New AJP Study Identifies Childhood Psychiatric Patterns Preceding Arrest In Early Adulthood

Main Category: Pediatrics / Children's Health
Also Included In: Psychology / Psychiatry;  Alcohol / Addiction / Illegal Drugs
Article Date: 02 Nov 2007 - 3:00 PDT

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A child diagnosed with an anxiety or depressive disorder who also has a conduct or substance abuse disorder has a significantly higher risk of later being arrested for a major criminal offense as a teenager or young adult, according to researchers. The new findings, from Duke University's Department of Psychiatry and Behavioral Sciences, appear in the November 2007 issue of The American Journal of Psychiatry (AJP), the official journal of the American Psychiatric Association (APA).

Different childhood histories, the researchers found, are associated with less serious charges against young adults. For example, childhood substance abuse, either alone or with an anxiety disorder, increases the risk of arrest for a minor offense, such as shoplifting. The odds of arrest for a moderately severe offense, such as simple assault or property-related crime, are increased by an anxiety disorder in girls but not boys. Furthermore, the combination of emotional and behavioral disorders remains an important risk factor even if the two disorders do not occur at the same time.

These new findings are part of the Great Smoky Mountains Study, which assessed children in 11 predominantly rural counties of North Carolina over several years. The analysis appears in the AJP study, "Childhood Psychiatric Disorders and Young Adult Crime: A Prospective, Population-Based Study" by William E. Copeland, Ph.D., and his colleagues Duke.

The group studied included 1,420 children, who were nine, 11, or 13 years old at the beginning of the study. Psychiatric disorders were assessed annually until age 16. According to official criminal charges, 473 of the youths were arrested between the ages of 16 and 21. Although a smaller percentage of females were arrested, the authors estimated that a larger proportion of their arrests was attributable to childhood psychiatric disorders: 21 percent versus 15 percent for males. These amounts are substantial; in comparison, the authors point out that the amount of risk for heart attacks that is attributable to being overweight is only 11 percent.

AJP editor-in-chief Robert Freedman, M.D., stated, "The first expressions of mental illness in childhood are becoming increasingly associated with problems later in life, including increased criminal behavior in some cases. The data in Dr. Copeland's paper underscore the need for society to support early assessment and treatment of these vulnerable children."

Childhood conduct disorder and substance abuse have previously been identified as risk factors for adult crime. The findings from the current study increase the specificity of the identified risk factors, from individual disorders to patterns of disorders in boys and girls. For instance, the combination of both depressive and anxiety disorders in boys actually lowered the risk of moderately severe crimes in early adulthood.

Clinicians are already attentive to the risk for criminal activity among youth with conduct disorder. These findings draw attention to the role of other psychiatric disorders in children and to the importance of the occurrence of multiple disorders, even if they do not occur simultaneously.

The analysis took into account poverty status, but the sample was not representative of the U.S. population. Native Americans made up a substantial proportion but did not differ significantly from whites in their arrest rates. The sample contained few African Americans and no Latinos or Asian Americans. Although the participants lived in rural areas, the authors present evidence that crime trends and crime-related factors are similar to those in urban areas.

"It is not necessarily surprising that a substantial proportion of criminals have a childhood history of psychiatric disorders and that conduct and substance disorders commonly precede criminality, but this study underscores the role of depressive and anxiety disorders-disorders not typically associated with criminal behavior-in even the most severe criminal offenses," said lead author William Copeland, Ph.D.

This study was funded by the National Institute of Mental Health, the National Institute on Drug Abuse, and the William T. Grant Foundation.

About the American Journal of Psychiatry

The American Journal of Psychiatry, the official journal of the American Psychiatric Association, publishes a monthly issue with scientific articles submitted by psychiatrists and other scientists worldwide. The peer review and editing process is conducted independently of any other American Psychiatric Association components. Therefore, statements in this press release or the articles in the Journal are not official policy statements of the American Psychiatric Association. The Journal's editorial policies conform to the Uniform Requirements of the International Committee of Medical Journal Editors, of which it is a member. For further information about the Journal visit http://www.ajp.psychiatryonline.org.

About the American Psychiatric Association

The American Psychiatric Association is a national medical specialty society whose more than 38,000 physician members specialize in diagnosis, treatment, prevention and research of mental illnesses including substance use disorders. Visit the APA at http://www.psych.org and http://www.HealthyMinds.org.