Attention Deficit Hyperactivity Disorder (ADHD) among longer-term prison inmates is a prevalent, persistent and disabling disorder

<p>Abstract</p> <p>Background</p> <p>ADHD is a common and disabling disorder, with an increased risk for coexisting disorders, substance abuse and delinquency. In the present study, we aimed at exploring ADHD and criminality. We estimated the prevalence of ADHD among longer-term prison inmates, described symptoms and cognitive functioning, and compared findings with ADHD among psychiatric outpatients and healthy controls.</p> <p>Methods</p> <p>At Norrtälje Prison, we approached 315 male inmates for screening of childhood ADHD by the Wender Utah Rating Scale (WURS-25) and for present ADHD by the Adult ADHD Self-Report Screener (ASRS-Screener). The response rate was 62%. Further, we assessed 34 inmates for ADHD and coexisting disorders. Finally, we compared findings with 20 adult males with ADHD, assessed at a psychiatric outpatient clinic and 18 healthy controls.</p> <p>Results</p> <p>The estimated prevalence of adult ADHD among longer-term inmates was 40%. Only 2 out of 30 prison inmates confirmed with ADHD had received a diagnosis of ADHD during childhood, despite most needed health services and educational support. All subjects reported lifetime substance use disorder (SUD) where amphetamine was the most common drug. Mood and anxiety disorders were present among half of subjects; autism spectrum disorder (ASD) among one fourth and psychopathy among one tenth. Personality disorders were common; almost all inmates presented conduct disorder (CD) before antisocial personality disorder (APD). Prison inmates reported more ADHD symptoms during both childhood and adulthood, compared with ADHD psychiatric outpatients. Further, analysis of executive functions after controlling for IQ showed both ADHD groups performed poorer than controls on working memory tests. Besides, on a continuous performance test, the ADHD prison group displayed poorer results compared with both other groups.</p> <p>Conclusions</p> <p>This study suggested ADHD to be present among 40% of adult male longer-term prison inmates. Further, ADHD and coexisting disorders, such as SUD, ASD, personality disorders, mood- and anxiety disorders, severely affected prison inmates with ADHD. Besides, inmates showed poorer executive functions also when controlling for estimated IQ compared with ADHD among psychiatric outpatients and controls. Our findings imply the need for considering these severities when designing treatment programmes for prison inmates with ADHD.</p

The Development of Criminal Style in Adolescence and Young Adulthood: Separating the Lemmings from the Loners

Despite broad consensus that most juvenile crimes are committed with peers, many questions regarding developmental and individual differences in criminal style (i.e., co-offending vs. solo offending) remain unanswered. Using prospective 3-year longitudinal data from 937 14- to 17-year-old serious male offenders, the present study investigates whether youths tend to offend alone, in groups, or a combination of the two; whether these patterns change with age; and whether youths who engage in a particular style share distinguishing characteristics. Trajectory analyses examining criminal styles over age revealed that, while most youth evinced both types of offending, two distinct groups emerged: an increasingly solo offender trajectory (83%); and a mixed style offender trajectory (17%). Alternate analyses revealed (5.5%) exclusively solo offenders (i.e., only committed solo offenses over 3 years). There were no significant differences between groups in individuals’ reported number of friends, quality of friendships, or extraversion. However, the increasingly solo and exclusively solo offenders reported more psychosocial maturity, lower rates of anxiety, fewer psychopathic traits, less gang involvement and less self reported offending than mixed style offenders. Findings suggest that increasingly and exclusively solo offenders are not loners, as they are sometimes portrayed, and that exclusively solo offending during adolescence, while rare and previously misunderstood, may not be a risk factor in and of itself

How Distinctive are ADHD and RD? Results of a Double Dissociation Study

The nature of the comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and Reading Disability (RD) was examined using a double dissociation design. Children were between 8 and 12 years of age and entered into four groups: ADHD only (n = 24), ADHD+RD (n = 29), RD only (n = 41) and normal controls (n = 26). In total, 120 children participated in the study; 38 girls and 82 boys. Both ADHD and RD were associated with impairments in inhibition and lexical decision, although inhibition and lexical decision were more severely impaired in RD than in ADHD. Visuospatial working memory deficits were specific to children with only ADHD. It is concluded that there was overlap on lexical decision and to a lesser extent on inhibition between ADHD and RD. In ADHD, impairments were dependent on IQ, which suggest that the overlap in lexical decision and inhibition is different in origin for ADHD and RD. The ADHD only group was specifically characterized by deficits in visuospatial working memory. Hence, no double dissociation between ADHD and RD was found on executive functioning and lexical decision

Inhibition, Reinforcement Sensitivity and Temporal Information Processing in ADHD and ADHD+ODD: Evidence of a Separate Entity?

This study compared children with ADHD-only, ADHD+ODD and normal controls (age 8–12) on three key neurocognitive functions: response inhibition, reinforcement sensitivity, and temporal information processing. The goal was twofold: (a) to investigate neurocognitive impairments in children with ADHD-only and children with ADHD+ODD, and (b) to test whether ADHD+ODD is a more severe from of ADHD in terms of neurocognitive performance. In Experiment 1, inhibition abilities were measured using the Stop Task. In Experiment 2, reinforcement sensitivity and temporal information processing abilities were measured using a Timing Task with both a reward and penalty condition. Compared to controls, children with ADHD-only demonstrated impaired inhibitory control, showed more time underestimations, and showed performance deterioration in the face of reward and penalty. Children with ADHD+ODD performed in-between children with ADHD-only and controls in terms of inhibitory controls and the tendency to underestimate time, but were more impaired than controls and children with ADHD-only in terms of timing variability. In the face of reward and penalty children with ADHD+ODD improved their performance compared to a neutral condition, in contrast to children with ADHD-only. In the face of reward, the performance improvement in the ADHD+ODD group was disproportionally larger than that of controls. Taken together the findings suggest that, in terms of neurocognitive functioning, comorbid ADHD+ODD is a substantial different entity than ADHD-only

Extending the Construct of Psychopathy to Youth: Implications for Understanding, Diagnosing, and Treating Antisocial Children and Adolescents

This paper reviews several attempts to extend the construct of psychopathy to children and adolescents. The research suggests that the presence of callous-unemotional (CU) traits may be particularly important. Specifically, the presence of these traits designates a clinically important subgroup of youth with childhood-onset conduct problems who show a particularly severe, aggressive, and stable pattern of antisocial behaviour. Also, children with CU traits show numerous emotional, cognitive, and personality features that are distinct from other antisocial youth that are similar to features found in adults with psychopathy. The research on CU traits has important implications for understanding the different causal pathways through which children develop severe antisocial and aggressive behaviour, as well as implications for diagnosing and intervening with antisocial youth