To Örebro University

Background: Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) face an elevated risk of criminal convictions compared to those without ADHD. However, understanding this link involves considering sex differences, coexisting psychiatric conditions, and unmeasured familial factors. This study aimed to explore the connection between ADHD and criminal convictions (both violent and non-violent) in males and females, while also assessing the impact of comorbid psychiatric disorders and familial factors.

Methods: Using Swedish national registers, we identified individuals born between 1986 and 1997 (635,391 males and 600,548 females). ADHD was defined through clinical diagnosis and prescribed medications, while criminal convictions were determined based on Swedish lower court records. Unmeasured familial factors were accounted for using a sibling design approach.

Results: Findings revealed that individuals with ADHD had a notably higher absolute and relative risk of both violent and non-violent criminal convictions compared to those without ADHD. While criminal convictions were more frequent among males with ADHD, females with ADHD exhibited higher relative risks (HR violent 10.50, non-violent 4.04) than their male counterparts (HR violent 6.03, non-violent 3.57). Additionally, lower socioeconomic status (SES) in individuals with ADHD was associated with increased relative risks for criminal convictions compared to individuals with ADHD who had higher SES. Adjusting for childhood and internalizing psychiatric disorders partially attenuated these associations, while substance use disorders (SUD) substantially attenuated them. SUD also contributed to an elevated absolute risk of criminal convictions in both male and female individuals with ADHD. Accounting for unmeasured shared familial factors slightly reduced the estimates, but the association between ADHD and criminal convictions persisted.

Conclusion: In conclusion, ADHD remains a potent independent risk factor for criminal convictions, with varying effects based on gender. This underscores the importance of tailored crime prevention strategies and early interventions for individuals with ADHD, especially when comorbid SUD is present.

Biopsychosocial criminological theories suggest that it is important to consider interactions between risk factors from different domains in the prediction of externalizing behavior. Lower resting heart rate is considered the best replicated biological risk factor for externalizing behavior. The psychological construct of empathy has also shown to be predictive of such behavior, but little is known about the potential interaction between these two different risk factors in predicting externalizing behavior. We examined the moderating role of empathy on the association between resting heart rate in childhood and adolescence with externalizing behavior by young adulthood using two subsets of participants from the Longitudinal Risk Factors for Antisocial Behavior project: Subsample 1 (n = 697) at ages 9–10 and 19–20 years and Subsample 2 (n = 394) at ages 14–15 and 19–20 years. Linear and logistic regressions showed that empathy moderated the association between resting heart rate in adolescence and externalizing behavior by young adulthood. Among individuals with low but not high levels of empathy, increased resting heart rate predicted lower levels of externalizing behavior. Interventions enhancing empathic skills in individuals with psychophysiological risk profiles could be beneficial.

BACKGROUND: Lower autonomic arousal is a well-known correlate of criminal offending and other risk-taking behaviors in men, but few studies have investigated this association in women.

AIM: To test associations between autonomic arousal and criminal offending as well as unintentional injuries among female conscripts.

METHODS: All women born 1958-1994 in Sweden who participated in voluntary military conscription (n = 12,499) were identified by linking Swedish population-based registers. Predictors were resting heart rate (RHR) and systolic blood pressure (SBP). Covariates were height, weight, and physical energy capacity. Main outcomes were criminal convictions (any, violent, and non-violent) from the National Crime Register. Secondary outcome was unintentional injuries requiring medical treatment or causing death. We used survival analyses to test for associations between predictors and outcomes.

RESULTS: Low RHR, relative to high RHR, was associated with an increased risk of any criminal conviction, non-violent criminal convictions, and unintentional injuries. Low SBP, relative to high SBP, was associated with an increased risk of violent criminal convictions.

CONCLUSIONS: Results support lower autonomic arousal, particularly lower RHR, as a correlate of criminal offending among women that warrants further examination, as the reported findings have potential implications for the prediction of future female crime.

Background: Youth offenders have a high risk of being injured or dying prematurely. However, few studies have considered the role of imprisonment and potential childhood risk factors for these high rates.

Aim: To examine the risk of unintentional injury and premature death in non-imprisoned and imprisoned youth offenders, and to examine the role of parental criminal convictions and psychiatric disorders and own childhood psychiatric disorders.

Methods: All individuals (N = 1,839,711) born in Sweden between 1978 and 1996 were identified using Swedish population-based registers. The exposure was criminal conviction between ages 15-20 years of age.

Results: Imprisoned youth offenders had the highest risk for unintentional injury (HR = 2.29 [2.19-2.40]) and premature death (HR = 10.76 [9.52-12.16]), followed by nonimprisoned youth offenders, compared to non -convicted youth. All childhood risk factors increased the risk for these outcomes among non-imprisoned youth offenders. Among imprisoned youth offenders, parental criminal convictions and parental psychiatric disorders increased the risk for unintentional injury, and parental psychiatric disorders and own childhood psychiatric disorders increased the risk for premature death.

Conclusions: Our study shows there are robust modifiable childhood risk factors for injury and mortality among youth offenders. However, the importance of them to assess risk may differ between non-imprisoned and imprisoned youth offenders.

Background: We examined associations of adverse perinatal events with offspring violent and non-violent criminal convictions in men and women.

Methods: All singleton births between 1973 and 1995 (n = 1,146,570 men, n = 1,085,217 women) were identified through Swedish population-based registers. Information about adverse perinatal events was retrieved from the Medical Birth Register. Outcomes were criminal convictions collected from the National Crime Register. We estimated absolute and relative risks of being convicted of criminal convictions using the Kaplan-Meier method and survival analyses for men and women separately. We also tested for differences in magnitudes of associations for men versus women.

Results: Several adverse perinatal events were associated with an increased risk of violent and non–violent criminal convictions in both men and women. Associations between low birth weight, small nessrelative to gestational age and preterm birth with non–violent criminal convictions were statistically significantly higher for men than for women. There was a dose–dependent association between adverse perinatal events with violent and non–violent criminal convictions for both men and women, indicated by the strengthened magnitude of HR estimates with exposure to an increasing number of adverse perinatal events.

Conclusions: Adverse perinatal events are associated with violent and non-violent criminal convictions in men and women, with some differences in risk estimates between sexes. Findings are compatible with theoretical accounts implicating disruption of the neurodevelopment during the perinatal period.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is associated with an increased risk of poor mental health. However, the understanding of ADHD-related burden and impairments in women during the postpartum period is limited. The aim with the present study was to examine the risk of depression and anxiety disorders during the postpartum period among women with and without an ADHD diagnosis.

METHODS: We used register-based data to identify women who gave birth to their first and/or second child between 2005 and 2013 in Sweden (n = 773,047), of which 0.5 % (n = 3515) had a diagnosis of ADHD prior to pregnancy. Diagnoses of depression and anxiety disorders up to one year after delivery were collected from the national patient register.

RESULTS: A total of 16.76 % of the women with an ADHD diagnosis were also diagnosed with depression disorders in the postpartum period, prevalence ratio (PR) 5.09 (95 % confidence interval (CI), 4.68-5.54). A total of 24.92 % of the women with an ADHD diagnosis were also diagnosed with anxiety disorders in the postpartum period, PR 5.41 (5.06-5.78). Stratified results revealed that having a diagnosis of ADHD increased the risk for both depression and anxiety disorders postpartum, beyond other well-known risk factors.

LIMITATIONS: There is a potential risk of surveillance bias as women diagnosed with ADHD are more likely to have repeated visits to psychiatric care and might have an enhanced likelihood of also being diagnosed with depression and anxiety disorders postpartum, compared to women without ADHD.

CONCLUSIONS: ADHD is an important risk factor for both depression and anxiety disorders postpartum. Therefore, ADHD needs to be considered in the maternal care, regardless of sociodemographic factors and the presence of other psychiatric disorders.

Background: Psychiatric diagnoses are important risk factors for criminal convictions, but few longitudinal studies have examined comorbidity patterns in relation to youth criminal convictions.

Aim: To explore associations between specific psychiatric diagnoses (substance use disorder (SUD), ADHD, depression, PTSD, intellectual disabilities (ID), and autism spectrum disorders (ASD)) and comorbidities of internalizing, externalizing, or neurodevelopmental diagnoses (NDD) in relation to risk of non-violent or violent criminal convictions in youth, including potential sex differences.

Methods: Data on 1,411,538 individuals born in Sweden (1985–1998) were obtained from national population-based registers. Exposure was psychiatric diagnoses and outcome was criminal convictions between ages 15 and 20.

Results: 17% of individuals had a psychiatric diagnosis, of whom 20% were convicted of a crime. All diagnoses, except ID and ASD, increased the risk of non-violent and violent crimes. Comorbidities of externalizing and internalizing diagnoses heightened the risk compared to single diagnoses. NDD increased the risk among SUD, depression, and PTSD, while NDD comorbid with another NDD decreased the risk for criminal convictions.

Conclusion: Of the three comorbidity categories, externalizing disorders heightened risk the most, followed by internalizing disorders. This study highlights specific risk patterns for criminal convictions related to comorbidities, and to crime type and sex.

Lower resting heart rate and lower levels of empathy have independently been associated with an increased risk of antisocial behavior. However, little is known about the potential interaction between resting heart rate and empathy in predicting antisocial behavior. The aim of the current project was to examine the moderating role of empathy in young adulthood on the association between resting heart rate in childhood and antisocial behavior in young adulthood. We utilized two subsamples from the University of Southern California Risk Factors for Antisocial Behavior Project (n=707, n=616), a longitudinal project with data from five waves. Resting heart rate was measured using disposable electrodes attached to the torso. Empathy was measured using the Interpersonal Reactivity Index with four subscales. Antisocial behavior was defined as law enforcement involvement. After adjusting for potential confounds, results suggest that lower resting heart rate in childhood and lower empathy in young adulthood predict antisocial behavior in young adulthood. Most importantly, empathy in young adulthood moderated the association between resting heart rate in childhood and antisocial behavior in young adulthood. Results indicate that at lower levels of empathy, a lower resting heart rate was associated with increased probability of being in trouble with the police.

Background: We examined associations of adverse perinatal events with offspring violent and non-violent criminal convictions in men and women.

Methods: All singleton births between 1973 and 1995 (n =1,146,570 men, n =1,085,217 women) were identified through Swedish population-based registers. Information about adverse perinatal events was retrieved from the Medical Birth Register. Outcomes were criminal convictions collected from the National Crime Register. We estimated absolute and relative risks of being convicted of criminal convictions using the Kaplan-Meier method and survival analyses for men and women separately. We also tested for differences in magnitudes of associations for men versus women.

Results: Several adverse perinatal events were associated with an increased risk of violent and non-violent criminal convictions in both men and women. Associations between low birth weight, smallness relative to gestational age and preterm birth with non-violent criminal convictions were statistically significantly higher for men than for women. There was a dose-dependent association between adverse perinatal events with violent and non-violent criminal convictions for both men and women, indicated by the strengthened magnitude of HR estimates with exposure to an increasing number of adverse perinatal events.

Conclusions: Adverse perinatal events are associated with violent and non-violent criminal convictions in men and women, with some differences in risk estimates between sexes. Findings are compatible with theoretical accounts implicating disruption of the neurodevelopment during the perinatal period.

Low resting heart rate (HR) is a well-replicated correlate of antisocial behavior. Previous findings have suggested that low resting HR is associated with criminal offending, psychopathy, conduct problems and aggression. More recent work has also indicated that low systolic blood pressure is associated with an increased risk of criminal offending. However, little is known about the predictive value of low autonomic arousal for reoffending. Thus, the present study examined associations of resting HR and systolic blood pressure with reoffending. We used Swedish population-based registers to conduct a cohort study of all male conscripts born between 1958 and 1990 who had been convicted of a crime (N=407,533). Resting HR and systolic blood pressure was measured at the conscription assessment. Criminal convictions were obtained from the National Crime Register. We used survival analyses to test for associations between resting HR and systolic blood pressure with reoffending while covarying for socioeconomic status, height, weight, physical energy capacity and birth year. A lower resting HR was associated with an increased risk of reoffending for violent and nonviolent crime compared to a higher resting HR. Lower systolic blood pressure was also associated with an increased risk of reoffending for violent and nonviolent crime compared to a higher systolic blood pressure. Low autonomic arousal should be further investigated as a predictor for reoffending as it may help to improve identification of individuals at risk for repeated criminal justice involvement.