Risk of Criminal Justice System Interactions in Young Adults with Attention-Deficit/Hyperactivity Disorder: Findings From a National Birth Cohort

Abstract

Objective: To examine criminal justice system (CJS) interactions and pathways through the justice system for young adults with ADHD compared to young adults without ADHD. Method: Nationwide 3-year birth cohort study using linked health and CJS data. Cox proportional hazards models were employed to examine associations between ADHD and police proceedings, court charges, court convictions, and incarcerations. Results: Young adults with ADHD were significantly more likely to interact with the CJS including police proceedings (hazard ratio [HR], 2.1 95% CI [2.0, 2.2]) court charges (HR, 2.2 95% CI [2.1, 2.3]), court convictions (HR, 2.3 95% CI [2.2, 2.4]), and incarceration (HR, 4.8 95% CI [4.3, 5.4]). Conclusions: Young adults with ADHD are overrepresented at all stages of the CJS. Results highlight the importance of early identification and responsivity to ADHD within the CJS and suggest that the NZ justice system may require changes to both areas to ensure that young individuals with ADHD receive equitable access to, and treatment within, the CJS.

Prevalence of attention‐deficit hyperactivity disorder in adult prisoners: An updated meta‐analysis

“…The lower prevalence in adults compared with adolescents in prison settings (8% vs. 17%) is consistent with findings in the general population and reflects the overall decrease in prevalence of ADHD with age (Faraone et al., 2006). The higher rate of persistence of ADHD from young to adult prisoners compared with the general population may be due to the link between ADHD and offending (Angström et al., 2024; Anns et al., 2023) and offenders having a specific profile in terms of ADHD, although uncertainty remains about the causal nature of this relationship (Tully, 2022).…”

“…Attention‐deficit hyperactivity disorder (ADHD) is a childhood‐onset neurodevelopmental disorder that frequently persists into adulthood (Faraone et al., 2024) and is associated with a wide range of adverse outcomes, including offending (Angström et al., 2024; Anns et al., 2023). Therefore, people with ADHD are thought to be overrepresented in the criminal justice system, although prevalence estimates vary widely.…”