Mueser KT, Gottlieb JD, Cather C, Glynn SM, Zarate R, Smith LF, et al. Antisocial Personality Disorder in People with Co-Occurring Severe Mental Illness and Substance Use Disorders: Clinical, Functional, and Family Relationship Correlates. Psychosis. 2012;4(1):52-62

Center for Psychiatric Rehabilitation, Boston University.
Psychosis (Psychological, Social and Integrative Approaches) (Impact Factor: 1.45). 02/2012; 4(1):52-62. DOI: 10.1080/17522439.2011.639901
Source: PubMed


Antisocial personality disorder (ASPD) is an important correlate of substance abuse severity in the addiction population and in people with co-occurring serious mental illness and addiction. Because family members often provide vital supports to relatives with co-occurring disorders, this study explored the correlates of ASPD in 103 people with co-occurring disorders (79% schizophrenia-schizoaffective, 21% bipolar disorder) in high contact with relatives participating in a family intervention study. Clients with ASPD were more likely to have bipolar disorder and to have been married, but less likely to have graduated from high school. ASPD was associated with more severe drug abuse and depression, worse functioning, and less planning-based social problem solving. The relatives of clients with ASPD also reported less planning-based problem solving, worse attitudes towards the client, and worse mental health functioning. Client ASPD was associated with less long-term exposure to family intervention. The findings suggest that clients with ASPD in addition to co-occurring disorders are a particularly disadvantaged group with greater illness severity, more impaired functioning, and more strained family relationships. These difficulties may pose special challenges to delivering family intervention for this group.

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    • "Relatively few studies have considered the relationship between psychiatric illness, SUDs, and ASPD (Hodgins, Toupin, & Côté, 1996; Moran & Hodgins, 2004; Mueser et al., 2012). Moreover, few studies have investigated people who were being assessed or treated by forensic mental health services. "
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    ABSTRACT: Despite the number of studies investigating co-occurring disorders, and more recently, co-occurring disorders and criminal offending, few studies have considered samples from forensic mental health services. The present study was conducted to investigate the relationship between mental illness, substance use disorders, antisocial personality disorder, and offending. The prevalence of co-occurring disorders was investigated in 130 male offenders who had contact with the statewide forensic mental health service in Victoria, Australia. Offense histories and severity of offending were compared among participants diagnosed with a single mental illness (or no mental illness), co-occurring mental illness and substance use, and co-occurring disorders plus antisocial personality disorder. The majority of participants had co-occurring mental and substance use disorders; a significant minority met the criteria for antisocial personality disorder. Participants with co-occurring mental illness and substance use disorders, and those who had an additional diagnosis of antisocial personality disorder, were responsible for more serious and frequent offending than those with mental illness alone. Forensic mental health services must take into account the effect that co-occurring disorders have on clients' functioning and offending. Those who work with people with psychiatric disabilities and co-occurring substance use disorders must ensure that the substance disorders are addressed to help ensure recovery from the mental illness and to reduce the likelihood of offending. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Full-text · Article · Mar 2015 · Psychiatric Rehabilitation Journal

  • No preview · Article · Feb 2012 · (Psychosis) Psychological, Social and Integrative Approaches
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    ABSTRACT: Background Little is known about gender difference in correlates of antisocial personality disorder (ASPD) among drug users. Objective To detect gender difference in correlates of ASPD in a Chinese heroin dependent sample. Methods Structured interviews were conducted among 882 heroin dependent users in two compulsory isolation settings in Changsha, China. Descriptive statistics were employed to report sample characteristics by gender. Bivariate relationships were examined between co-occurring ASPD and variables measuring demographic, drug use, and psychiatric co-morbidities. Multivariate logistic regressions with stepwise forward method were conducted to determine independent predictors for co-occurring ASPD. All analyses examining correlates of co-occurring ASPD were conducted for the total, the male and the female participants respectively to detect both the common and the unique correlates of ASPD by gender. Results Of the total participants, 41.4% (54.2% of males and 15.4% of females) met the DSM-IV criteria of ASPD. For male participants, lower educational level, unemployment, unmarried, younger age at first heroin use, previous history of compulsory treatment, larger amounts of heroin used per day and poly-drug abuse during past month before admission, as well as psychiatric co-morbidities of lifetime major depressive disorder and borderline personality disorder were independent predictors for co-occurring ASPD; while for female participants, only three variables: younger age at first heroin use, paranoid personality disorder and borderline personality disorder were independent predictors for co-occurring ASPD. Conclusions Gender differences in prevalence and correlates of ASPD among heroin dependent users were detected. The findings highlight a need for gender-specific interventions.
    No preview · Article · Jan 2013 · Addictive behaviors
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