CRIMINAL BEHAVIOUR AND MENTAL HEALTH
ADHD
DSM-IV Criteria
Inattention
6 or more for at least 6 months (disruptive and inappropriate for developmental level- not just a
normal toddler):
- Inattention to details, makes careless mistakes
- Often has trouble keeping attention on tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow instructions and fails to finish things
- Often has trouble organizing activities.
- Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long
period of time
- Often loses things needed for tasks and activities
- Is often easily distracted.
- Is often forgetful in daily activities.
Hyperactivity
6 or more present for at least 6 months (disruptive and inappropriate for developmental level):
- Often fidgets with hands or feet or squirms in seat.
- Often gets up from seat when remaining in seat is expected.
- Often runs about or climbs when and where it is not appropriate (adolescents or adults may
feel very restless).
- Often has trouble playing or enjoying leisure activities quietly.
- Is often "on the go" or often acts as if "driven by a motor".
- Often talks excessively.
Impulsivity
- Often blurts out answers before questions have been finished. (Often has trouble waiting
one's turn. Often interrupts or intrudes on others )
- Some symptoms that cause impairment were present before age 7 years.
- Some impairment from the symptoms is present in two or more settings (not just acting out
because doesn’t want to be at school)
- There must be clear evidence of significant impairment in social, school, or work
functioning.
- The symptoms do not happen only during the course of another disorder
, Features:
Prevalence 5.3 per 1000 boys in 1999
3-5% in USA (0.5-1% persistence into adulthood)
Controversy over diagnosis and treatment
High rates of ADHD in offending adolescents (Timmons-Mitchell et al., 1997)
Childhood ADHD associated with onset delinquency, persistence and higher arrest (Retz)
Diagnosis - static factor in recidivism and risk of crime
Rayner et al (2005):
- 31 persistent male offenders (13-17 years)
- 4 + offences that warranted custodial if adult
- Prominent diagnosis = conduct disorder, ADHD & drug abuse
- Triad (CD, ADHD and drug abuse)= most associated with offending (Timmons-Mitchell et al.,
1997)
ADHD & Offending
Pratt et al (2002)
Meta analysis of 20 studies found strong relationship between ADHD and antisocial
behaviour
Young et al (2009)
Self report measures of ADHD and ASPD and critical incidents of aggression
Differences observed between those symptomatic of ADHD and those who were not
Retz et al (2004)
129 young male offenders
No ADHD (no ADHD)
Childhood not adult ADHD (CARS)
Childhood and adult (ADHD)
Significant differences - age of first conviction lower in ADHD and CARS
Delinquency prior age 14 higher in CARS than ADHD , both higher than no ADHD
ADHD have higher anxiety, depression and aggressive behaviour
ADHD higher neuroticism, lower conscientiousness & agreeableness
The high prevalence of persistent ADHD in young offenders highlights the necessity
of early diagnosis and therapy to prevent ADHD children from starting a criminal
career.
CONDUCT DISORDER
DSM-IV
- Repetitive and persistent pattern of behaviour where basic rights of others, age-appropriate
societal norms are violated.
- Presence of three + in last year, and 1+ in last 6 months
- Behaviours linked to significant impairment in social, academic occupational functioning
ADHD
DSM-IV Criteria
Inattention
6 or more for at least 6 months (disruptive and inappropriate for developmental level- not just a
normal toddler):
- Inattention to details, makes careless mistakes
- Often has trouble keeping attention on tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow instructions and fails to finish things
- Often has trouble organizing activities.
- Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long
period of time
- Often loses things needed for tasks and activities
- Is often easily distracted.
- Is often forgetful in daily activities.
Hyperactivity
6 or more present for at least 6 months (disruptive and inappropriate for developmental level):
- Often fidgets with hands or feet or squirms in seat.
- Often gets up from seat when remaining in seat is expected.
- Often runs about or climbs when and where it is not appropriate (adolescents or adults may
feel very restless).
- Often has trouble playing or enjoying leisure activities quietly.
- Is often "on the go" or often acts as if "driven by a motor".
- Often talks excessively.
Impulsivity
- Often blurts out answers before questions have been finished. (Often has trouble waiting
one's turn. Often interrupts or intrudes on others )
- Some symptoms that cause impairment were present before age 7 years.
- Some impairment from the symptoms is present in two or more settings (not just acting out
because doesn’t want to be at school)
- There must be clear evidence of significant impairment in social, school, or work
functioning.
- The symptoms do not happen only during the course of another disorder
, Features:
Prevalence 5.3 per 1000 boys in 1999
3-5% in USA (0.5-1% persistence into adulthood)
Controversy over diagnosis and treatment
High rates of ADHD in offending adolescents (Timmons-Mitchell et al., 1997)
Childhood ADHD associated with onset delinquency, persistence and higher arrest (Retz)
Diagnosis - static factor in recidivism and risk of crime
Rayner et al (2005):
- 31 persistent male offenders (13-17 years)
- 4 + offences that warranted custodial if adult
- Prominent diagnosis = conduct disorder, ADHD & drug abuse
- Triad (CD, ADHD and drug abuse)= most associated with offending (Timmons-Mitchell et al.,
1997)
ADHD & Offending
Pratt et al (2002)
Meta analysis of 20 studies found strong relationship between ADHD and antisocial
behaviour
Young et al (2009)
Self report measures of ADHD and ASPD and critical incidents of aggression
Differences observed between those symptomatic of ADHD and those who were not
Retz et al (2004)
129 young male offenders
No ADHD (no ADHD)
Childhood not adult ADHD (CARS)
Childhood and adult (ADHD)
Significant differences - age of first conviction lower in ADHD and CARS
Delinquency prior age 14 higher in CARS than ADHD , both higher than no ADHD
ADHD have higher anxiety, depression and aggressive behaviour
ADHD higher neuroticism, lower conscientiousness & agreeableness
The high prevalence of persistent ADHD in young offenders highlights the necessity
of early diagnosis and therapy to prevent ADHD children from starting a criminal
career.
CONDUCT DISORDER
DSM-IV
- Repetitive and persistent pattern of behaviour where basic rights of others, age-appropriate
societal norms are violated.
- Presence of three + in last year, and 1+ in last 6 months
- Behaviours linked to significant impairment in social, academic occupational functioning
