Attention Deficit Hyperactivity Disorder is one of the most prevalent neurodevelopmental disorder among children and the clinical picture varies with the developmental stage. In pre-school years (3-5 years) the clinical picture is characterized by excessive physical activity, difficulty in cooperation with peers and non-compliance to the recommendations of adults. In school age (6-12 years), apart from the nuclear symptoms of the disorder, as described in the classification systems, i.e. inattention, hyperactivity and impulsivity, oppositional behavior often occurs, conflicts with peers and academic problems. In adolescence hyperactivity lessens, conflicts with parents continue and high risk behaviors often appear. In adults physical activity usually decreases significantly, while inattention and impulsivity still remain. With the passing of time the number of symptoms is usually reduced, however the impact and impairment caused by the disorder remain (Koumoula, 2012).
The long term consequences of ADHD have been explored on different dimensions such as physical growth, cognitive functions, and other mental health problems. The link between ADHD and criminal activities in adolescents and adulthood were also studied by using cross sectional and longitudinal methods and many found a relation with criminal activities. But it is important to explore how the disorder, its symptoms, comorbidities, social and familial adversities affects the relation. This chapter attempted to find the link on these dimensions.
ADHD and Crime
There is growing evidence of an association between ADHD and rule-breaking behaviour and that subjects with ADHD are more likely to be involved in the legal system(Philipp-Wiegmann, Rösler,Clasen,Zinnow, Retz-Junginger, &Retz,2018). Young, González, Mullens, Mutch, Malet-Lambert, & Gudjonsson (2018) reported that 25% of inmates in a prison had a diagnosis of ADHD. Many different types of crimes were reported among individuals with ADHD such as traffic violations and speeding, property theft, carrying a concealed weapon, illegal drug possession, and the rate of performing risky and recidivistic behaviors were also found to be high(Mannuzza&Klein,2000;Biederman,&Faraone,2005;Barkley,Fischer,Smallish,&Fletcher, 2004:Valero,Bosch,Corominas,Barrau,Ramos-Quiroga & Casas,2018).
In a meta-analysis and systematic review of the risks associated with childhood attention-deficit hyperactivity disorder on long-term outcome of arrests, convictions, and incarcerations, Mohr-Jensen & Steinhausen (2016) reported that childhood ADHD was significantly associated with adolescent and adulthood arrests, convictions and incarcerations. Individuals with ADHD had a younger age at onset of antisocial involvement and an increased risk of criminal recidivism. The most frequently committed criminal offenses were theft, assault, drug- and weapon-related crimes. Early antisocial behavior problems, childhood maltreatment, sex, and IQ were identified as potentially relevant predictors for antisocial outcomes. The conclusion was drawn based on a total of 15,442 individuals with childhood ADHD from nine unique samples. The findings support a substantial long-term risk associated with ADHD for later antisocial involvement.
In a fifteen year follow-up study, Philipp-Wiegmann et al. (2018) explored the impact of ADHD on the course of delinquency in a sample of 106 incarcerated young men and reported that offenders with ADHD reoffended 2.5 times faster and showed a higher rate of recidivism and further incarcerations compared to non-ADHD offenders. More or less similar findings were in another study by Román-Ithier, González,Vélez-Pastrana, González-Tejera,& Albizu-García(2017).They found that adult offenders with a history of attention deficit hyperactivity disorder (ADHD) were more likely to re-offend, ADHD was independently associated with being under 15 years of age at first arrest and a number of violent and non-violent offences. Although some associations between ADHD and offending may be accounted for by co-morbidity with substance use disorders, early onset of offending and repeated violent offending appeared to be directly related to ADHD.