Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity and impulsivity. ADHD begins in childhood and often persists into adulthood. Recent studies suggest that ADHD is associated with an increased risk of engaging in criminal behavior.
What is ADHD?
ADHD is considered a neurodevelopmental disorder because it arises during brain development in childhood. Scientists believe that ADHD is caused by an imbalance in brain chemicals called neurotransmitters. The main neurotransmitters implicated in ADHD are dopamine and noradrenaline. Abnormalities in these neurotransmitter systems lead to problems with executive functions like attention, inhibition and impulsivity.
ADHD is categorized into three presentations based on the primary symptoms exhibited:
- Inattentive presentation – difficulty sustaining attention, easily distracted
- Hyperactive/impulsive presentation – excessive restlessness, difficulty controlling impulses
- Combined presentation – all of the above symptoms
ADHD begins in childhood and at least some symptoms persist into adulthood in around 60% of individuals. ADHD in adults can make it difficult to focus at work, manage finances, maintain relationships and control emotions or impulses.
How common is ADHD?
ADHD is one of the most common neurodevelopmental disorders of childhood. The Centers for Disease Control and Prevention (CDC) estimates that 9.4% of children aged 2-17 in the United States have been diagnosed with ADHD as of 2016. Rates of ADHD are rising globally as well.
ADHD is more frequent in males than females, with male-to-female ratios ranging from 2:1 to 3:1. However, there is evidence that ADHD in females is underidentified and that the true gender ratio may be closer to 1:1.
What causes ADHD?
The exact causes of ADHD are not fully understood, but research suggests that both genetics and environmental factors play important roles. ADHD often runs in families, indicating a genetic component.
Some environmental risk factors that have been linked to ADHD include:
- Cigarette smoking and alcohol use during pregnancy
- Premature birth and low birth weight
- Exposure to environmental toxins like lead
- Traumatic brain injury
Ultimately ADHD arises from abnormalities in brain development and neurotransmitter systems. Imaging studies show structural and functional differences in the brains of people with ADHD compared to unaffected individuals.
How is ADHD treated?
Standard treatments for ADHD include medication, behavioral interventions, education and training for parents and teachers. The most common medications used are stimulants like methylphenidate and amphetamines, which boost dopamine signaling in the brain.
Medication is often combined with behavioral therapies aimed at improving organization, time management, emotional control and social skills. Parent training can also help equip caregivers to manage ADHD behaviors using positive reinforcement.
What is the link between ADHD and crime?
Several studies have found that both youth and adults with ADHD are at increased risk for engaging in criminal behavior compared to the general population. Some key findings on ADHD and criminality include:
- Children with ADHD are 2-4 times more likely to be arrested, convicted or incarcerated as adolescents and young adults.
- At least 25% of young offenders have ADHD.
- Adult prisoners have much higher rates of ADHD than the general population.
- ADHD is associated with earlier onset and more persistence of antisocial behavior.
Two large studies found that the relative risk of being arrested, convicted or imprisoned was 1.5 to 3.5 times higher for people with childhood ADHD compared to peers without ADHD, even after controlling for confounding factors like socioeconomic status.
Why is ADHD associated with criminal behavior?
Researchers have proposed several explanations for the link between ADHD and criminality:
Impulsivity and disinhibition
Impulsivity is a core symptom of ADHD. The impulsive behavior and difficulty controlling urges seen in ADHD may predispose individuals to rule-breaking and crimes of impulse like theft, substance abuse or physical aggression.
Poor executive function
ADHD involves deficits in executive functions like working memory, organization and forethought. This makes it difficult for people with ADHD to control their behavior, foresee consequences and learn from punishment or mistakes.
Low dopamine signaling
ADHD involves abnormal dopamine signaling in the brain. Dopamine is a neurotransmitter involved in motivation, reward and addiction. Insufficient dopamine has been associated with increased risk-taking and substance abuse as ways to compensate.
Comorbid conduct disorder
Around 25-40% of youth with ADHD also have conduct disorder, characterized by aggression, deceitfulness and rule-breaking. The combination of ADHD and conduct disorder further increases the risk of criminality.
School failure
Children with ADHD often struggle academically and have higher school dropout rates. This puts them at risk for the ‘school-to-prison pipeline’ and associating with deviant peer groups.
Does treatment reduce criminality risk?
Research suggests that effectively treating ADHD symptoms can reduce the risk of future criminal behavior:
- Medication improves impulse control and reduces rule-breaking behaviors in youth with ADHD.
- Behavioral therapies may improve social and organizational skills.
- Treating ADHD can increase school engagement and achievement.
- Adults with ADHD who are treated with medication are less likely to abuse substances and enter the criminal justice system.
However, some studies show increased risk for substance abuse and arrests during periods of medication discontinuation. This highlights the importance of consistency in managing ADHD across the lifespan.
Prevalence of ADHD in offender populations
Studies have found much higher rates of ADHD in offender populations compared to the general public:
| Population | ADHD Prevalence |
|---|---|
| General adult population | 2.5-4.4% |
| Adult prison inmates | 25-45% |
| Adult jail inmates | 15-25% |
| Juvenile offenders | 11-24% |
The much higher prevalence of ADHD in offender populations compared to general population rates suggests ADHD is a major criminogenic risk factor.
Should ADHD be considered during criminal sentencing?
There is debate around whether a diagnosis of ADHD should be considered a mitigating factor during criminal sentencing. Some arguments include:
Arguments for
- Symptoms like impulsivity reduce culpability.
- Effective treatment can lower recidivism rates.
- Failing to treat ADHD in prison perpetuates risk.
- Ignoring ADHD contributes to ‘school-to-prison pipeline’.
Arguments against
- ADHD alone does not deprive individuals of choice.
- Considering ADHD could lead to lighter sentences for serious crimes.
- Treating all offenders with ADHD as less culpable risks stigma.
- Correctional facilities may lack resources to properly diagnose and treat ADHD.
Ultimately, the role of ADHD in sentencing, corrections and recidivism reduction requires further study and debate around ethics, resources, and potential benefits/risks to society.
Conclusion
In summary, substantial research shows that ADHD is associated with increased risk of criminal and antisocial behaviors across the lifespan. Core ADHD symptoms like impulsivity, poor executive function and low dopamine signaling likely contribute to this risk. Youth and adults with ADHD are overrepresented in offender populations. While effective ADHD treatment may lower criminality risk, there are complex ethical issues around whether ADHD should be considered a mitigating factor. Addressing ADHD could be one strategy for reducing crime and recidivism rates, but much more research is still needed.