21-45% of criminals in prison have ADHD 15 clinical studies from peer reviewed journals show that I list below. Only 8% of children and 5% of adults have ADHD.

If people with ADHD are 4 to 9 times more likely to commit crimes and go to jail than non ADDers, shouldn’t every court screen for ADHD and offer diagnosis and proper treatment? The UK screens all prisoner for ADHD why don’t we? Pay to diagnose and treat ADHD now (cheap), or pay exponentially more later for crime costs and expensive jails. Costs $101,000 a year to keep a prisoner in a Canadian jail.

In this post I’ll do 3 things:

1. Go over the background of ADHD, crime and prison.

2. Show statistics on people with ADHD who are in prison and arrests.

3. Give excerpts of abstracts of 15 clinical studies from peer reviewed journals.

4. Ask you to do something.

1. Background of ADHD, Crime and Prison:

They don’t screen for ADHD in prisons in Canada, or in the vast majority jails in the US (they might in some places I’m not sure). In the UK, police, courts and prisons tests all adult offenders for attention deficit disorder in a bid to reduce re-offending rates and cut aggressive behaviour in prisons.

Research revealed a disproportionately high number of undiagnosed and untreated sufferers in the criminal justice system. “We know that conditions like attention deficit hyperactivity disorder can contribute to people turning to crime,” said UK health minister Phil Hope. “We are concerned that ADHD is not understood well enough in the criminal justice system so cases go unnoticed.

Most people with ADHD do not commit crimes or go to jail. There are billionaires that attribute their success to ADHD,  many entrepreneurs have ADHD, there’s a MENSA ADHD special interest group with 600+ members, I’ve coached many successful adults with ADHD including police officers.

When ADHD is ignored, ADDers are more likely to accumulate comorbid or co-existing conditions. I.e., depression, anxiety, bipolar, learning disabilities, OCD, PTSD, huge rates of drug and alcohol addiction, gambling, eating disorders, oppositional defiant disorder, conduct disorder, antisocial personality disorder etc.

80% of adults with ADHD don’t know they have it. Some will self medicate with negative methods; drugs, alcohol, gambling, high risk activities, conflict and violence. vs positive methods.

Please tell your politicians, police and media about these studies. and ask them to start training doctors to diagnose and treat ADHD in children, teens and adults, and run anti stigma and ADHD education campaigns and start screening them in prison like the UK does.

Read ADHD and the Criminal Justice System Spinning out of Control

2. Statistics On People With ADHD Who Are In Prison And Arrests

These are taken from the abstracts of 15 clinical studies on ADHD, crime and jail from peer reviewed journals

I’ll cover these topics:

• Numbers of people with ADHD in jail

• Rates of arrests and types of crime

• Teens with ADHD in Jail and comorbidities / co-existing conditions

• Comorbidities / co-existing conditions of adult ADHD inmates

• Some reasons why people with ADHD commit crimes

• ADHD medications and crime- inverse correlation

• Some reasons why people with ADHD commit crimes

Numbers of people with ADHD in jail

• 46% of female prisoners in Rhode Island met criteria for childhood ADHD.

• Swedish study showed 40% of adult male longer-term prison inmates had ADHD.
• The overall prevalence of ADHD in young male prisoners according to DSM-IV was 45%

• Half of the male prisoners in Iceland (50%) were found on screening to have met criteria for ADHD in childhood

• Studies show that at least 25% of prisoners in the United States have ADHD.

• Diagnosable ADHD was found to occur in 25.5% of the adult male inmates, and major depression occurred in 25.5 % of the inmates. A significant relationship between ADHD and depression was found to exist.

Rates of arrests and types of crime

• Follow up study using arrest records showed significantly more people with ADHD than comparisons had been arrested (47% vs. 24%), convicted (42% vs. 14%), and incarcerated (15% vs. 1%).

• Follow up study using arrest records showed people with ADHD had significantly higher rates of felonies and aggressive offenses than non adders

• The ADHD symptomatic group had significantly higher rates of total, acquisitive and violent offending than other prisoners, as well as greater regular heroin use.

• For violent offending, ADHD symptoms were the strongest predictor followed by alcohol dependence.

• Hyperactive subjects had significantly higher juvenile (46% versus 11%) and adult (21% versus 1%) arrest rates. Juvenile and adult incarceration rates were also significantly higher. Childhood conduct problems predicted later criminality,

Teens with ADHD in Jail and comorbidities / co-existing conditions

• Only 2 out of 30 Swedish prison inmates confirmed with ADHD had received a diagnosis of ADHD during childhood

• Addicted delinquents with ADHD showed worse social environment and a higher degree of psychopathology, including externalizing and internalizing behavior, compared to addicted delinquents without ADHD.

• Hyperactive children are at risk for both juvenile and adult criminality. The risk for becoming an adult offender is associated with conduct problems in childhood and serious antisocial behavior (repeat offending) in adolescence.

• Children with impulsive ADHD were more likely to commit impulsive crimes such as theft. Children with inattentive ADHD were more likely to engage in premeditated crimes, such as burglary and selling drugs.

• Significant increase of emotional and internalizing problems in the ADHD group compared to delinquents without ADHD or ADHD history. ADHD delinquents scored higher on the personality dimension neuroticism, and showed lower scores on the dimensions agreeableness and consciousness

• Follow up study using arrest records showed the development of an antisocial or substance use disorder in adolescence completely explained the increased risk for subsequent criminality for ADHD inmates

• Even in the absence of comorbid conduct disorder in childhood, ADHD increases the risk for developing antisocial and substance use disorders in adolescence, which, in turn, increases the risk for criminal behavior in adolescence and adulthood.

Comorbidities / co-existing conditions of adult ADHD inmates

• Women with ADHD were more likely to be inconsistently employed, recently homeless, lifetime incarceration of more than 90 days, current smokers and ever used marijuana regularly

• Offenders with ADHD were more likely to report problems with emotional and social functioning and to have higher suicide risk scores

• Offenders with ADHD had higher rates of mood, anxiety, psychotic, somatoform, antisocial and borderline personality disorders

• The results support prior findings of high ADHD prevalence in prison inmates and suggest that emotional and internalizing abnormalities are prominent problems in this population.

Some reasons why people with ADHD commit crimes

• It also appears that when individuals with ADHD commit violent crimes, these acts are more likely to be crimes of spontaneous and “reactive” aggression rather than carefully plotted out offenses. Such crimes are generally impulsive acts driven by a provocation or conflict that triggers an outburst.

• Those with ADHD also have other triggers for crimes; adolescents and adults with untreated ADHD are often bored, sensation seeking, or simply impulsive, and this combination of attributes leads them to react with poor judgment. A desired item appears, they want it, so they take it

• Children with ADHD are struggling with chronic symptoms of inattention, distractibility, hyperactivity, and impulsivity and frequently do not realize this satisfaction. They can become alienated or friendless, and to avoid this outcome, they learn that outlandish behavior can earn them the respect of their peers. To them, negative attention is more desirable than no attention whatsoever, and befriending “bad kids” is preferable to having no friends.

ADHD medications and crime- inverse correlation

• The researchers compared the rates of prescriptions for these psychiatric medications to rates of violent crimes in the United States from 1997-2004 with a statistical regression analysis.[4] They found a significant inverse correlation; that is, as prescriptions went up, violent crimes came down

• The researchers stated, “Our evidence suggests that, in particular, sales of new-generation antidepressants and stimulants used to treat ADHD are negatively associated with rates of violent crime.”

Recommendations

• The results underline the need of adequate therapeutic programs for addicted young prison inmates considering ADHD comorbidity, which is associated with additional psychopathology and social problems.

• Prisoners should routinely undergo screening for ADHD in order to identify those who would benefit from a comprehensive assessment to determine who may have ADHD and associated problems.

• ADHD’s presence should alert prison staff that the offender is likely to require more intensive mental health services.

• The study recommended extensive school intervention programs for children with ADHD

• Development of such intervention programs and evaluating them for efficiency could be dollars well spent in terms of crime and drug abuse averted.

• There is an urgent need to treat drug addiction and ADHD symptoms in order to reduce offending among the most persistent offenders. Recently, treatment programmes have been developed for adults with ADHD, heroin and crack cocaine addiction which can be applied to this population.

• ADHD is a significant factor relating to both crime and punishment. The condition increases the risk of committing a crime, and once the individual is incarcerated, the conundrum develops regarding appropriate treatment. Evidence suggests that proper treatment may reduce the risk for criminal behavior and the rate of recidivism among afflicted criminals.

• it is important for psychiatrists to consider ADHD as a valid factor in crime and the treatment of ADHD as a potentially preventive measure against the commission of violent and nonviolent criminal acts. Resolving or improving ADHD symptoms can bring relief to the individual as well as to society at large.

3. Excerpts from Abstracts of 15 Clinical Studies from Peer Reviewed Journals Documenting the Links Between ADHD, Crime and Jail

1. Swedish study showed 40% of adult male longer-term prison inmates had ADHD.

BMC Psychiatry. 2010; 10: 112.
Ylva Ginsberg, Tatja Hirvikoski, and Nils Lindefors

ADHD among longer-term prison inmates is a prevalent, persistent and disabling disorder

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.

Our findings imply the need for considering these severities when designing treatment programmes for prison inmates with ADHD

2. Childhood attention deficit hyperactivity disorder, substance use, and adult functioning among incarcerated women.

J Atten Disord. 2010 Nov;14(3):273-80. Epub 2009 Sep 22.
Hennessey KA, Stein MD, Rosengard C, Rose JS, Clarke JG.
Rhode Island Hospital, USA.

OBJECTIVE: To estimate prevalence of childhood ADHD among incarcerated women and determine its association with substance use and adult functioning.

METHOD: 192 female participants are recruited from the Department of Corrections in Rhode Island. Childhood ADHD is defined as scoring >46 on the Wender Utah Rating Scale.

RESULTS: The findings reveal that 46% met criteria for childhood ADHD. Multivariate analysis reveal that women meeting WURS criteria were more likely to be inconsistently employed (OR = 0.23, 95% CI = 0.10-0.54), recently homeless (OR = 2.09, 95% CI = 1.02-4.30), lifetime incarceration of more than 90 days (OR = 3.00, 95% CI = 1.37-6.57), current smokers (OR = 2.99, 95% CI = 1.24-7.20), and ever used marijuana regularly (OR = 3.47, 95% CI = 1.61-7.45).

CONCLUSION: Among incarcerated women, childhood ADHD is associated with negative social and health behaviors.

3.  Attention Deficit Hyperactivity Disorder in Men and Women Newly Committed to Prison
Clinical Characteristics, Psychiatric Comorbidity, and Quality of Life

Int J Offender Ther Comp Criminol June 2010 vol. 54 no. 3 361-377
Patricia Westmoreland, Iowa Department of Corrections, Oakdale, Tracy Gunter, Peggy Loveless, Jeff Allen, Bruce Sieleni, Donald W. Black University of Iowa, Iowa City, email hidden; JavaScript is required

Attention deficit hyperactivity disorder (ADHD) is associated with comorbid psychiatric diagnoses and antisocial behaviors that contribute to criminality, yet studies of ADHD in offenders are few. The authors evaluate a random sample of 319 offenders using a version of the Mini International Neuropsychiatric Interview and Medical Outcome Survey Health Survey.

ADHD was present in 68 subjects (21.3%). Offenders with ADHD were more likely to report problems with emotional and social functioning and to have higher suicide risk scores (p < .001). They also had higher rates of mood, anxiety, psychotic, and somatoform disorders. Antisocial and borderline personality disorders were also more common among offenders with ADHD.

The authors conclude that ADHD is common in offenders and is associated with comorbid disorders, worse quality of life, and higher risk for suicidal behaviors. Its presence should alert prison staff that the offender is likely to require more intensive mental health services.

4. Drug addiction in young prison inmates with and without attention deficit hyperactivity disorder

Fortschr Neurol Psychiatr. 2007 May;75(5):285-92. Epub 2006 Jan 4
Retz W, Retz-Junginger P, Schneider M, Scherk H, Hengesch G, Rösler M.
Institut für Gerichtliche Psychologie und Psychiatrie der Universität des Saarlandes, Homburg/Saar. email hidden; JavaScript is required

Prospective studies of children with ADHD have shown a high level of substance use disorder comorbidity, particularly when associated with social maladaptation and antisocial behavior. Conversely, studies of drug abusing participants and delinquents revealed a high prevalence of ADHD comorbidity. In this study 129 young male prison inmates were systematically examined for ADHD and substance use disorders. 64,3 % showed harmful alcohol consumption. 67,4 % fulfilled DSM-IV criteria for any drug abuse or dependence. 28,8 % of these participants were diagnosed with ADHD, combined type, other 52,1 % showed ADHD residual type. Opioid dependence was more common in delinquents without ADHD.

Addicted delinquents with ADHD showed worse social environment and a higher degree of psychopathology, including externalizing and internalizing behavior, compared to addicted delinquents without ADHD. Neuroticism and conscientiousness ratings of the addicted ADHD group, but not of those without ADHD, differed from non-addicted delinquents.

The results underline the need of adequate therapeutic programs for addicted young prison inmates considering ADHD comorbidity, which is associated with additional psychopathology and social problems.

5. Screening for attention-deficit hyperactivity disorder and co-morbid mental disorders among prison inmates.

Nord J Psychiatry. 2009 Feb 26:1-7. [Epub ahead of print]
Einarsson E, Sigurdsson JF, Gudjonsson GH, Newton AK, Bragason OO.
Department of Psychology, University of Aarhus, Aarhus, Denmark.

Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder, which is associated with a number of psychiatric conditions, mostly personality disorder, substance misuse, anxiety and depression. The aim of the present study was to investigate the relationship between ADHD symptoms and associated psychiatric conditions among prisoners. The participants were 90 male prisoners in Iceland who were assessed within 10 days of admission to the prison. The Mini International Neuropsychiatric Interview (MINI) and the Standardised Assessment of Personality-Abbreviated Scale (SAPAS) were administered. Childhood ADHD symptoms were screened by the Wender-Utah Rating Scale and current adult symptoms by the DSM-IV Checklist for ADHD.

Half of the prisoners (50%) were found on screening to have met criteria for ADHD in childhood and of those over half (60%) were either fully symptomatic or in partial remission of their symptoms. A logistic regression analysis revealed that the MINI Antisocial Personality Disorder scale was the single best predictor of current ADHD symptoms. Many prisoners are either fully symptomatic or in partial remission of their ADHD symptoms and have serious co-morbid problems, primarily associated with antisocial personality disorder and substance dependence.

Prisoners should routinely undergo screening for ADHD in order to identify those who would benefit from a comprehensive assessment to determine who may have ADHD and associated problems.

6. Lifetime criminality among boys with attention deficit hyperactivity disorder: a prospective follow-up study into adulthood using official arrest records.

Psychiatry Res. 2008 Sep 30;160(3):237-46. Epub 2008 Aug 15.
Mannuzza S, Klein RG, Moulton JL 3rd.
New York University Child Study Center, Department of Child and Adolescent Psychiatry, NYU School of Medicine, New York, NY 10016, USA. email hidden; JavaScript is required

This study investigates the relationship between childhood attention deficit hyperactivity disorder (ADHD) and later criminality. White boys (n=207, ages 6-12) with ADHD, free of conduct disorder, were assessed at ages 18 and 25 by clinicians who were blind to childhood status. A non-ADHD group served as comparisons. Lifetime arrest records were obtained when subjects were 38 years old for subjects who resided in New York State throughout the follow-up interval (93 probands, 93 comparisons).

Significantly more ADHD probands than comparisons had been arrested (47% vs. 24%), convicted (42% vs. 14%), and incarcerated (15% vs. 1%). Rates of felonies and aggressive offenses also were significantly higher among probands.

Importantly, the development of an antisocial or substance use disorder in adolescence completely explained the increased risk for subsequent criminality.

Results suggest that even in the absence of comorbid conduct disorder in childhood, ADHD increases the risk for developing antisocial and substance use disorders in adolescence, which, in turn, increases the risk for criminal behavior in adolescence and adulthood.

7. A prospective study of hyperactive boys with conduct problems and normal boys: adolescent and adult criminality.

J Am Acad Child Adolesc Psychiatry. 1997 Dec;36(12):1726-35.
Satterfield JH, Schell A.
Department of Psychiatry, Oregon Health Sciences University, Portland, USA.

OBJECTIVE: To examine the relationship between attention deficit disorder with hyperactivity in childhood and criminality in adolescence and adulthood in 89 hyperactive and 87 normal control subjects.

METHOD: In this prospective study, adolescent follow-up intervals ranged from 13 to 21 years and adult follow-up ranged from 18 to 23 years. The official arrest records for all subjects were obtained.

RESULTS: Hyperactive subjects had significantly higher juvenile (46% versus 11%) and adult (21% versus 1%) arrest rates. Juvenile and adult incarceration rates were also significantly higher. Childhood conduct problems predicted later criminality, and serious antisocial behavior in adolescence predicted adult criminality.

CONCLUSIONS: Hyperactive children are at risk for both juvenile and adult criminality. The risk for becoming an adult offender is associated with conduct problems in childhood and serious antisocial behavior (repeat offending) in adolescence. Hyperactive children who do not have conduct problems are not at increased risk for later criminality

8. Children with ADHD were twice as likely as their peers to commit robbery in adulthood and were 50 percent more likely to sell drugs

PubMed version

J Ment Health Policy Econ. 2009 Sep;12(3):119-38.
Fletcher J, Wolfe B.
Yale University, School of Public Health, 60 College Street # 303, New Haven, CT 06520, USA. email hidden; JavaScript is required

After controlling for race, education and income level, certain types of crime were linked to particular symptoms of ADHD in children ages 5 to 12.

The type of crime committed depended on whether the child was diagnosed with impulsive ADHD, inattentive ADHD or a combination of the two. Children with impulsive ADHD were more likely to commit impulsive crimes such as theft. Children with inattentive ADHD were more likely to engage in premeditated crimes, such as burglary and selling drugs. Children with both impulsive and inattentive ADHD were less likely to commit crimes compared to children with the other subtypes.

The study recommended extensive school intervention programs for children with ADHD, who not only tend to perform worse in school but also leave school earlier than their peers.

Implications: Our results suggest that children showing ADHD symptoms should be viewed as a group at high risk of poor outcomes as young adults. As such, a good case can be made for targeting intervention programs on this group of children and conducting evaluations to learn if such interventions are effective in reducing the probability that these children commit a crime. Development of such intervention programs and evaluating them for efficiency could be dollars well spent in terms of crime and drug abuse averted.

9. Prevalence of attention deficit-/hyperactivity disorder (ADHD) and comorbid disorders in young male prison inmates.

Eur Arch Psychiatry Clin Neurosci. 2004 Dec;254(6):365-71. Epub 2004 Nov 12.
Rösler M, Retz W, Retz-Junginger P, Hengesch G, Schneider M, Supprian T, Schwitzgebel P, Pinhard K, Dovi-Akue N, Wender P, Thome J.
Institut für Gerichtliche Psychologie und Psychiatrie, Neurozentrum, Universitätskliniken des Saarlandes, 66421 Homburg/Saar, Germany. email hidden; JavaScript is required

METHOD: We investigated 129 prison inmates (mean age+/-SE: 19.2+/-2.0 years) and 54 healthy male control subjects (mean age+/-SE: 22.2+/-3.12 years) for the presence of adult ADHD using the Wender Utah Rating Scale (WURS), the Eysenck Impulsivity Questionnaire (EIQ), the diagnostic criteria for ADHD according to DSM-IV and ICD-10-research criteria and the Utah criteria for adult ADHD. In order to determine comorbid personality disorders we applied the International Personality Disorder Examination (IPDE). Externalization (ED) and Internalization Disorders (ID) were evaluated by means of the Achenbach Scales. Alcoholism (ALC) was examined via the Alcohol Use Disorder Test (AUDIT) and substance use disorder (SUD) has been investigated with the Structured Clinical Interview for DSM-IV (SCID).

RESULTS: The overall prevalence of ADHD according to DSM-IV was 45%. The prevalence of disturbance of activity and attention (DAA) and hyperkinetic conduct disorder (HCD) via the ICD-10 research criteria was 21.7%. Sole DAA without any comorbid condition could be detected in one case. The most common diagnostic combinations were DAA/HCD and SUD/ALC (89% of all DAA/HCD cases).

CONCLUSION: The prevalence of DAA/HCD or ADHD in young adult prison inmates is significantly elevated when compared to nondelinquent controls. Generally the population of young adult male prison inmates exhibits a considerable psychiatric morbidity. Of the total sample, 64% suffered from at least 2 disorders. Only 8.5% had no psychiatric diagnoses. This indicates the urgent need for more psychiatric expertise in young offender facilities.

10. An epidemiological study of ADHD and major depression in a male prison population.

Bull Am Acad Psychiatry Law. 1994;22(2):181-93.
Eyestone LL, Howell RJ.
Brigham Young University, Provo, Utah 84602.

One hundred two inmates were interviewed and tested to determine epidemiological rates of ADHD and depression in an adult male prison population. The Beck Depression Inventory, Hamilton Rating Scale, and four measures to assess childhood and adult ADHD were completed. The two disorders were diagnosed independently.

Diagnosable ADHD was found to occur in 25.5 percent of the inmates, and major depression occurred in 25.5 percent of the inmates. A significant relationship between ADHD and depression was found to exist (p < .001). Having identified a major mental health problem in the prison population, implications include a need for further diagnosis and treatment of these disorders within a prison setting. The relationship between depression and ADHD also needs further examination.

11. Predictors of offending among prisoners: the role of attention-deficit hyperactivity disorder and substance use.

J Psychopharmacol. 2010 Jun 17. [Epub ahead of print]
Young S, Wells J, Gudjonsson G.
King’s College London, Institute of Psychiatry.

The aim of the study was to investigate predictors of offending among prisoners from official records after controlling for age at first conviction and antisocial personality disorder. The participants were 198 Scottish prisoners, who had completed Diagnostic Statistical Manual IV screens for child and adult attention-deficit hyperactivity disorder (ADHD) symptoms and the Millon Clinical Multiaxial Inventory III for Axis I and Axis II disorders.

The ADHD symptomatic group had significantly higher rates of total, acquisitive and violent offending than other prisoners, as well as greater regular heroin use. Hierarchical multiple regressions, using child and adult symptoms as dimensions, showed that frequent use of heroin in the year prior to imprisonment was the single most powerful predictor of the extent of total offending, with ADHD symptoms also adding independently to the variance in offending.

In contrast, for violent offending, ADHD symptoms were the strongest predictor followed by alcohol dependence. The findings demonstrate the importance of heroin use and ADHD symptoms in the persistence of offending.

There is an urgent need to treat drug addiction and ADHD symptoms in order to reduce offending among the most persistent offenders. Recently, treatment programmes have been developed for adults with ADHD, heroin and crack cocaine addiction which can be applied to this population.

12. Interrogative suggestibility, compliance and false confessions among prisoners and their relationship with attention deficit hyperactivity disorder (ADHD) symptoms.

Psychol Med. 2008 Jul;38(7):1037-44. Epub 2008 Feb 14.
Gudjonsson GH, Sigurdsson JF, Bragason OO, Newton AK, Einarsson E.
Department of Psychology, Institute of Psychiatry, London, UK. email hidden; JavaScript is required

BACKGROUND: Interrogative suggestibility and compliance are important psychological vulnerabilities during interrogation. The aim of the study was to investigate the relationship of suggestibility and compliance with childhood and current symptoms of attention deficit hyperactivity disorder (ADHD). Compliance has not been studied previously in relation to ADHD. A further aim was to investigate the relationship between ADHD and the reporting of having made a false confession to the police.

METHOD: The participants were 90 male prisoners, all of whom had completed the Gudjonsson Suggestibility and Compliance Scales (GSS and GCS) within 10 days of admission to the prison. Childhood ADHD symptoms were screened by the Wender Utah Rating Scale (WURS) and current adult symptoms by the DSM-IV Checklist criteria for ADHD.

RESULTS: Half of the prisoners (50%) were found on screening to meet criteria for ADHD in childhood and, of those, over half (60%) were either fully symptomatic or in partial remission of their symptoms. ADHD symptoms were found to be significantly associated with compliance, but not with suggestibility. The relationship with compliance was stronger (effect size) in relation to current than childhood symptoms. The ADHD symptomatic groups were significantly more likely to claim that they had made a false confession to the police in the past.

CONCLUSIONS: The findings raise important questions about the potential vulnerability of adults with ADHD symptoms in terms of their ability to cope with interrogation.

13. Psychometric and psychopathological characterization of young male prison inmates with and without attention deficit/hyperactivity disorder.

Eur Arch Psychiatry Clin Neurosci. 2004 Aug;254(4):201-8.
Retz W, Retz-Junginger P, Hengesch G, Schneider M, Thome J, Pajonk FG, Salahi-Disfan A, Rees O, Wender PH, Rösler M.

Regarding WRI and YSR/YASR we found a significant increase of emotional and internalizing problems in the ADHD group compared to delinquents without ADHD or ADHD history. ADHD delinquents scored higher on the personality dimension neuroticism, and showed lower scores on the dimensions agreeableness and consciousness. Using discriminant analysis, high scores on the WRI subscales disorganization and attention difficulties and NEO-FFI neuroticism were the best predictors of ADHD diagnosis.

The results support prior findings of high ADHD prevalence in prison inmates and suggest that emotional and internalizing abnormalities are prominent problems in this population.

Further studies are needed to elucidate the role of ADHD as an independent factor for life-persistent criminality, since specific treatment may help to ameliorate the legal prognosis.

14. ADHD and correctional health care.

J Correct Health Care. 2009 Jan;15(1):5-18. Eme RF.
American School of Professional Psychology, Argosy University, Schaumburg, Illinois 60173, USA. email hidden; JavaScript is required

Two thirds of all felons released from state prisons are rearrested within 3 years. This appalling recidivism rate explains the intense and growing interest on the topic of desistance from crime. Yet, inexplicably, one of the major factors affecting desistance from crime and the recidivism rate has received scant attention. That factor is attention-deficit/hyperactivity disorder (ADHD).

This article establishes the widespread prevalence of ADHD in the prison system and the critical importance of identifying and treating ADHD as an essential component for any best practice models for preventing crime and reducing recidivism.

It also examines the major mechanisms whereby ADHD increases the risk for crime and recidivism.

15. ADHD and Crime: Considering the Connections CME Continuing Medical Education

From MedscapeCME Psychiatry & Mental Health
Joel L. Young, MD
CME Released: 04/12/2010; Valid for credit through 04/12/2011

Those with ADHD also have other triggers for crimes; adolescents and adults with untreated ADHD are often bored, sensation seeking, or simply impulsive, and this combination of attributes leads them to react with poor judgment. A desired item appears, they want it, so they take it.[1]

It also appears that when individuals with ADHD commit violent crimes, these acts are more likely to be crimes of spontaneous and “reactive” aggression rather than carefully plotted out offenses. Such crimes are generally impulsive acts driven by a provocation or conflict that triggers an outburst. Research with adult male offenders seems to bear out this hypothesis.[2]

Studies show that at least 25% of prisoners in the United States have ADHD. The recidivism rate among all felons is high, and an estimated two thirds are rearrested within about 3 years.[3] These statistics have important implications for society at large.

The researchers compared the rates of prescriptions for these psychiatric medications to rates of violent crimes in the United States from 1997-2004 with a statistical regression analysis.[4] They found a significant inverse correlation; that is, as prescriptions went up, violent crimes came down. As a comparison, the authors also looked at the prescription rate of statins for cholesterol treatment and found no relationship between the number of prescriptions for statins and the crime rate.

The researchers stated, “Our evidence suggests that, in particular, sales of new-generation antidepressants and stimulants used to treat ADHD are negatively associated with rates of violent crime.”
In ADHD in Adults: What the Science Says,[5] Russell Barkley and colleagues report on the Milwaukee Study, a longitudinal outcome assessment of crime and other activities of hyperactive children through the life cycle.

Table 1. Crime Categories for Each Group in the Milwaukee Study

	H+ADHD (%) (n=55)	H-ADHD (%) (n=80)	Community (%) (n=73)	P Value
Stole others’ property	74	58	45	.004
Stole others’ money	47	42	28	NS
Robbed someone of money	7	2	1	NS
Breaking and entering	14	15	3	.021
Assaulted with fists	42	33	16	.004
Assaulted with a weapon	29	6	3	< .001
Set fires intentionally	11	9	5	NS
Carried a weapon illegally	40	20	8	< .001
Forced sexual activity	2	0	0	NS
Possessed illegal drugs	67	61	48	NS
Sold drugs illegally	40	27	19	.026
Engaged in disorderly conduct	47	34	24	.022
Arrested	73	52	33	< .001
Jailed	58	46	24	< .001

H+ADHD (%) (n=55)
H-ADHD (%) (n=80)
Community (%) (n=73)

H+ADHD = adults diagnosed with ADHD with hyperactivity as children;
H-ADHD = adults not diagnosed with ADHD until adulthood;
NS = not significant

Adapted from Barkley RA, Murphy KR, Fischer M. ADHD in Adults: What the Science Says. New York, NY: Guilford Press; 2008:313.

A study of 320 prisoners in Iowa found that 14.3% of the female prisoners and 23.1% of the male prisoners met the diagnostic criteria for ADHD.[10]

In an analysis of 110 female offenders with ADHD in a German prison,[11] Rösler and colleagues found a 24.5% lifetime prevalence of ADHD and a 10% prevalence of persistent ADHD. The inmates with ADHD were significantly younger at their first conviction (19.2 years, compared with 27 years for the non-ADHD women). In addition, the rate of diagnosis of ADHD was higher with younger age; for example, the prevalence of ADHD was 17.9% among the female inmates ages 25 and below and fell to just 10% among inmates ages 26-45 years.[11] Why the older inmates were less symptomatic is unclear. Perhaps they were more experienced at dealing with their symptoms.

Children and adolescents derive their self-esteem through succeeding in school and pleasing the adults around them. Children with ADHD are struggling with chronic symptoms of inattention, distractibility, hyperactivity, and impulsivity and frequently do not realize this satisfaction. They can become alienated or friendless, and to avoid this outcome, they learn that outlandish behavior can earn them the respect of their peers. To them, negative attention is more desirable than no attention whatsoever, and befriending “bad kids” is preferable to having no friends.

Punishment for impulsive and criminal actions can begin a cascade of decline. A young offender’s introduction to the juvenile justice system exposes them to increasingly troubled adolescents who can readily offer further education about wayward activities. Preventing this destructive cycle is the fundamental reason for early identification and treatment of this population.

ADHD is a significant factor relating to both crime and punishment. The condition increases the risk of committing a crime, and once the individual is incarcerated, the conundrum develops regarding appropriate treatment. Evidence suggests that proper treatment may reduce the risk for criminal behavior and the rate of recidivism among afflicted criminals.

Coherent approaches to treating youth with ADHD both in and out of the criminal justice system need to be developed. Additional study will further enlighten these difficult issues. For the present, it is important for psychiatrists to consider ADHD as a valid factor in crime and the treatment of ADHD as a potentially preventive measure against the commission of violent and nonviolent criminal acts. Resolving or improving ADHD symptoms can bring relief to the individual as well as to society at large.

4. Ask you to do something

Please tell your politicians of all levels, criminal justice system, healthcare system and the media both mainstream and social media about this clinical research between ADHD, crime, and jail.

Please demand they take stop ignoring ADHD and start committing resources to diagnosing and  treating it, and running anti stigma and education campaigns on ADHD and start screening prisoners for ADHD and diagnosing and treating in prison.

People with ADHD can be very productive or very destructive and expensive members of society. It’s much cheaper to diagnose and treat us than to waste taxpayers dollars warehousing us in expensive jails.

Hopefully the BC Liberals and the BC NDP leadership candidates will read this and respond. Please let them know about this.

The BC Liberal Government closed down the only Adult ADHD clinic in BC, the BC adult ADHD clinic that was added on to the children’s BC ADHD clinic at children’s hospital. George Abbott who is now running for leader of the BC Liberals was the health minister responsible for killing the clinic at the time. Kevin Falcon was later health minister and he never reopened the clinic, Kevin is also running for Leader of the BC Liberals.

The adult clinic quickly became half their case load (more adults with ADHD than children with it) and developed a politically embarassing  year long wait list for an entire year. They asked the govt for money to reduce the wait list and the BC Liberal govt refused, and shut the clinic down and abandoned the patients.

I asked the BC NDP health critic Adrians Dix‘s office to do something about it and just got empty promises and no action at all. Adrian Dix is probably likely to announced he’s running for leadership of the BC NDP soon. The BC NDP are the ones that empties the mental hospitals in BC and said they’d “integrate them into the community”. But they didn’t, and they abandoned them to the predators of Vancouver’s downtown Eastside and homelessness.

Hopefully both parties call to reopen the BC adult ADHD clinic at at Adult hospital in Vancouver (safer from the chance of possible budget cuts/destruction down the road than at a childrens one)

Hopefully they’ll both actually carry out the 8 policy recommendations on ADHD that the BC Medical Association asked for in their white paper on ADHD in BC

The one where they had useful suggestions but underestimated the costs of ADHD to BC taxpayers by billions because they only counted the costs of children with ADHD and ignored the costs of adults with ADHD.

#9. This post is a part of a series where people answer my anonymous survey question. If you have ADHD but haven’t gone public with it, what would it take to you go public with ADHD?

There are risks and rewards for going public with ADHD AND for staying hidden in the ADHD closet. See this post for context on the series.

“I still feel shame about my diagnosis of Adult ADHD. I believe it would harm me at this point to “go public” . I shared my new diagnosis with my family and a few close friends, their reaction and lack of empathy made me realize the negative stigma associated with ADHD. I would go public if I felt it would be viewed as a real medical condition. My family physician had little empathy or understanding of ADHD and how it affects my life. If my physician doesn’t understand, how can I expect my employer or colleagues to understand?”