A shared core, distinct network organization: urban–rural variation in ADHD–aggression networks and simulated intervention profiles among Chinese college students

Introduction Attention-deficit/hyperactivity disorder (ADHD)-related difficulties are associated with aggression, but the connections between specific features of the two domains remain poorly understood in young adults. It is also unclear whether this organization varies across socioecological backgrounds. Methods This cross-sectional study mapped ADHD–aggression networks among 3,572 Chinese college students with urban or rural backgrounds. Six ADHD-related difficulties assessed with the Adult ADHD Self-Report Scale Screener and four aggression components assessed with the Buss–Perry Aggression Questionnaire were modeled as network nodes. We examined network structure, expected influence (EI), bridge expected influence (BEI), computer-simulated intervention profiles, and associations with peer relationship difficulties. Results Task-initiation difficulty and hostility emerged as prominent central and bridge nodes in both networks, identifying a shared interface between self-regulatory difficulty and aggression-related cognition. The urban and rural networks nevertheless differed in overall structure and global EI. Exploratory comparisons suggested larger estimated weights for selected ADHD-related connections, higher expected influence for overactivity, and higher bridge expected influence for forgetfulness in the urban network. The alleviating simulations identified a shared set of leading nodes, with task-initiation difficulty showing the largest mean projected reduction in network activity in both groups. Moderation analyses identified FDR-significant interactions with residential background for several self-regulatory difficulties, indicating stronger associations with peer difficulties in rural-background students. Discussion These findings reveal a shared self-regulation–hostility interface within the ADHD–aggression system while showing variation in network organization and interpersonal relevance across urban- and rural-background students.