ADHD and Sex Differences in School Bullying Victimization and Perpetration Based on Inverse Probability Treatment Weighting.

Adolescents with attention-deficit/hyperactivity disorder (ADHD) exhibit heightened vulnerability to school bullying, with sex-specific patterns. This study analyzed data from the 2021 Korean National Survey on Mental Health of Youth, comprising 6,689 adolescents (ages 12-18; 50.9% male). After inverse probability of treatment weighting (IPTW) adjustment, the effective sample comprised 3,1789 adolescents at risk of ADHD and 3,511 controls. Logistic regression analyses revealed pronounced sex differences. Female adolescents with ADHD symptoms showed significantly elevated odds of overall victimization, teasing/verbal provocation, and bullying perpetration, particularly verbal abuse. Conversely, male adolescents with ADHD symptoms demonstrated reduced odds of social exclusion and sexual harassment victimization, but an increased risk of verbal abuse perpetration. These findings underscore the critical role of sex in shaping the dynamics of ADHD-related bullying behaviors. They highlight the need for tailored, sex-sensitive interventions targeting emotional regulation and social skills deficits in adolescents with ADHD.