Neurophysiological correlates of delinquent behaviour in adult subjects with ADHD Nadja M. Meier a, ⁎, Walter Perrig a, c , Thomas Koenig b a Department of Psychology, Division of Experimental Psychology and Neuropsychology, University of Bern, Muesmattstrasse 45, 3012 Bern, Switzerland b Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland c Center for Cognition, Learning, and Memory, University of Bern, Bern, Switzerland abstract article info Article history: Received 4 May 2011 Received in revised form 7 November 2011 Accepted 31 December 2011 Available online xxxx Keywords: ADHD Delinquency Continuous performance task Event-related potentials Adults Emotions Face-processing The attention deficit/hyperactivity disorder (ADHD) shows an increased prevalence in arrested offenders com- pared to the normal population. The aim of the present study was to investigate whether ADHD symptoms are a major risk factor for criminal behaviour, or whether further deficits, mainly abnormalities in emotion- processing, have to be considered as important additional factors that promote delinquency in the presence of ADHD symptomatology. Event related potentials (ERPs) of 13 non-delinquent and 13 delinquent subjects with ADHD and 13 controls were compared using a modified visual Go/Nogo continuous performance task (VCPT) and a newly developed version of the visual CPT that additionally requires emotional evaluation (ECPT). ERPs were analyzed regarding their topographies and Global Field Power (GFP). Offenders with ADHD differed from non-delinquent subjects with ADHD in the ERPs representing higher-order visual processing of objects and faces (N170) and facial affect (P200), and in late monitoring and evaluative functions (LPC) of behavioural re- sponse inhibition. Concerning neural activity thought to reflect the allocation of neural resources and cognitive processing capability (P300 Go), response inhibition (P300 Nogo), and attention/expectancy (CNV), deviances were observable in both ADHD groups and may thus be attributed to ADHD rather than to delinquency. In con- clusion, ADHD symptomatology may be a risk factor for delinquency, since some neural information processing deficits found in ADHD seemed to be even more pronounced in offenders with ADHD. However, our results sug- gest additional risk factors consisting of deviant higher-order visual processing, especially of facial affect, as well as abnormalities in monitoring and evaluative functions of response inhibition. © 2012 Elsevier B.V. All rights reserved. 1. Introduction According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA, 2000), the essential feature of ADHD in children and adolescents is a persistent pattern of inattention and/ or hyperactivity and impulsivity that is maladaptive and inappropri- ate to the developmental level. In approximately one half of children with ADHD, symptoms continue into adulthood with persisting attentional problems, difficulties with organisation and time man- agement, a lack of self-control (Biederman, 2005; Wender et al., 2001) and emotional dysregulation (Wender, 1995). Hyperactivity often transforms into feelings of restlessness with increasing age (Barkley, 2009). Neuropsychological deficits besides inattention are found in executive functions and working memory (e.g. Gallagher and Blader, 2001). ADHD is commonly regarded as a risk factor for social maladapta- tion and delinquency (e.g. Vermeiren, 2003; Schlicht, 2006), and the prevalence of ADHD is elevated in delinquents. While its incidence is estimated at 3.7% of adults in the normal population (Fayyad et al., 2007), the majority of studies have reported ADHD prevalence rates between 14% and 19% in offender populations (Vermeiren, 2003). In the USA, 20% of 453 incarcerated male youths were diagnosed with this disorder (Gordon and Malmsjo Moore, 2005). In Germany, Schlicht (2006) and Rösler et al. (2004) found 45% of de- linquent male adolescents to be affected by ADHD, and incarcerated offenders with ADHD had a lower age at first sentence and a higher number of sentences than inmates without ADHD (Schlicht, 2006). One reason for this might be that ADHD-related psychopathology starts early in life and may have a negative impact on an individual's development, education, and socialisation (Rösler et al., 2004). Also, individuals with ADHD are less likely to reach the level of education- al and academic achievement expected on the basis of their intellec- tual abilities in comparison to normal controls, and they change or lose their jobs more often (Barkley and Murphy, 2006). Further- more, adult individuals with ADHD display a significantly elevated risk for marital problems, have more motor vehicle driving risks (Woodward et al., 2000), and a higher risk for accidents with serious injury compared with controls (Grützmacher, 2001). Those prob- lems may additionally increase the risk of delinquency. In this con- text, it seems important to distinguish the delinquent behaviour that is associated with reactive impulsive aggression in the context of strong emotions from the proactive instrumental aggression International Journal of Psychophysiology xxx (2012) xxx–xxx ⁎ Corresponding author. Tel.: +41 31 631 40 11; fax: +41 31 631 82 12. E-mail address: nmeier@students.unibe.ch (N.M. Meier). INTPSY-10426; No of Pages 16 0167-8760/$ – see front matter © 2012 Elsevier B.V. All rights reserved. doi:10.1016/j.ijpsycho.2011.12.011 Contents lists available at SciVerse ScienceDirect International Journal of Psychophysiology journal homepage: www.elsevier.com/locate/ijpsycho Please cite this article as: Meier, N.M., et al., Neurophysiological correlates of delinquent behaviour in adult subjects with ADHD, Int. J. Psychophysiol. (2012), doi:10.1016/j.ijpsycho.2011.12.011