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The Association Between ADHD-like Characteristics and Anti-Social Behaviour (Past Academic Project)

I wrote this as my final dissertation for my post-graduate Psychology Degree (MSc) at Northumbria University which I attended between 2021 - 2023. I want to write a disclaimer that I do not find this to be my best work and it did not at first suprass a passing grade - this was due to me being hospitalised repeatedly during the time I was conducting this project for a chronic illness which had not presented in my life until this point. Please be considerate of this whilst reading this piece.


(AN MSc THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MSc PSYCHOLOGY)


Author Name: Ryan James Gittins

Supervisor: Dr Colin Hamilton

Word count: 7795


Contents


  • Abstract

  • Introduction

  • Research question, Aims, Hypothesis, and Rationale

  • Attention Deficit Hyperactivity Disorder (ADHD)

  • Antisocial Behaviour

  • The relationship between ADHD and Antisocial Behaviour

  • Methods

    • Design of study

    • Participants

    • Materials

    • Procedure 

    • Data collection methods

  • Results

    • Descriptive analysis

    • Correlation Regression Analyses

  • Discussion

    • Results for this study

    • Meaning and significance in relation to the existing literature and implications for future research

    • Strengths and limitations of the study

  • Conclusion

  • References



Abstract


ADHD is a neurodevelopmental condition with high levels of distractibility, impulsivity, and hyperactivity. Some recently published research papers have shown that ADHD may lead to a development of Antisocial Behaviour (AB) if left untreated, when compared with the general population. This may be due to a lack of dopamine production in the brain or environmental influences such as trauma. This paper aimed to address the research question, "How strong is the relationship between ADHD characteristics and Antisocial Behaviour?". The central hypothesis was that those who display characteristics of ADHD would show higher levels of Antisocial Behaviour than those within the general population using an online survey which was later analysed using correlation regression analysis in SPSS. It was found that there was a correlation of r=0.565* between the ADHD characteristics variable and the Antisocial Behaviour characteristics variable, which indicated a moderate to strong positive correlation. This would go on to support the original hypothesis that those who display characteristics of ADHD will show higher levels of Antisocial Behaviour than those within the general population. 



Introduction


This paper will explore the research question, “How strong is the relationship between ADHD characteristics and Antisocial Behaviour?”. The hypothesis for this study is that those who display characteristics of ADHD will show higher levels of Antisocial Behaviour than those within the general population. The rationale for this hypothesis was firstly based on experience as I know many people who have been either diagnosed with ADHD or possess traits of ADHD who have then gone on to develop Antisocial Behaviour. This caused me to begin researching whether there could be a potential link there, as well as sparking curiosity surrounding what causes the potential relationship. It was found that not much research had been conducted on the matter; however, the research that had been conducted suggested that there is compelling evidence that those who have ADHD may have a significant risk of developing Antisocial traits. 


It is vital to find a link between ADHD and Antisocial Behaviour because there is a necessity for intervention and prevention strategies when it comes to developing Antisocial Behaviour. If ADHD can be linked as a key contributing factor, then there is a real chance that early intervention can prevent Antisocial Behaviour. Within the introduction, there will be an explanation of what characteristics there are in both ADHD and antisocial behaviour, as well as why it is believed there is a correlation between the two conditions using previous literature. 


Attention Deficit Hyperactivity Disorder (ADHD)


Attention Deficit Hyperactivity Disorder (ADHD) is one of the most recognised neurodevelopmental disorders alongside Autistic Spectrum Disorder (ASD). Most commonly, ADHD is diagnosed early in childhood but still present in adulthood. ADHD is often categorised into three types, inattentive, hyperactive, or combined. 


Within the inattentive subtype, it may be difficult for the individual to organise or finish tasks, pay attention to details, or follow instructions. Symptoms of the inattentive subtype include making careless mistakes, difficulty in sustaining attention, an inability to listen when spoken to directly, failure to follow through on tasks or instructions, poor organisational skills, avoidance of taking part in activities that require sustained mental effort, losing items regularly, becoming easily distracted, and being generally forgetful. 


Within the hyperactive presentation, there is a crucial difficulty with hyperactivity. This person may be very fidgety, leave their seat in situations where remaining seated is expected, experience restlessness, have difficulty engaging in quiet activities, talk excessively, blurt out answers, and have difficulty waiting their turn. The combined presentation will have symptoms drawn from both presentations. 


It is still unknown what the exact cause of ADHD is, but there are known risk factors for its development, mainly genetic factors. One factor that may cause ADHD is a brain injury. A study was conducted with 187 children between the ages of 3 and 7 who displayed no symptoms of ADHD prior to their brain injury-related hospitalisations. (G. Mammoser., 2018) Out of 187 children, 48 met the criteria for ADHD, with severe traumatic brain injury four times more likely to develop ADHD than those with less severe injury. (ibid., G. Mammoser., 2018) Research has shown that children who have suffered a traumatic brain injury during early life will develop symptoms of inattentive ADHD later. It was found that approximately 1 in 5 children who have had traumatic brain injury will then develop ADHD, manifesting within a few years since the injury. (ibid., G. Mammoser., 2018)


Another factor that may cause ADHD is exposure to environmental risks such as lead poisoning during pregnancy or early childhood. Research has suggested a new connection between the symptoms of low-level lead exposure and ADHD. Children with detectable levels of lead in their blood stream will have difficulties with inattentiveness and may experience behavioural issues. (Symptoms from Lead Exposure Similar to ADHD - CHADD, 2016)


Alcohol and tobacco use during pregnancy has been linked to the development of ADHD in children. A study was conducted between 1999 and 2008 where 114 247 children and 94 907 mothers used self-reported measurements of alcohol use obtained in week 30 during the pregnancy. (E. Eilertsen, & Others, 2021) It was found that there was an overall positive association between maternal alcohol use during pregnancy and offspring ADHD symptoms. 


Premature delivery of a baby or a low birth weight can cause ADHD. Researchers examined data from 12 previous studies with 1,787 participants and found that ADHD was at increased risk. (L. Rapaport., 2017) Compared to healthy babies, low-weight babies were considered more than twice as likely to develop ADHD. Premature babies often suffer the stress of breathing difficulty, food indigestion, impaired vision, and cognitive skills. It is believed that it is possibly the stress of early birth, underdevelopment of vital organs, and inflammation causing hormonal changes that contribute to ADHD. (ibid., L. Rapaport., 2017)


This research thesis will look at the characteristics of ASPD to create a comparison between those and the characteristics of ADHD to evaluate where the characteristics of ADHD have a significant correlation with the development of ASPD characteristics. 


Antisocial Behaviour


This paper does not aim to establish any research surrounding Antisocial Personality Disorder (ASPD) as a condition but rather to explore some of its characteristics. To establish the characteristics of Antisocial Behaviour, ASPD must be researched as a whole to recognise the behaviours.


Antisocial behaviour is understood as ‘relating to a pattern of behaviour in which social norms and the rights of others are persistently violated’. (Dictionary.com - seriously don't judge me for this, I do know better) If the behaviours are persistent enough, it may lead to a diagnosis of Anti-Social Personality Disorder (ASPD). ASPD is a cluster B personality disorder that can be categorised as a ‘pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following: having hurt, mistreated, or stolen from another’. (American Psychiatric Association, 2013) A personality disorder is a condition that affects how a person thinks, feels, and behaves. (A. Smith., 2021) The symptoms of ASPD begin with a failure to conform to social norms concerning lawful behaviours, as indicated by repeatedly performing acts that are grounds for arrest. They are also commonly deceitful, shown by persistent lying for personal pleasure. Those with ASPD tend to be incredibly impulsive with a failure to plan in situations. ASPD patients tend to be aggressive or irritable, as shown by repeated physical assaults and reckless disregard for the safety of themselves or others. They tend to be consistently irresponsible, presented by repeated failure to honour financial obligations or attend work duties, in addition to a total lack of remorse or guilt. 


Whilst a patient can be diagnosed with antisocial traits, a person must have significant impairments in personality functioning as with any personality disorder to be diagnosed with ASPD. This is recognised as the first category of antisocial personality disorder. These include ego-centrism, which is derived from personal gain, power, or pleasure. In addition to a total lack of concern for the feelings, needs, or suffering of others and a complete lack of remorse after hurting or mistreating another. (ibid., American Psychiatric Association, 2013) As well as an incapacity for mutually intimate relationships, which is usually displayed by exploitation as a primary means of relating to others, and the use of power dynamics in a relationship. 


In the second category of antisocial personality disorder, there must be pathological personality traits that are recognised as antagonistic. These can be characterised by the frequent use of artificial charm to influence or control others, including seduction, charm, glibness, or ingratiation to achieve one end. (ibid., American Psychiatric Association, 2013) They are often dishonest and may fabricate events in order to appear as a misrepresentation of themselves. They will have a lack of concern for the feelings or problems of others with a lack of guilt for the harmful acts they carry out; this is callousness. Those with ASPD commonly have frequent anger in response to minor inconveniences or insults. 


In the final category, those with ASPD are prone to disinhibition which a total disregard can characterise financial and other obligations or commitments with a lack of respect for agreements and promises. (ibid., American Psychiatric Association, 2013) They act spur of the moment in response to immediate stimuli by acting without planning or considering outcomes. They will engage in dangerous, risky, and potentially self-damaging activities unnecessarily and without regard for consequences. This makes them very prone to boredom. 


The individual must be over the age of 18 years old; below that, their personality is still developing, and there should be evidence of a conduct disorder before the age of 15. (ibid., American Psychiatric Association, 2013) The risk of developing ASPD can also be increased if the individual has a conduct disorder accompanied by Attention Deficit Hyperactivity Disorder (ADHD), which developed before the age of 10. The presence of antisocial behaviour should not exclusively be during an episode of schizophrenia or bipolar mania, and the trait expression should not be better explained by another disorder or a medical condition such as head trauma. (ibid., American Psychiatric Association, 2013)


Both genetic and environmental factors can cause ASPD. The risk of developing ASPD is more ‘common among 1st-degree relatives of patients with the disorder than among the general population’ with a high risk of developing the disorder when the individual's parents have the disorder. (M. Zimmerman., 2021) When diagnosed with ASPD, it is not uncommon to be diagnosed with associated psychopathic or sociopathic traits depending on the severity of the disorder. If someone is diagnosed with psychopathic traits, they tend to be genetically predisposed to antisocial personality disorder, whilst sociopathic traits tend to be made by their environment. 


Research shows that psychopaths have been related to physiological brain differences where there is underdevelopment in the components of the brain commonly thought to be responsible for emotion regulation and impulse control. (L. Haley., 2021) One study compared the brains of 20 prisoners diagnosed with psychopathy against 20 prisoners who were not diagnosed. The study showed that ‘psychopaths have reduced connections between the ventromedial prefrontal cortex’, which is responsible for empathy and guilt. (Psychopaths’ brains show differences in structure and function, 2017) They also had differences in their amygdala from those without psychopathy; this part of the brain mediates fear and anxiety. It was presented that compelling evidence proved ‘that there is a specific brain abnormality associated with criminal psychopathy’. (Psychopaths’ brains show differences in structure and function, 2017) Psychopaths tend to be artificial and shallow with other people and form relationships which are designed to be manipulated in order for them to achieve their goals. They tend to be high functioning with steady working environments. However, they still tend to engage in criminal behaviour to minimise the risk to themselves so they do not get caught. 


Sociopaths, on the other hand, are created by environmental factors such as an individual's upbringing, including physical abuse, emotional abuse, or childhood trauma. Whilst sociopaths still struggle to form attachments to others, they tend to be more 'impulsive and erratic in their behaviour’ than their psychopath counterparts. (ibid., L. Haley., 2021) The main difference between psychopaths and sociopaths is their ability to plan, as sociopaths are unable to maintain long-term commitments, and when they engage in criminal behaviour, they do so impulsively, making them more likely to get caught. Sociopaths also tend to become agitated and angered more easily.


The characteristics of ASPD that need to be examined are related to criminal behaviours. These can be categorised into two groups: aggressive or passive. Aggressive behaviours tend to affect others; these include threatening people, physically harming people, or hitting things. Passive behaviours are victimless crimes such as taking illegal substances or shoplifting. Both types of Antisocial Behaviour are essential in discovering whether there is a link between ADHD and Antisocial Behaviour based on impulse or Antisocial Behaviour based on a total lack of empathy for others. 


This research, in particular, will focus on three Antisocial Behaviour groups. (Metropolitan Police., 2022) The first group of Antisocial Behaviour will be behaviour that targets a specific individual or group, such as violence towards others or threatening behaviour. The second group of Antisocial Behaviour will be behaviour that causes a nuisance to a community, such as shoplifting or local graffiti. The final group of Antisocial Behaviour will be behaviour that affects the wider environment, such as public spaces or buildings. Some examples of this could be causing trouble within hospitals, schools, or in more extreme cases, acts of terrorism.


Antisocial Behaviour is known to produce significant harm to both the individual committing the acts and those involved. It is incredibly important to find ways to prevent Antisocial Behaviour before it becomes problematic for the individual and those around them. It is also crucial to find treatments for the individuals that will prevent them from offending again in the future whilst also helping them to learn the consequences of their actions. This makes it vital to be able to identify the main predictors of this behaviour. 


The relationship between ADHD and Antisocial Behaviour


When researching the relationship between ADHD and Antisocial Behaviour, not many articles or papers had been published, with only 16,200 results on Google Scholar. This is not much compared to when ADHD has been researched alone, with over 980,000 results. It was found that Antisocial Behaviour was not well researched as it only showed 14,900 results. The research area is very under-researched, hence why it became a chosen topic for this study. 


The first time a pattern between ADHD and ASPD was acknowledged prior to this research on literature was upon reading the biography of a late serial killer called "The Night Stalker", otherwise known as Richard Ramirez. Ramirez was diagnosed with ADHD as a child after experiencing multiple head traumas. (C. Allely, & Others, 2014) Ramirez also suffered copious amounts of childhood trauma from an early age. His mother was poisoned at her workplace whilst pregnant with him, his sibling was heavily disabled and had to be cared for by his siblings as the family could not afford proper medical care, and Ramirez suffered from multiple head traumas that led to him developing Temporal Lobe Epilepsy. (P. Carlo, 1996) Beyond this, his father would regularly beat the children causing Ramirez to spend many of his teenage years sleeping in graveyards and getting high on LSD as a coping mechanism. Ramirez had a special connection to his older cousin Miguel who often bragged about crimes he had committed whilst at war, 'showing young Richard a photo of himself posing with the severed head of a Vietnamese woman he had abused'. (J. Learish, 2021) When Ramirez was 13, Miguel murdered his wife in front of Ramirez, leaving him traumatised. After copious amounts of drug use to cope with the trauma, Ramirez regularly committed petty crimes such as shoplifting or vandalism. When he moved to Los Angeles, he began killing people in seemingly random attacks, initially led by his drug-induced psychosis. Later Ramirez stopped using drugs but continued to kill. In total, he murdered 13 victims and sexually assaulted multiple young children. (ibid., J. Learish, 2021) In court, he was diagnosed with ASPD Psychopathy. In this case, there is a direct link between Antisocial Behaviour and someone who has grown up with ADHD and emotional trauma. The rest of this section of the paper will explain further links between these variables in greater detail. 


The first piece of research relating to ADHD and Antisocial Behaviour was a research journal written in 2006; based on literature searches from 1980-2004, there was evidence found to explore the relationship between ADHD and Antisocial Behaviour. This research paper aimed to examine the ‘clinical, genetic and environmental factors that contribute to the link between ADHD and antisocial behaviour’ to prove the hypothesis that ‘Antisocial behaviour is an important adverse outcome of ADHD’. (A. Thapar, & Others, 2006) The method if this study was to find previous literature in order to provide compelling evidence for the chosen hypothesis. The results of this research concluded that those who displayed more severe symptoms of ADHD were predicted to develop Antisocial Behaviour, as they stated ‘ADHD symptom severity and pervasiveness predict the development of antisocial behaviour’. (ibid., A. Thapar, & Others, 2006) It was believed that this is due to genetic factors and environmental risk. It was also discovered that Antisocial Behaviour in children alongside ADHD was further linked to family problems in early childhood and rejection from peers; however, the causes were still being assumed, with very little research to define evidence for that theory. The researcher themselves had not conducted any studies on the subject, so the paper was less reliable than a study where participants may have been studied. The journal did, however, lead towards other research journals and studies where the assumptions had been explored.


One example which included an alternative viewpoint suggested that those participating in Antisocial Behaviour may have resulted from parenting styles. A study conducted by the Department of Psychology in Spain found through a parenting questionnaire that there seemed to be two parenting style dimensions most commonly used. On the one hand, one parenting style would use ‘affection, communication, and behavioural control’, which had a ‘protective effect’ on Antisocial Behaviour. (D. Álvarez-García, & Others, 2019) The children raised by these families tended to follow what they had been shown in childhood and presented later in life to be empathetic and neutral. On the other hand, parents who had a negative relationship with their children, such as promoting ‘antisocial friendships and low adolescent empathy’, presented a considerable risk factor for Antisocial Behaviour in later life. (ibid., D. Álvarez-García, & Others, 2019) This kind of parenting may also be seen in abusive households which much research has already shown may cause Antisocial Behaviour in adulthood as a coping mechanism. This study did not question the association that Antisocial Behaviour may have with ADHD but found environmental causes for the behaviour. It was felt that this was important information for this project because it gave an alternative approach where Antisocial Behaviour is assumed to be solely related to environmental causes, rather than a total difference in the brain which would assume that there is no definable relationship between ADHD and Antisocial Behaviour. 


Whilst the environment does play a large role on whether children grow up to have Antisocial traits, it could be argued that the environment affects those with ADHD much more than those who do not. A study conducted in 2004, found that within a large sample of hyperactive and community control children that were revisited in adulthood and asked to fill in a self-report survey reporting on the lifetime antisocial activities and illegal drug use, more of the hyperactive group of children ‘committed a variety of antisocial acts and had been arrested for doing' so than the control children group had. (R.A. Barkley, & Others, 2004) The hyperactive group also had higher frequencies of 'property theft, disorderly conduct, assault with fists, carrying a concealed weapon, and illegal drug possession, as well as more arrests' which could be proven with police records. (ibid., R.A. Barkley, & Others, 2004) The study concluded that hyperactive children were at higher risk of developing Antisocial Behaviour in adulthood than the community control children. 


A 2013 study supports this case as it hypothesised that children with ADHD may have an increased risk of developing personality disorders and criminal behaviour in the future. This led researchers to conduct eighteen prospective studies, which showed that ADHD with and without comorbid conduct disorder (CD) had a high risk of later developing ASPD. Across thirteen of these studies, it was suggested from the results that ‘ADHD and CD might be a separate subtype of ADHD, that especially impulsivity in ADHD is a predictor for later development of ASPD’. (OJ. Storebø, E. Simonsen., 2016) This suggests that the ‘callous-unemotional traits in the ADHD children are called for a risk factor for later ASPD’; thus, there may be early warning signs. (ibid., OJ. Storebø, E. Simonsen., 2016) This information shows that whilst ADHD may have the potential to develop into ASPD, it is more likely that it is a specific sub-type of ADHD not yet explored that causes this development. The other question, then, is why does ADHD have a higher risk potential of developing into ASPD than other disorders?


The characteristics of ADHD have been explored in studies that have shown that there are 'dopaminergic and noradrenergic mechanisms at the prefrontal cortex' which indicate that 'α-2A adrenoreceptor stimulation results in increased dendritic firing during delay periods for preferred directions, while moderate levels of D1 receptor stimulation result in a reduction of delay-related firing to non-preferred directions, allowing representational control in the PFC'. (F. Levy., 2009) These results explain why stimulant medication may be utilised to prevent negative symptoms such as lack of motivation and impulsive behaviour. The lack of dopamine production and incorrect firing of the chemicals within the brain is a theory known as dopamine theory. This theory is vital in the low arousal theory, which suggests that the low levels of dopamine in the brain lead to deficiencies in attention, which may cause the individual to have less interest in stimuli that are not overly exciting. (N. Campo, & Others, 2013) The person may then compensate for this low arousal by looking for stimulation in other things in their environment, which can then lead to hyperactivity. It has also been theorised that those suffering from ASPD also suffer from low dopamine levels, which leads them to search for fulfilling stimuli. 


It has been a discussion among many individuals that there may be a possibility that personality disorders are not reliable diagnoses within the DSM-5; they result from neurodivergent conditions that have not been treated or supported effectively. This is because it is common for personality disorders, especially Borderline Personality Disorder, to be 'a common misdiagnosis for Autistic women and genderqueer people'. (Neurodivergent Insights - BPD or Autism?) Whilst it is considered that an 'autistic person is more vulnerable to developing Borderline Personality Disorder' and co-occur at high rates, it has also been shown that 'when the underlying Autism is missed, Borderline Personality Disorder symptoms are likely exacerbated'. (ibid., Neurodivergent Insights - BPD or Autism?) The other possibility that could be assumed here is that Borderline Personality Disorder is just the exacerbated symptoms of an autistic individual who has not received mental health support. The Venn diagram in figure 1 shows the overlap between these symptoms.




As can be seen on the diagram, both disorders show a huge overlap of symptoms ranging from mood fluctuations to increased risk of self harm or suicidality. The left over symptoms displayed only in Borderline Personality Disorder can be caused by past experiences and events that have left a person to feel hypersensitive in those situations when they appear as though they are reoccurring. So it may be possible to assume that both conditions are one of the same. 


This research led to the assumption that perhaps the same connection could be made between ADHD and ASPD. As ASPD can often be caused by environmental factors such as physical abuse, emotional abuse, or childhood trauma, it is also possible to hypothesise that those with a neurodevelopmental disorder such as ADHD or Autism Spectrum Disorder may have a more challenging time trying to cope with the trauma that they are subjected to. Whilst someone with a neurotypical brain may healthily process trauma, someone who does not understand the trauma they are going through or the world around them, which has been socially constructed to aid those with neurotypical brains, those with neurodivergent brains may react to their trauma in more unhealthy ways. This may lead to unhealthy coping mechanisms that allow their minds to protect themselves from more emotional pain. For example, those with ASPD have the characteristic of not being able to experience guilt; this may be a coping strategy that their minds have put in place so that they do not have to experience connections to people or feel negative emotions about the things they do. 


Due to the totality of this research, an impression was created that those who display characteristics of ADHD will show higher levels of Antisocial Behaviour than those within the general population. This paper does not specify that anyone is diagnosed with any disorders or conditions to take part but instead focuses on the characteristics and behaviours of individuals in order to compare them. 


Within the next part of this paper, there will be the methods section which will look into the study's design, which will be used to explore the relationship between the characteristics of ADHD and Antisocial Behaviour. 



Methods


Design


The study will use a non-experimental quantitative approach by using a survey asking the general population about their experiences with ADHD-like characteristics and Antisocial behaviour. The data will then be collected via SPSS to correlate the variables using regression analysis. The relationships that will require analysis will be the relationship between ADHD-like characteristics and Antisocial behaviour, using average responses. This design should clearly understand how the relationship between ADHD characteristics and Antisocial Behaviour compares with the relationship between the general population and Antisocial Behaviour.


Participants


The survey was sent to the general population via university email and social media. Using G Power, assuming a small/medium effect size with a power of 0.8, a minimum of 78 participants was needed to participate in this study. There were no criteria for gender, sexual orientation, or health-related conditions. Due to insufficient time to circulate the survey, only 53 participants could complete the questionnaire. This means that the results may not be considered as accurate as intended. This point will be evaluated further in the discussion section. 


Ethics have been considered for the participants. Sensitive topics may arise from the survey, such as questioning whether the individuals have been through any traumatic experiences which could explain their behaviours. It is also essential to ask about their use of recreational substances. The research topic will be explicit in the participant briefing, and any participant who becomes anxious about answering questions about ADHD-like traits, recreational drug use or antisocial behaviour can find support online through websites provided in the brief and debrief to minimise harm to any participants who do become distressed. They are also advised to withdraw at any point in the procedure by closing their browser. All ethical concerns have been addressed through the thesis supervisor and two ethical risk supervisors within Northumbria University.


Materials 


  • Questionnaire: This study will be using a questionnaire that asks participants about their experiences with characteristics of attention deficits and hyperactivity, in addition to any possible antisocial behaviours. The study will also use a questionnaire that asks about potential substance abuse as this is an essential trait in ADHD and Anti-Social Behaviour. This questionnaire will require them to answer questions about their behaviour on a time scale ranging from “never” to “very often”. The questionnaire has been created using three pre-existing questionnaires, which psychologists have used within clinical psychology. These are Adler, Kessler Spencer (2005) Adult ADHD Self-Report Scale (ASRS-v1.1); Burt and Donellann (2009) Subtypes of Antisocial Behavior Questionnaire; and Heffernan (2010) The Recreational Drug Use Questionnaire. The questionnaire consists of 2 biographical questions relating to their gender and age. Eighteen questions relating to the characteristics of ADHD, such as “how often do you have difficulty getting things in order when you have to do a task that requires organisation” or “how often are you distracted by activity or noise around you”. Thirty-two questions relating to the characteristics of Antisocial Behaviour, such as “felt like hitting people” or “was suspended, expelled, or fired from school or work”. Moreover, thirteen questions relating to potential substance misuse, such as “have you ever used any recreational drugs” and the frequency of their substance misuse. (Ryan James Gittins. 2022. Qualtrics Ryan ADHD RDUQ Anti Social Behaviour Questionnaire. Available through: https://nupsych.qualtrics.com/jfe/form/SV_1G5KJcc6zuyQopU )

  • SPSS: The survey results will be analysed using IBM® SPSS® Statistics version 27 provided by Northumbria University. SPSS is a statistical software platform that allows the organisation of data sets and analysis. 

  • Google Scholar: Google Scholar will be used to conduct primary research about ADHD, ASPD, and the relationship between the two. 

  • Participant collection poster: I have included the poster material that was used to collect participants for the study below in figure 2.



Figure 2: Participant Collection Poster


A Qualtrics link for the questionnaire will be provided to the general public through social media platforms to recruit an opportunity sample of participants. The used platforms will be FaceBook, Instagram, TikTok, Twitter, and WhatsApp. In snowballing, friends and families will be asked to place the recruitment poster on their media sites. 


These participants will then have to read the brief and give informed consent before participating so that each participant from the sample willingly wants to be a part of the research. They will then be asked to complete a questionnaire discussed within the material section of this paper. The study overall will take approximately 20 minutes for the participants to complete. Once enough participants have been obtained for the study, a correlation regression analysis will take place using SPSS. Outliers will be removed in order to get the most accurate results. The data will be presented via descriptive statistics, box plots, and scatter graphs. More information about the procedure is discussed throughout the results in chronological order. 


Once the results have been recorded, the paper will enter a discussion where the results will be explained thoroughly. This will include a section on what they mean about previous literature and what they might mean for future research. This part of the paper will also aim to highlight the strengths and limitations of this study. The paper will then conclude with a summary of what has been discussed and a closing statement. 

Treatment of data


An ethical consideration which must be taken into account is how each participant's data will be treated and kept anonymous to reduce any mental stress on participants and enforce the confidentiality of the information they give. Firstly, participants will be asked at the start of the questionnaire to give a code name instead of using their real name or any of their truthful information. This is only so that if they wish to withdraw, the researchers know exactly which participants' information needs to be removed. This means that even the researchers are unaware of each participant's personal information, which will be highlighted within the information sheets before the participants take part in the questionnaires, so they feel safe knowing their information is anonymous.  


All of the data collected within the study will be saved in a cloud-based file on a password-protected computer so that no one who does not have permission can access the data that participants have given. As well as this, it will be explained to participants that only the researchers can access this information and that they will not know who each participant is, which will also give them peace of mind and reduce stress on participants. (No names or details have been provided about participants within this study)


Results


The analysis used a non-experimental quantitative approach by using a survey asking the general population about their experiences with ADHD-like characteristics and Antisocial Behaviour to establish a relationship between the two variables. The data set was imported directly from the Qualtrics questionnaire using the “Data and Analysis tab”. Before beginning the analysis, it was noticed that one participant chose to answer “no” when asked for consent; this participant was removed from the data set before beginning the analysis. The data set was then edited to create sub-groups using Data/Split File …/Organize output by groups. This split the ADHD characteristics questions into one group, which averaged the responses, the Antisocial Behaviour characteristics questions into one group, which averaged the responses, and the Substance Misuse questions into one group, which averaged the responses. Splitting the groups separated all of the critical data that would be needed to run an analysis that would compare each of the groups. These variables were correlated using regression analysis.


Descriptive Statistics


The first step to analysing the data was to find out the descriptive statistics by using Analyze/Descriptive Statistics/Descriptive Statistics for average measures of the ADHD and ASB scores and the Types of drug used and useage as seen in figure 3.




The descriptive statistics show the mean for each of the groups being analysed as well as the Standard Deviation (SD). (The mean is the average value in the data set. Standard Deviation is a measure of distribution of a set of data from its mean. The higher the SD is, the greater the range of deviation will be from the mean value.) These are of importance because they can tell the researcher whether the participants are able to be heavily related back to the research question. Answers for ADHD were on average 3.291 which means that the majority of participants were answering most commonly with “sometimes” or “often” to these questions. The standard deviation (SD) was 0.736 which implies there was little range in the answers being given. Answers for AB were on average 1.893 which means that the majority of participants were answering most commonly with “rarely” to these questions. The SD was 0.576 which implies that there was very little range in the answers being given. Answers for substance misuse were on average 2.98 which means that the majority of participants were answering most commonly with “rarely” or “sometimes” to these questions. The SD was 3.927 which implies that there was a large range in the answers being given. 

Correlation and Regression Analyses 


Regression analysis was then conducted in order to describe the relationship between the variables, firstly by creating a correlation table shows in figure 4. In this figure, the ADHD measures are significant (large blue font) predictors of most of the ASB scores. When compared, the ADHD average and the AB average showed a correlation of r=0.526*.



In order to highlight these correlations, I created a scatterplot. This was completed by using Graphs/Legacy Dialogs/Scatter Dot. After this, in a new window I clicked on Simple Scatter and then on Define. This was where I moved the ADHD average to the Y Axis box and the ASB average to the X Axis box. This created the scatterplots in the output window as seen in figure 5. 


Once the scatterplots were completed, I checked for non-linearity and outliers in the data. Here it was checked if there were any strong curvilinear relationship between the variables. It was found that there was a strong positive curvilinear relationship between both variables as shown by the red regression line which has been added in on the graph above. This regression line so far supports the hypothesis as it shows that the higher the ADHD average score rises, the higher the ASB average score rises. Thus indicating that ADHD characteristics relate to Antisocial Behaviours in a positive trend.


Then it was checked it there were any extreme outliers, where it was found that whilst the majority of plots of the graph followed the red line, there were a number of outliers which have been highlighted in the blue circle which has been added to the graph. In order to get accurate results, the outliers need to be removed. To do this, I firstly clicked on Analyze/Descriptive Statistics/Explore, then I dragged the variables to Dependent List and clicked Ok. This showed me that the outliers originated from ASB average (21 and 7) on a box plot which I have shown in figure 6. I went through and removed these participants once they were discovered before recomputing the correlation using Data/Select Cases/If condition is satisfied, and then entered (ASB_Ave <= 3.1) which removed the two outliers.


 

 I then moved onto compute the correlation again by using Analyze/Correlate/Bivariate. In the new window I moved the ADHD average and the Antisocial Behaviour average across and clicked Ok. The new descriptive statistics and correlations can be seen in figure 7 and 8.



This found the results in the output window which allowed me to report the correlations as r=0.565* between the ADHD characteristics variable and the Antisocial Behaviour characteristics variable. A correlation of -1.0 indicates a perfect negative correlation, and a correlation of 1.0 indicates a perfect positive correlation. This indicates that the correlation found is a moderate to strong positive correlation. To display the results, a new updated scatterplot has been created below in figure 9. 





It is observed that the slope of the regression line is positive, thus showing a positive linear relationship between both variables. This means that as one variable increases, so does the other.



Discussion


The study results show that the relationship between ADHD characteristics and Antisocial Behaviour is very strong according to the scatterplot, which showed a strong positive curvilinear relationship between both variables, as shown by the red regression line. As the correlation coefficient was more significant than 0.5, it was indicated that there was a moderate to strong positive correlation. This would go on to support the original hypothesis that those who display characteristics of ADHD will show higher levels of Antisocial Behaviour than those within the general population. 


Meaning and significance in relation to the existing literature and implications for future research 


Most previous literature had acknowledged the correlation between ADHD characteristics and Antisocial Behaviour. However, it had not acknowledged the clear distinction between which behaviours were being acted upon. The first piece of the literature concluded that those who displayed more severe symptoms of ADHD were predicted to develop Antisocial Behaviour. This was supported by the 2004 study, which found that children with hyperactive traits were far more likely to develop Antisocial Behaviour in adulthood than children who did not show signs of ADHD. This journal did not, however, acknowledge the other factors such as environment or what Storebø OJ, Simonsen E. found in 2016 that discussed whether it may be that children who have ADHD may have an increased risk of developing personality disorders and criminal behaviour in the future, leading to eighteen prospective studies which showed that ADHD with and without comorbid conduct disorder (CD) had a high risk of later developing ASPD but as a separate subtype of ADHD. (ibid., Storebø OJ, Simonsen E., 2016) The results of my study on the association between ADHD-like characteristics and Antisocial Behaviour show that this may be accurate. 


Some interesting patterns were noticed while observing the individual questions within the data. Those with a higher average of ADHD characteristics tended to present with higher levels of passive Antisocial Behaviour rather than aggressive Antisocial Behaviour. This would mean that individuals tended to answer "no" to questions that were considered violent or aggressive towards other people; however, they tended to answer "yes" to passive questions where the Antisocial Behaviour would only affect themselves (e.g. Substance misuse, shoplifting). This would indicate that the Antisocial Behaviour experienced by those with ADHD-like characteristics may be considered passive behaviours. 


This may support the previous literature because it shows that whilst the individuals would not meet the criteria for ASPD itself, they may still engage in passive Antisocial Behaviour as a sub-type of ADHD. This information may give new insight into the link between ADHD and specific behaviours such as substance misuse or addiction, which may, in turn, help find new ways to prevent the behaviour or, at the very least, understand what causes it in this group of individuals. 


Another piece of literature looked at Dopamine vs Noradrenaline (2009), and it found that both those with ADHD and those with ASPD both conditions had a lack of dopamine production and incorrect firing of the chemicals within the brain, which led to impulsive behaviours due to deficiencies in attention that then cause the individual to have less of an interest in stimuli that is not overly exciting. (Ibid., A positron emission tomography study of nigro-striatal dopaminergic mechanisms underlying attention, 2013) The results of the study on the association between ADHD-like characteristics and Antisocial Behaviour support this theory as they have shown that those with ADHD-like characteristics tend to partake in forms of Antisocial Behaviour that seem impulsive. It could be assumed that these results are caused by this lack of dopamine production, which this study questions. It would be very interesting to see this theory implemented in further research, knowing there is a relationship between the two variables. 

A recommendation for further study into the relationship between ADHD and Antisocial Behaviour could be if the study were to be replicated by someone with a background in clinical psychology. If this were the case, then they could specialise the study to work with individuals who have an official diagnosis and compare them against those who do not. It would also be interesting to work with participants who raise higher ethical risk such as those in prisons or those in psychiatric facilities. This would open up the study to more reliable results. 


Strengths and limitations of the study 


  • Survey reliability: The questionnaire used for this study used questions from questionnaires that had been used by previous psychologists and have been listed in the footnotes. This means that the questions used were reliable in the collection of data. The questionnaire was also kept moderately short and used easy-to-understand terms to hold the participant's attention which is very important as most participants may struggle to hold attention due to the nature of the survey aimed at those with ADHD.

  • Additional causes of Antisocial Behaviour: Within the research on Neurodivergent Insights, it was hypothesised that personality disorders were the result of neurodivergent conditions that have not been treated or supported effectively whilst enduring environmental trauma such as physical abuse, emotional abuse, or childhood trauma. (ibid., BPD or Autism?) This was later translated to apply to ADHD and ASPD. The study's association between ADHD-like characteristics and Antisocial Behaviour could not give any new insight into this discussion; however, in the future, it should be considered by asking more in-depth questions about trauma which could be compared amongst those with ADHD-like characteristics and Antisocial Behaviour. The reasoning for not including additional causes of the behaviour was that there might be an issue surrounding ethics. Those with characteristics of ADHD or ASPD without a formal diagnosis may be vulnerable as they both possess traits that may make them more vulnerable than typical individuals. This risk was minimised by frequently consulting with this project's thesis supervisor and keeping data sets anonymised. However, it meant that questions relating to trauma were avoided, which may have helped distinguish between whether the ADHD-like characteristics solely caused the behaviours or whether they were related to trauma.

  • Participants: The sample group focused on the general population and did not require a prior diagnosis to take part. This would mean that a broader range of participants could participate, and a more extensive comparison between those with ADHD characteristics could be compared with those who did not. However, due to insufficient time to circulate the survey, only 53 participants could complete the questionnaire, though g* power found that 78 participants were needed. This means that the results may not be considered as accurate as intended. In the future, more time should be considered to find more participants to ensure the reliability of the study. The descriptive statistics showed that the average answers ranged from “rarely” to “often” with a Standard Deviation which implied there was little range in the answers being given. On average, the responses to the questions seem to fall in a mid-area rather than having the direct expression of high ADHD-like characteristics or Antisocial Behaviour traits. This means that the participants who took part likely do not have many ADHD-like characteristics or Antisocial Behaviour, which may make the data less reliable even though both seemed closely related. 

  • Data analysis: The survey's data found the intended results and used both accurate correlation analysis and a supporting scatterplot which showed the same results. This means that the data should be considered reliable. The standard deviation in the descriptive statistics was 0.7, which implies that the data can be trusted as it is considered typical to work with values above 1 or below 1. As can most likely be seen in the results section, there was a significant amount of time attempting to correlate the data, which was met with errors throughout the process. In the future, the analysis should aim to be much cleaner. 

  • Outliers: When analysing the data, it was found that there were few outliers detected within the Antisocial Behaviour average variable (20, 22, and 7). This did not make sense when removing them, as SPSS attempted to delete all of the data. The box-plot calculation was recalculated, and it was found that the previous answer had been incorrect. The true outliers were 7 and 21. These have been acknowledged when calculating the data as they were then removed from the data set, and the data was then recalculated. However, they show that the results may not be as reliable as if no outliers were detected. Whilst it is normal to have some outliers in a data set, this must be considered in the overall report.



Conclusion


The purpose of this paper was to explore how strong the relationship is between ADHD characteristics and Antisocial Behaviour. The rationale for this hypothesis is that a small amount of previous literature suggests compelling evidence that those with ADHD may have a significant risk of developing Antisocial traits. 


The topic of the relationship between these two variables is under-researched, with limited previous literature or studies. Some articles found were discussed within both the introduction of the paper and the discussion section. These studies explored ADHD and ASPD characteristics as separate sets of traits and how they may be linked. This formed the original hypothesis for this study that those who display characteristics of ADHD will show higher levels of Antisocial Behaviour than those within the general population.


This study used a quantitative via an online survey to collect data which explored the relationship between ADHD characteristics and Antisocial Behaviour amongst the general population using 53 participants. Data were analysed using correlation in SPSS, where it was found that once outliers were removed, there was a correlation of r=0.565*, indicating a moderate to a strong positive correlation. The scatterplot supported this, which showed a strong positive curvilinear relationship between both variables. These results support the original hypothesis that those who display characteristics of ADHD will show higher levels of Antisocial Behaviour than those within the general population, in addition to forming a solid foundation for further research into the topic. The work conducted within this paper is highly original and may hugely impact future research on how ADHD is understood and how Antisocial Behaviour may be prevented.



References


ADHD Resources:


Antisocial Behaviour Resources:


ADHD / Antisocial Behaviour Relationship Resources:

  • A. Thapar, M. Bree, T. Fowler, K. Langley, and N. Whittinger (2006). Predictors of antisocial behaviour in children with attention deficit hyperactivity disorder. European Child & Adolescent Psychiatry (volume 15, pp. 118–125). Retrieved 10 November 2021. Available via: https://www.springer.com/journal/787 

  • C. Allely, H. Minnis, L. Thompson, P. Wilson, C. Gillberg. (2014). Neurodevelopmental and psychosocial risk factors in serial killers and mass murderers, Aggression and Violent Behavior (Volume 19, Issue 3, pp. 288-301). Retrieved 13 September 2022. Available via: https://doi.org/10.1016/j.avb.2014.04.004.

  • D. Álvarez-García, P. González-Castro, J.C. Núñez, C. Rodríguez, and R. Cerezo. (2019) Impact of Family and Friends on Antisocial Adolescent Behavior: The Mediating Role of Impulsivity and Empathy. Front. Psychol. (10, pp.2071). Retrieved 9 November 2021. doi: 10.3389/fpsyg.2019.02071

  • F. Levy. (2009). Dopamine vs Noradrenaline: Inverted-U Effects and ADHD Theories. Australian & New Zealand Journal of Psychiatry, (pp.101–108). Retrieved 7 November 2021. Available via: https://doi.org/10.1080/00048670802607238

  • J. Learish (2021). Richard Ramirez: The story, the evidence, the Night Stalker. CBS NEWS. Retrieved 13 September 2022. Website available via: https://www.cbsnews.com/pictures/richard-ramirez-night-stalker-murders/2/

  • N. Campo, T. Fryer, Y. Hong, R. Smith, L. Brichard, J. Acosta-Cabronero, S. Chamberlain, R. Tait, D. Izquierdo, R. Regenthal, J. Dowson, J. Suckling, J. Baron, F. Aigbirhio, T. Robbins, B. Sahakian, and U. Muller. (2013). A positron emission tomography study of nigro-striatal dopaminergic mechanisms underlying attention: implications for ADHD and its treatment Brain, (pp.3252-3270). Retrieved 10 November 2021. DOI: 10.1093/brain/awt263

  • OJ. Storebø, E. Simonsen. (2016) The Association Between ADHD and Antisocial Personality Disorder (ASPD): A Review. J Atten Disord. (Abstract) (pp.815-24). Retrieved 10 September 2022. doi: 10.1177/1087054713512150.

  • P. Carlo (1996). The night stalker: The true story of America's most feared serial killer (1st ed.), Kensington. Retrieved 6 October 2021.

  • R.A. Barkley, M. Fischer, L. Smallish, K. Fletcher. (2004). Young adult follow-up of hyperactive children: antisocial activities and drug use. The Journal of Child Psychology and Psychiatry. Retrieved 11 September 2022. https://doi.org/10.1111/j.1469-7610.2004.00214.x

  • (Unknown Author) Neurodivergent Insights (undated). BPD or Autism?. Retrieved 10 September 2022. Website available via: https://neurodivergentinsights.com/misdiagnosis-monday/boderline-personality-disorder-or-autism


SPSS Outputs, Data, and Questionnaire:

  • Adler, Kessler Spencer (2005) Adult ADHD Self-Report Scale (ASRS-v1.1) 

  • Burt and Donellann (2009) Subtypes of Antisocial Behavior Questionnaire 

Heffernan (2010) The Recreational Drug Use Questionnaire 



Citing this project:

Article Title:

The Association Between ADHD-like Characteristics and Anti-Social Behaviour

Author:

Mx. R.J. Gittins

Publisher:

SheThinkDifferent (The Unseen Spectrum)

Date Written:

2022 - 2023

Date Published:

August 2024



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