ADHD and offending

Matthew Gobbett, Registered & Chartered Forensic Psychologist

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that influences the way the brain functions and in doing so how a person acts and reacts.  Some key cognitive traits of ADHD include inattentiveness, distractibility, and forgetfulness. Key behavioural traits include

• hyperactivity
• impulsivity
• difficulty relaxing

There is some variability depending on what research you read, but it is generally believed that around 5% of the general population have ADHD (for example see Song et al, 2021). But within prison it is suggested that around 25% of the population have ADHD (Young, et al 2014), which equates to one in four prisoners having ADHD.  The figures suggest that a person with ADHD is more likely than a 'neurotypical' person to end up in prison. WHY?  Understanding the individual traits of ADHD and how they impact the person might be key to answering this question. 

The majority of people with ADHD will not commit crime or end up in prison, and for those who do end up in prison the pathway that leads there will vary according to many dynamic factors.  However, in my work with people with ADHD in the criminal justice system, I have come across typical narratives in which the traits of ADHD have played a part in criminality.

Some of these narratives are easily identifiable and understood.  Impulsivity, irritability, difficulties controlling emotions and urges are common symptoms of ADHD.  These can lead to reactive situations, aggression, and violence.

Other narratives are more hidden but are similarly common.  For example, when exploring a person’s story about why they ended up in prison, it is typical for them to reference their experience in school.  ADHD traits of inattentiveness can hinder a person's ability to progress in the formal education system. For a person with ADHD, their mind is often very active and some people I work with talk about having a ‘spaghetti junction’ of thoughts occurring at once.  This particular symptom makes it difficult to focus attention and maintain concentration over a period of time.  Paying attention to what a teacher is saying in a classroom becomes very difficult when your brain is processing a myriad of other simultaneous thoughts.  Add to that the difficulties of ‘hyperactivity’ in which every part of the person’s body has an urge to get up and move, and you can see why formal education is a challenging setting for someone with ADHD.  Many of the people I work with in courts and prisons recount how they were told that they are 'not listening,' 'naughty,' or 'acting up' in school.  Despite efforts, they do not get the same results or praise as their peers.  Their self-esteem is impacted and they ‘give up’ on school, begin truanting, and seek more exciting or stimulating things, such as drinking, drugs and petty crime with other like-minded children.  For a lot of these young people, they gain a sense of identity and status amongst this peer group, which could not be achieved in school.  From this narrative you can see the pathway towards ending up in trouble with the police and prison.

None of the narratives I hear about the link between ADHD and offending are an excuse for criminal behaviour. Someone with ADHD is subject to the same rules and laws as everyone else, especially if they have hurt another person in their actions. Having ADHD is not that person’s ‘fault’; however, they are responsible for managing their condition and behaviour, particularly when it comes to not hurting others.  However, the above narratives are just some examples of how we can understand a person's criminal behaviour through recognising the impact that ADHD has on their brain and behaviour. In my experience, making the link between ADHD and offending can have a significant impact on the person’s insight and ability to manage their behaviour.  It can also help those working with them or making decisions about their future, make informed decisions and adjustments when they come into contact with the criminal justice system.

This understanding needs to begin with a thorough ADHD assessment and a psychological formulation that seeks to explain how ADHD has impacted that person's life and offending behaviour.

FPC have psychologists skilled in providing ADHD assessments and formulations. You can contact us here.

References:

Song, P., Zha, M., Yang, Q., Zhang, Y., Li, X. & Rudan, I (2021). The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis.  Journal of Global Health 11: 04009.  10.7189/jogh.11.04009" class="redactor-autoparser-object">https://doi: #####replace...
Young, S., & Woodhouse, E. (2020). Assessment and treatment of substance use in adults with ADHD: a psychological approach. Journal of Neural Transmission. https://doi.org/10.1007/s00702...

Young, S, & Cocallis, K.M. (2019)  Attention Deficit Hyperactivity Disorder (ADHD) in the Prison System.  Current Psychiatry Reports 21(6):41.