Antisocial Personality Disorder and Substance Abuse. November 18, 2003 By: Ms. K. Meetze Ms. R. Melton Mr. M. Melvin Ms. B. Mooza. Antisocial Personality Disorder DSM-IV Criteria.
November 18, 2003
Ms. K. Meetze
Ms. R. Melton
Mr. M. Melvin
Ms. B. Mooza
1) failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
2) deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
3) impulsivity or failure to plan ahead
4) Irritability and aggressiveness, as indicated by repeated physical fights or assaults
5) reckless disregard for safety of self or others
6) consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
7) lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another
1) recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance; substance related absences, suspensions, or expulsions from school; neglect of children or household)
2) recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
3) recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
4) continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
B. The symptoms have never met the criteria for Substance Dependence for this class of substance.
Structured Clinical Interview for the DSM-III-R, Axis and the
Millon Clinical Multiaxial Inventory, 2nd edition.
African-American men 49%
African-American women 26%
Caucasian men 52%
Caucasian women 39%
1. people with ASPD experience higher rates of alcohol abuse and dependence than the general population, and
2. people who drink to excess are more likely to experience alcohol-related problems than other alcoholics.
This adds to evidence that the DSM-IV requirement of childhood onset of ASPD is very important to look at in substance abusers. This will also help identify this chronically antisocial and drug addicted group, to be at much higher risk for early post treatment failure.
Women are more likely to receive a lifetime or current diagnosis of barbiturate/sedative/hypnotic abuse or dependence; more likely to have an anxiety disorder or psychosexual dysfunctions and bulimia.
Men are more likely given lifetime and current diagnoses of cannabis abuse/dependence and tobacco dependence significantly more often than female patients and more likely to receive the diagnosis of ASPD.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: 1994.
Bucholz, K.K., V.M. Hesselbrock, A.C. Health, J.R. Kramer, and M.A. Schuckit (2000). Research report. A latent class analysis of antisocial personality disorder symptom data from a multi-centre family study of alcoholism. Retrieved November 10, 2003, from EBSCOhost Research Databases.
Compton, III, W.M., Cottler, L.B., Abdallah, A.B., et al. “Substance
Dependence and Other Psychiatric Disorders Among Drug Dependent
Subjects: Race and Gender Correlates.” The American Journal on Addictions 9 (2000): 113-125.
Goldstein, Rice B., Carol Bigelow, Jane McCusker, Benjamin F. Lewis, Kenneth A. Mundt, and Sally I. Powers (2001). Research article. Antisocial Behavioral Syndromes and Return to Drug Use Following Residential Relapse Prevention/Health Education Treatment. Retrieved November 10, 2003, from EBSCOhost Research Databases.
Gerra, G., A. Zaimovic, G. Moi, M. Bussandri, R. Delsignore, R. Caccavari, & F. Brambilla (2003). Research article. Neuroendocrine correlates of antisocial personality disorder in abstinent heroin-dependent subjects. Retrieved November 10, 2003, from EBSCOhost Research Databases.
Lewis, C.E. & Bucholz, K.K. “Alcoholism, Antisocial Behavior and Family History.” British Journal of Addiction 86 (1991): 177-194.
Lewis, C.E., Halikas, J.A., Morse, C., et al. “Alcoholism in Narcotic Addicts with Antisocial Personality. British Journal of Addiction 82 (1987): 305-311.
Messina, Nena, et al. “Diagnosing Antisocial Personality Disorder Among Substance Abusers: The SCID versus The MCMI-II” The American Journal of Drug Alcohol Abuse 27 (2001): 699-717.
Ross, Helen E., Ph.D., et al. “Sex Differences in the Prevalence of Psychiatric Disorders in Patients With Alcohol and Drug Problems” British Journal of Addiction 83 (1988):1179-1192.
Tomasson, Kristinn & Vaglum, Per. “Psychopathology and alcohol consumption among treatment-seeking alcoholics: a prospective study” Addiction 91 (1996): 1019-1030.