Genetics & Sentencing Simon Easteal John Curtin School of Medical Research, ANU

1. Genetics & Sentencing Simon Easteal John Curtin School of Medical Research, ANU

2. Judge for yourself A Guide to Sentencing in Australia Published by the Judicial Conference of Australia

3. Is genetics relevant to the purposes of sentencing? Punishment Rehabilitation Specific deterrence General deterrence Denunciation Community Protection Restorative justice

4. Do advances in our understanding of human genetics raise issues relevant to sentencing? Can these issues be dealt with within the existing system of judicial discretion including consideration of mitigating and aggravating factors and the use of specialist courts?

5. There is an increasing availability of genetic tests

6. ... being applied to disorders that are much more common and in which there is an interaction of genetic and environmental factors After a two year visit to the United States, Michelangelo's David is returning to Italy ...

7. Psychological traits and psychiatiric conditions are highly heritable

8. ... including psychological ones

9. Some examples of relatively large genetic effects on behavioural traits

10. Sunday 27 December 2009 00.17 GMT All prisoners to be tested for ADHD Research shows one in five suffers from the condition but is not diagnosed Police, courts and prisons will test all adult offenders for attention deficit disorders in a bid to reduce reoffending rates and cut aggressive behaviour in prisons. The scheme is being set up by the Department of Health after research revealed a disproportionately high number of undiagnosed and untreated sufferers in the criminal justice system.

11. Adult ADHD is characterised by poor executive functioning • Disorganisation • Poor time perception • Poor time management • Forgetfulness, especially for tasks that need to be done • Failure to plan ahead & anticipate • Dificulty keeping track of several things at once • Difficulty completing tasks • Impulsive decision making • Problems keeping promises and commitments • Inability to shift from ongoing activity to a more important or urgent tasks Barkley RA (2010) Attention Deficit Hyperactivity in Adults. Jones & Bartlett

12. Adults with ADHD can also be unusually: • Adventurous • Intense • Humorous • Insightful • Creative • Open to new ideas • Divergent in their thinking

13. It’s very common in children ... 7.4% US Birth cohort (N=5718); Barbaresi WJ et al. (2002) Arch Pediatr Adolesc Med 156:217-24. 8.7% US National Representative Sample (N=3082); Froehlich et al. (2007) Arch Pediatr Adolesc Med 161:857-64. 8.5% Finnish Birth cohort (N=6620); Smalley et al. (2007) J Am Acad Child Adolesc Psychiatry 46:1575-83 ... and in adults Male:Female =1.5 Fayyad J. et al. (2007) Brit J Psychiat. 190:402-9; WHO WMH Survey

14. It’s highly heritable Spencer et al. 2007. J Pediat Psychol. 32:631-642

15. A number of genes are reliably associated with it Biederman J. & Faraone SV. 2005. Lancet 366:237-48

16. It’s a treatable condition Clinical trail results Biederman J. & Faraone SV. (2005) Lancet 366:237-48 Epidemiological evidence 73% episodes of treatment with stimulant medication associated with favourable response. Birth cohort to 17yr. N=379. Barbaresi et al. 2006. J Dev Behav Pediatr 27:1-10.

17. ... which remains largely untreated. • In Western Australia • All Children 2.2% treated • All Adults 0.4% treated Stimulant Prescribing and Usage Patterns for the Treatment of ADHD in Western Australia (1 August 2003 – 31 December 2004) Department of Health, Western Australia. 2005 ... which implies: Untreated ADHD Children >65% Adults >90%

18. General Health Greater use of the health care system More sick days Barkley RA (2010) Attention Deficit Hyperactivity in Adults. Jones & Bartlett

19. Mental Health Post Traumatic Stress Disorder; Suicidality Barkley RA (2010) Attention Deficit Hyperactivity in Adults. Jones & Bartlett Biederman et al. (2004) Biol Psychiatr 55:692-700 Brown T (ed) (2009) ADHD Comorbidities

20. Relationship & employment problems • Workplace diffculties: • Following instructions, • Getting along with coworkers, • Meeting deadlines, • Managing large workloads • Concentrating • Paying attention Barkley RA (2010) Attention Deficit Hyperactivity in Adults. Jones & Bartlett Biederman et al. (2004) Biol Psychiatr 55:692-700

21. More serious accidents • More frequent accidents • More work-related accidents • More accidents at home • Less stable work history • Lower quality of life • More criminal activity • More arrests • Greater rates of recidivism • Greater incarceration rate General functional problems Fayyad J. et al. (2007) Brit J Psychiat. 190:402-9; WHO WMH Survey Able et al. (2007) Psychol Med 37:97-107 Barkley RA (2010) Attention Deficit Hyperactivity in Adults. Jones & Bartlett Rasmussen & Levander (2008) J. Attent. Disord.

22. ADHD in the prison population

23. ADHD summary

24. “Every community needs to devote a good deal of time and energy to producing a justice system that is as logical, rational, sensible and effective as possible” Judge for yourself A Guide to Sentencing in Australia Published by the Judicial Conference of Australia A logical, rational, sensible and effective justice systems needs to account for the heritable psychological diversity that is an intrinsic aspect of human nature

25. Our brutal past “But we slowly learned the inescapable truth; brutal punishment creates angrier and more violent people.” ... “Today sentencing laws are designed to be much more effective as well as humane.” Judge for yourself A Guide to Sentencing in Australia Published by the Judicial Conference of Australia Psychological genetics can inform the development of even more effective and humane sentencing laws, by clarifying the interplay between innate predispositions and life circumstances in shaping individual behaviour and response to intervention.