Anxiety Disorders among Offenders with Antisocial Personality Disorders: A Distinct Subtype?

Abstract

W La Revue canadienne de psychiatrie, vol 55, no 12, décembre 2010 784Objectives: About 50% of men with antisocial personality disorder (APD) present a comorbid anxiety disorder. Historically, it was thought that anxiety limited criminal activity and the development of APD, but recent evidence suggests that heightened responsiveness to threat may lead to persistent violent behaviour. Our study aimed to determine the prevalence of APD comorbid with anxiety disorders among offenders and the association of these comorbid disorders with violent offending.Method: A random sample of 495 male penitentiary inmates completed an interview using the Diagnostic Interview Schedule. After excluding men with psychotic disorders, 279 with APD were retained. All authorized access to their criminal records.Results: Two-thirds of the prisoners with APD presented a lifetime anxiety disorder. Among them, one-half had the onset of their anxiety disorder before they were aged 16 years. Among the offenders with APD, those with, compared with those without, anxiety disorders presented significantly more symptoms of APD, were more likely to have begun their criminal careers before they were aged 15 years, to have diagnoses of alcohol and (or) drug abuse and (or) dependence, and to have experienced suicidal ideas and attempts. While there were no differences in the mean number of convictions for violent offences between APD prisoners with and without anxiety disorders, more of those with anxiety disorders had been convicted of serious crimes involving interpersonal violence. Conclusions:Among men with APD, a substantial subgroup present life-long anxiety disorders. This pattern of comorbidity may reflect a distinct mechanism underlying violent behaviour and signalling the need for specific treatments.Can J Psychiatry. 2010;55(12):784-791. Clinical Implications· Among male offenders with APD, two-thirds presented lifetime anxiety disorders. · Among 50% of male offenders with APD and anxiety disorders, the anxiety disorders had onset before they were aged 16 years. · APD plus anxiety disorders may constitute a subtype with distinctive treatment needs and etiology. Limitations· Interrater reliability estimates for diagnoses could not be read from old computer tapes. · The syndrome of psychopathy was not assessed. · The Diagnostic and Statistical Manual of Mental Disorders (DSM), Third Edition, Revised, not DSM-IV, criteria for diagnoses were used.

Using Neurofeedback to Lower Anxiety Symptoms Using Individualized qEEG Protocols: A Pilot Study

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Do Psychopathic Traits Assessed in Mid-Adolescence Predict Mental Health, Psychosocial, and Antisocial, Including Criminal Outcomes, over the Subsequent 5 Years?

“…This result concurs with findings from other studies showing that both ASPD and CD are associated with elevated rates of anxiety disorders. 37,38 Thus these comorbid disorders may be relatively long-standing by adolescence and present a challenge to clinics focused on substance misuse.…”

Antisocial personality disorder: new directions

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