Predictors of Offending and Critical Incidents among Prisoners

Gisli H Gudjonsson, Susan Young
European Psychiatric Review, 2011;4(1):15-17
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Abstract

The strongest predictors of recidivism are the age at first conviction, the extent and variety of past offending, antisocial personality traits and history of substance use. Research into the motivation for offending among prisoners has shown the additional potential importance of clinical problems (anxiety, alcohol dependence, drug dependence, attention deficit hyperactivity disorder [ADHD]) in relation to specific offences. ADHD is a particularly powerful predictor of critical incidents and behavioural disturbance in institutional settings.
Keywords
Prisoners, critical incidents, recidivism
Disclosure Gisli Gudjonsson has been a consultant for Eli-Lilly. Susan Young has been a consultant for Janssen-Cilag, Eli-Lilly and Shire. She has given educational talks at meetings sponsored by Janssen-Cilag, Shire, Novatis, Eli-Lilly and Flynn-Pharma and has received research grants from Janssen-Cilag, Eli-Lilly and Shire. Susan Young was a member of the National Institute for Health and Clinical Excellence guideline development group for attention deficit hyperactivity disorder. She is co-author of ‘R&R2 for ADHD Youths and Adults’ and ‘R&R2 for Youths and Adults with Mental Health Problems’. Both Susan Young and Gisli Gudjonsson are committee members of the UK Adult ADHD Network.
Received: February 01, 2011 Accepted March 03, 2011
Correspondence: Gisli H Gudjonsson, King’s College London, Department of Psychology (PO 78), Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK. E: gisli.gudjonsson@kcl.ac.uk

Worldwide, over 9.25 million people are being detained in penal institutions with vastly different rates being reported in different regions and countries.1 The US incarcerates more people than any other country in the world, with a rate of 760 per 100,000 of the population.2,3 Even within European countries, the rates fluctuate greatly with highest rates being reported for Lithuania, Poland, the Czech Republic and Bulgaria, and the lowest in Cyprus, Iceland and Greece.1

In spite of the large worldwide prison population, little has been done to understand the effect of incarceration on critical incidents within prison4 and on the post-release criminal behaviour of prisoners.5 The causes and implications of critical incidents within prisons is a commonly neglected area of research. The focus in this article is on the known psychological and psychiatric predictors of critical incidents during incarceration and recidivism after release from prison. This includes personality factors, mental health factors including attention deficit hyperactivity disorder (ADHD), illicit drug use and the potentially beneficial impact of therapy programmes completed during incarceration.

Mental Health and Psychopathology Among Prisoners

A rising proportion of mentally disordered people has been reported among prisoners in Europe and the US, which at least in part may be attributed to the closure of psychiatric hospitals and increased alcohol abuse and illicit drug use of many citizens.1 In a systematic review of 62 prison surveys covering 22,790 prisoners from 12 countries, 81% of whom were men, it was found that about 4% had been diagnosed with psychotic illness, 10% of the prisoners suffered from major depression and 47% of the men and 21% of the women fulfilled the criteria for an antisocial personality disorder.6 Symptom prevalence is often highest during the first week of custody and stabilises or decreases during custody, especially for convicted men with depression.7

In a recent study among Scottish prisoners, it was found that, according to scores obtained on the Millon Clinical Multiaxial Inventory-III (MCMI-III), the three most common personality disorders were antisocial (48%), depressive (16.5%) and negativistic (15%).8 The three most common clinical syndromes were drug dependence (48%), anxiety (36%) and alcohol dependence (16%).8 This is consistent with findings from other studies that the majority of prisoners have a previous history of alcohol abuse and illicit drug use,7,9,10 about 60% of prisoners report a history of head injury11 and up to 45% are symptomatic for ADHD.12,13 The high rate of mental health problems, ADHD and other psychopathology among prisoners has implications for their management and treatment within institutional settings,1,14 critical incidents within the prison environment4,15 and post-release offending or level of recidivism.8,16

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