Childhood antecedents of serious violence in adult male offenders

Prospective longitudinal studies have shown strong predictions from conduct disorders (CDs) in childhood to antisocial personality disorder (ASPD) and violence in adults. However, little is known of the childhood antecedents of serious violence nor whether these may vary depending on the context in which the violence occurs. In this study, 54 men aged 21-40 years serving prison sentences for violent crime were assessed. Standardized interviews of ASPD and violence were conducted independently of interviews covering retrospective recall of childhood psychiatric disorders and adverse experiences. Analyses of the predictors of overall violence suggested a pathway involving childhood CD and adult ASPD associated with interparental discord, and an additional pathway associated with experiencing interparental violence in childhood. Different results were however obtained when account was taken of the context of the violence. The CD-ASPD pathway was associated with social violence, but not with partner violence. Partner violence was predicted by retrospective reports of having been exposed to interparental violence during childhood but not by reports of childhood CD or adult ASPD. Thus developmental pathways to serious violence may be different depending on the social domain in which the violence occurs.     

Conduct Disorder and Psychosocial Outcomes at Age 30: Early Adult Psychopathology as a Potential Mediator

Conduct disorder (CD) is associated with a number of adverse psychosocial outcomes in adulthood. There is consistent evidence that CD is predictive of antisocial behavior, but mixed evidence that CD is predictive of other externalizing and internalizing disorders. Further, externalizing and internalizing disorders are often associated with similar psychosocial outcomes as CD. However, relatively little work has examined whether forms of psychopathology (e.g., externalizing and/or internalizing disorders) mediates the relationship between youth CD and adult psychosocial outcomes. The present study examined associations between youth CD and adult psychosocial outcomes and sought to identify forms of psychopathology that may potentially mediate this relationship. Participants completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood. Analyses found that most domains of adult psychosocial functioning were associated with youth CD. Adult antisocial behavior was the only form of psychopathology predicted by CD. Adult antisocial behavior appeared to mediate the relationship between CD and marital status, life satisfaction, and being in jail and partially mediated the relationship between CD and family support and global functioning. These data suggest that reducing the progression to adult antisocial behavior may improve multiple psychosocial outcomes among those with a history of CD.     

Antisocial personality disorder, affect dysregulation and childhood abuse among incarcerated women

The aim of this study was to examine the role of affect dysregulation and childhood abuse in antisocial personality disorder (ASPD), using a sample of incarcerated women. Subjects for this study were 85 incarcerated women who were administered structured interviews to assess for ASPD, borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), childhood trauma, and affect dysregulation. Using a series of logistic regressions, this study found that a greater degree of affect dysregulation--in particular, poor anger modulation--was significantly related to ASPD, controlling for BPD and PTSD in women prisoners. After controlling for BPD, recent self mutilation was not significantly related to ASPD. Likewise, a history of childhood abuse was not significantly associated with ASPD.     

Evidence for a Multi-Dimensional Latent Structural Model of Externalizing Disorders

Strong associations between conduct disorder (CD), antisocial personality disorder (ASPD) and substance use disorders (SUD) seem to reflect a general vulnerability to externalizing behaviors. Recent studies have characterized this vulnerability on a continuous scale, rather than as distinct categories, suggesting that the revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) take into account the underlying continuum of externalizing behaviors. However, most of this research has not included measures of disorders that appear in childhood [e.g., attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD)], nor has it considered the full range of possibilities for the latent structure of externalizing behaviors, particularly factor mixture models, which allow for a latent factor to have both continuous and categorical dimensions. Finally, the majority of prior studies have not tested multidimensional models. Using lifetime diagnoses of externalizing disorders from participants in the Fast Track Project (n?=?715), we analyzed a series of latent variable models ranging from fully continuous factor models to fully categorical mixture models. Continuous models provided the best fit to the observed data and also suggested that a two-factor model of externalizing behavior, defined as (1) ODD+ADHD+CD and (2) SUD with adult antisocial behavior sharing common variance with both factors, was necessary to explain the covariation in externalizing disorders. The two-factor model of externalizing behavior was then replicated using a nationally representative sample drawn from the National Comorbidity Survey-Replication data (n?=?5,692). These results have important implications for the conceptualization of externalizing disorders in DSM-5.     

Die Bedeutung der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung für die Entstehung und Prognose von Störungen des Sozialverhaltens im Kindes- und Jugendalter

Attention Deficit/Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) are two of the most common neurobehavioral disorders of childhood. Despite of their high comorbidity rate both disorders can be reliably differentiated. Especially the comorbid condition is associated with a poor outcome and some of the affected children develop an Antisocial Personality Disorder. This article summarizes diagnostic criteria and epidemiological data of both disorders and emphasises the role of ADHD in the aetiology and pathogenesis of antisocial behavior. ADHD seems to have a negative impact particular in children of the early-starter subtype of CD. Findings from genetic, psychophysiological and neuroimaging studies emphasise the relevance of biological risk factors in the etiological models and developmental pathways of antisocial behavior. We present so far unpublished data of children with ADHD and ADHD/disruptive behavior disorders which indicate group-specific neurocognitive impairments in the comorbid condition. ADHD and CD seem to constitute a synergistic and interactive relationship in that each disorder aggravates the other. Recent findings point to a “true hybrid” of ADHD/CD. Considering the negative outcome of the comorbid condition, several findings suggest that high-quality treatments may have considerable impact on restoring ADHD children to better functioning.     

Substance use and violent behavior in women with antisocial personality disorder

The purpose of this study was to examine the relationship between substance abuse and dependence and violent behavior in a sample of incarcerated women with antisocial personality disorder (ASPD). Among male populations, substance dependence is associated with aggression and criminal behavior. Individuals with ASPD have more severe substance dependence, including higher symptom counts, earlier age of onset, and more frequent co-morbidity. Incarcerated women have a high prevalence of ASPD and substance dependence, but there has been little detailed work regarding addiction severity. Similarly, work on association of substance abuse and dependence with specific violent behaviors has been limited. This study examined a group of 41 mid-sentence female felons with a diagnosis of ASPD to determine associations with substance abuse and dependence. Data were gathered through administration of the Semi-Structured Assessment of the Genetics of Alcoholism II (SSAGA II). Substance dependence was highly prevalent (i.e., alcohol dependence, 56.1%; opiate dependence, 48.8%; cocaine dependence, 61.0%). While specific diagnoses were not associated with violent behavior and offending, symptom severity (i.e., age of onset, symptom count, co-morbidity) was associated with violent behavior in women dependent on opiates, alcohol, and cocaine. Arrest for an assault 1 was associated with alcohol dependence and opiate dependence. These data suggest that measurement of symptom severity and co-morbidity is important in assessing violent behavior in incarcerated women with ASPD. These findings are potentially important in examining non-incarcerated, substance-dependent women.     

Intergenerational transmission of antisocial behavior: How do kids become antisocial adults?

Exposure to many potential environmental risk factors for child antisocial behavior is associated with one of the strongest predictors of antisocial behavior, a family history of antisociality. Because most studies of putative environmental factors do not take into account genetic propensities for antisocial behavior shared between parent and child, the possibility of genetic contributions to these “environmental” markers is typically not evaluated. In this paper, we review research on the environmental correlates of antisociality, their association with parental antisociality, and highlight findings from studies that have controlled for either genetic propensities or parental antisociality.     

Test of the plausibility of adolescent substance use playing a causal role in developing adulthood antisocial behavior

DSM-IV antisocial personality disorder diagnosis requires that conduct disorder be exhibited before age 15. However, recent studies have reported on men and women without conduct disorder before age 15 but qualified for the adulthood antisocial personality criterion (AAB). This general-population, retrospective study investigated the plausibility of causal relationships between adolescent drug and alcohol misuse (ADAM) and AAB among subgroups who reported childhood-onset conduct problems (CP), adolescent-onset CP, or no more than one conduct problem. Data from the Epidemiological Catchment Area Study (N = 8,724) suggested that persons with childhood-onset CP are at much greater risk for AAB than persons with adolescent-onset CP. Nevertheless, large proportions of men and women with AAB had adolescent-onset CP or no CP. Regardless of CP history, being drunk by age 18 or having a drug use-related symptom before age 18 increased AAB risk, even after controlling for having a substance use-related disorder in adulthood. Mechanisms that potentially explain these associations are discussed.     

Unique roles of antisocial personality disorder and psychopathic traits in distress tolerance

Previous research indicates that individuals with antisocial personality disorder (ASPD) evidence low distress tolerance, which signifies impaired ability to persist in goal-directed behavior during an aversive situation, and is associated with a variety of poor interpersonal and drug use outcomes. Based on theory and research indicating that psychopathic traits are associated with hypo-reactivity in emotional responding, a unique hypothesis emerges where psychopathic traits should have the opposite effect of ASPD and be related to high levels of distress tolerance. In a sample of 107 substance-dependent patients in an inner-city substance use residential treatment facility, this hypothesis was supported. ASPD was related to lower distress tolerance, while psychopathic traits were related to higher distress tolerance, with each contributing unique variance. Findings are discussed in relation to different presentations of distress tolerance as a function of psychopathic traits among those with an ASPD diagnosis.     

Developmental trajectories of disruptive behavior problems among sons of alcoholics: effects of parent psychopathology,family conflict,and child undercontrol

This study examined trajectories of disruptive behavior problems from preschool to early adolescence in 302 boys from a community-recruited sample of high-risk families. Growth modeling showed that paternal alcoholism was associated with elevated levels of sons' disruptive behavior problems. Family conflict predicted more disruptive behaviors at school entry and a slower rate of decline in such problems. Parent antisocial personality disorder (ASPD) exacerbated the effects of high preschool levels of sons' undercontrol on level of disruptive behaviors at school entry; this effect became progressively stronger across time. Low levels of undercontrol protected sons of ASPD parents from experiencing heightened levels of disruptive behaviors both at school entry and increasingly as sons grew older. Implications for subsequent maladjustment are discussed.     

Histrionic personality disorder and antisocial personality disorder: sex-differentiated manifestations of psychopathy?

Little is known about the etiology of histrionic personality disorder (HPD) or its relation to other personality disorders. In this study, we examined whether HPD is etiologically related to psychopathy and more specifically whether HPD and antisocial personality disorder (ASPD) are sex-typed alternative manifestations of psychopathy. In addition, based on Newman's (1987) response modulation hypothesis of psychopathy, we examined the associations between psychopathic, HPD, and ASPD features and performance on laboratory measures of passive avoidance errors and interference effects. Seventy-five live theater actors completed self-report questionnaires and two laboratory measures of response modulation, and peers completed questionnaires concerning the participants' personality disorder features. The results provided weak and inconsistent support for the hypotheses that HPD is a female-typed variant of psychopathy and that ASPD is a male-typed variant of psychopathy. Contrary to previous findings, scores on response modulation tasks were not significantly related to psychopathy, or to either HPD or ASPD. The limitations of this study and possibilities for future research in this area are outlined.     

The Emotional Lexicon of Individuals Diagnosed with Antisocial Personality Disorder

This study investigated the specific emotional lexicons in narratives created by persons diagnosed with antisocial personality disorder (ASPD) to test the hypothesis that individuals with ASPD exhibit deficiencies in emotional language. Study participants consisted of 60 prison inmates with ASPD, 40 prison inmates without ASPD, and 60 men without antisocial tendencies who described situations involving love, hate and anxiety depicted by photographs. The lexical choices made in the narratives were analyzed, and a comparison of the three groups revealed differences between the emotional narratives of inmates with ASPD, inmates without ASPD, and the control group. Although the narratives of the individuals with ASPD included more words describing emotions and higher levels of emotional intensity, the valence of these words was inappropriate. The linguistic characteristics of these narratives were associated with high levels of psychopathy and low emotional reactivity.     

Factors associated with antisocial behavior in combat veterans

The objective of this study was to identify factors associated with antisocial behavior in 1,543 Marines who deployed to combat zones in support of conflicts in Iraq and Afghanistan during 2002–2007. Five factors were associated with antisocial behavior in multivariate analyses: post‐traumatic stress disorder (PTSD) symptoms, deployment‐related stressors, combat exposure, younger age, and being divorced. PTSD symptoms had a stronger association with antisocial behavior than any other variable. A unique and important finding of this study was the association between deployment‐related stressors and a higher incidence of antisocial behavior. Because deployment‐related stressors are potentially modifiable, the military may be able to address them in concrete ways such as by shortening deployments and improving communication with home. Aggr. Behav. 36:330–337, 2010. Published 2010 by Wiley‐Liss, Inc.     

Utilization of emotion cues in male and female offenders with antisocial personality disorder: results from a lexical decision task

Antisocial personality disorder (ASPD) diagnoses have demonstrated good reliability and validity in male offenders. However, there is a paucity of research assessing utilization of emotion cues in ASPD individuals and the extent to which correlates of ASPD in males generalize to females. This investigation examined emotion utilization in incarcerated men and women with and without ASPD using a lexical decision task with emotional and neutral words. The performance of male offenders with ASPD was similar to that of male controls, whereas women with ASPD demonstrated greater emotional facilitation than female controls. Moreover, the number of violent crimes committed by female inmates with ASPD was related to emotion facilitation, suggesting a link between their sensitivity to emotion cues and antisocial behavior.     

The association between axis I and II psychiatric symptoms and high-risk sexual behavior during adolescence

This study was conducted to investigate the association between psychiatric disorders and high-risk sexual behavior among adolescent primary care patients. Interviews assessing anxiety, conduct, depressive, eating, substance use, and personality disorders (PDs), as well as histories of sexual behavior were administered to 119 male and 284 female adolescent primary care patients. Results indicated that, after co-occurring psychiatric disorders were controlled statistically, adolescents with elevated PD symptom levels were more likely than adolescents without elevated PD symptom levels to report a high number of sexual partners during the past year and during their lifetime. Adolescents with a history of conduct disorder were more likely than adolescents without such a history to report a high number of lifetime unsafe sexual partners. Elevated antisocial, dependent, and paranoid PD symptom levels were associated with high-risk sexual behavior after co-occurring psychiatric disorders were controlled. Further, certain specific antisocial, borderline, dependent, histrionic, narcissistic, obsessive-compulsive, paranoid, and schizotypal PD symptoms were independently associated with high-risk sexual behavior after co-occurring psychiatric disorders and overall PD symptom levels were controlled. The association between overall PD symptom levels and the number of sexual partners was significantly stronger among the females than among the males in the sample. Increased recognition and treatment of PDs, coupled with increased recognition of high-risk sexual behavior may facilitate the prevention of sexually transmitted diseases and teenage pregnancy among adolescents.     

Sex differences in the genetic and environmental influences on childhood conduct disorder and adult antisocial behavior

Sex differences in the genetic and environmental influences on childhood conduct disorder and adult antisocial behavior were examined in a large community sample of 6,383 adult male, female, and opposite-sex twins. Retrospective reports of childhood conduct disorder (prior to 18 years of age) were obtained when participants were approximately 30 years old, and lifetime reports of adult antisocial behavior (antisocial behavior after 17 years of age) were obtained 8 years later. Results revealed that either the genetic or the shared environmental factors influencing childhood conduct disorder differed for males and females (i.e., a qualitative sex difference), but by adulthood, these sex-specific influences on antisocial behavior were no longer apparent. Further, genetic and environmental influences accounted for proportionally the same amount of variance in antisocial behavior for males and females in childhood and adulthood (i.e., there were no quantitative sex differences). Additionally, the stability of antisocial behavior from childhood to adulthood was slightly greater for males than females. Though familial factors accounted for more of the stability of antisocial behavior for males than females, genetic factors accounted for the majority of the covariation between childhood conduct disorder and adult antisocial behavior for both sexes. The genetic influences on adult antisocial behavior overlapped completely with the genetic influences on childhood conduct disorder for both males and females. Implications for future twin and molecular genetic studies are discussed.     

Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder

A childhood history of sexual or physical abuse is highly prevalent in borderline personality disorder (BPD) and is associated with self-destructive behavior in clinical and nonclinical samples. Viewing BPD as a "high risk" disorder, we asked if childhood abuse was a risk factor for adult suicidal behavior or if it was related to other known risk factors for suicide in BPD. A semistructured Abuse History was obtained in 61 criteria-defined BPD patients, who were characterized by structured interviews and self-reports for Axis I disorders, Suicide History, BPD severity, hopelessness, impulsivity, impulsive-aggression, and antisocial traits. Occurrence and severity of childhood sexual abuse, but not physical abuse, predicted adult suicidal behavior independent of other known risk factors. The odds of a sexually abused patient attempting suicide in adulthood was over 10 times that of a patient who was never sexually abused. Given a history of childhood sexual abuse, the risk of adult suicidal behavior in BPD was increased by antisocial traits, severity of BPD, hopelessness, or comorbid major depressive episode (MDE).     

Maternal Antisocial Behavior, Parenting Practices, and Behavior Problems in Boys at Risk for Antisocial Behavior

We investigated the independent contributions of maternal history of antisocial behavior and parenting practices to the worsening course of sons' behavior problems in a sample of young urban boys at risk for antisocial behavior. Mothers reported on boys' behavior problems at baseline and one year later, as well as on their own history of antisocial behavior before and after age 15, and of lifetime depression and substance use disorders (provisional DSM-III-R diagnoses). Baseline reports of parenting practices were obtained. Lower involvement, lower monitoring, and higher levels of parent–child conflict and maternal Conduct Disorder (CD) before age 15 contributed to the worsening of boys' behavior problems one year later; mothers' symptoms of Antisocial Personality Disorder after age 15 did not. Mothers' lifetime history of Major Depression and Substance Use Disorder did not add to the worsening of boys' behavior problems after accounting for these other factors. Although maternal CD contributed directly to the worsening of boys' behavior problems, the effect of parenting was more substantial. We discuss clinical implications for prevention and treatment of children's antisocial behavior, and intergenerational implications of girls' early antisocial behavior.     

Brain structure abnormalities in young women who presented conduct disorder in childhood/adolescence

The phenotype and genotype of antisocial behavior among females are different from those among males. Previous studies have documented structural brain alterations in males with antisocial behavior, yet little is known about the neural correlates of female antisocial behavior. The present study examined young women who had presented conduct disorder (CDW) prior to age 15 to determine whether brain abnormalities are present in adulthood and whether the observed abnormalities are associated with comorbid disorders or maltreatment that typically characterize this population. Using magnetic resonance imaging and voxel-based morphometry, we compared gray matter volumes (GMV) of 31 women who presented CD by midadolescence and 25 healthy women (HW), age, on average, 23 years. Participants completed structured, validated interviews to diagnose mental disorders, and validated questionnaires to document physical and sexual abuse. Relative to HW, CDW presented increased GMV in the left superior temporal gyrus that was associated with past alcohol and drug dependence, current use of alcohol and drugs, and current anxiety and depression symptoms and maltreatment. Additionally, CDW displayed reduced GMV in lingual gyrus, hippocampus, and anterior cingulate cortex that was associated with past comorbid disorders, current alcohol and drugs use, current anxiety and depression symptoms, and maltreatment. The CDW also presented reduced total GMV that was associated with past comorbid disorders and current anxiety/depression symptoms. Alterations of brain structure were observed among young adult females with prior CD, relative to HW, all of which were associated with internalizing and externalizing disorders and maltreatment that typically accompany CD.     

Effects of comorbid psychopathy on criminal offending and emotion processing in male offenders with antisocial personality disorder

Antisocial personality disorder (ASPD) and psychopathy are two syndromes with substantial construct validity. To clarify relations between these syndromes, the authors evaluated 3 possibilities: (a) that ASPD with psychopathy and ASPD without psychopathy reflect a common underlying pathophysiology; (b) that ASPD with psychopathy and ASPD without psychopathy identify 2 distinct syndromes, similar in some respects; and (c) that most correlates of ASPD reflect its comorbidity with psychopathy. Participants were 472 incarcerated European American men who met Diagnostic and Statistical Manual (4th ed., American Psychiatric Association, 1994) criteria for ASPD and Psychopathy Checklist criteria for psychopathy, who met the criteria for ASPD but not for psychopathy, or who did not meet diagnostic criteria for either ASPD or psychopathy (controls). Both individuals with ASPD only and those with ASPD and psychopathy were characterized by more criminal activity than were controls. In addition, ASPD with psychopathy was associated with more severe criminal behavior and weaker emotion facilitation than ASPD alone. Group differences in the association between emotion dysfunction and criminal behavior suggest tentatively that ASPD with and ASPD without prominent psychopathic features may be distinct syndromes.