Forensic and Mental Health - 2 lectures (1. Criminal behaviour and Mental Health, 2. Mental Health in Young Offenders.)

CRIMINAL BEHAVIOUR AND MENTAL HEALTH


ADHD

DSM-IV Criteria

Inattention

6 or more for at least 6 months (disruptive and inappropriate for developmental level- not just a
normal toddler):

- 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.

Hyperactivity

6 or more present for at least 6 months (disruptive and inappropriate for developmental level):

- Often fidgets with hands or feet or squirms in seat.
- Often gets up from seat when remaining in seat is expected.
- Often runs about or climbs when and where it is not appropriate (adolescents or adults may
feel very restless).
- Often has trouble playing or enjoying leisure activities quietly.
- Is often "on the go" or often acts as if "driven by a motor".
- Often talks excessively.

Impulsivity

- Often blurts out answers before questions have been finished. (Often has trouble waiting
one's turn. Often interrupts or intrudes on others )
- Some symptoms that cause impairment were present before age 7 years.
- Some impairment from the symptoms is present in two or more settings (not just acting out
because doesn’t want to be at school)
- There must be clear evidence of significant impairment in social, school, or work
functioning.
- The symptoms do not happen only during the course of another disorder

, Features:

 Prevalence 5.3 per 1000 boys in 1999
 3-5% in USA (0.5-1% persistence into adulthood)
 Controversy over diagnosis and treatment
 High rates of ADHD in offending adolescents (Timmons-Mitchell et al., 1997)
 Childhood ADHD associated with onset delinquency, persistence and higher arrest (Retz)
 Diagnosis - static factor in recidivism and risk of crime

Rayner et al (2005):

- 31 persistent male offenders (13-17 years)
- 4 + offences that warranted custodial if adult
- Prominent diagnosis = conduct disorder, ADHD & drug abuse
- Triad (CD, ADHD and drug abuse)= most associated with offending (Timmons-Mitchell et al.,
1997)

ADHD & Offending

 Pratt et al (2002)
 Meta analysis of 20 studies found strong relationship between ADHD and antisocial
behaviour
 Young et al (2009)
 Self report measures of ADHD and ASPD and critical incidents of aggression
 Differences observed between those symptomatic of ADHD and those who were not
 Retz et al (2004)
 129 young male offenders
 No ADHD (no ADHD)
 Childhood not adult ADHD (CARS)
 Childhood and adult (ADHD)
 Significant differences - age of first conviction lower in ADHD and CARS
 Delinquency prior age 14 higher in CARS than ADHD , both higher than no ADHD
 ADHD have higher anxiety, depression and aggressive behaviour
 ADHD higher neuroticism, lower conscientiousness & agreeableness
 The high prevalence of persistent ADHD in young offenders highlights the necessity
of early diagnosis and therapy to prevent ADHD children from starting a criminal
career.

CONDUCT DISORDER

DSM-IV

- Repetitive and persistent pattern of behaviour where basic rights of others, age-appropriate
societal norms are violated.
- Presence of three + in last year, and 1+ in last 6 months
- Behaviours linked to significant impairment in social, academic occupational functioning