The predictive and incremental validity of ADHD beyond the VRAG-R in a high-risk sample of young offenders

Eur Arch Psychiatry Clin Neurosci. 2022 Dec;272(8):1469-1479. doi: 10.1007/s00406-021-01352-x. Epub 2021 Dec 3.

Abstract

The VRAG-R is a well-established actuarial risk-assessment instrument, which was originally developed for assessing violent recidivism risk in adult male offenders. Whether or not the VRAG-R can also predict violent recidivism in young offenders is unclear so far. In the emergence of juvenile offending, attention-deficit/hyperactivity disorder (ADHD) seems to be of major importance suggesting that it could be relevant for risk assessment as well. Thus, we examined the predictive accuracy of the VRAG-R in a high-risk sample of N = 106 (M = 18.3 years, SD = 1.8) young offenders and assessed the incremental predictive validity of ADHD symptomatology beyond the VRAG-R. Within a mean follow-up time of M = 13 years (SD = 1.2), n = 65 (62.5%) young offenders recidivated with a violent offense. We found large effect sizes for the prediction of violent and general recidivism and re-incarcerations using the VRAG-R sum scores. Current ADHD symptomatology added incremental predictive validity beyond the VRAG-R sum scores concerning the prediction of general recidivism but not of violent recidivism. The results supported the use of the VRAG-R for predicting violent recidivism in young offenders. Because ADHD symptomatology improves the predictive performance of the VRAG-R regarding general recidivism, we argue that addressing ADHD symptoms more intensively in the juvenile justice system is of particular importance concerning a successful long-term risk management in adolescents and young adults.

Keywords: ADHD; Attention deficit/hyperactivity disorder; Recidivism risk; Risk assessment; VRAG-R; Young offenders.

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Criminals*
  • Humans
  • Male
  • Recidivism*
  • Risk Assessment / methods
  • Young Adult