Development of Antisocial Personality Disorder in Detained Youths: The Predictive Value of Mental Disorders

Department of Psychiatry and Behavioral Sciences , Northwestern University, Evanston, Illinois, United States
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 05/2007; 75(2):221-31. DOI: 10.1037/0022-006X.75.2.221
Source: PubMed


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 youths involved in the juvenile justice system is critical for prevention. The authors used a stratified random sample of 1,112 detained youths to examine the development of APD at a 3-year follow-up 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 5 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.

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    • "Thus far, research in the area has only painted very broad brushstrokes regarding male, female, White, Black differences. In terms of the prevalence of CD, it appears to be lower for females (APA, 2000; Cale & Lilienfeld, 2002; Kim-Cohen et al., 2003; Maughan et al., 2000; Washburn et al., 2007) and Blacks (Coid et al., 2002; Costello, Keeler, & Angold, 2001; Nock, Kazdin, Hiripi, & Kessler, 2007; Robins & Regier, 1991; cf. Bird et al., 2001; Lahey et al., 1995). "
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    ABSTRACT: The present study used data on prisoners to advance our understanding of the joint effects of sex, race, and psychopathology, specifically antisocial personality disorder (APD) and Psychopathy, on criminal violence. The sample comprised 3,525 male and 1,579 female inmates between the ages of 18 and 45 years who were incarcerated in state prisons in Wisconsin at the time of data collection. Multivariate analyses were used to examine all sex–race–psychopathology combinations. The findings indicate that Black males and females with comorbid APD and Psychopathy were more likely to commit violent crime than similarly situated White males. While gendered patterns of aggression may characterize males and females in the aggregate, the present study clearly highlights the importance of considering sex/race subgroups when examining the relationship between psychopathology and violent crime.
    Criminal Justice and Behavior 09/2013; DOI:10.1177/0093854813485412 · 1.71 Impact Factor
    • "It could be hypothesized that in previous studies, the range of overt symptoms was too limited to reveal the association between overt CD symptoms and future APD, while the significant association with covert symptoms may have reflected the association between total number of CD symptoms and APD. Furthermore, Washburn et al. (2007) used a mixed sample of detained youth; it is possible that the predictive power of overt and covert CD symptoms varies between genders. These hypotheses warrant further investigation, as they have an impact on assessment of youths at risk for APD. "
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    ABSTRACT: Studies have shown strong continuity between conduct disorder (CD) in adolescence and antisocial personality disorder (APD) in adulthood. Researchers have been trying to explain why some adolescents with CD persist into adult APD and others do not. A few studies reported that overt and covert CD symptoms have a differential predictive power for APD, with mixed results. The present study aimed to evaluate the prospective association of overt and covert CD symptoms with APD in a sample of male adolescents with CD (N = 128, mean age = 15.6, SD = 1.6). Participants were recruited at intake in Quebec Youth Centers and reassessed 3 years later (n = 73). CD and ADHD symptoms were assessed at intake with the DISC-R while APD was assessed 3 years later with the SCID-II. Logistic regression results showed that, contrary to previous prospective studies (Lahey, Loeber, Burke, & Applegate, 2005; Washburn et al., 2007), overt (OR = 2.12, 95% CI [1.29, 3.50]) but not covert (OR = 1.04, 95% CI [0.69, 1.56]) symptoms predicted later APD, controlling for ADHD symptoms and socioeconomic status. It is hypothesized that the divergence with previous studies may be explained by the higher mean number and wider range of overt CD symptoms in our sample.
    Journal of personality disorders 02/2013; 28(6). DOI:10.1521/pedi_2013_27_074 · 3.08 Impact Factor
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    • "Other studies have shown that depression can lead to conduct problems (e.g., Puig- Antich, 1982). More recent research has shown that the combination of Conduct Disorder (CD) and depression is predictive of Antisocial Personality Disorder (APD) in adulthood as well as later offending (Washburn et al., 2007). It is clear from past research that conduct problems and depression not only co-occur at higher than expected rates but also show potential for predicting one another over time. "
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    ABSTRACT: Psychopathy and depression have rarely been studied together despite relatively high rates of both in court-referred adolescent samples. To determine if youth high in psychopathy and depression experience more psychosocial difficulties, the current study examined psychopathy and depression in 103 adolescent offenders using two well-validated assessments: The Psychopathy Checklist-Youth Version (PCL-YV; Forth, Kosson, & Hare, 1996/2003) and the depression scale of the Adolescent Psychopathology Scale (APS; Reynolds, 1998). Findings showed that psychopathy and depression interact to statistically predict much higher levels of anger, aggression, interpersonal problems, and substance use. Implications for these findings include that youth who are high in psychopathy and come in contact with the law are also at high risk for numerous problems. Clinical implications driven from the current findings are that assessment and treatment programs in juvenile justice settings should be tailored and systematized to address externalizing and internalizing symptoms in youth and also to consider the co-occurrence of the two. Juvenile justice systems might also benefit from developing clinical practices that require assessment and treatment units to undergo program training to ensure that they (a) account for possible co-occurring effects of commonly assessed disorders and (b) adequately treat complex youth mental health problems with customized treatment programs. Such training would allow for more effective treatment affording youth greater opportunities to succeed in society. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
    Personality Disorders: Theory, Research, and Treatment 10/2012; 4(3). DOI:10.1037/per0000011 · 3.54 Impact Factor
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