The Romantic Relationships of Adolescents With ADHD

Abstract

Objective:
This study compared the romantic relationships of adolescents with and without ADHD with regard to romantic involvement, relationship content, and relationship quality.

Method:
A community sample of 58 participants (30 ADHD, 28 Comparison), ages 13 to 18, completed questionnaires assessing various features of romantic relationships.

Results:
Adolescents with ADHD reported having more romantic partners than their typically developing (TD) peers. Females with ADHD were found to have shorter romantic relationships than TD adolescents while males with ADHD reported their age of first intercourse to be nearly 2 years sooner than TD peers. Irrespective of gender, adolescents with ADHD had nearly double the number of lifetime sexual partners. However, the romantic relationships of adolescents with and without ADHD did not differ on levels of aggression or relationship quality.

Conclusion:
Given the outcomes associated with poor-quality romantic relationships, comprehensive assessments of adolescents with ADHD should include queries into their romantic relationships.

Full text

Journal of Attention Disorders
1 –11
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DOI: 10.1177/1087054714538660
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Article
The overall purpose of the present study is to explore the
romantic relationships of adolescents with ADHD.
Romantic relationships are a hallmark of adolescence
(Collins, Welsh, & Furman, 2009). By late adolescence,
more than 70% of teens have been involved in at least one
romantic relationship (Carver, Joyner, & Udry, 2003;
Furman, Low, & Ho, 2009) and rely primarily on their
romantic partner, rather than their peer group, for support
(Kuttler & La Greca, 2004). Romance is also at the fore-
front of adolescents’ minds; they spend between 5 and 8 hr
each week thinking about actual or potential romantic part-
ners (Richards, Crowe, Larson, & Swarr, 1998). These pro-
portions are considerably larger than those attributed to
school, peers, and family (Brown, 1999). Until recently,
however, adolescent romance had not garnered much inter-
est from the scientific community.
Currently, empirical studies of romantic relationships in
adolescence are burgeoning. No longer are these relation-
ships erroneously viewed as trivial and ephemeral. Instead,
they are increasingly regarded as a significant factor in ado-
lescent development and subsequent adult functioning
(Giordano, Manning, & Longmore, 2006). Healthy roman-
tic relationships may buffer negative outcomes and are
associated with several positive aspects of development,
including forming a personal identity, promoting harmoni-
ous relationships with peers, adjusting to changes in family
relationships, shaping positive romantic relationships in
adulthood, and lowered levels of adult psychopathology
(e.g., Furman & Collins, 2008; Wolfe, Jaffe, & Crooks,
2006). Poor-quality romantic relationships, however, have
been linked with alcohol and drug use, exposure to violence
in relationships, increases in externalizing and internalizing
symptomatology, academic underachievement, and an
inadequate rubric for adult relationships (e.g., Woodward,
Fergusson, & Horwood, 2002; Zimmer-Gembeck,
Siebenbruner, & Collins, 2004). While the last decade has
seen a marked increase in the number of studies examining
the romantic relationships of typically developing (TD)
adolescents, less is known about the nature of romantic
relationships in adolescents with various psychopathologies
such as ADHD.
When compared with other youth, the presence of
ADHD in childhood and adolescence is associated with dis-
turbances in family functioning, peer rejection, and lower
quality friendships (e.g., Bagwell, Molina, Pelham, & Hoza,
2001; Johnston & Mash, 2001; Wehmeier, Schacht, &
Barkley, 2010). Moreover, adolescent experiences
538660JADXXX10.1177/1087054714538660Journal of Attention DisordersRokeach and Wiener
research-article2014
1University of Toronto, Ontario, Canada
Corresponding Author:
Alan Rokeach, Applied Psychology and Human Development, Ontario
Institute for Studies in Education, University of Toronto, 252 Bloor
Street West, 9-272, Toronto, Ontario, Canada M5S 1V6.
Email: alan.rokeach@mail.utoronto.ca
The Romantic Relationships of
Adolescents With ADHD
Alan Rokeach1 and Judith Wiener1
Abstract
Objective: This study compared the romantic relationships of adolescents with and without ADHD with regard to
romantic involvement, relationship content, and relationship quality. Method: A community sample of 58 participants (30
ADHD, 28 Comparison), ages 13 to 18, completed questionnaires assessing various features of romantic relationships.
Results: Adolescents with ADHD reported having more romantic partners than their typically developing (TD) peers.
Females with ADHD were found to have shorter romantic relationships than TD adolescents while males with ADHD
reported their age of first intercourse to be nearly 2 years sooner than TD peers. Irrespective of gender, adolescents
with ADHD had nearly double the number of lifetime sexual partners. However, the romantic relationships of adolescents
with and without ADHD did not differ on levels of aggression or relationship quality. Conclusion: Given the outcomes
associated with poor-quality romantic relationships, comprehensive assessments of adolescents with ADHD should include
queries into their romantic relationships. (J. of Att. Dis. XXXX; XX(X) XX-XX)
Keywords
adolescent ADHD, romantic relationships, risky behavior
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2 Journal of Attention Disorders
with parents and peers are important precursors of romantic
relationship quality in young adulthood (Connolly, Furman,
& Konarski, 2000; Seiffge-Krenke, 2003). Individuals with
ADHD tend be forgetful, disorganized, distracted, and fail
to meet their responsibilities. In addition, they may be more
impulsive, explosive, and more likely to have verbal and
physical outbursts than their TD peers (Barkley, 2006). It is
therefore not unreasonable to expect that such characteris-
tics and behaviors may detrimentally affect their romantic
relationships. Nevertheless, the link between romantic rela-
tionships and individuals with ADHD has received little
empirical attention to date and even less is known about the
romantic relationships of adolescents with ADHD.
The study of romantic relationships in adolescence has
been hindered by a number of methodological challenges,
including operational definitions, obtaining representative
samples, and identifying the relevant dimensions of varia-
tion in romantic relationships (Collins et al., 2009). To facil-
itate assessments of romantic relationships, Collins (2003)
identified several features that characterize romantic rela-
tionships in adolescence: romantic involvement, partner
identity, relationship content, relationship quality, and cog-
nitive and emotional processes in the relationship. The
present study entails a comparison of adolescents with and
without ADHD on three of these features: romantic involve-
ment, relationship content, and relationship quality.
Romantic Involvement
Romantic involvement refers to whether or not a person
dates, the frequency and regularity of their dating, and the
duration of their relationships (Collins, 2003; Collins et al.,
2009). The timing of the initiation of dating is important
because early dating is closely associated with early sexual
initiation (Cooksey, Mott, & Neubauer, 2002), which in
turn is correlated with risky sexual behavior (RSB), depres-
sion, violence, academic underachievement, and substance
use (Crockett, Bingham, Chopak, & Vicar, 1996).
There is some evidence that the romantic involvement of
young adults with ADHD differs from typically functioning
adults. Canu and Carlson (2003) found that college students
with the inattentive subtype (ADHD-I) achieved dating
milestones later and had a lower number of steady dating
relationships, than both college students with the combined
subtype (ADHD-C) and healthy college students. Similarly,
Babinski et al. (2011) reported that when compared with
typically functioning peers, girls diagnosed with ADHD in
childhood experienced fewer romantic relationships in late
adolescence and young adulthood.
Relationship Content
Relationship content refers to the shared activities of rela-
tionship partners (Collins, 2003; Collins et al., 2009).
Adolescents in romantic relationships engage in patterns of
interaction that differ from interactions with parents or
peers. Two aspects of relationship content that have gar-
nered considerable attention are sexual behavior and aggres-
sion between partners. Although many adolescent couples
are in healthy and supportive relationships, physical aggres-
sion occurs in a sizeable proportion of adolescent romantic
relationships. Estimates vary widely across samples (e.g.,
national vs. regional surveys) and assessment methods
(one-time retrospective vs. cumulative), but roughly 10% to
48% of adolescents experience physical aggression and
25% to 50% endure psychological aggression in their dat-
ing relationships (Halpern, Oslak, Young, Martin, &
Kupper, 2001; Jouriles, McDonald, Garrido, Rosenfield, &
Brown, 2005). Young adults with ADHD have been found
to resort to more frequent negative conflict resolution pat-
terns (Canu & Carlson, 2007; Overbey, Snell, & Callis,
2011) and to be more verbally aggressive and violent in
their romantic relationships (Wymbs et al., 2012) than
young adults without ADHD.
Existing research on the sexual behavior of individuals
with ADHD focuses on young adults and exposes some
alarming tendencies. When compared with age-matched
peers, young adults with ADHD are at an increased risk for
unwanted pregnancies, sexually transmitted infections
(STIs), earlier initiation of sexual activity, and a greater fre-
quency of casual sex and sexual partners (Barkley, Murphy,
& Fischer, 2010; Flory, Molina, Pelham, Gnagy, & Smith,
2006; Huggins, Rooney, & Chronis-Tuscano, 2012; White
& Buehler, 2012; Winters, Botzet, Fahnhorst, Baumel, &
Lee, 2008). Such RSB has been linked to sexual victimiza-
tion in both the general population (Fargo, 2009) and in ado-
lescents with ADHD (White & Buehler, 2012). Other
studies, however, have found no significant associations
between ADHD symptomatology and RSB when co-occur-
ring conduct disorder (CD) is taken into account (Monuteaux,
Faraone, Gross, & Biederman, 2007; Ramrakha et al., 2007).
Mixed results also exist with respect to antisocial sexual
activities (e.g., forced sex) among adults diagnosed with
ADHD in childhood. Mandell (1999) and Theriault and
Holmberg (2001) found ADHD symptomatology and CD to
be small but significant predictors of both physical and sex-
ual aggression; however, Barkley, Fischer, Smallish, and
Fletcher (2004) did not find any such association. Although
these inconsistent findings appear puzzling, they most likely
reflect methodological variability across studies, such as dif-
fering sample characteristics (e.g., gender, population-based
vs. clinic-referred) and assessment methods (e.g., structured
interviews, self-report).
Relationship Quality
Relationship quality refers to the manifestation of affection
and nurturance to create generally beneficial experiences
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Rokeach and Wiener 3
(Collins, 2003; Collins et al., 2009). Evidence suggests that
the skills necessary for establishing and maintaining friend-
ships in childhood serve as the building blocks for estab-
lishing high-quality romantic relationships later in life
(Collins, Hennighausen, Schmit, & Sroufe, 1997).
Furthermore, the quality of peer and family relationships
early in life significantly predicts the quality of ensuing
romantic relationships (Collins & Van Dulmen, 2006;
Roisman, Booth-LaForce, Cauffman, & Spieker, 2009).
Low-quality relationships are marked by irritation, control-
ling behavior, antagonism, high levels of discord, and an
imbalance between conflict and support (Galliher, Welsh,
Rostosky, & Kawaguchi, 2004). High-quality relationships,
however, are associated with a high level of commitment,
feeling appreciated, good communication, and being
attracted to the partner (Levesque, 1993). Although interac-
tions with romantic partners involve more conflict than
with friends and less responsiveness and communication
than with mothers, adolescents perceive themselves as
receiving more support from their partners (Furman &
Shomaker, 2008).
To date, the quality of romantic relationships of individ-
uals with ADHD has only been studied in adults. Spouses of
adults with ADHD, who themselves are not diagnosed with
ADHD, report feeling resentful and overwhelmed due to
inadequate emotional support and an unequal distribution
of household tasks pertaining to planning, organizing,
financial decisions, and maintaining family harmony (Robin
& Payson, 2002; Weiss, Weiss, & Trokenberg-Hechtman,
1999). Thus, it not surprising that, when compared with
controls, ADHD status is associated with lower relationship
satisfaction and a higher incidence of divorce (Biederman
et al., 1993; Murphy & Barkley, 1996).
Rationale and Purpose of the Current
Study
Collectively, the findings described above paint a bleak pic-
ture of romantic relationships in individuals with ADHD,
with most of the existing research involving adult current or
retrospective report. Adolescence, however, represents a
period of flexible change and somewhat of a blank slate for
individuals who have yet to experience a romantic relation-
ship. Hence, it is evident that an additional emphasis should
be placed on the exploration of adolescent relationships, as
they represent the foundation for romantic relationships
throughout the life span (Collins & Sroufe, 1999).
The major purpose of present study was to compare the
romantic relationships of adolescents with and without
ADHD on the following three relationship features: (a)
romantic involvement, (b) relationship content, and (c) rela-
tionship quality. With regard to romantic involvement,
based on previous studies (Babinski et al., 2011; Canu &
Carlson, 2003), it was expected that adolescents with ADHD
would commence dating later and have fewer and shorter-
lasting relationships than their TD peers. In spite of com-
mencing dating later in life, it was anticipated that the
increased impulsivity of adolescents with ADHD may lead
them to engage in sexual activity at a younger age and with
more partners outside the context of an ongoing romantic
relationship, than teens without ADHD. Based on previous
research on adults with ADHD (e.g., Barkley et al., 2010;
Canu et al., 2007; Flory et al., 2006; Overbey et al., 2011;
Wymbs et al., 2012), differences between adolescents with
and without ADHD were anticipated on measures of rela-
tionship content and quality. When in relationships, it was
predicted that adolescents with ADHD would report higher
levels of dissatisfaction, conflict, and aggressive behaviors
(verbal, relational, sexual, physical), and lower levels of
affection and nurturance than TD adolescents. Finally, it
was also expected that adolescents with ADHD would
report higher levels of RSB (e.g., unprotected sex, unwanted
pregnancies, promiscuity, intercourse while using drugs or
alcohol, and STIs) than TD adolescents.
Method
Participants
A community sample of 30, 13- to 18-year-old adolescents
with ADHD (40% female [n = 12]; Mage = 15.71, SD = 1.49)
and 28 TD peers (57% female [n = 16]; Mage = 16.0, SD =
1.68) were recruited by distributing flyers to a select num-
ber of schools in the Greater Toronto Area (n = 2), chil-
dren’s mental health centers (n = 9), family doctors and
psychologists (n = 3), advertisements in newspapers (n = 2),
and phoning research participants from previous studies
who had consented to be contacted regarding future studies
(n = 42). Flyers informed participants that they would be
filling out questionnaires about their peer, family, and
romantic relationships. All participants were in Grades 7
through 12 with average intellectual ability (IQ ≥ 85) as
assessed by the Wechsler Abbreviated Scale of Intelligence
(WASI; Wechsler, 1999). Eligibility criteria for the ADHD
sample included (a) a parent-report of a previous diagnosis
of ADHD from a physician or psychologist, based on
Diagnostic and Statistical Manual of Mental Disorders (4th
ed.; text rev.; DSM-IV-TR; American Psychiatric
Association, 2000) criteria; and (b) at least one clinically
significant score (T ≥ 70) on the DSM-IV-TR ADHD scales
of the parent form of the Conners–3rd Edition (Conners,
2008); or (c) at least one borderline range score (T = 65-69)
on the DSM-IV-TR ADHD scales of the parent form of the
Conners, and at least one score on the same scales by
another informant (self-report or teacher) in the borderline
or clinical range (T ≥ 65). TD adolescents required scores
on the Conners’ parent scales within the average range (T ≤
60). While adolescents with co-occurring learning disabilities
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4 Journal of Attention Disorders
(LDs), CD, oppositional defiant disorder (ODD), anxiety, or
depression were included in the sample, participants with
Pervasive Developmental Disorders, Psychotic Disorders,
Bipolar Disorder, Obsessive-Compulsive Disorder, and
Tourette’s Syndrome were excluded.
Among the ADHD sample, 17 (57%) adolescents regu-
larly took stimulant medication. Significantly more ado-
lescents with ADHD (81%) had one or more
parent-reported comorbid diagnoses compared with their
TD (10%) peers, χ2(1, N = 58) = 23.59, p < .001. Within
the ADHD group, 19 adolescents were diagnosed with a
comorbid LD, 3 with Anxiety, 2 with Depression, 1 with
Oppositional Defiant Disorder, and none with CD. Within
the comparison group, three participants were diagnosed
with an LD.
As shown in Table 1, t tests revealed no significant
group differences on age, IQ, or years of parental educa-
tion. Furthermore, chi-square tests revealed no signifi-
cant groups differences on gender, χ2(1, N = 58) = 2.00,
p = .16; parental marital status, χ2(1, N = 58) = .01,
p = .94; or proportion of families where a language other
than English was spoken at home, χ2(1, N = 58) = 1.22,
p = .27. As expected, participants with ADHD had sig-
nificantly higher scores on variables measuring current
manifestation of inattentive and hyperactive/impulsive
symptoms (parent, teacher, and self-reports). However,
ratings of conduct problems were mixed. Whereas par-
ents of adolescents with ADHD rated their children as
having significantly more conduct problems than did
parents of TD adolescents, teacher and self-reports indi-
cated no differences in conduct problems for the subsam-
ple of participants with romantic experience (see DSM
CD, Table 1).
Measures
Sample definition and description. The Conners’ Rating
Scale–3rd Edition (Conners, 2008) Parent, Teacher, and
youth Self-Report long-forms were used to confirm current
manifestation of ADHD symptoms. The Conners is a well-
validated standardized measure consisting of 99 to 115
items on a 4-point Likert scale from 0 (not at all/seldom,
never) to 3 (very much true/very often, very frequent). Inter-
nal consistency coefficients are high, .90 or above for Par-
ent and Teacher scales, and .85 or above for self-report
scales (Conners, 2008). Test–retest reliability ranges from
.82 to .98 (Parents), .83 to .90 (Teacher), and .71 to .83
(Self-Report; Conners, 2008).
Cognitive ability was assessed using the WASI
(Wechsler, 1999), an individually administered, brief test of
intelligence. This abbreviated IQ scale demonstrates solid
psychometric properties with high internal consistency
(.93), test–retest reliability (ranging from .88 to .93), and
concurrent and construct validity (Wechsler, 1999).
Romantic relationships. The Health and Sexual Behaviors
Questionnaire (HSBQ; Flory et al., 2006) was used to obtain
a history of participants’ romantic involvement and assess
their engagement in potentially RSB. Items included ques-
tions pertaining to age of first sexual experience and inter-
course, promiscuity, frequency of casual sex, use of reliable
contraception and STIs prevention methods, and unwanted
pregnancies. To minimize discomfort, the romantic rela-
tionships measures were branched such that answering “no”
to questions pertaining to previous involvement in romantic
relationships and intercourse precluded participants from
answering more in-depth questions. Thus, participants were
first asked if they had ever kissed someone. Next they were
asked if they had ever had sexual relations (more than kiss-
ing, but not intercourse). Finally, participants were asked if
they had ever had sexual intercourse. Participants’ responses
to this last question formed the basis for the variable “sex-
ual partners.” Most items were dichotomized to be consis-
tent with cut-offs for RSB used in other studies (Flory et al.,
2006; Grunbaum et al., 2004).
The Networks of Relationships Inventory–Behavioral
Systems Version (NRI-BSV; Furman & Buhrmester, 2009)
is based on an integration of attachment theory and
Sullivanian theory. It assesses how frequently different rela-
tionships (e.g., mother, father, romantic partner, same-sex
friend) are used to “fulfill the functions of three behavioral
systems: attachment, caregiving, and affiliation” (Furman &
Buhrmester, 2009). It is a 24-item survey, with 3 items per
scale, rated on a 5-point scale from 1 (little or none) to 5 (the
most). It assesses five support features (Provides Secure
Base, Seeks Secure Base, Provides Safe Haven, Seeks Safe
Haven, Companionship) and three negative interactions
(Conflict, Antagonism, Criticism). Two second-order factors
Table 1. Sample Characteristics and Demographics.
ADHD Comparison
Variable n M (SD)N M (SD)df t
Age 30 15.71 (1.49) 28 16.00 (1.68) 56 0.71
IQ 30 108.17 (12.08) 28 109.04 (8.52) 56 0.31
Parental education
(years)
17 15.89 (2.52) 18 16.47 (2.60) 33 0.67
Conners’ parent
DSM inattention 30 79.26 (9.57) 28 48.79 (6.21) 56 14.34***
DSM hyperactivity 30 78.84 (11.49) 28 48.29 (5.68) 56 12.73***
DSM conduct 30 59.88(13.87) 28 47.39 (4.5) 56 4.79***
Conners’ teacher
DSM inattention 20 62.50 (14.57) 21 51.76 (12.00) 39 2.58*
DSM hyperactivity 20 63.20 (16.78) 21 51.48 (13.84) 39 2.57*
DSM conduct 19 54.84 (13.60) 20 50.60 (11.92) 37 1.04
Conners’ self-report
DSM inattention 30 62.67 (10.77) 28 54.36 (10.17) 56 3.02**
DSM hyperactivity 30 62.30 (11.73) 28 52.39 (10.55) 56 3.37***
DSM conduct 30 55.56 (11.55) 28 50.75 (9.13) 56 1.77
Note. DSM = Diagnostic and Statistical Manual of Mental Disorders.
*p < .05. **p < .01. ***p < .001.
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Rokeach and Wiener 5
are computed by averaging the five support and three nega-
tive interactions scales. For the purposes of this study, only
responses pertaining to the participants’ romantic partner
were explored. The NRI-BSV has strong internal consis-
tency relating to romantic partners with alphas ranging from
.75 to .92. For this particular sample, internal consistency
was also strong, with alphas ranging from .82 to .95.
The Conflict in Adolescent Dating Relationships
Inventory (CADRI; Wolfe et al., 2001) is a 35-item self-
report scale assessing abusive behavior among adolescent
dating partners on five primary factors (Sexual Abuse,
Threatening Behavior, Verbal or Emotional Abuse,
Relational Abuse, and Physical Abuse). An Overall Abuse
factor is generated by summing all 25 items pertaining to
abuse (range = 25-100), whereas a Restricted Abuse factor
is derived by summing all items from the Threatening
Behavior, Verbal or Emotional Abuse, and Physical Abuse
factors (range = 18-72). The remaining 10 items on the
CADRI assess conflict resolution within the couple.
Participants with and without ADHD were compared on the
Overall Abuse Factor (perpetrated and incurred), the five
primary factors, and the Conflict Resolution scale within
the couple.
The CADRI is scored on a scale of 1 to 4 (from never to
often) with higher scores indicating greater levels of abuse.
The CADRI has fair internal consistency with alphas in the
mid ’80s for Verbal, Physical, and Overall abuse, and .51 to
.66 for the remaining scales. With the exception of Sexual
Abuse (.28), the remaining scales of the CADRI have
acceptable test–retest reliability ranging from .58 to .72. For
this particular sample, internal consistency was also fair,
with alphas ranging from .83 to .89 for Conflict Resolution
and Verbal and Emotional, and Overall abuse, and.47 to .63
for the remaining scales.
Procedures
Institutional ethic’s board approval was obtained from the
University of Toronto (protocol reference #25468) and all
participants and their parents provided informed written
consent prior to the start of the study. During an initial
phone screening, parents of participants provided demo-
graphic information about their child and family, completed
the Conners–Parent long form, and consented to having
their child’s teacher fill out the Conners–Teacher long form.
On the day of testing, researchers assisted participants in
completing an individually administered battery of stan-
dardized tests and self-report measures that were part of a
large-scale study assessing the peer and family relation-
ships of adolescents with ADHD. Researchers were gradu-
ate students in school and clinical child psychology with
considerable training in psychological testing. Participants
were given the choice of receiving $30 as compensation for
their time (approximately 4 hr) and travel expenses incurred,
or receiving a volunteer community service certificate doc-
umenting time spent participating in the study. In addition,
participants were provided with an educational report
detailing their cognitive, academic, and socio-emotional
functioning.
Data Analyses
Statistical analyses were conducted using the Statistical
Package for the Social Sciences (SPSS) version 20.
Descriptive statistics were calculated for the demographic
characteristics (e.g., age, gender, IQ, parental marital status,
parental education, language spoken at home) of the ADHD
and comparison groups separately. Data points of variables
with SDs larger than 3 were adjusted using the winsorizing
method. Statistical assumptions checking for homogeneity
of variance and normality of the outcome variables were
met. If t tests revealed gender differences on outcome vari-
ables, gender and group status were included as fixed fac-
tors in subsequent 2 × 2 ANOVAs. Partial η2 values were
computed to ascertain effect size and determine clinically
meaningful differences. According to Vacha-Haase and
Thompson (2004), η2 ≥ .01 constitutes a small effect, η2 >
.09 corresponds to a medium effect, and η2 > .25 represents
a large effect. To minimize the possibility of type I error,
overarching scales were first examined, and only when sig-
nificant differences existed were the results of item-level
differences reported.
Results
History of Romantic Involvement
As shown in Table 2, adolescents with ADHD reported hav-
ing more romantic partners than their TD counterparts,
F(1, 53) = 5.18, p = .03, η2 = .09. Males reported beginning
dating at a younger age than females, F(1, 53) = 3.79, p =
.05, η2 = .07; there was no group main effect nor Group ×
Gender interaction effect on age of onset of dating. Females
with ADHD had shorter romantic relationships than their
TD counterparts, whereas males with and without ADHD
reported equally short relationships across groups,
F(1, 53) = 5.53, p = .02, η2 = .10. A significant interaction
effect also indicated that males with ADHD reported a
younger age of first intercourse than their TD male counter-
parts, while females with and without ADHD reported their
first intercourse to occur at approximately the same age,
F(1, 17) = 4.41, p = .05, η2 = .21.
Relationship Content and Quality
As reported on the HSBQ, when compared with their TD
peers, adolescents with ADHD were significantly more
likely to have had multiple sex partners in their lifetime
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6 Journal of Attention Disorders
(defined as four or more), and to have had casual sex within
the past year (Table 3). While adolescents with and without
ADHD did not differ in terms of other high-risk sexual
behavior, both adolescent groups showed alarming rates for
the frequency of intercourse while under the influence of
drugs/alcohol, and irregular use of a combination of reliable
contraception and STI prevention methods.
Adolescents with and without ADHD did not differ on
the Overall Abuse factor of the CADRI (Sexual Abuse,
Threatening Behavior, Verbal or Emotional Abuse,
Relational Abuse, and Physical Abuse), assessing abuse per-
petrated by the participant, F(1, 41) = 1.59, p = .22, η2 = .04,
or incurred by the participant, F(1, 41) = .03, p = .86,
η2 = .00. Nor did they differ on the frequency of more adap-
tive, conflict resolution, patterns of behavior, F(1, 41) = .05,
p = .82, η2 = .00. Similarly, adolescents with and without
ADHD did not differ on the Social Support, F(1, 40) = .16,
p = .69, η2 = .00, or Negative Interactions (Conflict,
Antagonism, Criticism), F(1, 40) = 1.14, p = .29, η2 = .03,
factors of the NRI-BSV.
Discussion
The current study set out to compare the romantic relation-
ships of adolescents with and without ADHD on three fea-
tures of romantic relationships: romantic involvement,
relationship content, and relationship quality. Adolescents
with ADHD were found to have significantly more roman-
tic partners than their TD peers, and in particular, female
adolescents with ADHD were found to have shorter roman-
tic relationships than their TD counterparts. In addition,
males with ADHD reported their age of first intercourse to
be nearly 2 years prior to males without ADHD, and adoles-
cents with ADHD, irrespective of gender, had nearly double
the number of lifetime sexual partners than TD adolescents.
However, in the current study, adolescents with and without
ADHD did not differ on measures assessing the quality of
their romantic relationships or the levels of aggression per-
petrated or incurred.
Romantic Involvement
Nearly identical proportions of males and females with and
without ADHD reported experiencing a romantic relation-
ship in their lifetime. Adolescents with ADHD had more
romantic partners than their TD peers, but, similar to the
findings of Canu and Carlson (2003) regarding college stu-
dents with ADHD−Combined Type, adolescents with and
without ADHD did not differ on their age of entry into
romantic relationships. Although Babinski et al. (2011)
found that college students with ADHD have a lower num-
ber of romantic partners than TD students, only female stu-
dents were included in their sample whereas in the present
study the majority of students with ADHD were male. As
predicted, differences also emerged in terms of duration of
romantic relationships; females with ADHD reported
shorter romantic relationships than their TD counterparts,
whereas males with and without ADHD reported relation-
ships of similar lengths. These results suggest that the defi-
cits in social skills, excessive negative behavior, and poor
social information processing present in girls with ADHD
(Crick & Dodge, 1994; Hoza, Waschbusch, Pelham, Molina,
Table 2. Romantic Involvement of Adolescents With and Without ADHD by Gender.
Variablesa
ADHD Comparison
Group Gender Group × GenderMale Female Male Female
n M (SD)n M (SD)n M (SD)n M (SD)Fη2Fη2Fη2
Number of RRb18 3.50 (2.23) 12 2.33 (1.50) 11 2.09 (1.38) 16 1.75 (0.86) 5.18* .09 2.96 .05 0.89 .02
Age of 1st RR
(years)
18 13.11 (1.63) 12 14.36 (1.50) 11 13.55 (1.37) 16 13.81 (1.17) 0.02 .00 3.79* .07 1.60 .03
Longest RR
(months)
18 8.75 (9.16) 12 6.33 (6.64) 11 5.82 (5.42) 16 14.88 (11.87) 1.32 .02 1.85 .03 5.53* .10
Age of more than
kissing
14 14.29 (1.68) 6 15.17 (0.75) 6 14.17 (2.14) 11 14.91 (1.30) 0.12 .00 2.21 .06 0.02 .00
Age of 1st sexual
intercourse
6 14.50 (1.76) 4 15.50 (0.58) 5 16.40 (0.55) 6 15.33 (0.82) 3.10 .15 0.01 .00 4.41* .21
Number of sexual
partners
6 4.00 (3.69) 4 4.50 (3.87) 5 1.60 (0.55) 6 2.00 (1.10) 4.34* .20 0.15 .01 0.00 .00
aRange for number of romantic relationships (1-8); age of 1st RR (9-18), longest RR (months; 1-36); age of more than kissing (11-17); age of 1st sexual
intercourse (12-17); number of sexual partners (1-10).
bRR: romantic relationships.
*p < .05.
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Rokeach and Wiener 7
& Milich, 2000), may not only affect the stability of the
friendships they form (Bagwell et al., 2001; Blachman &
Hinshaw, 2002), but also their romantic relationships.
Boys with ADHD reported their first intercourse to be
nearly 2 years sooner than their TD counterparts and a year
earlier than girls with ADHD, who did not differ from TD
girls. Furthermore, when compared with TD adolescents, ado-
lescents with ADHD had nearly double the number of lifetime
sexual partners. These findings have important implications
because sexual precociousness and exposure to multiple sex
partners early in adolescence are associated with HIV infec-
tions (Overby & Kegeles, 1994) and a host of other negative
outcomes including depression, academic underachievement,
substance use, and further RSB (Crockett et al., 1996).
Relationship Content
Like other studies examining the sexual behavior of young
adults with ADHD (Barkley et al., 2010; Flory et al., 2006;
Huggins et al., 2012; White & Buehler, 2012; Winters et al.,
2008), when compared with their TD peers, adolescents
with ADHD were significantly more likely to have had mul-
tiple sex partners in their lifetime (defined as four or more)
and to have had casual sex within the past 12 months.
Despite the sample’s young age, these high proportions of
promiscuity are disconcerting, and a risk factor for subse-
quent internalizing and externalizing psychopathology.
Unlike findings from previous research (Barkley et al.,
2010; Flory et al., 2006), in the current study, participants
with ADHD were not more likely than their TD peers to
have contracted an STI or become unintentionally pregnant.
Discrepant results may be partially explained by the small
sample size and younger age of the current sample relative
to other studies. More specifically, adolescents may have
thus far been fortunate enough to escape further ramifica-
tions of their RSB, in spite of their irregular use of a combi-
nation of reliable contraception and STI prevention
methods. Alternatively, participants may have been con-
cerned about the confidentiality of their responses, or reluc-
tant to divulge potentially embarrassing information,
thereby decreasing their endorsement of socially undesir-
able items.
Adolescents with and without ADHD did not differ on
other items assessing RSB. Both groups showed startlingly
high rates for the frequency of intercourse while under the
influence of drugs/alcohol, and infrequent use of a combi-
nation of reliable contraception and STI prevention meth-
ods. In addition to the numerous risk factors of unprotected
sex mentioned above, alcohol and drug use prior to sex is
associated with further lapses in judgment, disinhibition of
sexual behaviors, and an increased likelihood of additional
RSB (Cooper, 2002; Staton et al., 1999).
Contrary to expectations and studies assessing relation-
ship aggression and conflict resolution in adults with ADHD
(Canu & Carlson, 2007; Overbey et al., 2011; White &
Buehler, 2012; Wymbs et al., 2012), adolescents with and
without ADHD did not differ on any variables assessing
abuse perpetrated or incurred. Nor they did differ on the
frequency of more adaptive, reconciliatory, patterns of
behavior. These results may be partially explained by the
relatively low ratings of conduct problems in the sample of
adolescents with ADHD. Although there were significant
group differences in parental appraisal of conduct prob-
lems, the mean score of the ADHD sample still fell within
the average range. Furthermore, no group difference
emerged according to teacher and self-reports of conduct
problems. CD and its successor antisocial personality disor-
der (ASP) are linked with intimate partner violence
(Schumacher, Feldbau-Kohn, Smith Slep, & Heyman,
2001). The moderately low scores of adolescents in this
sample may therefore be mitigating the levels of relation-
ship aggression found in other studies. Alternatively, it is
also possible that participants with ADHD were reluctant to
disclose abusive and potentially self-incriminating
behavior.
Relationship Quality
Finally, adolescents with and without ADHD did not differ
on measures of relationship quality, as assessed by levels of
social support and negative interactions. While ADHD sta-
tus in adulthood is associated with lower relationship satis-
faction and a higher incidence of divorce (Biederman et al.,
1993; Murphy & Barkley, 1996), and non-ADHD spouses
report feelings of resentment and dissatisfaction due to
Table 3. Risky Sexual Behavior Among Adolescents With and
Without ADHD.
ADHD Comparison
Behavior n%n%χ2
1st sexual partner casual 6/10 60 5/11 46 0.44
Casual sex (past year) 6/10 60 2/11 18 3.89*
Multiple sex partners
lifetimea
4/10 40 0/11 0 5.44*
Intercourse while usingb
drugs/alcohol
5/10 50 5/11 45 0.04
Infrequentc use of
reliabled B/C + STI
prevention methods
8/10 80 9/11 81 0.01
Unwanted pregnancy 1/10 10 0/11 0 1.16
STI 0/11 0 0/10 0 —
Note. STI = sexually transmitted infection.
aMultiple is defined as 4 or more partners.
bDefined as some of the time, half of the time, most of the time.
cInfrequent is defined as less than almost always.
dReliable methods of birth control plus STI prevention defined as use of
condom + birth control.
*p < .05.
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8 Journal of Attention Disorders
inadequate emotional support and an unequal distribution
of household responsibilities (Weiss et al., 1999), it is pos-
sible that the expectations and level of support implied in
adolescent relationships are not as demanding as in adult-
hood. Furthermore, several studies and comprehensive
reviews (e.g., Hoza et al., 2004; Owens, Goldfine,
Evangelista, Hoza, & Kaiser, 2007) describe how individu-
als with ADHD tend to underreport the presence of prob-
lems and overestimate their own competence in social
domains.
Limitations and Future Directions
These preliminary results, while interesting, should be con-
sidered in light of several important caveats. As in all stud-
ies, the generalizability of the findings is constrained by
sample characteristics. The small sample size decreased the
power of this study to detect small effects. Furthermore, the
small sample prevented further exploration of factors poten-
tially moderating the relationship between ADHD status
and various outcome variables. Future studies should exam-
ine the role of the distal context (e.g., culture, ethnicity,
socioeconomic status), the immediate context (e.g., family
structure, family relations, parental monitoring, peer
groups) and child characteristics (comorbidity, self-esteem,
attachment, achievement) in explaining the association
between ADHD and the features of romantic relationships.
For example, comorbid externalizing behaviors have been
found to exacerbate the social skills problems and peer
functioning difficulties associated with ADHD (for reviews,
see Becker, Luebbe, & Langberg, 2012; Villodas, Pfiffner,
& McBurnett, 2012). Thus, while it is likely that comorbid
ODD/CD would also affect romantic functioning similarly,
the absence of comorbid ODD/CD diagnoses in the present
sample did not allow for further exploration of this
predictor.
Conversely, it would also be interesting to examine how
romantic relationships can positively or negatively affect
other developmental outcomes, including cognitive and
emotional processes, educational attainment, family and
peer functioning, substance use, and externalizing and
internalizing symptomatology. Finally, future studies
should also examine other features of romantic relation-
ships defined by Collins (2003) that were not described in
the present study. For example, it would be important to
investigate the characteristics of the partner with whom the
adolescent has had a romantic experience.
Another limitation of this study was its reliance on self-
report to assess relationship content and quality. Although
the use of self-report is commonplace in the study of ado-
lescent behavior, it is susceptible to response bias (Kazdin,
1998; Wolfe et al., 2001). Eakin et al. (2004) suggests that
in ADHD couples, partners often have conflicting views
regarding their relationship. In addition, adolescents with
ADHD have a propensity to inflate self-appraisals and
downplay problematic behavior. Accordingly, obtaining
corroboration from romantic partners would lend more
credibility to the findings.
Given the unique contributions of this multi-faceted
study, it would appear that the strengths of the current
investigation outweigh its limitations. This investigation
explored several aspects, rather than just one facet, of
romantic relationships in individuals with ADHD.
Moreover, the sample included both males and females and
the age range was 13 to 18. The inclusion of adolescents
who are still attending middle school or secondary school is
important because romantic relationships of adolescents
with ADHD in this age range has been understudied. The
young age of the sample also meant that participants did not
have to retrospectively recall their relationship history, thus
limiting the confounding and biased effects of recall.
Clinical Implications
The findings regarding romantic involvement and sexual
behavior in the current study have important implications
for the parents, educators, and clinicians who work with
adolescents with ADHD. Unfortunately, only a minority of
adolescents with ADHD, about one in eight, receive care
for their disorder (Jensen et al., 1999). Most are treated
with stimulant medication (Smith, Waschbusch,
Willoughby, & Evans, 2000) and few receive some form or
psychosocial or educational intervention. Given the poor
outcomes associated with RSB, relationship instability, and
negative partner characteristics, it is imperative that any
comprehensive assessment of adolescents with ADHD
include queries into the nature of their romantic relation-
ships. In turn, information obtained may help clinicians
devise specific and individualized strategies to help adoles-
cents prevent and/or cope with romantic relationship diffi-
culties. At a more universal level, results from this study,
although preliminary, may help inform sex education pro-
grams seeking to reduce unsafe sexual behavior in this at-
risk population.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The current study was supported by the Social Sciences and
Humanities Research Council of Canada.
References
American Psychiatric Association. (2000). Diagnostic and sta-
tistical manual of mental disorders (4th ed., text rev.).
Washington, DC: Author.
at UNIV TORONTO on January 18, 2016jad.sagepub.comDownloaded from

Rokeach and Wiener 9
Babinski, D. E., Pelham, W. E., Molina, B. S., Gnagy, E. M.,
Waschbusch, D. A., Yu, J., . . .Karch, K. M. (2011). Late
adolescent and young adult outcomes of girls diagnosed with
ADHD in childhood: An exploratory investigation. Journal of
Attention Disorders, 15, 204-214.
Bagwell, C., Molina, B. S. G., Pelham, W. E., & Hoza, B. (2001).
Attention-deficit hyperactivity disorder and problems in peer
relations: Predictions from childhood to adolescence. Journal
of the American Academy of Child & Adolescent Psychiatry,
40, 1285-1292.
Barkley, R. A. (2006). Attention-deficit hyperactivity disorder: A
handbook for diagnosis and treatment (3rd ed.). New York,
NY: Guilford Press.
Barkley, R. A., Fischer, M., Smallish, L., & Fletcher, K. (2004).
Young adult follow-up of hyperactive children: Antisocial
activities and drug use. Journal of Child Psychology and
Psychiatry, 45, 195-211.
Barkley, R. A., Murphy, K. R., & Fischer, M. (2010). ADHD in
adults: What the science says. New York, NY: Guilford Press.
Becker, S. P., Luebbe, A. M., & Langberg, J. M. (2012).
Co-occurring mental health problems and peer functioning
among youth with attention-deficit/hyperactivity disorder:
A review and recommendations for future research. Clinical
Child and Family Psychology Review, 15, 279-302.
Biederman, J., Faraone, S., Spencer, T., Wilens, T., Norman, D.,
Lapey, K. A., . . .Doyle, A. (1993). Patterns of psychiatric
comorbidity, cognition, and psychosocial functioning in
adults with attention deficit hyperactivity disorder. American
Journal of Psychiatry, 150, 1792-1798.
Blachman, D. R., & Hinshaw, S. P. (2002). Patterns of friendship
among girls with and without attention-deficit/hyperactivity
disorder. Journal Abnormal Child Psychology, 30, 625-640.
Brown, B. (1999). “You’re going with who?” Peer group influ-
ences on adolescent romantic relationships. In W. Furman,
B. Brown, & C. Feiring (Eds.), The development of roman-
tic relationships in adolescence (pp. 1-16). New York, NY:
Cambridge University Press.
Canu, W. H., & Carlson, C. L. (2003). Differences in heterosocial
behavior and outcomes of ADHD symptomatic subtypes in a
college sample. Journal of Attention Disorders, 6, 123-133.
Canu, W. H., & Carlson, C. L. (2007). Rejection sensitivity
and social outcomes of young men with ADHD. Journal of
Attention Disorders, 10, 261-275.
Carver, K., Joyner, K., & Udry, J. (2003). National estimates of
adolescent romantic relationships. In P. Florsheim (Ed.),
Adolescent romantic relations and sexual behavior: Theory,
research, and practical implications (pp. 291-329). Mahwah,
NJ: Lawrence Erlbaum.
Collins, W. A. (2003). More than myth: The developmental signif-
icant of romantic relationships during adolescence. Journal of
Research on Adolescence, 13, 1-25.
Collins, W. A., Hennighausen, K. C., Schmit, D. T., & Sroufe,
L. A. (1997). Developmental precursors of romantic relation-
ships: A longitudinal analysis. New Directions for Child and
Adolescent Development, 78, 69-84.
Collins, W. A., & Sroufe, L. A. (1999). Capacity for intimate rela-
tionships: A developmental construction. In W. Furman, B.
Brown, & C. Feiring (Eds.), The development of romantic
relationships in adolescence (pp. 125-147). New York, NY:
Cambridge University Press.
Collins, W. A., Van Dulmen, M. (2006). “The course of true
love(s) . . .”: Origins and pathways in the development of
romantic relationships. In A. Booth & A. Crouter (Eds.),
Romance and Sex in Adolescence and Emerging Adulthood:
Risks and Opportunities (pp. 63-86). Mahwah, NJ: Erlbaum.
Collins, W. A., Welsh, D., & Furman, W. (2009). Adolescent
romantic relationships. Annual Review of Psychology, 60,
631-652.
Conners, C. K. (2008). Conners-3 (3rd ed.). Toronto, Ontario,
Canada: Multi-Health Systems.
Connolly, J., Furman, W., & Konarski, R. (2000). The role of
peers in the emergence of heterosexual romantic relationships
in adolescence. Child Development, 71, 1395-1408.
Cooksey, E. C., Mott, F. L., & Neubauer, S. A. (2002). Friendships
and early relationships: Links to sexual initiation among
American adolescents born to young mothers. Perspectives
on Sexual and Reproductive Health, 34, 118-126.
Cooper, M. L. (2002). Alcohol use and risky sexual behavior
among college students and youth: Evaluating the evidence.
Journal of Studies on Alcohol and Drugs, 14, 101-117.
Crick, N. R., & Dodge, K. A. (1994). A review and reformulation
of social information-processing mechanisms in children’s
social adjustment. Psychological Bulletin, 115, 74-101.
Crockett, L. J., Bingham, C. R., Chopak, J. S., & Vicar, J. R.
(1996). Timing of first sexual intercourse: The role of social
control, social learning, and problem behavior. Journal of
Youth and Adolescence, 25, 89-111.
Eakin, L., Minde, K., Hechtman, L., Ochs, E., Krane, E., Bouffard,
R., . . .Looper, K. (2004). The marital and family functioning
of adults with ADHD and their spouses. Journal of Attention
Disorders, 8, 1-10.
Fargo, J. D. (2009). Pathways to adult sexual revictimization
direct and indirect behavioral risk factors across the lifespan.
Journal of Interpersonal Violence, 24, 1771-1791.
Flory, K., Molina, B. S., Pelham, W. E., Jr., Gnagy, E., & Smith,
B. (2006). Childhood ADHD predicts risky sexual behavior
in young adulthood. Journal of Clinical Child & Adolescent
Psychology, 35, 571-577.
Furman, W., & Buhrmester, D. (2009). Methods and measures:
The Network of Relationships Inventory: Behavioral systems
version. International Journal of Behavioral Development,
33, 470-478.
Furman, W., & Collins, W. (2008). Adolescent romantic relation-
ships and experiences. In K. H. Rubin, W. Bukowski, & B.
Laursen (Eds.), Handbook of peer interactions, relationships,
and groups (pp. 341-360). New York, NY: Guilford Press.
Furman, W., Low, S., & Ho, M. J. (2009). Romantic experience
and psychosocial adjustment in middle adolescence. Journal
of Clinical Child & Adolescent Psychology, 38, 75-90.
Furman, W., & Shomaker, L. B. (2008). Patterns of interaction in
adolescent romantic relationships: Distinct features and links to
other close relationships. Journal of Adolescence, 31, 771-788.
Galliher, R. V., Welsh, D. P., Rostosky, S. S., & Kawaguchi, M.
C. (2004). Interaction and relationship quality in late ado-
lescent romantic couples. Journal of Social and Personal
Relationships, 21, 203-216.
at UNIV TORONTO on January 18, 2016jad.sagepub.comDownloaded from

10 Journal of Attention Disorders
Giordano, P. C., Manning, W. D., & Longmore, M. A. (2006).
Adolescent romantic relationships: An emerging portrait of
their nature and developmental significance. In A. Crouter
& A. Booth (Eds.), Romance and sex in adolescence and
emerging adulthood: Risks and Opportunities (pp. 127-150).
Mahwah, NJ: Lawrence Erlbaum.
Grunbaum, J. A., Kann, L., Kinchen, S., Ross, J., Hawkins, J.,
Lowry, R., . . .Collins, J. (2004). Youth risk behavior surveil-
lance-United States, 2003 [Electronic version]. Morbidity and
Mortality Weekly Report: Surveillance Summaries, 53(SS02),
1-96.
Halpern, C. T., Oslak, S. G., Young, M. L., Martin, S. L., &
Kupper, L. L. (2001). Partner violence among adolescents
in opposite-sex romantic relationships: Findings from the
National Longitudinal Study of Adolescent Health. American
Journal of Public Health, 91(10), 1679-1685.
Hoza, B., Gerdes, A. C., Hinshaw, S. P., Arnold, L. E., Pelham,
W.E., Jr., Molina, B. S., . . .Hechtmna, L. (2004). Self-
perceptions of competence in children with ADHD and
comparison children. Journal of Consulting and Clinical
Psychology, 72, 382-391.
Hoza, B., Waschbusch, D. A., Pelham, W. E., Molina, B. S., &
Milich, R. (2000). Attention-deficit/hyperactivity disordered
and control boys’ responses to social success and failure.
Child Development, 71, 432-446.
Huggins, S. P., Rooney, M. E., & Chronis-Tuscano, A. (2012).
Risky sexual behavior among college students with ADHD:
Is the mother–child relationship protective? Journal
of Attention Disorders. Advance online publication.
doi:10.1177/1087054712459560
Jensen, P. S., Kettle, L., Roper, M. T., Sloan, M. T., Dulcan, M.
K., Hoven, C., . . .Payne, J. D. (1999). Are stimulants over-
prescribed? Treatment of ADHD in four US communities.
Journal of the American Academy of Child & Adolescent
Psychiatry, 38, 797-804.
Johnston, C., & Mash, E. J. (2001). Families of children with
attention-deficit/hyperactivity disorder: Review and recom-
mendations for future research. Clinical Child and Family
Psychology Review, 4, 183-207.
Jouriles, E. N., McDonald, R., Garrido, E., Rosenfield, D., &
Brown, A. S. (2005). Assessing aggression in adolescent
romantic relationships: Can we do it better? Psychological
Assessment, 17, 469-475.
Kazdin, A. E. (1998). Research design in clinical psychology (3rd
ed.). New York, NY: Macmillan.
Kuttler, A. F., & La Greca, A. M. (2004). Linkages among ado-
lescent girls’ romantic relationships best friendships, and peer
networks. Journal of Adolescence, 27, 395-414.
Levesque, R. (1993). The romantic experiences of adoles-
cents in satisfying love relationships. Journal of Youth and
Adolescence, 22, 219-251.
Mandell, A. R. (1999). An investigation of the presence of adult
attention hyperactivity disorder behaviors in a population of
court-mandated domestic violence perpetrators. Dissertation
Abstracts International, 59(12-A), 4369-4523.
Monuteaux, M. C., Faraone, S. V., Gross, L. M., & Biederman,
J. (2007). Predictors, clinical characteristics, and outcome of
conduct disorder in girls with attention-deficit/hyperactivity
disorder: A longitudinal study. Psychological Medicine, 37,
1731-1742.
Murphy, K., & Barkley, R. A. (1996). Attention-deficit hyper-
activity disorder adults: Comorbidities and adaptive impair-
ments. Comprehensive Psychiatry, 37, 393-401.
Overbey, G. A., Snell, W. E., & Callis, K. E. (2011). Subclinical
ADHD, stress, and coping in romantic relationships of uni-
versity students. Journal of Attention Disorders, 15, 67-78.
Overby, K. J., & Kegeles, S. M. (1994). The impact of AIDS on
an urban population of high-risk female minority adolescents:
Implications for intervention. Journal of Adolescent Health,
15, 216-227.
Owens, J. S., Goldfine, M. E., Evangelista, N. M., Hoza, B., &
Kaiser, N. M. (2007). A critical review of self-perceptions
and the positive illusory bias in children with ADHD. Clinical
Child and Family Psychology Review, 10, 335-351.
Ramrakha, S., Bell, M. L., Paul, C., Dickson, N., Moffitt, T. E.,
& Caspi, A. (2007). Childhood behavior problems linked to
sexual risk taking in young adulthood: A birth cohort study.
Journal of the American Academy of Child & Adolescent
Psychiatry, 46, 1272-1279.
Richards, M. H., Crowe, P. A., Larson, R., & Swarr, A. (1998).
Developmental patterns and gender differences in the expe-
rience of peer companionship during adolescence. Child
Development, 69, 154-163.
Robin, A., & Payson, E. (2002). The impact of ADHD on mar-
riage. The ADHD Report, 10, 9-14.
Roisman, G. I., Booth-LaForce, C., Cauffman, E., & Spieker, S.
(2009). The developmental significance of adolescent romantic
relationships: Parent and peer predictors of engagement and qual-
ity at age 15. Journal of Youth and Adolescence, 38, 1294-1303.
Schumacher, J. A., Feldbau-Kohn, S., Smith Slep, A. M., &
Heyman, R. E. (2001). Risk factors for male-to-female partner
physical abuse. Aggression and Violent Behavior, 6, 281-352.
Seiffge-Krenke, I. (2003). Testing theories of romantic develop-
ment from adolescence to young adulthood: Evidence of a
developmental sequence. International Journal of Behavioral
Development, 27, 519-531.
Smith, B. H., Waschbusch, D. A., Willoughby, M. T., & Evans,
S. (2000). The efficacy, safety, and practicality of treatments
for adolescents with attention-deficit/hyperactivity disorder
(ADHD). Clinical Child and Family Psychology Review, 3,
243-267.
Staton, M., Leukefeld, C., Logan, T. K., Zimmerman, R., Lynam,
D., Milich, R., . . .Clayton, R. (1999). Risky sex behavior and
substance use among young adults. Health & Social Work,
24, 147-154.
Theriault, S. W., & Holmberg, D. (2001). Impulsive, but violent?
Are components of the attention deficit-hyperactivity syn-
drome associated with aggression in relationships? Violence
Against Women, 7, 1464-1489.
Vacha-Haase, T., & Thompson, B. (2004). How to estimate
and interpret various effect sizes. Journal of Counseling
Psychology, 51, 473-481.
Villodas, M. T., Pfiffner, L. J., & McBurnett, K. (2012). Prevention
of serious conduct problems in youth with attention deficit/
hyperactivity disorder. Expert Review of Neurotherapeutics,
12, 1253-1263.
at UNIV TORONTO on January 18, 2016jad.sagepub.comDownloaded from

Rokeach and Wiener 11
Wechsler, D. (1999). Manual for the Wechsler Abbreviated Scale
of Intelligence (WASI). San Antonio, TX: Psychological
Corporation.
Wehmeier, P. M., Schacht, A., & Barkley, R. A. (2010). Social
and emotional impairment in children and adolescents with
ADHD and the impact on quality of life. Journal of Adolescent
Health, 46, 209-217.
Weiss, M., Weiss, G., & Trokenberg-Hechtman, L. (1999). ADHD
in adulthood: A guide to current theory, diagnosis and treat-
ment. Baltimore, MD: Johns Hopkins University Press.
White, J. W., & Buehler, C. (2012). Adolescent sexual victimiza-
tion, ADHD symptoms, and risky sexual behavior. Journal of
Family Violence, 27, 123-132.
Winters, K. C., Botzet, A. M., Fahnhorst, T., Baumel, L., & Lee,
S. (2008). Impulsivity and its relationship to risky sexual
behaviors and drug abuse. Journal of Child & Adolescent
Substance Abuse, 18, 43-56.
Wolfe, D. A., Jaffe, P., & Crooks, C. (2006). Adolescent risk
behaviors: Why teens experiment and strategies to keep them
safe. New Haven, CT: Yale University Press.
Wolfe, D. A., Scott, K., Reitzel-Jaffe, D., Wekerle, C., Grasley,
C., & Straatman, A. (2001). Development and validation of
the Conflict in Adolescent Dating Relationships Inventory.
Psychological Assessment, 13, 277-293.
Woodward, L. J., Fergusson, D. M., & Horwood, L. J. (2002).
Romantic relationships of young people with childhood and
adolescent onset antisocial behavior problems. Journal of
Abnormal Child Psychology, 30, 231-243.
Wymbs, B., Molina, B., Pelham, W., Cheong, J., Gnagy, E.,
Belendiuk, K., . . .Waschbusch, D. (2012). Risk of intimate
partner violence among young adult males with childhood
ADHD. Journal of Attention Disorders, 16, 373-383.
Zimmer-Gembeck, M., Siebenbruner, J., & Collins, W. (2004).
A prospective study of intraindividual and peer influences
on adolescents’ heterosexual romantic and sexual behavior.
Archives of Sexual Behavior, 33, 381-394.
Author Biographies
Alan Rokeach is a doctoral student in school and clinical child
psychology in the Department of Applied Psychology and Human
Development at the University of Toronto (OISE). His current
focus of research is on the peer and romantic relationships of ado-
lescents with ADHD. He is also investigating the efficacy of a
social skills intervention program for pediatric brain tumour
survivors.
Judith Wiener is a professor of school and clinical child psy-
chology in the Department of Applied Psychology and Human
Development at the University of Toronto (OISE). Her current
research is on the self-perceptions, family and social relationships
of children and adolescents with learning disabilities and ADHD.
She has published over 60 book chapters and articles in peer-
reviewed journals. Her book Psychological Assessment of
Culturally and Linguistically Diverse Children and Adolescents:
A Practitioner’s Guide, coauthored with Dr. Esther Geva, will be
published by Springer in the summer of 2014.
at UNIV TORONTO on January 18, 2016jad.sagepub.comDownloaded from