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IV. Criminality and Its Relationship to Psychiatric Status

Salvatore Mannuzza, PhD; Rachel Gittelman Klein, PhD; Paula Horowitz Konig; Tina Louise Giampino

Arch Gen Psychiatry. 1989;46(12):1073-1079.

Abstract
• Attention-deficit disorder with hyperactivity is believed, by some, to be a developmental antecedent (predisposing factor) to antisocial personality disorder and criminality. However, evidence supporting this association has not been consistent. We report on a prospective follow-up study of 103 males (ages 16 to 23 years), who were diagnosed as hyperactive (attention-deficit disorder with hyperactivity) between ages 6 and 12 years, and 100 normal controls. The official arrest records of all subjects who resided in New York State during the follow-up interval were obtained. Blind diagnoses (based on structured interviews with subjects and their parents) were made on 98% of the initial cohort at follow-up. Although other investigators have reported on the delinquent behavior of hyperactive children in a prospective design, to our knowledge, follow-up mental status has not been studied previously in relation to official arrest records. Significantly more probands than controls had been arrested (39% vs 20%), convicted (28% vs 11%), and incarcerated (9% vs 1%). The presence of an antisocial/conduct disorder in young adulthood almost completely accounted for the increased risk for criminal activities in the former hyperactive children whether or not it was accompanied by a substance use disorder. Continuing attentiondeficit disorder with hyperactivity at follow-up, by itself, was not associated with arrest history. The findings support the view that childhood attention-deficit disorder with hyperactivity is a risk factor for later criminality, but that this relationship is almost exclusively mediated by the development of an antisocial disorder in early adulthood.

Author Affiliations
From the New York State Psychiatric Institute, Department of Clinical Psychology, New York, and Long Island Jewish Medical Center, Children's Behavior Disorders Clinic, New Hyde Park, NY.

Footnotes
Accepted for publication October 11, 1988.

Presented in part at the Annual Meeting of the American Psychiatric Association, Montreal, Canada, May 12, 1988.

Reprint requests to the Department of Psychology, New York State Psychiatric Institute, 722 W 168th St, New York, NY 10032 (Dr Mannuzza).

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