To Örebro University

BACKGROUND: ADHD is a neurodevelopmental disorder linked to impulsivity and self-regulation difficulties. While the association between ADHD and nicotine dependence is well-established, less is known about the association with smokeless tobacco use, such as snuff. Given the adverse health effects of nicotine during pregnancy, this study examines whether women diagnosed with ADHD are more likely to use snuff prior to and early in pregnancy, and whether they persist in use between these periods. This study also explores the associations between ADHD and snuff use in the presence of common psychiatric disorders: depression, anxiety and substance use disorders (SUDs).

METHODS: Using Swedish population-based registers, we identified women who gave birth between 2000 and 2020. ADHD was defined based on clinical diagnoses and/or ADHD medication prescriptions. Snuff use was self-reported during a prenatal care visit. Logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs) for snuff use prior to and early in pregnancy among women with ADHD, adjusting for sociodemographic factors. We also stratified the analyses by depression, anxiety, and/or SUDs to assess potential differences in associations.

RESULTS: Women diagnosed with ADHD were more likely to use snuff prior to pregnancy (adjOR = 1.89, 95% CI: 1.83-1.95), early in pregnancy (adjOR = 2.43, 95% CI: 2.32-2.55), as well as be persistent snuff users (adjOR = 2.39, 95% CI: 2.27-2.52) compared to women without ADHD. Stratification by common psychiatric disorders revealed that the associations between ADHD and snuff use prior to and early in pregnancy were strongest among women diagnosed with ADHD without depression, anxiety, and/or SUDs.

CONCLUSIONS: ADHD is an important risk factor for snuff use prior to and early in pregnancy, underscoring the need for targeted interventions to prevent nicotine use in young women with ADHD as part of integrated care.

TRIAL REGISTRATION: Retrospectively registered.

Parental criminality is a risk factor for crime, but little is known about why some individuals exposed to this risk refrain from crime. We explored associations of resting heart rate (RHR), systolic blood pressure (SBP), cognitive ability (CA), and psychological functioning (PF) with criminal convictions among men with a convicted parent, accounting for unmeasured familial factors in sibling analyses. Data were         obtained from Swedish registers, including all men born in Sweden between 1958 and 1992 with a convicted parent (N = 495,109), followed for up to 48 years. The potential protective factors were measured at mandatory conscription. Outcomes were conviction of any, violent, and nonviolent crime. Survival analyses were used to test for associations, adjusting for measured covariates and unmeasured familial factors. Higher levels of RHR, SBP, CA, and PF were associated with reduced risk of criminality after adjusting for covariates. RHR associations were largely explained by familial factors. CA and PF associations were not due to sibling-shared confounders, in line with a causal interpretation. SBP results, indicating a protective effect against non-violent crime, warrant further investigation.

Low resting heart rate (RHR) is considered the best-replicated biological correlate for antisocial and conventional criminal behaviors, but there is limited research investigating whether this extends to white-collar crime. Using longitudinal data (n = 707,490) from multiple population-based Swedish registers and Cox proportional hazard regressions, results suggest that after accounting for demographic and criminality covariates, low RHR is not associated with white-collar criminality (aHR: 1.02, 95 % CI [0.99, 1.06]) whereas high RHR is associated with a lower risk of white-collar criminality (aHR: 0.92, 95 % CI [0.89, 0.95]), compared to average RHR. Findings indicate that low RHR is not associated with white-collar criminality, per se, but high RHR is a protective factor, reducing the risk of white-collar criminality.

Purpose: We investigated how multidimensional neighborhood types, capturing the complexity of neighborhood social structure, related to criminal convictions and substance use disorders (SUDs) in Sweden while accounting for residential mobility and shared familial influences.

Methods: Using nationwide Swedish register data (1991-2020), we followed 1.82 million individuals born 19852002 across five neighborhood types previously identified using latent class analysis. These were defined by socioeconomic and demographic indicators, with the most common type (rural low-diversity neighborhoods) serving as the reference category. Associations between neighborhood types, violent and nonviolent convictions, and SUDs were estimated using Cox proportional hazards models with hazard ratios (HRs) and 95% confidence intervals (CIs). Neighborhood type was modeled as a time-varying exposure, capturing residential changes over time. Sibling comparison models were applied to account for familial confounding.

Results: Risks of violent convictions, nonviolent convictions, and SUDs were highest in resource-limited neighborhoods (i.e., socioeconomically deprived areas with high residential turnover; violent: adjusted HR (aHR) = 4.70, 95% CI 4.26-5.19; nonviolent: aHR = 2.07, 95% CI 1.92-2.22; SUDs: aHR = 3.36, 95% CI 3.093.65). Moderate increases were observed in urban high-diversity neighborhoods (i.e., characterized by ethnic heterogeneity), whereas risks were lowest in socioeconomically advantaged urban areas. Associations were attenuated but remained statistically significant in sibling comparisons. Sex differences were modest and followed similar patterns across outcomes.

Conclusion: Neighborhoods marked by socioeconomic disadvantage and residential instability, rather than ethnic diversity, were linked to higher risks of criminal convictions and SUDs. Remaining associations after familial adjustment suggest modest but meaningful contextual effects.

BACKGROUND: Maternal attention-deficit/hyperactivity disorder (ADHD) has been associated with various pregnancy outcomes, but the degree to which that association is explained by concomitant mental disorders and smoking during pregnancy remains unclear.OBJECTIVE: To investigate the association between maternal ADHD and pregnancy outcomes.

METHODS: Through the Swedish Medical Birth Register, we identified 977,266 women who gave birth to a live singleton between January 1, 2006, and December 1, 2020 (1,617,121 pregnancies). Of these, 1.3% (12,553 women; 17,434 pregnancies) had an ADHD diagnosis prior to pregnancy. The primary outcome was preterm birth (< 37 weeks), with secondary outcomes being postterm birth (> 41 weeks), small for gestational age, large for gestational age, birth weight (≤ 2500, 2501-3500, > 4500 g), acute and planned cesarean section, assisted vaginal delivery, preeclampsia, and gestational diabetes. Generalized linear mixed-effects models adjusted for maternal age, year of childbirth, maternal education, comorbid mental disorders, and smoking during pregnancy.

RESULTS: There were 1089 (6.6%) preterm births among women with ADHD, and 73,423 (4.9%) preterm births among women without an ADHD diagnosis, corresponding to a crude OR of 1.33 (95% CI 1.25, 1.42). This association attenuated to nonsignificance after adjusting for maternal age, year of childbirth, maternal education, and comorbid mental disorders (adjOR = 1.06, 95% CI: 0.99, 1.13). Fully adjusted models revealed that ADHD was associated with an increased risk of having a large for gestational age baby (adjOR = 1.16, 95% CI: 1.06, 1.26) and undergoing a planned caesarean section (adjOR = 1.16, 95% CI: 1.06, 1.26). Sensitivity analyses using a broader ADHD definition suggested associations with preterm birth (adjOR = 1.09, 95% CI: 1.04, 1.15) and acute caesarean section (adjOR = 1.09, 95% CI: 1.04, 1.13).

CONCLUSIONS: After adjustments for comorbid mental disorders and smoking during pregnancy, maternal ADHD was not associated with preterm birth. An increased risk of delivering large for gestational age babies and undergoing planned caesarean sections was found in women with ADHD.

Parental antisocial behavior (ASB) is a risk factor for ASB in the next generation. While social and environmental mechanisms contribute to this relationship, research also supports the influence of genetic components. A low resting heart rate (RHR) is moderately heritable and a well-established risk factor that may contribute to the intergenerational transmission of ASB. However, research investigating this relationship is limited. The overarching aim of the current study was to examine the influence of RHR in the intergenerational transmission of ASB from parent to child. Three minutes of RHR was collected on 129 girls and boys at age 9-10 years, alongside maternal ASB. At the age of 14-15 years, data on offspring ASB were collected using the externalizing scale of the Youth Self-Report. Results showed that maternal ASB predicted offspring ASB (B = 2.36, beta = 0.36, t = 4.28, p < .001). However, offspring RHR did not mediate or moderate this relationship. Findings indicate that RHR is not a biological marker of risk in the intergenerational transmission of ASB in this community sample, although the results may be influenced by low statistical power.

Parental criminality is a risk factor for crime, but little is known about why some individuals exposed to this risk refrain from crime. We explored associations of resting heart rate (RHR), systolic blood pressure (SBP), cognitive ability (CA), and psychological functioning (PF) with criminal convictions among men with a convicted parent, accounting for unmeasured familial factors in sibling analyses. Data were obtained from Swedish registers, including all men born in Sweden between 1958 and 1992 with a convicted parent (N=495,109), followed for up to 48 years. The potential protective factors were measured at mandatory conscription. Outcomes were conviction of any, violent, and non-violent crime. Survival analyses were used to test for associations, adjusting for measured covariates and unmeasured familial factors. Higher levels of RHR, SBP, CA, and PF were associated with reduced risk of criminality after adjusting for covariates. RHR associations were largely explained by familial factors. CA and PF associations were not due to sibling-shared confounders, in line with a causal interpretation. SBP results, indicating a protective effect against non-violent crime, warrant further investigation.

INTRODUCTION: Considerable evidence exists for reduced electrodermal reactivity to aversive cues/events in high-psychopathic individuals, but most research of this kind has employed adult samples and cross-sectional designs. The current study examined skin conductance (SC) activation during anticipation of and in response to a noise stressor in a sample of 9-10 year old children in relation to constituent traits of psychopathy described by the triarchic model (i.e., boldness, disinhibition, meanness), both concurrently and at a five-year follow-up, and in relation to antisocial behavior at the follow-up.

METHODS: Participants were 1,082 children from the greater Los Angeles area who underwent successive waves of testing in a longitudinal twin project. Current study analyses focused on (a) SC from the noise stressor task and parental ratings of children's triarchic traits collected at wave 1 of the project (W1; ages 9-10), and (b) parent- and child-ratings of the triarchic traits along with child-reported engagement in aggressive and nonaggressive antisocial behavior (ASB) collected at wave 3 (W3; ages 14-15).

RESULTS: Reduced SC reactivity in the noise-stressor task at W1 was related to parent-rated boldness both concurrently (at W1) and prospectively (at W3), but not to parent-rated disinhibition or meanness at either wave. Interestingly, reduced SC reactivity at W1 showed associations with both boldness and meanness as rated by child participants themselves at W3. Additionally, reduced W1 SC reactivity was uniquely predictive of child-reported nonaggressive ASB at W3, whereas W1 parent-rated boldness was uniquely predictive of child-reported aggressive behavior at W3.

DISCUSSION: Our finding of an inverse relationship between SC reactivity and parent-rated boldness at W1 corroborates evidence from prior adult research and points to low fear (threat sensitivity) as the basis of deficient stress responding in psychopathy. The finding of contrasting predictive relations for W1 SC reactivity and W1 parent-rated boldness with ASB at W3 suggests differing roles for elements of threat sensitivity tapped by each (e.g., low anxiousness versus social dominance) in nonaggressive versus aggressive forms of ASB. Our findings highlight the nuances of dispositional fearlessness as construct of relevance to psychopathy and suggest important avenues for future research.

Background: The association between ADHD and criminality is well established, yet little is known about the familial liability of ADHD and crime across different types of relatives, from twins to cousins. This study aims to clarify the association between ADHD and crime by examining their co-aggregation both in the general population and across a range of familial relationships in a nationwide population-based sample, including separate analyses for men and women.

Methods: We analyzed data from 1,507,211 individuals born in Sweden between 1987 and 2002. Using Cox proportional hazard regressions, we estimated the associations between clinically diagnosed ADHD and official crime records within individuals and families.

Results: Analyses showed that individuals with ADHD had a significantly higher risk of being convicted of any crime—violent or non-violent—compared to those without ADHD, with the risk being significantly higher for women than men. Additionally, individuals with a relative diagnosed with ADHD were at increased risk of criminal convictions, with some gender-based variations.

Conclusions: ADHD and criminal convictions co-aggregate within families, consistent with shared familial liability. Patterns across relatives and sexes suggest genetic contributions, with stronger associations in women. These findings may help inform risk assessment and prevention efforts.

Attention-deficit/hyperactivity disorder (ADHD) symptoms are associated with myriad adverse outcomes, including interpersonal difficulties, but factors that moderate the developmental course and functional impact of ADHD over time are not well understood. The present study evaluated developmental contributions of the triarchic neurobehavioral traits (boldness, meanness, and disinhibition) to ADHD symptomatology and its subdimensions from adolescence to young adulthood. Participants were twins and triplets assessed at ages 14, 17, and 19 (initial N = 1,185, 51.2% female). Path analyses using negative binomial regression revealed that boldness at age 14 was associated with more ADHD symptoms cross-sectionally (especially hyperactivity/impulsivity), but fewer symptoms (especially inattention) at age 19 in the prospective analysis. Notably, inclusion of interpersonal problems at ages 14 and 17 as covariates reduced the latter effect to nonsignificant. Disinhibition concurrently and prospectively predicted higher levels of ADHD symptoms, including both subdimensions, and the prospective effects were partially mediated by greater social impairment at age 17. Meanness prospectively (but not concurrently) predicted higher levels of hyperactivity/impulsivity symptoms. Sex moderated certain associations of meanness and disinhibition with ADHD symptoms. These findings highlight how fundamental neurobehavioral traits shape both psychopathology and adaptive outcomes in the developmental course of ADHD.