The Epidemiology of Antisocial Behavioral Syndromes in Adulthood

Abstract

Objective To present current, nationally representative U.S. findings on prevalence, correlates, psychiatric comorbidity, disability and treatment of DSM-5 antisocial personality disorder (ASPD) and syndromal adult antisocial behavior without conduct disorder before age 15 (AABS). Method Face-to-face interviews with respondents (n=36,309) in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions–III. DSM-5 alcohol, nicotine, specific drug use disorders, and selected mood, anxiety, trauma-related, eating, and personality disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule–5. Results Prevalences of ASPD and AABS were 4.3% and 20.3%, highest among male, white, Native American, younger, and unmarried respondents, those with high school or less education, lower incomes, and Western residence. Both antisocial syndromes were significantly associated with 12-month and lifetime substance use, dysthymia/persistent depressive, bipolar I, posttraumatic stress and borderline and schizotypal personality disorders (ORs=1.2-7.0). ASPD was additionally associated with 12-month agoraphobia and lifetime generalized anxiety disorder; AABS, with 12-month and lifetime major depressive and 12-month generalized anxiety disorders. Both were associated with significant disability (p<0.001 to 0.01). Most antisocial respondents were untreated. Conclusions One in 4 U.S. adults exhibits syndromal antisocial behavior, with similar sociodemographic and psychiatric correlates and disability regardless of whether onset occurred before age 15, illustrating the clinical and public health significance of both ASPD and AABS. In addition to laying groundwork for estimates of social and economic costs, and further etiologic and nosologic research, these findings highlight the urgency of effectively preventing and treating antisocial syndromes, including investigation of whether treatment for comorbidity hastens symptomatic remission and improves quality-of-life outcomes.

Personality disorder in an Early Intervention Psychosis cohort: Findings from the Social Epidemiology of Psychoses in East Anglia (SEPEA) study

“…Participants receiving a PD diagnosis in our sample were more likely to be women, white British, and from lower SES groups, consistent with the previous literature [24,27,39,40]. While PD diagnoses were more likely to be recorded for people of white British ethnicity accepted into EIP care for suspected psychosis, our study does not provide information on the relative prevalence of PD by ethnicity in the general population.…”

Early adolescent aggression predicts antisocial personality disorder in young adults: a population-based study

“…Sex differences existed, to some extent, in our study. Our ASPD cases included about two-thirds males, which is typical [ 1 ]. The base model with only sex and age showed that sex is a significant predictor of ASPD, however, the AUC value was quite low, indicating that sex accounts only for a small portion of the variance in ASPD.…”

Associations of Harsh Physical Punishment and Child Maltreatment in Childhood With Antisocial Behaviors in Adulthood

“…18 Adults who demonstrate antisocial behaviors may experience many difficulties in developing and maintaining positive relationships, have trouble sustaining successful employment, and have problems with the law, among other challenges. 19 , 20 , 21 Antisocial behaviors are generally found to be more prevalent among men compared with women, again making the examination of sex differences an important consideration. 22 , 23 , 24 Harsh physical punishment and child maltreatment are likely associated with antisocial behaviors among men and women in the general population in the United States—the extent, however, is unknown.…”