Adolescent and Adult Attention-Deficit Hyperactivity Disorder


F - Forgetful
A – Achieving below potential
S – Stuck in a rut
T – Time challenged
M – Motivationally challenged
I - Impulsive
N – Novelty seeking
D - Distractible
S - Scattered

Treatment of ADHD reduces criminality

In a very early draft of the book  FAST  MINDS (the final version will be launched in February 2013), I included a chapter titled “ADHD Goes to Jail”. I recognized at the time that this was not a very encouraging title for a chapter in a book I expected to be full of hope for the future, however, the reality is that under-diagnosed or insufficiently treated ADHD can definitely lead a person to the justice system.

Thankfully, a new study has revealed that medical treatment of ADHD can reduce criminality and recidivism.

But let’s start from the beginning. We know that children with ADHD underachieve academically. And it is this lack of bonding between young ADHD minds and educators and the educational systems which is a later predictor of addictions, according to a report from the Canadian Centre on Substance Abuse.  Addictions can lead to dropping out of school, and eventually, if a person is caught possessing drugs or driving while under the influence, into the hands of the police.

ADHD and addictions overlap in up to 50% of cases.

Impulsivity is a core symptom of ADHD, and outcomes of this symptom can clearly contribute to criminal charges: Using drugs impulsively and then in an intoxicated state driving a car, getting into a fight, dangerous driving, hit and run accidents, impulsive stealing (shoplifting) – these all are problematic.

A study published in the International Journal of Offender Therapy and Comparative Criminology, published in 2009, looked at Attention-Deficit Disorder in men and women newly committed to prison. Out of 319 offenders, 68 (21.3%) met criteria for ADHD. This study also looked at the symptoms of ADHD which were over-represented in this population and they very much resemble theFASTMINDS acronym. Figures revealed that 89.7% were distractible, 91.2% were impulsive, 89.7% were fidgety and 70.6% were irritable; 86.8% were not achieving and 67.6% were not organized; 92.6% had problems with impulsive money spending.

While those figures showed that 21.3% of those incarcerated had ADHD, numbers cited elsewhere vary. In an excellent blog by Pete Quily titled Adult ADHD Strengths (you can find it at prison figures range from 25% of prisoners from theU.S.having ADHD, up to 50% of male prisoners inIceland.

And these figures do not only pertain to males, as it is noted in Pete Quily’s blog: “46% of female prisoners in Rhode Islandmet criteria for childhood ADHD.” When researching the original FASTMINDS book, I also dug up some information on females and the penal system. In a study by Rosler et al., published in 2009 in the European Archives of Psychiatry and Clinical Neurosciences, it was noted that females with ADHD were likely to have an earlier age of incarceration and to be incarcerated for longer periods of time.

Now to the hopeful part of this blog.

On November 22, 2012, the New England Journal of Medicine published an article by Lichenstein et al. titled: “Review of Medication for Attention-Deficit Hyperactivity Disorder and Criminality” Despite the “criminality” in the title, this is a good news story.

This article derived data from 16,087 men and 9,569 women in Sweden who had at least one diagnosis of ADHD. Among the men with ADHD, 36.6% had been convicted of at least one crime, compared to 8.9% of the general population control group. For women, the figures were 15.4% and 2.2% respectively.

While many in the study had, at one time, taken ADHD medication (53.6% of men and 62.7% of women), very few had continuous treatment for their condition. It was noted: “At total of 689 men (4.3%) and 368 women (3.8%) were receiving ADHD medication during the entire period.”

However, the very good news is that for those who were being treated for their ADHD, there was a huge reduction in criminality. The authors noted that among those receiving ADHD medication, “There was a significant reduction of 32% in the criminality rate for men and 41% for women.”

The authors also reported, “These findings raise the possibility that the use of medication reduces the risk of criminality among patients with ADHD.”

With this new information, shared by my Swedish colleagues, it looks like we are making good headway now.