November 2, 2007

Do childhood mental disorders cause adult crime?

Forensic scholar Tom Grisso has a nice editorial on the link between childhood mental disorders and adult crime, in the current issue of the American Journal of Psychiatry. The editorial, commenting on new epidemiological research out of the Smoky Mountains of North Carolina, starts out:
The past ten years have witnessed a surge of research on adolescent offenders with mental disorders. The research shows that youths with delinquencies often have mental disorders, and youths with mental disorders are at greater risk of delinquencies. This 'overlap' of the two populations is a good deal less than a majority when examined as a proportion of all delinquent youths or of all youths with mental disorders. Yet it is substantial, especially among the subset of delinquent youths in juvenile justice secure facilities, where about one-half to two-thirds meet criteria for one or more mental disorders.

These findings have focused attention on the implications of public child protective and mental health services for criminal conduct. Is the national crisis in child community mental health services contributing to delinquency and causing the juvenile justice system to become the dumping ground for youths who are inadequately served? Can we reduce delinquency by providing better resources for responding to youths with mental disorders?
The essay continues here.

The important Smoky Mountains study, "Childhood Psychiatric Disorders and Young Adult Crime: A Prospective, Population-Based Study," by William E. Copeland, Shari Miller-Johnson, Gordon Keeler, Adrian Angold, and E. Jane Costello, is also available online. Here is the Abstract:
While psychopathology is common in criminal populations, knowing more about what kinds of psychiatric disorders precede criminal behavior could be helpful in delineating at-risk children. The authors determined rates of juvenile psychiatric disorders in a sample of young adult offenders and then tested which childhood disorders best predicted young adult criminal status. A representative sample of 1,420 children ages 9, 11, and 13 at intake were followed annually through age 16 for psychiatric disorders. Criminal offense status in young adulthood (ages 16 to 21) was ascertained through court records. Thirty-one percent of the sample had one or more adult criminal charges. Overall, 51.4% of male young adult offenders and 43.6% of female offenders had a child psychiatric history. The population-attributable risk of criminality from childhood disorders was 20.6% for young adult female participants and 15.3% for male participants. Childhood psychiatric profiles predicted all levels of criminality. Severe/violent offenses were predicted by comorbid diagnostic groups that included both emotional and behavioral disorders. The authors found that children with specific patterns of psychopathology with and without conduct disorder were at risk of later criminality. Effective identification and treatment of children with such patterns may reduce later crime.