The Delinquency Outcomes of Boys with ADHD with and Without Comorbidity

Abstract

This study examined the association between childhood ADHD and juvenile delinquency by examining data from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of individuals diagnosed with ADHD in childhood (ages 5-12) and recontacted in adolescence and young adulthood for yearly follow-up (age at first follow-up interview M= 17. 26, SD=3.17). Participants were 288 males with childhood ADHD and 209 demographically similar males without ADHD who were recruited into the follow-up study. Delinquency information gathered yearly during the second through eighth follow-up provided a comprehensive history of juvenile delinquency for all participants. Four childhood diagnostic groups [ADHD-only (N=47), ADHD +ODD (N=135), ADHD+CD (N=106), and comparison (N=209)] were used to examine group differences on delinquency outcomes. Analyses were conducted across three dimensions of delinquency (i.e., severity, age of initiation, and variety). Individuals with childhood ADHD+CD displayed significantly worse delinquency outcomes than the other three groups, across almost all indices of offending. When compared to comparison participants, boys with ADHD-only and ADHD+ODD in childhood displayed earlier ages of delinquency initiation, a greater variety of offending, and higher prevalence of severe delinquency. These findings suggest that although childhood ADHD+CD creates the greatest risk for delinquency, boys with ADHD-only and ADHD+ODD also appear at a higher risk for later offending. The patterns of offending that emerged from the PALS are discussed in the context of the relationship between ADHD, comorbidity, and delinquency. Keywords ADHD; Delinquency; Conduct DisorderEvery year thousands of individuals fall victim to criminal acts committed by juveniles in the United States. In 2006, 19.1% of property crimes and 12.1% of violent crimes involved only juveniles (U.S. Department of Justice, 2007). The young individuals who commit these crimes are at a high risk of continuing this criminality into adulthood (Loeber, 1982;Moffitt, Caspi, Harrington, & Milne, 2002), which also incurs a high economic cost to society. By one estimate, a lifetime criminal costs the public between $1.3 million and $1. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript (Cohen, 1998). In addition to the increased risk of adult criminality, delinquent adolescents are also more likely to experience multiple negative personal outcomes in adulthood, ranging from substance abuse to work-related problems (Loeber, Stouthamer-Loeber, & White, 1999;Moffitt et al., 2002).Given the gravity of juvenile offending, much attention has been directed toward identifying developmental pathways to serious delinquency in order to identify children who are most at risk for this costly outcome. Although minor delinquency appears to be somewhat normative and transient in adolescence, a subset of offenders display a pattern of severe and persistent offending that begins in childhood (Loeber, 1988;Moffitt 1993;2003). These individuals ...

Attention-deficit hyperactivity disorder (ADHD), substance use disorders, and criminality: a difficult problem with complex solutions

“…Impulsivity appears to be the best predictor for the presence of CD among ADHD adolescents, with minor contributions from sensation seeking and other ADHD symptoms (67). ADHD and CD constitute a relevant association as it has been related with poor social functioning and the highest risk for delinquency outcomes (26,58,79,(82)(83)(84). In service sectors (which include the juvenile justice system), the public costs for adolescents with the ADHD-CD phenotype have been estimated to double the costs of those with ADHD alone (85).…”

“…It has also been proposed that ADHD, in the absence of a comorbid CD, is not associated with higher rates of either criminal behavior (22,23,(86)(87)(88)(89) or recidivism (90,91). However, several studies have reported that ADHD, when controlling for early aggressive behavior, ODD, CD, antisocial personality disorder, or other psychiatric comorbidities, is still a potential risk factor for delinquency and criminal offences (24,48,71,84,(92)(93)(94). Gudjonsson et al (25) recently estimated that ADHD contribution to the variance in nonviolent and violent delinquency among 11,388 young (16-24 years old) students was 8.2% and 8.8%, respectively, but these effects were almost completely mediated by the presence of peer delinquency and comorbidities, particularly CD and SUD.…”

Towards a functional model of mental disorders incorporating the laws of thermodynamics

“…26,27 In the context of this research and applying the model proposed in the current paper, people with ADHD can firstly be considered to be experiencing ill health in that they have areas of poor adaptive functioning, commonly expressed as impairments in academic performance and social relationships, 22,28 and later antisocial and delinquent behaviour. 29 This ill health can be considered to result from a lack of homeostasis at various points in the system, as illustrated by the work of Wåhlstedt et al 25 In this context problems with capacity can be viewed as the range of neuropsychological and cognitive impairments demonstrated by children and adults with ADHD both through standardised neuropsychological testing and through measures of academic achievement at school. 30 These impairments in capacity are likely to interfere with efficient energy transfer, as limited capacity in areas such as cognitive attention, executive functioning, 31 and specifically poor behavioural and response inhibition 32 are expressed as fidgeting, inattention, distraction, shouting out and other behaviours that are seen as disruptive in classroom and other settings.…”

Effects of Methylphenidate on Acute Math Performance in Children with Attention-Deficit Hyperactivity Disorder

“…11 Comorbid disorders affect the psychosocial functioning of children with ADHD and increase their risk of developing delinquent behaviours. 12 Three different subtypes of ADHD exist: the predominantly inattentive, hyperactive-impulsive, or combined. The combined subtype is most prevalent in clinical studies, but population-based studies noted that the inattentive subtype is more common.…”