Profile and outcomes of male offenders with ADHD

Attention Deficity Hyperactivity Disorder (ADHD) is characterized by difficulties regulating attention, activity, and impulsivity. Primarily diagnosed in childhood, this disorder is increasingly being recognized as persisting into adulthood. Adult ADHD is associated with increased criminality, substance abuse, and disruptive behaviours. Approximately 2-5% of adults in the general population suffer from this disorder, and it is estimated that the prevalence in forensic populations is much higher. This study examined the relationship of ADHD among federal male offenders with key correctional outcomes.

A sample of 497 male offenders newly admitted to a regional reception and assessment centre completed the Adult ADHD Self-Report Scale (ASRS) over a 14 month period spanning 2006-2007. Outcomes for offenders with ADHD were examined including their program completion rates, insitutional behaviour, and success upon release. In addition, the merits of the ASRS and its various scoring methods were examined to determine its possible utility in a computerized mental health assessment battery.

Results from the ASRS indicated that approximately 16.5% of offenders had high scores on the measure that are closely correlated with clinical levels of ADHD, and a further 25% scored in the moderate range for this disorder. A profile of these offenders indicated that they were more likely to have lower educational attainment, unstable job history, learning disabilties, higher risk and need ratings, as well as increased substance abuse and other mental health problems.

ADHD was found to predict institutional misconduct. Offenders with high levels of ADHD were 2.5 times more likely to receive an institutional charge than offenders without these symptoms. ADHD was also associated with poorer release outcomes. They returned to custody more frequently and in a shorter time period than those with low or no levels of the disorder. Contrary to hypothesis, ADHD was not associated with drop out from correctional programs. Offenders with ADHD were equally as likely to complete their programs as other offenders.

The longer version and the short versions of the ASRS were found to correlate highly, and results of analyses did not differ significantly when using either the full scale or the 6-item screener. This suggests that the ASRS is a quick and reliable measure of ADHD that could be incorporated into future mental health assessment procedures.

ADHD is prevalent in CSC's offender population at rates that exceed those found in the community. High levels of ADHD present challenges for CSC in terms of institutional behaviour management and outcomes upon release. This suggests that intervention strategies that mitigate the effects of this disorder such as teaching consequential thinking, goal setting and self monitoring could improve some key correctional outcomes. On the positive side, ADHD does not affect an offender's ability to complete a correctional program.

Usher, A., Stewart, L., Wilton, G., & Malek, A. (2010). Profile and outcomes of male offenders with ADHD. Ottawa: Correctional Service Canada.

To obtain a PDF version of the full report, contact the following address: research@csc-scc.gc.ca.

Prepared by: Amelia Usher