The Effects of Child Mental Health on Juvenile Criminal Justice Contact and Victimization.

Abstract

Background: There is extensive evidence on the associations between mental disorders such as attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), oppositional/defiant disorder (ODD), and anxiety/depression and delinquency among youths. However, research has largely overlooked the potential confounding from comorbidity of these mental disorders as well as unobserved familial heterogeneity.

Aims of the study: This study aims to estimate the causal effects of mental health in childhood (age 4-12) on delinquency in adolescence (age 13-18) by adjusting for comorbid mental disorders and unobserved maternal heterogeneity in a longitudinal setup.

Methods: A total of 721 sibling pairs from the Child Development Supplement of the Panel Study of Income Dynamics (PSID), a nationally representative US longitudinal survey, are followed from 1997 to 2019. The Behavior Problems Index (BPI) was used to measure the mental health of children. The hyperactive, antisocial, oppositional, and anxiety/depression subscales of the BPI measuring the symptoms of ADHD, CD, ODD, and anxiety/depression were assessed by their biological mothers who were the primary caregivers. We further consider early-onset cannabis use, a symptom of substance use/abuse, as a risk factor for subsequent delinquency. Delinquency is measured by self-reported retrospective lifetime contact with the criminal justice system and victimization by age 18. The types of contact include arrest, probation, and incarceration, and victimization from physical assault and rape, whose information is drawn from the Transition into Adulthood Supplements of the PSID.

Results: When comorbidity and family-specific unobserved factors are accounted for, we find little evidence for the effects of ADHD, ODD, and depression/anxiety on lifetime contact with criminal justice system in adolescence whereas the symptom scores for CD in childhood are modestly associated with having been attacked in adolescence (p=0.001). Rather, we find that early-onset cannabis use strongly and robustly predicts lifetime arrest (p=0.013), probation (p=0.034), and incarceration (p=0.093) by age 18. These estimated effects of CD and cannabis use on juvenile delinquency are mostly driven by boys.

Discussion: The findings suggest that childhood mental disorders are a risk factor for juvenile delinquency, but the associations may not be causal except for CD and substance use disorder. Crime is often seen as a rational choice of individuals with low educational attainment, yet our findings show that childhood ADHD, which has been shown to generate substantial educational gaps, does not necessarily lead to a higher probability of delinquency in adolescence. Study limitations include mother-reported measures of child mental disorders, lack of information on treatment for mental disorders, especially ADHD, and partial genetic control.

Implications for health policies: High incidence of comorbid mental problems needs to be adjusted when evaluating the cost of a mental health condition in childhood. The large effects of early-onset cannabis use on delinquent outcomes warrant more attention from researchers, especially given the expanding legalization of marijuana in the US.

Implications for further research: Investigating the role of medical/behavioral interventions for ADHD in the relation between ADHD and delinquency will be fruitful.