 ACEs. Principal component analysis revealed threat vs. deprivation components of adversity in both ADHD and comparison participants. Via regression models we examined each component’s associations with adult psychopathology (internalizing and externalizing symptom composites) and academic achievement, adjusting for childhood ADHD diagnosis and baseline symptom levels. Women with childhood ADHD reported higher overall ACE exposure than comparisons. Higher threat scores independently predicted greater internalizing and externalizing symptoms after accounting for childhood symptom levels and ADHD status. Distinct dimensions of childhood adversity can be identified, with different predictive relevance. Threat-related adversities conferred persistent risk for psychopathology into early adulthood, beyond prior vulnerabilities. Findings suggest targeted trauma-informed interventions and support a dimensional approach to adversity in clinical practice and research.