To Örebro University

Background: Neighborhoods shape daily life through physical and social structures, such as socioeconomic conditions, population density, and resident turnover. Decades of research link neighborhood characteristics to health and behavioral outcomes. However, these factors are often studied independently, neglecting their interrelated nature.

Methods: Using Swedish population registry data, we employed latent class analyses to identify neighborhood typologies across six timepoints spanning 1991-2020. Neighborhoods, defined by Demographic Statistical Areas, were characterized by socioeconomic conditions, ethnic heterogeneity, residential instability, and urbanicity. Latent transition analyses examined changes over time.

Results: Four neighborhood types emerged in the early period (1991-2000): Rural Low-Diversity (45 %), Urban Professional (27 %), Urban Affluent (21 %), and Resource-Limited (7 %). From 2001 onwards, five types were identified, with the addition of Urban High-Diversity (9 %) and Rural Resource-Limited (3 %). Three types, Rural Low-Diversity, Urban Professional, and Urban Affluent, persisted across 30 years, representing 87-93 % of neighborhoods, with over 90 % of neighborhoods retaining their classification over time.

Conclusions: This multidimensional framework offers a foundation for future research, urban planning, and policy development.

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.

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.

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.

Purpose: Parental history of criminal offending is a major risk factor for later criminal behavior in children. Extensive research has also shown low resting heart rate (RHR), a moderately heritable biological variable, to be prospectively predictive of criminal behavior. Despite its status as a replicable risk factor, limited research exists on RHR's role in the intergenerational transmission of crime. Specifically, it remains unclear whether parent-child resemblance for biological characteristics such as RHR might play a role in intergenerational crime transmission.

Method: The current study was undertaken to clarify the role of RHR in the intergenerational transmission of crime, and test for moderating effects of socioeconomic status (SES) on its role, in a large Swedish population-based sample of fathers and their sons combined (N similar to 266,000).

Results: Beyond replicating prior work documenting paternal crime history and RHR as predictors of later offspring crime, we show tfhat father-son resemblance for RHR accounts in part for father-to-son crime transmission, and that familial SES does not moderate this transmission.

Conclusions: Our findings have important implications for understanding the role of biological and environmental influences in the intergenerational transmission of crime.

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.

Low resting heart rate (RHR) is a well-replicated biological correlate of interpersonal violence (i.e., violence against others). However, there is limited research examining the relationship between RHR and intrapersonal violence (i.e., violence against oneself). Using Swedish population-based data, this study examined the relationship between RHR and suicide, an extreme form of intrapersonal violence, among individuals with no convictions (n = 458,785), violent convictions only (n = 8,694), non-violent convictions only (n = 187,138), and both violent and non-violent convictions (n = 37,745). Cox regression analyses indicated that low RHR lowered the risk of suicide by 22% among non-convicted individuals. High RHR increased the risk of suicide by 25% among individuals with non-violent convictions. RHR was not associated with the risk of suicide among individuals with violent convictions only or both violent and non-violent convictions. Research into shared and distinct etiological mechanisms and risk/protective factors for interpersonal and intrapersonal violence may provide valuable insights for treatment and prevention efforts.

Background: Research on the association between depression and crime is limited regarding different types of crime and severity of crime.

Aim: Using Swedish national register data, we explored the association between depression and various crime outcomes and the severity of crime.

Methods: We identified 72,057 individuals with an outpatient depression diagnosis between 2001 and 2013. Individuals with depression were age-, sex-, and socioeconomic status (SES)-matched to undiagnosed population controls (n = 1,080,855). Logistic regression models estimated odds of any, violent, property, drug-related and non-violent crime, as well as the severity of crime.

Results: In fully adjusted models, individuals with depression had significantly higher odds of any conviction (adjusted OR [adjOR] 1.66 [95 % CI 1.60-1.71]). This pattern persisted across all crime types (violent, property, drug-related, non-violent), and for crime severity, including increased odds for longer sentences and multiple convictions.

Conclusions: Individuals with depression had an increased risk for convictions across all crime types and more severe crimes. Our results emphasize the importance of early identification of risk factors and targeted treatments, and the necessity for clarification of the underlying mechanisms of our findings.

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.