PSGY3013: Psychopathy and Serious Offence

ADHD Diagnostic criteria

Persistence into adulthood in more than 50 % (Franke et al., 2018)

A) Persistent pattern of (1) inattention and/or (2) hyperactivity-impulsivity that interferes with functioning or development

B) Several symptoms present before 12 yrs

C) Several symptoms present in 2+ settings

D) Symptoms clearly interfere with functioning

E) Symptoms do NOT occur exclusively during course of schizophrenia/another psychotic disorder and are not better explained by another mental disorder

ADHD Symptoms - Inattention

6 + for at least 6 months (disruptive and inappropriate for developmental level):

Inattention to details, makes careless mistakes.

Often has trouble keeping attention on tasks or play activities.

Often does not seem to listen when spoken to directly.

Often does not follow instructions and fails to finish things.

Often has trouble organizing activities.

Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time.

Often loses things needed for tasks and activities.

Is often easily distracted.

Is often forgetful in daily activities.

What is a symptom of ADHD related to fidgeting?

Often fidgets with hands or feet or squirms in seat.

What is a symptom of ADHD regarding staying seated?

Often gets up from seat when remaining is expected.

What is a symptom of ADHD related to inappropriate climbing or running?

Often runs about/climbs when and where not appropriate.

What is a symptom of ADHD regarding quiet leisure activities?

Often has trouble playing/enjoying leisure activities quietly.

What is a symptom of ADHD that describes being overly active?

Is often 'on the go' or often acts as if 'driven by a motor'.

What is a symptom of ADHD related to excessive talking?

Often talks excessively.

What is a symptom of ADHD regarding answering questions?

Often blurts out answers before questions have been finished.

What is a symptom of ADHD related to waiting one's turn?

Often has trouble waiting one's turn.

What is a symptom of ADHD regarding interrupting others?

Often interrupts or intrudes on others.

What are the three subtypes of ADHD?

Predominantly inattentive, hyperactive-impulsive, and combined presentation.

What percentage of ADHD cases are predominantly inattentive?

20-30% of cases.

What percentage of ADHD cases are hyperactive-impulsive?

15% of cases.

What percentage of ADHD cases are of combined presentation?

50-75% of cases.

What is the estimated prevalence of ADHD in adults in the UK?

3% to 4%.

What is the male to female ratio of ADHD prevalence in the UK?

Approximately 3 to 1.

What are common co-morbidities associated with ADHD?

Low self-esteem, academic and occupational difficulties.

How does ADHD affect school performance and professional success?

They are often impaired in individuals with ADHD.

How does the job turnover in individuals with ADHD compare to those without?

The number of jobs is higher in individuals with ADHD.

Who conducted research linking ADHD and offending in 2011?

Young and Thome

What percentage of youths in the criminal justice system have a childhood history of ADHD?

45%

What percentage of male adults in the criminal justice system have a childhood history of ADHD?

24%

What percentage of individuals with a childhood history of ADHD have persisting symptoms in adulthood?

14%

What are the associations of persisting ADHD symptoms in adulthood?

Younger onset of offending and higher rate of recidivism.

How much more likely are young adults with ADHD to interact with the criminal justice system?

Significantly more likely.

What types of interactions do young adults with ADHD have with the criminal justice system?

Police proceedings, court charges, court convictions, and incarceration.

Which studies support the link between ADHD and interactions with the criminal justice system?

Anns et al., 2023; Fazel & Favril, 2023

What age do individuals with childhood ADHD typically commit their first crime?

Before the age of 15 years.

How much earlier is first police contact for young offenders with childhood ADHD compared to others?

Usually 1 year earlier.

At what average age do individuals with childhood ADHD have their first arrest compared to controls?

16.9 years for ADHD individuals vs 18.2 years for controls.

Which gender with ADHD shows an earlier onset of criminal activities compared to controls?

Men with ADHD.

What is the relationship between childhood ADHD and delinquency onset?

Childhood ADHD is associated with earlier onset of delinquency.

What is the significance of early onset in relation to childhood ADHD and criminal activities?

Early onset is important as it is associated with higher arrest rates.

What is the trend of ADHD rates in offender populations with age?

There are declining rates of ADHD with age in offender populations.

Which populations show an overrepresentation of ADHD according to studies?

Adolescent and young adult offender populations.

What do findings suggest about criminal behavior in ADHD subjects over the lifespan?

Criminal behavior in ADHD subjects might decline with increasing age.

How does ADHD affect road traffic rule violations?

ADHD appears to increase the risk for violations of road traffic rules like speeding, driving after consumption of alcohol, or driving without a license.

What is the prevalence of traffic accidents in individuals with ADHD compared to those without?

Individuals with ADHD have a higher prevalence of traffic accidents compared to individuals without ADHD.

What did the Mohr-Jensen and Steinhausen (2016) meta-analysis conclude about reasons for contact with the justice system?

Assault, theft, drug-related crimes, and possession of weapons were among the most frequent reasons for contact with the justice system.

What study examined the effect of ADHD on critical incidents of aggression in a Scottish prison?

Young et al. (2009) - Scottish Prison Study

What type of measures were used in Young et al. (2009) to assess ADHD and Antisocial Personality Disorder?

Self-report measures

From where were the critical incidents obtained in Young et al. (2009)?

Prison records

What should be considered in the critical appraisal of Young et al. (2009)?

Measures taken and not taken, representativeness of sample, sample size, methodology

What was the sample size of the study conducted by Retz et al. (2004)?

129 young male offenders

How many groups were the participants divided into in Retz et al. (2004)?

Three groups

What were the three groups in Retz et al. (2004)?

Group 1 - Childhood and adult ADHD; Group 2 - Childhood ADHD; no adult ADHD; Group 3 - No ADHD history or current diagnosis

What does CARS stand for in the context of Retz et al. (2004)?

Childhood ADHD related Symptoms

What were some findings related to ADHD in Retz et al. (2004)?

Lower education status, higher unemployment, higher rate of family delinquency

What emotional problems and social characteristics were associated with ADHD in Retz et al. (2004)?

Higher anxiety, depression, and aggressive behaviour

What Big Five personality traits were found to be associated with ADHD in Retz et al. (2004)?

Higher Neuroticism (N), lower Conscientiousness (C) and Agreeableness (A)

Which traits distinguished offenders from controls in the context of ADHD according to Retz et al. (2004)?

Neuroticism (N) and Conscientiousness (C)

What is the relationship between ADHD and delinquent behavior?

ADHD is strongly related to delinquent behavior.

What do meta-analyses indicate about ADHD and delinquency?

Meta-analyses support that ADHD can be an important risk factor for offending.

What is the prevalence of co-morbid disorders in individuals with ADHD?

The prevalence of co-morbid disorders in individuals with ADHD is generally high.

Which co-morbid mental disorders are commonly associated with ADHD?

Common co-morbid mental disorders include conduct disorder and antisocial personality disorder.

How well is the interaction between ADHD and delinquency understood?

The complex interaction between ADHD and delinquency is only partially understood.

What is the association between ADHD medications and offending risk?

The use of ADHD medications is associated with reduced risk of offending (e.g., Chang et al., 2016; Lichtenstein et al., 2012).

What did Boland et al. (2020) find in their literature review regarding ADHD medication?

ADHD medication use is associated with decreased risk of outcomes including motor vehicle crashes and depression.

What are some positive findings associated with ADHD medication use according to Boland et al. (2020)?

ADHD medication use is associated with lowered rates of mood disorders, substance use disorders, criminality, suicidality, traumatic brain injuries, motor vehicle crashes, injuries, and improved academic outcomes.

How is the ADHD medication shortage in the UK affecting people?

The answer is not provided in the original flashcard.

What is Conduct Disorder (CD)?

A type of Disruptive, Impulse-Control and Conduct Disorder.

What are the problems associated with Conduct Disorder?

Problems in the self-control of emotions and behaviors.

What can Conduct Disorder lead to in adulthood?

Antisocial personality disorder.

What is the diagnostic criteria for Conduct Disorder?

A) Repetitive and persistent behaviours that violate the rights of others and/or significantly conflict with age-appropriate societal norms/authority figures

B) Significant impairment in functioning

C) If 18 years+ does not meet criteria for ASPD

Symptoms and Diagnostic Criteria for Conduct Disorder

(A) 3 + for in last 12 months and 1+ in last 6 months

Aggression to People or/and Animals:

1. Bullies, threatens, or intimidates

2. initiates physical fights

3. used a weapon that can cause serious harm

4. physically cruel to people

5. physically cruel to animals

6. stolen while confronting victim

7. forced sexual activity.

Destruction of property:

8. Deliberately set fires

9. deliberately destroyed others' property.

Deceitfulness or theft:

10. Broken into house, building, car

11. lies to obtain goods/favours or avoid obligations

12. stolen non-trivial items without confronting.

Serious violations of rules:

13. Stays out at night before 13 years

14. run away from home overnight 2+ times, or once for lengthy period

15. truant from school, before 13 years.

Childhood-onset and adolescent-onset subtypes:

→ Childhood onset more likely to persist into adulthood (e.g., Fairchild et al., 2019; Loeber, 1991)

→ Unspecified onset: when the age at onset of CD is unknown or insufficient information is available to determine this

What is the estimated worldwide prevalence of Conduct Disorder (CD)?

2-2.5%

What is the prevalence of Conduct Disorder (CD) in boys?

3-4%

What is the prevalence of Conduct Disorder (CD) in girls?

1-2%

What have some studies suggested about the prevalence of Conduct Disorder (CD) over recent decades?

An increase in prevalence

What have other studies suggested about the changes in prevalence of Conduct Disorder (CD) over recent decades?

Minimal changes in prevalence

Did studies in the United States report differences in prevalence of Conduct Disorder (CD) between ethnic groups?

No, differences were accounted for by socio-economic status disparities.

Is there evidence suggesting that the prevalence of Conduct Disorder (CD) differs between countries?

No, there is little evidence of differences despite cultural variations.

What is the prevalence of conduct disorder in youth/juvenile detention facilities in the US?

Between 23% and 87% (Department of Justice, 2006).

What educational outcome is strongly linked with conduct disorder in adolescence?

Poor educational performance.

What social issue is associated with conduct disorder in adolescence?

Social isolation.

What substance-related issue is linked to conduct disorder?

Substance misuse.

What is the relationship between conduct disorder and contact with the criminal justice system (CJS) in adolescence?

Increased contact with CJS.

What are the adult outcomes associated with conduct disorder?

Poor educational/occupational outcomes and involvement with CJS (up to 50%).

What mental health issue is prevalent among adults with conduct disorder?

High level of Mental Health problems.

What cognitive factors are associated with Conduct Disorder?

Intelligence and cognitive deficits, including IQ one standard deviation below the mean and executive function difficulties.

How do executive function difficulties manifest in individuals with Conduct Disorder?

Difficulties in shifting between tasks, planning, and organizing.

What brain differences are observed in individuals with Conduct Disorder?

Decreased response in OFC regions during stimulus-reinforcement tasks and decreased grey matter volume in the amygdala.

What are the neurochemical differences associated with Conduct Disorder?

Altered serotonin and cortisol levels.

How does having a sibling or parent with Conduct Disorder affect heritability?

It increases the likelihood of heritability with a rate of .53.

Is there a stronger genetic link for childhood-onset or adolescent-onset Conduct Disorder?

There is a stronger genetic link for individuals with childhood-onset.

How does the genetic contribution to Conduct Disorder change over time?

The genetic contribution is not stable, suggesting different genes contribute at different stages of the lifespan.

What family and peer influences are associated with Conduct Disorder?

Single parent status, parental divorce, large family size, and young age of mothers.

How does poverty and low SES influence Conduct Disorder?

It leads to decreased parental involvement, inadequate supervision, and unpredictable discipline practices.

What effects do peer rejection have on Conduct Disorder?

It contributes to the continuity of the disorder over time.

What are the 'selection' and 'facilitation' effects in relation to Conduct Disorder?

'Selection' effect refers to the tendency to associate with similar peers, while 'facilitation' effect refers to peers reinforcing deviant behaviors.

What is the relationship between Conduct Disorder (CD) and ADHD?

Both are associated with juvenile delinquency and risk for Antisocial Personality Disorder (ASPD).

What percentage of people diagnosed with ADHD also have Conduct Disorder (CD)?

CD is reported to be present in 50% of people diagnosed with ADHD.

What are common co-occurring childhood crimes associated with Conduct Disorder (CD) and ADHD?

Common crimes include stealing and assault.

How do Conduct Disorder (CD) and ADHD differ in terms of long-term behavior outcomes?

They differ in terms of long-term behavior outcomes.

What is the continuity of conduct problems from childhood to adolescence?

Conduct problems at ages 6, 8, and 10 are highly continuous with offending behavior at age 13.

Are conduct problems related to academic achievement when accounting for comorbid ADHD effects?

Conduct problems are unrelated to academic achievement when accounting for comorbid ADHD effects.

How does ADHD correlate with academic difficulties?

ADHD is correlated with academic difficulties.

Is ADHD related to offending behavior when controlling for Conduct Disorder (CD) effects?

ADHD is unrelated to offending behavior when CD effects are controlled.

What is the risk factor chain from ADHD to Conduct Disorder (CD)?

ADHD leads to poor school performance, which can result in dropouts and increased risk for CD.