To Örebro University

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.

There is a strong tradition in criminological research to uncover risk factors for crime in youth and, more recently, to examine risk factors for subsequent adverse outcomes among youth offenders. This knowledge serves not only for crime prevention but also to mitigate future harm resulting from youth crime. Psychiatric diagnoses are recognized as important risk factors for youth crime, yet questions persist regarding their extent and nature of association with crime and later adverse outcomes in youth offenders.

In this dissertation, the overarching aim was to expand the knowledge about the role of psychiatric diagnoses in the risk of crime in youth and later injuries, mortality, and reoffending among youth offenders. Study I examined the association between psychiatric diagnoses, including comorbidities, and risk of criminal conviction in youth. Study II examined the association between psychiatric diagnoses and risk of unintentional injuries and premature death among non-imprisoned and imprisoned youth offenders. Lastly, study III examined the role of psychiatric diagnoses in the association between violent victimization and reoffending among youth offenders.

The overall findings of the present dissertation suggest that psychiatric diagnoses are important risk factors for crime in youth and later adverse outcomes, but their significance and magnitude vary depending on type of diagnosis, presence of comorbidities, type of crime committed, sex, crime history, and presence of other important risk factors such as violent victimization. This dissertation highlights the heterogeneity in risk patterns among youth offenders, which is highly important to consider in both risk assessments and prevention strategies to better target youth at risk of these outcomes.

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: 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.

The startle reflex has been suggested to operate as a psychophysiological marker of psychopathic personality, based on findings from studies using a range of different methodologies and participant samples. The present review aims at synthesizing existing evidence of the relationship between psychopathy and the startle reflex across task paradigms, psychopathic personality subtypes and subdimensions, participant samples (i.e., incarcerated/ clinical or non-offenders), and age groups using the triarchic model of psychopathy as a frame of reference. Systematic literature searches were conducted up until the 24th of March 2020 in PubMed, PsycINFO, and Web of Science. A total of 2311 potential studies were identified, out of which 40 met relevancy and quality criteria. Results indicate that reduced aversive startle potentiation is associated with psychopathic personality in general, but clusters of traits relating to the triarchic model constructs of boldness and meanness in particular. Available evidence suggest that startle paradigms could be meaningful for differentiating individuals with and without psychopathic personality. Findings support suggestions of psychopathic personality as a multifaceted, rather than a unitary construct. Reduced aversive startle potentiation has also been found in relation to psychopathic features in child-aged samples but work of this kind is limited and more research is needed. Future studies should focus on greater consistency in task paradigms and analytic strategies to enhance the capacity to compare and integrate findings across studies.