Adverse childhood events and self-harming behaviours among individuals in Ontario forensic system: the mediating role of psychopathy.

BACKGROUND: Adverse childhood events (ACEs), psychopathy, and self-harming behaviours are prevalent among individuals in the forensic psychiatry system. While existing literature suggests that ACEs, self-harm, and psychopathy are interrelated, little is known about the interplay of psychopathic traits in this relationship. The present study aimed to determine the mediating role of psychopathy in the relationship between ACEs and self-harming behaviours in forensic patients. METHODS: This was a retrospective study of patients under the Ontario Review Board (ORB) between 2014 and 2015. In the analysis, we included patients with complete data on ACEs, self-harming behaviours, and a Psychopathy Checklist-Revised (PCL-R) score - a measure of psychopathic traits and their severity conducted during the reporting period. Mediation analysis was based on the Baron and Kenny approach, and sensitivity analysis was performed based on the types of ACEs. RESULTS: ​​​The sample population (n = 593) was made up of adults, with a mean age of 41.21 (± 12.35) years and were predominantly males (92.37%). While there was a partial mediating effect of psychopathy on the relationship between ACEs and incidents of self-harming behaviours in the past year, the mediation was complete in the relationship between ACEs and a lifetime history of self-harming behaviours. Following sensitivity analysis based on the types of ACE, the mediating effects were more attributed to specific ACEs, especially having experienced child abuse or having an incarcerated household member before 18 years. CONCLUSION: Among forensic patients in Ontario, psychopathy mediates​ ​the relationship between experiencing ACEs and engaging in self-harming behaviours. Effective intervention to mitigate self-harming behaviours in this population should consider the potential role of psychopathy, especially among individuals who have experienced ACEs involving a history of child abuse and a family who was incarcerated.

Superhomicide offenders: Nosology, empirical features, and linkages to sexual and multiple murder typologies.

The nosology for criminals who murder multiple victims is at once well-established and controversial, perhaps because theorists have largely segregated such offenders from the broader criminal population. The current study introduces the superhomicide offender, an individual convicted of at least five murders, to locate multiple homicide offenders within the criminological and epidemiological science pertaining to the most pathological offenders, and statistically place them with other conceptualizations of severe offenders at the 95th percentile of the offending distribution. Relative to other capital murderers, superhomicide offenders have lengthier criminal history, greater conviction history, and coextensive psychopathology characterized by psychopathy, sexual sadism, homicidal ideation, cluster A and B personality disorders, and major depressive disorder. Superhomicide offenders are profoundly psychopathic with 20 of the 39 offenders reaching the clinical threshold of 30 or more on the PCL-R, and 19 of the 39 are sexually sadistic. Regarding extant typologies of sexual and multiple homicide offenders, 15 are serial murderers, 17 are sexual homicide offenders, 17 are mass murderers, and 17 are spree murderers. Twenty-four of the 39 superhomicide offenders (61.5%) met criteria for multiple typologies, suggesting the new prototype can help unify the study of those who perpetrate multicide and embed them within criminological and epidemiological models that specify pathological antisocial outcomes.

Do autism and psychopathy co-occur? A systematic review and clinical discussion.

BACKGROUND: Although the prevalence is unknown, psychopathy can be a possible co-occurring condition associated with autism especially among forensic populations. However, the relationship between these two conditions remains poorly understood. AIMS: To carry out a systematic review of the available literature exploring the relationship between autism and psychopathy. METHODS: A systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using terms for autism and psychopathy to search the literature databases Scopus, Pubmed, Web of Science, ASSIA, APA Psych Info, Medline and EMBASE from 1980 to March 2024. For inclusion, we required that a recognised measure of autism and psychopathy or associated features of the latter had been used. RESULTS: Of the 4230 potential articles identified, 37 met the selection criteria. Insufficient and inconsistent methodologies for data pooling meant that a narrative analysis was used. Although there is some overlap, four broad themes emerged relating to (1) assessment and frequency of co-occurrence, (2) behavioural and neurophysiological expressions of empathy, (3) behavioural contagion effects, mirroring, mimicry and other linking mechanisms and (4) emotional face perception and theory of mind characteristics. Within these areas there are some specific differences between the two conditions. However, the research to date examining the relationship between autism and psychopathy has mostly been with children and males, carried out with non-clinical non-forensic populations, as well as using self-report measures and parental ratings. Prior research has also largely focused on looking for differences between these conditions rather than co-occurrence. CONCLUSION: This review outlines a case for considering autism and psychopathy as distinct, but potentially co-occurring conditions and highlights the need for more research into how the two conditions interact with clinical populations. There also appears to be a need for guidelines on when and how to assess psychopathy with autistic individuals and a better understanding of the therapeutic needs and factors influencing the long-term outcomes of autistic individuals who may also present with co-occurring psychopathy.

Psychopathy traits explain variance shared between features of substance use disorders and violence.

BACKGROUND: There is a substantial research literature on identifying risk and protective factors for violence perpetration. Substance use disorders have long been identified as constituting a significant predictor of violent behaviour. Psychopathy traits have also been similarly recognised, but inter-relationships between psychopathy traits, features of substance use disorders and violence have been little explored. AIMS: To determine the degree to which shared variance between substance dependence symptoms and violence, as indicated by criminal charges for violent offences, among jailed men can be explained by psychopathy traits. METHODS: Features of dependence on substances in three drug classes (alcohol, cannabis and cocaine) were assessed in a sample of 682 men in a county jail awaiting trial on criminal charges, many for violent offences. Statistical comparisons of zero-order and partial correlations tested whether accounting for psychopathy total and facet scores, assessed by the Psychopathy Checklist-Revised (PCL-R), affected associations between substance dependence symptoms and violent charges. RESULTS: Total PCL-R scores accounted for a significant proportion of the shared variance between the history of criminal charges for violence offences and lifetime substance dependence symptoms in all three drug classes. At the facet level, controlling for ratings on the interpersonal and modified antisocial facets reduced the association between criminal charges for violent offences and symptoms of cocaine dependence; controlling for ratings on a modified antisocial facet also attenuated links between alcohol and cannabis dependence symptoms and history of charges for violent offences. CONCLUSION: These findings build on the sparse literature to date on the role of psychopathy traits on relationships between features of substance use disorders and violence. Given that the observed connection between substance dependence symptoms and charges for violent offences is partly accounted for by individual differences in psychopathy traits, it follows that effective treatment for those traits may be useful, perhaps essential to reducing links between features of some substance use disorders and violent offending.

Brain structural correlates of psychopathic traits in elite female combat-sports athletes.

Psychopathy is characterized by glibness and superficial charm, as well as a lack of empathy, guilt and remorse, and is often accompanied by antisocial behaviour. The cerebral bases of this syndrome have been mostly studied in violent subjects or those with a criminal history. However, the antisocial component of psychopathy is not central to its conceptualization, and in fact, psychopathic traits are present in well-adjusted, non-criminal individuals within the general population. Interestingly, certain psychopathy characteristics appear to be particularly pronounced in some groups or professions. Importantly, as these so-called adaptive or successful psychopaths do not show antisocial tendencies or have significant psychiatric comorbidities, they may represent an ideal population to study this trait. Here, we investigated such a group, specifically elite female judo athletes, and compared them with matched non-athletes. Participants completed psychopathy, anger, perspective-taking and empathic concern questionnaires and underwent structural magnetic resonance imaging (MRI). Grey matter volume (GMV) was computed using voxel-based morphometry from the T1-weighted images. Athletes scored significantly higher in primary psychopathy and anger and lower in empathy and perspective taking. They also exhibited smaller GMV in the right temporal pole, left occipital cortex and left amygdala/hippocampus. GMV values for the latter cluster significantly correlated with primary psychopathy scores across both groups. These results confirm and extend previous findings to a little-studied population and provide support for the conceptualization of psychopathy as a dimensional personality trait which not only is not necessarily associated with antisocial behaviour but may potentially have adaptive value.

Antisocial behavior is associated with reduced frontoparietal activity to loss in a population-based sample of adolescents.

BACKGROUND: Adolescent antisocial behavior (AB) is a public health concern due to the high financial and social costs of AB on victims and perpetrators. Neural systems involved in reward and loss processing are thought to contribute to AB. However, investigations into these processes are limited: few have considered anticipatory and consummatory components of reward, response to loss, nor whether associations with AB may vary by level of callous-unemotional (CU) traits. METHODS: A population-based community sample of 128 predominantly low-income youth (mean age = 15.9 years; 42% male) completed a monetary incentive delay task during fMRI. A multi-informant, multi-method latent variable approach was used to test associations between AB and neural response to reward and loss anticipation and outcome and whether CU traits moderated these associations. RESULTS: AB was not associated with neural response to reward but was associated with reduced frontoparietal activity during loss outcomes. This association was moderated by CU traits such that individuals with higher levels of AB and CU traits had the largest reductions in frontoparietal activity. Co-occurring AB and CU traits were also associated with increased precuneus response during loss anticipation. CONCLUSIONS: Findings indicate that AB is associated with reduced activity in brain regions involved in cognitive control, attention, and behavior modification during negative outcomes. Moreover, these reductions are most pronounced in youth with co-occurring CU traits. These findings have implications for understanding why adolescents involved in AB continue these behaviors despite severe negative consequences (e.g. incarceration).

Cognitive and clinical characteristics of offenders and non-offenders diagnosed with schizophrenia spectrum disorders: results of the Recoviwel observational study.

The association between schizophrenia spectrum disorders (SSD) and violent behavior is complex and requires further research. The cognitive correlates of violent behavior, in particular, remain to be further investigated. Aims of the present study were to comprehensively assess the cognitive and clinical profile of SSD violent offenders and evaluate individual predictors of violent behavior. Fifty inmates convicted for violent crimes in a forensic psychiatry setting and diagnosed with SSD were compared to fifty non-offender patients matched for age, gender, education, and diagnosis. Offender and non-offender participants were compared based on socio-demographic, clinical, and cognitive variables using non-parametric testing to select potential predictors of violent behavior. Multivariate logistic regressions were then performed to identify individual predictors of violent behavior. Offender participants showed more school failures, higher prevalence of substance use, higher Clinical Global Impression Severity Scale (CGI-S) and Positive and Negative Syndrome Scale Excited Component (PANSS-EC) scores, worse working memory and better attention performance, higher Historical Clinical and Risk Management scale 20 (HCR-20) and Hare Psychopathy Checklist (PCL-R) scores in all subdomains and factors. School failures, higher PANSS-EC scores, worse working memory and processing speed, better attention performance, higher scores in HCR-20 Management subscale and the PCL-R "Callous" factor emerged as predictors of violent behavior. Better attentional performance was correlated with higher PCL-R "Callous" factor scores, worse cognitive performance in several domains with higher PCL-R "Unstable" factor scores. In conclusion, the present study highlights the importance of carefully assessing SSD patients with violent behavior in all clinical, cognitive, and behavioral aspects.

A latent class analysis of mental disorders, substance use, and aggressive antisocial behavior among Swedish forensic psychiatric patients.

BACKGROUND: Patients in the forensic mental health services (FMHS) with a mental disorder, a co-occurring substance use disorder (SUD), and high risk of aggressive antisocial behavior (AAB) are sometimes referred to as the 'triply troubled'. They suffer poor treatment outcomes, high rates of criminal recidivism, and increased risk of drug related mortality. To improve treatment for this heterogeneous patient group, more insight is needed concerning their co-occurring mental disorders, types of substances used, and the consequent risk of AAB. METHODS: A three-step latent class analysis (LCA) was used to identify clinically relevant subgroups in a sample of patients (n = 98) from a high-security FMHS clinic in Sweden based on patterns in their history of mental disorders, SUD, types of substances used, and AAB. RESULTS: A four-class model best fit our data: class 1 (42%) had a high probability of SUD, psychosis, and having used all substances; class 2 (26%) had a high probability of psychosis and cannabis use; class 3 (22%) had a high probability of autism and no substance use; and class 4 (10%) had a high probability of personality disorders and having used all substances. Both polysubstance classes (1 and 4) had a significantly more extensive history of AAB compared to classes 2 and 3. Class 3 and class 4 had extensive histories of self-directed aggression. CONCLUSIONS: The present study helps disentangle the heterogeneity of the 'triply troubled' patient group in FMHS. The results provide an illustration of a more person-oriented perspective on patient comorbidity and types of substances used which could benefit clinical assessment, treatment planning, and risk-management among patients in forensic psychiatric care.

Prevalence, demographics, and clinical correlates of antisocial personality disorder in Chinese methamphetamine patients.

BACKGROUND AND OBJECTIVES: Antisocial personality disorder (ASPD) is very common among methamphetamine (MA) patients, but very few studies have been conducted in China. This study aimed to investigate the prevalence and clinical correlates of ASPD among Chinese MA patients. METHODS: We recruited 627 MA patients and collected demographic and MA use data through one-on-one semi-structured interviews. ASPD was measured by the Mini International Neuropsychiatric Interview (M.I.N.I.). The Desires for Drug Questionnaire (DDQ) and visual analog scale (VAS) were used to assess drug cravings. RESULTS: The prevalence rate of ASPD among MA patients was 27.59% (173/627). Patients with ASPD had greater age at the first onset, duration of MA use, length of abstinence, VAS, DDQ desire and intention, negative reinforcement, and total DDQ scores than patients without ASPD. Stepwise binary logistic regression analysis revealed that age, age at the first onset, length of abstinence, and DDQ-negative reinforcement were independently associated with ASPD in MA patients. DISCUSSION AND CONCLUSIONS: Our findings suggest that the prevalence of ASPD is high among Chinese MA patients. Furthermore, some demographic and clinical variables are associated with ASPD in MA patients. SCIENTIFIC SIGNIFICANCE: We focused our study on the clinical profile of ASPD and the reasons for its high prevalence in Chinese methamphetamine patients. We identified several demographic and clinical variables as correlates of the occurrence of ASPD in methamphetamine patients, which provides evidence for ASPD comorbidity in methamphetamine patients.

The Fast Track intervention's impact on behaviors of despair in adolescence and young adulthood.

How to mitigate the dramatic increase in the number of self-inflicted deaths from suicide, alcohol-related liver disease, and drug overdose among young adults has become a critical public health question. A promising area of study looks at interventions designed to address risk factors for the behaviors that precede these -often denoted-"deaths of despair." This paper examines whether a childhood intervention can have persistent positive effects by reducing adolescent and young adulthood (age 25) behaviors that precede these deaths, including suicidal ideation, suicide attempts, hazardous drinking, and opioid use. These analyses test the impact and mechanisms of action of Fast Track (FT), a comprehensive childhood intervention designed to decrease aggression and delinquency in at-risk kindergarteners. We find that random assignment to FT significantly decreases the probability of exhibiting any behavior of despair in adolescence and young adulthood. In addition, the intervention decreases the probability of suicidal ideation and hazardous drinking in adolescence and young adulthood as well as opioid use in young adulthood. Additional analyses indicate that FT's improvements to children's interpersonal (e.g., prosocial behavior, authority acceptance), intrapersonal (e.g., emotional recognition and regulation, social problem solving), and academic skills in elementary and middle school partially mediate the intervention effect on adolescent and young adult behaviors of despair and self-destruction. FT's improvements to interpersonal skills emerge as the strongest indirect pathway to reduce these harmful behaviors. This study provides evidence that childhood interventions designed to improve these skills can decrease the behaviors associated with premature mortality.

A comparison of the role of aggression in the association between hostile interpretation bias and antisocial personality features between young offenders and university students.

BACKGROUND: Antisocial personality features in adolescents are frequently associated with delinquency and constitute the problem that most concerns the criminal justice system and the public. Hostile interpretation bias has been identified as a candidate for explaining emergent adolescent antisocial personality problems and aggression, but it is unclear whether offenders and non-offenders show differences in the relationships between hostile interpretation bias, aggression and antisocial personality features. AIMS: To compare relationships between hostile interpretation bias and a personality measure between incarcerated teenagers and first year university students and to explore aggression and criminal history as mediating or moderating variables. METHODS: Fifty-three 16-18-year-old incarcerated male offenders and 69 17-20-year-old male university students were recruited, the former through institutional staff and the latter by online advert only. Individuals in both groups self-rated, in private, on the Word and Sentence Association Paradigm-hostile (WSAP), The Ambiguous Intentions Hostility Questionnaire (AIHQ), Hostility Interpretation Bias Task (HIBT) as tests for hostile interpretation bias, and on the Buss-Perry Aggression Questionnaire and on Hyler's Personality Disorder Questionnaire (PDQ-4). Among the students, criminal history was assessed by a self-reported binary question. LASSO regressions were used to test inter-relationships between hostile interpretation bias and aggression or antisocial personality traits. Mediation and moderation were tested using MPLUS 7.4. RESULTS: The WSAP and AIHQ, as measures of self-reported hostility bias, had relationships with self-reported aggression (Pearson r 0.24-0.58, p < 0.001) and with antisocial personality features (r 0.36-0.50, p < 0.001), the HIBT did not. Aggression scores mediated the relationship between hostile interpretation bias and antisocial personality features. Furthermore, the relationship between hostile interpretation bias and aggression was stronger among the young offenders (estimates 0.43-0.75) than among the university students without criminal history (estimates 0.13-0.36). CONCLUSIONS: Hostile interpretation bias appears to promote antisocial personality features by increasing an individual's aggression, regardless of social status, although the effect was much stronger among the young offenders. To reduce young people's antisocial personality features, future studies should perhaps focus on evaluating strategies to reduce hostile bias or prevent it from being expressed in aggressive behaviours.

Features of attention deficit/hyperactivity disorder and antisocial behaviour in a general population-based sample of adults.

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is known to be a risk factor for antisocial and delinquent behaviour, but there is still a lack of information on how features of ADHD relate to offending behaviour among adults not already defined by their offending. AIMS: Our aim was to add to knowledge about relationships between ADHD and antisocial behaviour among adults in the general population by answering the following questions: (A) Does the level of self-reported ADHD features relate to criminal and non-criminal antisocial behaviour? (B) To what extent are self-ratings of ADHD features independent of socio-demographic features previously identified as predictors of antisocial behaviour? METHODS: A sample of adults was originally recruited to study public response to the COVID-19 outbreak through an online panel to be representative of the Israeli population. Among other scales, the 2025 participants completed an ADHD self-report scale, an antisocial behaviour self-report scale and a socio-demographic questionnaire probing for age, gender, urbanity, place of birth, socioeconomic status (education and income), family status (being in a relationship and having children) and religiosity. RESULTS: Higher mean totals for the inattention and hyperactivity ADHD scale scores were associated with higher mean antisocial behaviour scores. These relationships were only slightly affected by socio-demographic variables, including sex, age, education and income. CONCLUSION: Our findings suggest that not only may features of ADHD, even below a diagnostic threshold, constitute a risk factor for antisocial behaviour, but also that the self-rated levels of these problems covary. These findings are important for informing the early detection of risk of antisocial behaviour in the general population and its prevention.

Correlates of Homelessness Among Adults with Personality Disorder.

Although personality disorders (PDs) are more common among persons experiencing homelessness than the general population, few studies have investigated the risk of experiencing homelessness among persons with PDs. This study seeks to identify the demographic, socioeconomic, and behavioral health correlates of past-year homelessness among persons with antisocial, borderline, and schizotypal PDs. Nationally representative data of the civilian, noninstitutionalized population of the United States was used to identify correlates of homelessness. Descriptive statistics and bivariate associations between variables and homeless status were summarized prior to conducting several multivariate logistic regression models to identify correlates of homelessness. Main findings revealed positive associations between poverty, relationship dysfunction, and lifetime suicide attempt with homelessness. In the antisocial PD (ASPD) and borderline PD (BPD) models, comorbid BPD and ASPD, respectively, were associated with higher odds of past-year homelessness. Findings underscore the importance of poverty, interpersonal difficulties, and behavioral health comorbidities on homelessness among persons with ASPD, BPD, and schizotypal PD. Strategies to promote economic security, stable relationships, and interpersonal functioning may buffer against the effects of economic volatility and other systemic factors that could contribute to homelessness and persons with PD.

Deconstructing childhood conduct and adult antisocial criteria for the diagnosis of antisocial personality disorder.

BACKGROUND: Antisocial personality disorder (ASPD) is a serious psychiatric disorder that can be incapacitating and costly to individuals and society. The ASPD diagnosis has 2 main components, childhood conduct problems and adult antisocial behaviors, with specific age requirements. The nosological effects of these criteria on population subgroups defined by these aspects of the criteria have not been fully explored. METHODS: Data for ASPD were analyzed for 3,498 individuals in the St Louis, Missouri, site of the Epidemiologic Catchment Area study of general population psychiatric disorders collected in the early 1980s using structured diagnostic interviews for DSM-III criteria. Effects of the criteria on population subgroups defined by various combinations of the criteria were examined. RESULTS: Earlier-onset conduct disorder was more severe than later-onset childhood conduct disorder, with more total childhood and adult symptoms and negative psychosocial adult outcomes (substance use disorders, criminality, and homelessness). Three subgroups with adult antisocial behaviors (differentiated by no conduct disorder, later-onset conduct disorder, and earlier-onset conduct disorder meeting ASPD criteria) were similar in numbers of adult antisocial symptoms, but the ASPD subgroup had more negative psychosocial adult outcomes. CONCLUSIONS: These findings provide evidence for and against reconsideration of the 15-year age-of-onset requirement for conduct symptoms in ASPD criteria.

Antisocial personality disorder and associated factors among incarcerated in prison in Dessie city correctional center, Dessie, Ethiopia: a cross-sectional study.

BACKGROUND: Antisocial Personality Disorder (ASPD) describes individuals who engage in repetitive aggressiveness, deceitfulness, impulsivity, and unlawful behavior. It has a broad impact on families, relationships, and social functioning, and also people with ASPD make heavy demands on the judicial system, social and mental health services. Even though ASPD is a common problem among incarcerated in prisons, it is not well studied in developing countries including Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of ASPD among incarcerated in prison in Dessie city correctional center. METHOD: A cross-sectional study design was conducted among 320 incarcerated in prison at Dessie correctional center, Ethiopia. The study subjects were selected by using a simple random sampling technique and the Diagnostic and Statistical Manual 5th text revision (DSM-5) was used to measure ASPD using face-to-face interviews. Social support was assessed using the Oslo social support scale (Oslo-3). The collected data were checked for completeness and entered into Epi-data Version 3.1 and then exported to SPSS version 26 for analysis. Bivariate and multivariable logistic regressions were done to identify factors related to antisocial personality disorder. In multivariable logistic regression variables with a p-value, less than 0.05 were considered significant and, adjusted OR (AOR) with 95% CI was used to present the strength of the association. RESULTS: The current study showed that the prevalence of ASPD was found to be 30.6% (95% CI:25.6,35.9). In a multivariable analysis, being single [AOR = 2.33; 95%CI (1.39,3.89)], monthly income of 1000-2000 ETB (Ethiopian Birr) [AOR = 2.12; 95%CI (1.163,3.45)], reconviction [AOR = 2.37; 95%CI (1.08,5.19)], and alcohol use [AOR = 2.00; 95% CI (1.16,3.45)] were discovered to be predictors of antisocial personality disorder. CONCLUSION: This study revealed that nearly one-third of incarcerated in prison were found to have an anti-social personality disorder. Being single, 1000-2000 ETB income, reconviction, and alcohol users were variables that are independent predictors of ASPD. A screening and intervention program is required and further research should be needed.

Outcomes of serious antisocial behavior from childhood to early adulthood in two Puerto Rican samples in two contexts.

PURPOSE: The patterns or trajectories of serious antisocial behavior (ASB) in children are examined to determine the extent to which context, gender, and the severity and persistence of ASB from childhood/early adolescence to later adolescence/early adulthood is associated with negative outcomes. METHODS: A four wave longitudinal study obtained data on two multi-stage probability household samples of Puerto Rican background children (5-13 years at baseline) living in the San Juan Metropolitan Area of Puerto Rico (PR) and the South Bronx (SBx) of New York. The outcomes studied were any psychiatric disorder including substance use disorders and teenage pregnancy. RESULTS: Both males and females raised in the SBx had much higher risk of serious ASB (42.3%) as compared to those in PR (17.8%). Concurrent ASB4 + in the fourth wave was strongly related to SUD and MDD for both males and females at Wave 4. CONCLUSIONS: Serious ASB is likely to persist at least to the next developmental period of a child and is likely to be associated with substance use disorders and major depression later in life.

Prevalence and correlates of antisocial personality disorder in older adults.

OBJECTIVES: There is a paucity of research on antisocial personality disorder (ASPD) in the geriatric population and the majority of knowledge on the disorder is drawn from young adult samples. Researchers posit that the prevalence of ASPD as well as other personality disorders (PDs) is underestimated among older adults. Using a nationally representative sample, the present study examines the prevalence and correlates of ASPD in adults ages 50 and older. METHODS: We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions Waves I and III. Multivariate logistic regression analyses were employed to investigate associations between ASPD and sociodemographic characteristics. A series of logistic regression analyses were also conducted to study associations between ASPD and medical conditions (liver and cardiovascular disease, arthritis, and stomach ulcer), major psychiatric disorders (lifetime major depressive disorder, mania, and generalized anxiety disorder), and substance use disorders (lifetime alcohol, marijuana, cocaine, heroin, and nicotine use disorders). RESULTS: Findings indicated that the prevalence of ASPD increases through early adulthood, with a peak at 3.91% in younger adults and decline to 0.78% in adults ages ≥65. Older adults with ASPD are more likely to be diagnosed with a substance use disorder, major depression, mania, and generalized anxiety disorder as well as each medical condition. CONCLUSION: Older adults with ASPD experience increased rates of medical and psychiatric comorbidities. These conditions exacerbate the existing challenges associated with diagnosing and treating this population and may have serious consequences for the patient, their caregivers and society.

Latent triple trajectories of substance use as predictors for the onset of antisocial personality disorder among urban African American and Puerto Rican adults: A 22-year longitudinal study.

Background: Antisocial personality disorder (ASPD) incurs a high cost to society due to the high risk of violent and nonviolent offenses associated with this personality disorder, thus making the examination of the etiology and the onset of ASPD an important public health concern. Method: The present study consisted of five waves of data collection of the Harlem Longitudinal Development Study (N = 674). In the Cox proportional hazard model, latent multiple substance use trajectories from mid-adolescence to emerging adulthood (mean age 14 to mean age 24) were used as a predictor for the onset of ASPD during emerging adulthood to the mid-thirties (mean age 24 to mean age 36). The control variables were gender, ethnicity, problem behaviors, and victimization. Results: In the multiple Cox proportional hazard model, the high (HR = 2.74, p < 0.001) and the increasing frequency of (HR = 2.55, p < 0.001) use on alcohol, cigarette, and cannabis latent trajectory groups were associated with an increased hazard of ASPD onset as compared with the no or low frequency of use on alcohol, cigarette, and cannabis latent trajectory group after controlling for demographic factors and earlier problem behaviors as well as victimization. Conclusions: The implications of this study for the prediction of adult ASPD onset time may focus on the early use of alcohol, cigarette, and cannabis from mid adolescence to emerging adulthood.

The endocannabinoid system in borderline personality disorder and antisocial personality disorder: A scoping review.

Individuals with borderline personality disorder (BPD) or antisocial personality disorder (ASPD) are overrepresented in forensic settings. Yet, despite the burden these disorders place on healthcare and criminal justice systems, there remains a lack of evidence-based pharmacological treatments. Epidemiological data have shown that comorbid cannabis use disorders are common in BPD and ASPD. ∆9 -Tetrahydrocannabinol, the primary psychoactive constituent of cannabis, is an exogenous cannabinoid that stimulates the endocannabinoid system (ECS). Hence, an investigation of the ECS in these conditions is warranted. This scoping review screened 105 records and summarized the extant research on the ECS in ASPD (n = 69) and BPD (n = 61) participants. Preliminary results suggest that alterations of the ECS may be present in these disorders. Although research examining the ECS in personality disorders is still in its infancy, more research is warranted given initial positive findings.

An Epidemiologic Survey and Violent Behavior Analysis of Antisocial Personality Disorder in Young Men in Chengdu.

OBJECTIVES: To investigate the epidemiological characteristics of antisocial personality disorder (ASPD) in young men in Chengdu and explore the characteristics and risks of violence. METHODS: Stratified random sampling was used to conduct a self-assessment questionnaire survey in 4 108 males aged from 18 to 34 in Chengdu, including general demographic characteristics, structured clinical interview for the diagnostic and statistical manual of mental disorders-Ⅳ axis Ⅱ disorders (SCID-Ⅱ) personality disorder screen questionnaire, violence questionnaire, psychosis screening questionnaire (PSQ), Alcohol Use Disorders Identification Test (AUDIT) and drug use. χ2 test, univariate and multivariate logistic regression were used for analysis and odds ratio (OR) was calculated. RESULTS: The positive rate of ASPD was 5.91%, which was associated with young age, unmarried, unemployment state, low educational level, violent behavior, psychotic symptoms, alcohol and drug use (P<0.05). Young men with ASPD also had a risk (P<0.05) of violence (OR was 8.51), multiple violence (OR was 16.57), injury (OR was 6.68), intentional violence (OR was 11.41), etc., the risk decreased after controlling for psychotic symptoms and substance abuse, but was still statistically significant. CONCLUSIONS: The risk of violence, severe violence and intentional violence in young men in Chengdu is high, and psychotic symptoms and substance abuse increase the risk of ASPD violence and relate characteristics.