Attention deficit hyperactivity disorder and critical incidents in a Scottish prison population

There is a well-documented association between ADHD symptoms and antisocial behaviour. The relationship between ADHD symptoms and critical incidents within a Scottish prison was investigated. A total of 198 serving prisoners were screened for both childhood and adult ADHD symptoms using the DSM-IV checklist of symptoms (DCS). Antisocial personality disorder (ASDP) was measured by the MCMI-III and used as a covariate. Behavioural problems in prison were determined using a measure of recorded critical incidents over a period of three months, including verbal and physical aggression, damage to property, self-injury, and severity of aggression. Functional impairment was determined by extreme number of critical incidents. Forty eight (24%) of the prisoners met DCS criteria for childhood ADHD, of whom 11 (23%) were fully symptomatic, 16 (33%) in partial remission and 21 (44%) in full remission. The 27 participants who were fully symptomatic or in partial remission of symptoms, had significantly more aggressive incidents and were more functionally impaired in terms of their behaviour than those participants who were symptom free, after controlling for ASPD. Symptomatic prisoners, including those in partial remission, engaged in extreme incidents in terms of both frequency and severity. It is important to identify and treat prisoners who remain symptomatic for ADHD.