Death Rates in 71 Men with Antisocial Personality Disorder

Black, Donald W.; Baumgard, Connie H.; Bell, Sue; Kao, Chi

doi:10.1016/s0033-3182(96)71579-7

Cited by 82 publications

(44 citation statements)

References 21 publications

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“…Antisocial personality disorder is also associated with increased mortality, particularly at a young age, largely because of reckless behaviour (Black 1996). As well as causing considerable harm to the individual, people with the disorder have a broad impact on family, relationships and social functioning, and make heavy demands on the judicial system, Social Services and mental healthcare.…”

Section: Costs Of Antisocial Personality Disordermentioning

confidence: 99%

Antisocial personality disorder: new directions

Yakeley¹,

Williams²

2014

Adv. psychiatr. treat

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SummaryAntisocial personality disorder is a complex condition carrying high rates of comorbidity and mortality for individuals as well as harmful consequences for their families and society. Despite the publication of National Institute for Health and Care Excellence (NICE) guidelines for the disorder, the evidence base and provision of effective treatments remain inadequate, and the belief that the condition is untreatable remains widespread among psychiatrists and other professionals. This article highlights current diagnostic controversies and summarises the evidence for conceptualising antisocial personality disorder as a disorder of attachment. Informed by this developmental perspective, we provide a framework for the management and treatment of adults with antisocial personality disorder, highlighting the importance of creating a safe setting and recommending adaptations of therapeutic technique to facilitate the engagement of this ‘treatment-rejecting’ patient population. We conclude with an outline of the current government policy on the treatment of high-risk offenders with personality disorder.LEARNING OBJECTIVESKnow the current diagnostic criteria and epidemiology of antisocial personality disorder.Evaluate the evidence that antisocial personality disorder can be conceptualised as a disorder of attachment, and use a developmental framework to inform treatment interventions.Gain an understanding of psychological approaches to antisocial personality disorder.

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Section: Costs Of Antisocial Personality Disordermentioning

confidence: 99%

Antisocial personality disorder: new directions

Yakeley¹,

Williams²

2014

Adv. psychiatr. treat

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“…Keywords conduct disorder; antisocial personality disorder; mental disorder; detained youth; longitudinal Persistent antisocial behavior places a heavy burden on the community, the justice system, and the public health system (Miller, Cohen, & Wiersema, 1996). Adults with antisocial personality disorder (APD) are likely to experience a range of problematic behaviors and outcomes: criminal and violent behavior, substance use, early death, divorce, unemployment, and homelessness (Black, Baumgard, Bell, & Kao, 1996;Hodgins & Cote, 1993;Jainchill, Hawke, & Yagelka, 2000;Robins, Tipp, & Przybeck, 1991;Westermeyer & Thuras, 2005).…”

Section: Introductionmentioning

confidence: 99%

Development of antisocial personality disorder in detained youths: The predictive value of mental disorders.

Washburn¹,

Romero²,

Welty³

et al. 2007

Journal of Consulting and Clinical Psychology

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Antisocial personality disorder (APD) is a serious public and mental health concern. Understanding how well conduct disorder (CD) and other mental disorders predict the development of APD among youth involved in the juvenile justice system is critical for prevention. This study used a stratified random sample of 1112 detained youth to examine the development of APD at a three-year followup interview. Nearly one fifth of male juvenile detainees later developed APD; approximately one quarter of male juvenile detainees with CD at baseline later developed APD. Significantly more males than females developed APD; no differences were found by race/ethnicity. Having five or more symptoms of CD, dysthymia, alcohol use disorder, or generalized anxiety disorder was significantly associated with developing modified APD (M-APD; APD without the CD requirement). Some disorders were strong predictors of APD; however, none were adequate screeners for identifying which detainees would later develop M-APD. The findings of this study have implications for interventions and further research in developmental psychopathology. Keywords conduct disorder; antisocial personality disorder; mental disorder; detained youth; longitudinal Persistent antisocial behavior places a heavy burden on the community, the justice system, and the public health system (Miller, Cohen, & Wiersema, 1996). Adults with antisocial personality disorder (APD) are likely to experience a range of problematic behaviors and outcomes: criminal and violent behavior, substance use, early death, divorce, unemployment, and homelessness (Black, Baumgard, Bell, & Kao, 1996;Hodgins & Cote, 1993;Jainchill, Hawke, & Yagelka, 2000;Robins, Tipp, & Przybeck, 1991;Westermeyer & Thuras, 2005).Corresponding Author: Jason J. Washburn, PhD, ABPP, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 710 N. Lakeshore Drive, Suite 900, Chicago, IL 60611. Phone: 312-503-3500. Fax: 312-503-3535. j-washburn@northwestern.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/journals/ccp. Considering the high social and financial costs associated with APD, identifying youth at risk for this disorder is critical for prevention (Loeber, Green, & Lahey, 2003;Offord, 2000). NIH Public AccessAmong many of the factors hypothesized to affect the development of APD are mental disorders in childhood and adolescence. Conduct disorder (CD) in childhood and adolescence is the factor most often associated with the development of APD (Abramowitz, Kosson, & Seiden...

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“…Furthermore, as our sample was in average 44 years old at inclusion, the impact of psychiatric comorbidity might have been partially censored. For example, antisocial men have been shown to be at excessive risk for premature death if younger than 40 years [42].…”

Section: Discussionmentioning

confidence: 99%

Mortality at 9 years in alcohol-dependence: The respective roles of alcohol, tobacco, and vulnerability genes

Wohl¹,

Sirolli²,

Romo³

et al. 2012

OJPsych

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Aims: Different vulnerability genes have been proposed in alcohol dependence, but replications are sparse, probably due to 1) phenotypical heterogeneity and 2) difficulties to rely on reliable definition of the correct phenotype. Indeed, specific subgroups of patients may be more directly concerned with some vulnerability genes, the actions of these genes being more directly related to their function. We postulated that three potential vulnerability genes, that were at least twice associated with alcohol dependence, influence the extreme of the severity of alcohol dependence, i.e. mortality, through traits with which they were previously associated, namely impulsivity and antisocial personality disorder and the 5-HT1B gene, suicide attempt and the short allele of 5-HTTLPR, and addictive disorder co-morbidity and the DRD2 gene. Methods: We analysed the survival status of a male alcohol-dependent sample (n = 126) recruited 9 years before, and could compare 61 surviving patients to 41 patients who died during this period (representing 81.0% of the initial sample). Results: The main clinical characteristic that was associated with an increased mortality rate was a larger cumulative tobacco use (pack-years). We also found that the C allele of the 5-HT1b was the only one in excess in the non-surviving patients. Contrary to our hypothesis, impulsivity and antisocial personality disorder were not explaining the role of this gene. Conclusions: Even if there is a significant involvement of the 5-HT1B C allele, no intermediate phenotype was detected in our sample. The relatively short delay of 9 years and the somewhat old age at baseline of our patients could have limited the influence of psychiatric comorbidity or the specificities of alcohol dependence, explaining why the only detected co-factor was tobacco consumption. Tobacco dependence is therefore the main factor to explain mortality within the first decade, and the effect of this co-morbid condition is not explained by three vulnerability genes previously associated to alcohol dependence.

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Death Rates in 71 Men with Antisocial Personality Disorder

Cited by 82 publications

References 21 publications

Antisocial personality disorder: new directions

Antisocial personality disorder: new directions

Development of antisocial personality disorder in detained youths: The predictive value of mental disorders.

Mortality at 9 years in alcohol-dependence: The respective roles of alcohol, tobacco, and vulnerability genes

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