Abstract
Compared with general population rates, prevalence rates of ADHD have been consistently reported to be higher in both male and female offender populations, the latter estimated to range between 10–29%. Research in forensic institutional settings has reported that aggressive behaviour is a particularly prominent source of impairment among men with ADHD. However there is a paucity of research investigating the type of behavioural incidents that may arise in female offenders with ADHD. This pilot study therefore aimed to further our understanding of ADHD within a cohort of female mentally disordered offenders by ascertaining estimated rates of ADHD and associated functional disturbance presenting in this population. Fifty female offenders completed the Barkley ADHD rating scales. Data on aggressive and self-harming behaviours were obtained from patients' clinical records. Almost one-third of patients (28%) screened positive for ADHD, most commonly hyperactive/impulsive and combined subtypes. They were significantly younger than their peers and there were no significant differences in behavioural disturbance records between groups. When controlling for age, hyperactive/impulsive symptoms and combined symptoms were significantly and positively correlated with measures of behavioural disturbance. ADHD symptoms correlated more strongly with self-harm than outward aggression, which is a novel finding. This pilot study has contributed to the knowledge base about the rate and functional problems of female offenders with ADHD. Future research should replicate the study using a larger sample and explore the effect of treatment (pharmacological and psychological) on the reduction of ADHD symptoms, behavioural disturbance, length of stay and quality of life.
Highlights
ADHD is a clinical syndrome defined in the DSM-5 [1] by impairing levels of hyperactive, impulsive and inattentive behaviours
Institutional records of critical incidents have shown a strong association between ADHD symptoms and aggressive behaviours in males with and without mental disorders detained in forensic settings [9,10]
Consistent with the literature, it was hypothesised that: (H1) rates of estimated ADHD would be considerably higher than that reported in the general population for females; (H2) that female mentally disordered offenders with ADHD symptoms would have greater behavioural impairments compared with their Non-ADHD peers; and (H3) that there would be a positive correlation between behavioural disturbance and ADHD symptoms and, in particular, hyperactive/impulsive symptoms
Summary
ADHD is a clinical syndrome defined in the DSM-5 [1] by impairing levels of hyperactive, impulsive and inattentive behaviours. The diagnosis can be classified into three subtypes of clinical presentation: predominantly inattentive, predominantly hyperactive/impulsive, and combined type. It is a common psychiatric disorder prevalent in around 2.5% of adults [2] and is associated with impaired functioning [3,4]. Much of the extant literature has focused on male forensic populations, and in institutional settings aggressive behaviour has presented as one of the key functional impairments among those with ADHD. Institutional records of critical incidents have shown a strong association between ADHD symptoms and aggressive behaviours in males with and without mental disorders detained in forensic settings [9,10]. In a study conducted in a Scottish prison, compared with their
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