Cited by 192Attention Deficit Hyperactivity DisorderPsychopathy, Forensic Psychiatry, Sexual OffendingCriminal Justice and Corrections Analysis

Attention Deficit Hyperactivity Disorder (ADHD) among longer-term prison inmates is a prevalent, persistent and disabling disorder

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Ginsberg, Ylva, Hirvikoski, Tatja, Lindefors, Nils·2010·BMC Psychiatry

Abstract

BACKGROUND: ADHD is a common and disabling disorder, with an increased risk for coexisting disorders, substance abuse and delinquency. In the present study, we aimed at exploring ADHD and criminality. We estimated the prevalence of ADHD among longer-term prison inmates, described symptoms and cognitive functioning, and compared findings with ADHD among psychiatric outpatients and healthy controls. METHODS: At Norrtälje Prison, we approached 315 male inmates for screening of childhood ADHD by the Wender Utah Rating Scale (WURS-25) and for present ADHD by the Adult ADHD Self-Report Screener (ASRS-Screener). The response rate was 62%. Further, we assessed 34 inmates for ADHD and coexisting disorders. Finally, we compared findings with 20 adult males with ADHD, assessed at a psychiatric outpatient clinic and 18 healthy controls. RESULTS: The estimated prevalence of adult ADHD among longer-term inmates was 40%. Only 2 out of 30 prison inmates confirmed with ADHD had received a diagnosis of ADHD during childhood, despite most needed health services and educational support. All subjects reported lifetime substance use disorder (SUD) where amphetamine was the most common drug. Mood and anxiety disorders were present among half of subjects; autism spectrum disorder (ASD) among one fourth and psychopathy among one tenth. Personality disorders were common; almost all inmates presented conduct disorder (CD) before antisocial personality disorder (APD). Prison inmates reported more ADHD symptoms during both childhood and adulthood, compared with ADHD psychiatric outpatients. Further, analysis of executive functions after controlling for IQ showed both ADHD groups performed poorer than controls on working memory tests. Besides, on a continuous performance test, the ADHD prison group displayed poorer results compared with both other groups. CONCLUSIONS: This study suggested ADHD to be present among 40% of adult male longer-term prison inmates. Further, ADHD and coexisting disorders, such as SUD, ASD, personality disorders, mood- and anxiety disorders, severely affected prison inmates with ADHD. Besides, inmates showed poorer executive functions also when controlling for estimated IQ compared with ADHD among psychiatric outpatients and controls. Our findings imply the need for considering these severities when designing treatment programmes for prison inmates with ADHD.

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  1. Ward MF Wender PH Reimherr FW The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder Am J Psychiatry 1993 150 6 885 890 8494063

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Authors
Ginsberg, Y., Hirvikoski, T., & Lindefors, N.
Affiliations
Karolinska Institutet (SE)
Corresponding author
Ginsberg, Ylva
Venue
BMC Psychiatry
Published
2010-12
Volume
10
Issue
1
Pages
112-112
ISSN
1471-244X (ISSN-L)
OpenAlex
W2049948820
Cited by
191
References
55
Citations by year
2026: 3 · 2025: 9 · 2024: 12 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 14 · 2019: 10 · 2018: 11 · 2017: 14 · 2016: 18 · 2015: 19 · 2014: 20 · 2013: 19 · 2012: 16
FWCI
8.96
Type
journal article
Language
en
Open access
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Karolinska Institutet
  • Stockholms Läns Landsting
  • Socialdepartementet
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
  • Social Sciences › Sociology and Political Science › Criminal Justice and Corrections Analysis
Keywords
adult ADHD, prisoners, comorbidities, substance use disorders, amphetamine use, autism spectrum disorder, psychopathy, conduct disorder, antisocial personality disorder, personality disorders, mood and anxiety disorders, executive function, working memory, continuous performance test, childhood ADHD
MeSH terms
Adult, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Cognition Disorders, Criminal Law, Humans, Male, Neuropsychological Tests, Prisoners, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Sweden, Time Factors, Comorbidity, Prevalence, Diagnostic and Statistical Manual of Mental Disorders, Executive Function

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