Medication Dramatically Decreases Criminality Among Those With ADHD
Researchers find that medicating those with ADHD reduces criminality rates among affected individuals by as much as 41 percent.
-- by Joann Jovinelly
According to the latest statistics released by the Centers for Disease Control and Prevention (CDC), 5 million U.S. children between the ages of 3 and 17 have been diagnosed with attention deficit hyperactivity disorder (ADHD).
Boys are nearly twice as likely to have the condition than are girls. Other factors that seem to tip the scales in favor of an ADHD diagnosis are: living in a single parent household, living in poverty, and/or having parents who missed out on higher education opportunities. Still, the prevailing prerequisite for ADHD remains genetic. It is a condition that is passed down from parent to child and either increased or decreased in prevalence depending on that child’s overall environment.
If a school age child shows symptoms of not being able to follow directions, has an inability to listen, is hyperactive, impulsive, or just plain unruly, chances are he or she will be evaluated for ADHD. The condition has three basic classifications: ADHD predominately inattentive, ADHD predominately hyperactive, and ADHD combined inattentive/hyperactive.
A 2012 study, published in this month’s New England Journal of Medicine, focuses on the importance of medication in order to control ADHD behaviors that very often translate to a life of criminal activity.
Lead study author Paul Lichtenstein, Ph.D. and his colleagues analyzed more than 25,000 patients with ADHD and noted significantly lower rates of criminality for those who were taking medication—a 32 percent decrease in criminality among men and a 41 percent decrease in criminality among women.
The prevailing question remains: Are the 5 million U.S. children currently diagnosed with ADHD heading for a life of crime?
The Expert Take
Overall, ADHD remains difficult to diagnose since its characteristics are common among all children at various times. For instance, Leah Klugness, Ph.D., a child psychologist specializing in ADHD, told Healthline that diagnosing children with the condition is often much easier after age 9.
“It takes time and much observation to know if a child’s behavior is the result of a situation or if it’s a global behavior,” said Klugness.
She described the ADHD child as one who often “misses details, is disorganized, easily distractible, and who doesn’t follow instructions or follow through with completed tasks or assignments.”
Children with ADHD do not process information in the same way that healthy children do, Klugness continued. They may avoid tasks that involve concentration. They have more difficulty following social cues, are statistically noted for having fewer close friends, and their lack of impulse control makes them more susceptible to accidents. According to multiple studies, it is precisely that lack of impulse control that may later contribute to a life of crime.
Anecdotally, Klugness described an experiment often conducted with young children to measure their level of impulse control. In that scenario, a group of children is seated at a table where a bowl of chocolate candies is within reach. All are told to wait until they are instructed before eating the candy. Those children with the greatest level of impulse control, and therefore those much less likely to have ADHD, can typically wait several minutes without incident. Other children find it much more difficult to wait and they eat the candy before given permission to do so. Klugness explains that it is often those children who lack the early mastery of impulse control that are more likely to be diagnosed later with ADHD.
Joel L. Young, M.D. and medical director of the Rochester Center for Behavioral Medicine and an ADHD specialist, agreed with that lack of impulse control and its relationship to criminality. “At least 25 percent of U.S. prisoners currently have ADHD, a condition that increases their recidivism rate,” said Young.
Young made the argument that the successful treatment and management of ADHD symptoms has had a positive impact on the level of violent crime in the United States, and cited a report from the National Bureau of Economic Research (NBER) to bolster his opinion. In that 2009 NBER report, the organization concluded that an increase in prescribing medications for ADHD since the 1990s was directly related to decreasing national crime rates.
Source and Method
In the 2012 Swedish study, Lichtenstein and his team gathered information on 25,656 ADHD patients and their pharmacologic treatment—both on and off medications—and compared that data to information about criminal convictions during the same three-year period.
The results noted a significant reduction in crime among those ADHD patients who remained medicated: a 32 percent decrease in criminality among men and a 41 percent decrease among women. Further analysis showed that a rate reduction of “17 percent and 46 percent in sensitivity analyses among men, with factors that included different types of drugs (e.g., stimulant versus non-stimulant) and outcomes (types of crimes).”
Although controversy surrounds the increasing rate at which U.S. doctors diagnose and treat ADHD in children, there are clear indications of how the symptoms associated with the disorder, when left untreated, may negatively affect them as they mature into adulthood. And while environment can make positive differences for school-age children suffering with ADHD and other learning disabilities, there is still a strong argument to be made regarding the importance of regulating the condition with medication into adulthood, though far less evidence that those medications work equally well in adults as they do in children.
There are abundant studies that have closely examined ADHD and criminality in the United States.
According to a 2009 study in the Journal of Mental Health Policy and Economics, “the Federal Bureau of Investigation concluded that children with ADHD often have more adversarial contacts with law enforcement and are four times more likely to spend time in juvenile justice facilities.” In that same report, “individuals with ADHD have been shown to be more likely to commit both minor offenses such as traffic violations and speeding as well as crimes leading to incarceration, in particular property theft, carrying a concealed weapon, and illegal drug possession. [In those cases] arrest rates [were] shown to be positively related to ADHD status.”
The same study noted correlations between impulsiveness and criminality. “Individuals with impulsive symptoms had the highest increase in criminal activities of all the ADHD types and were more likely to be arrested and convicted of a crime.” By contrast, “individuals with the combined type of ADHD symptoms [those who are inattentive, impulsive, and hyperactive] had the weakest associations with crime.”
On the other hand, a 2012 study published in Behavioral Science and the Law noted “no conclusive evidence that linked the effectiveness of medicating ADHD children and preventing future criminality."
In that study, as in others, authors noted a “significant relationship between ADHD and conduct disorder and a range of biological and environmental risk factors such as neuro-cognitive impairment, high parental psychopathology, poor social functioning, and other co-morbid mental disorders, particularly substance abuse.”