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Antisocial Personality Disorder (antisocial + personality_disorder)

Distribution by Scientific Domains

Psychology	51%
Medical Sciences	48%

Selected Abstracts

ANTISOCIAL PERSONALITY DISORDER AND GAMBLING: COMMENTS ON PIETRZAK & PETRY (2005)

ADDICTION, Issue 5 2006
XIANGNING WANG
No abstract is available for this article. [source]

MAOA-uVNTR Polymorphism May Modify the Protective Effect of ALDH2 Gene Against Alcohol Dependence in Antisocial Personality Disorder

ALCOHOLISM, Issue 6 2009
Sheng-Yu Lee
Background:, Antisocial alcoholism is related to dopamine and serotonin which are catalyzed by monoamine oxidase A (MAOA) and acetaldehyde dehydrogenase 2 (ALDH2). The objective of this study is to determine whether the interaction between the MAOA and the ALDH2 genes is associated with subjects with antisocial personality disorder (ASPD) having alcoholism. Methods:, A total of 294 Han Chinese men in Taiwan including 132 ASPD with alcoholism (Antisocial ALC) and 162 without alcoholism (Antisocial Non-ALC) were recruited in this study. Alcohol dependence and ASPD were diagnosed according to DSM-IV criteria. Genotypes of ALDH2 and MAOA-uVNTR were determined using PCR-RFLP. Results:, A significant difference of ALDH2 polymorphisms (p = 3.39E-05), but not of MAOA, was found among the 2 study groups. However, only after the stratification of the MAOA-uVNTR (variable number of tandem repeat located upstream) 3-repeat, a significant association between Antisocial Non-ALC and ALDH2*1/*2 or *2/*2 genotypes was shown (p = 1.46E,05; odds ratio = 3.913); whereas stratification of MAOA-uVNTR 4-repeat revealed no association. Multiple logistic regression analysis further revealed significant interaction of MAOA and ALDH2 gene in antisocial ALC (odds ratio = 2.927; p = 0.032). Conclusion:, The possible interaction of MAOA and ALDH2 gene is associated with Antisocial ALC in Han Chinese males in Taiwan. However, the protective effects of the ALDH2*2 allele against alcoholism might disappear in subjects with ASPD and carrying MAOA-uVNTR 4-repeat allele in the Han Chinese male population. [source]

Neither Antisocial Personality Disorder Nor Antisocial Alcoholism Is Associated With the MAO-A Gene in Han Chinese Males

ALCOHOLISM, Issue 6 2003
Ru-Band Lu
Background: Recent studies on the genetics of alcoholism have suggested an association between antisocial alcoholism and the MAO-A gene. However, previous studies have failed to include subjects with antisocial personality disorder without alcoholism even though there is a high comorbidity between antisocial personality disorder and alcoholism. Consequently, the finding of an association between the MAO-A gene and alcoholism or antisocial personality disorder seems tenuous. In Taiwan, about 70% of the Han Chinese population have the ADH2*2 allele and 50% show ALDH2*1/*2 or ALDH2*2/*2 genotypes, which offer protection against drinking behavior and the risk of developing alcoholism. Thus, it is possible to recruit individuals with antisocial personality disorder but without alcoholism in Taiwan. Therefore, association studies of alcoholism or antisocial personality disorder in Chinese may be more reliable if pure antisocial alcoholics, pure antisocial personality disorders, and normal controls as MAO-A gene are examined. Methods: In this study, the associations among antisocial alcoholism, antisocial personality disorder, and the uVNTR and Eco RV polymorphisms of the MAO-A gene, both individually and as a haplotype, were investigated among male adults recruited from jails in Taipei. A total of 129 Chinese Han males were studied, including 41 with antisocial personality disorder with alcoholism, 50 with antisocial personality disorder but without alcoholism, and 38 without either disorder as a jail control group. The diagnoses of alcohol dependence and antisocial personality disorder were made according to DSM-IV criteria. In addition, 77 normal controls were collected from the community. Results: Strong linkage disequilibrium was found for the uVNTR and Eco RV variants of MAO-A gene in each study group. Conclusions: No significant association was observed between these two polymorphisms and antisocial personality disorder with alcoholism, either individually or for the haplotype, or for antisocial personality disorder without alcoholism. Thus, neither antisocial alcoholism nor antisocial personality disorder was associated with the genetic variants of MAO-A gene. [source]

The Liverpool Violence Assessment: an investigator-based measure of serious violence

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2003
Rajan Nathan
Background Antisocial personality disorder (ASPD) identifies adults with persistent offending behaviour and social dysfunction. However, it lacks discrimination within high-risk and criminal populations and gives little indication of an individual's history of violence. Existing measures of violence have significant limitations. The Liverpool Violence Assessment (LiVA) is an investigator-based standardized interview for measuring patterns of violence. Method A total of 61 male prisoners who had been sentenced for serious violent offences were interviewed using the LiVA and the Structured Clinical Interview for DSM IV antisocial personality disorder and alcohol and drug dependence. Official records of offending were examined. Results The inter-rater reliability for the LiVA was high. There were significant correlations between histories of violence assessed by the LiVA and official records, but the frequency of self-reported violence was much higher than in the official records. Antisocial personality disorder was associated with increased violence. However, analyses revealed marked variability of the levels of violence among those with antisocial personality disorder and contrasting patterns of association of violence with antisocial personality disorder depending on the context. Conclusion The LiVA is a reliable and valid measure of the patterns and characteristics of violence. The findings suggest that the causes of violence should be studied in their own right and not only as a feature of ASPD. Copyright © 2003 Whurr Publishers Ltd. [source]

Antisocial personality disorder in older adults.

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2007
A qualitative study of Dutch forensic psychiatrists, forensic psychologists
No abstract is available for this article. [source]

Criminal Behavior in Antisocial Substance Abusers between Five and Fifteen Years Follow-Up

THE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2007
Mats Fridell PhD
Antisocial personality disorder (ASPD) is one of the most common co-occurring disorders in substance abusers, characterized among other things by a high propensity for criminal actions. A cohort of 125 substance abusers were followed in a longitudinal design. Patients were diagnosed with ASPD at an index treatment episode, interviewed at five-year follow-up, and followed-up through the Swedish criminal justice register by 2005 for the years 1995,2003. ASPD and non-ASPD subjects were compared using Mann Whitney U test for ordinal variables (number of offenses and months in prison) and chi-square tests for categorical variables. A total of 107 were alive by 1995, when the period of observation began. ASPD diagnosed at baseline was related to criminal offenses and incarceration during the follow-up from 5 to 15 years. For most categories, ASPD diagnosis was associated with higher frequency of offense. An ASPD diagnosis based on SCID-II interview made at five-year follow-up was related to the number of offenses but unrelated to incarceration. In a sample of drug abusers, ASPD was associated with high levels of criminal behavior, even years after the diagnosis was given. A diagnosis based on clinical observation during treatment was at least as predictive of criminal behavior as a diagnosis based on a SCID-II interview. [source]

Temporal reliability of psychological assessments for patients in a special hospital with severe personality disorder: a preliminary note

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2005
Professor P. Tyrer
Background The new programme for assessing those with dangerous and severe personality disorder relies heavily on psychological assessments of personality disorder and risk. Methods The temporal reliability of assessments of psychopathy (PCL-R), risk (HCR-20) and personality was assessed using the International Personality Disorder Examination (IPDE) in 15 randomly selected male prisoners in a high secure hospital carried out at intervals varying between a mean of nine and 19 months after initial assessments by a variety of assessors. Results Using the intra-class correlation coefficient the agreement varied between0.57 (HCR-20), 0.58 (PCL-R) and 0.38-0.70 for IPDE personality disorders, with the best agreement for antisocial personality disorder (0.70). Comment These levels of agreement are consistent with other recent work on temporal reliability of personality instruments but are a little too low for confidence in these measures alone in the assessment process. Copyright © 2005 Whurr Publishers Ltd. [source]

The Liverpool Violence Assessment: an investigator-based measure of serious violence

What are adolescent antecedents to antisocial personality disorder?

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2002
Rolf Loeber PhD
Background This paper fills a gap because there are very few studies that prospectively predict antisocial personality disorder (APD) from psychopathology earlier in life in clinic-referred samples of young males. Method The paper addresses the continuity between conduct disorder (CD) and other forms of psychopathology during ages 13,17 and modified APD at ages 18 and 19 (modified to remove the DSM-IV requirement of pre-existing CD by age 15) in the Developmental Trends Study. Results The results show that 82,90% of APD cases met criteria for CD at least once during ages 13,17, and very few youths who met criteria for ODD during this period progressed to APD without intermediate CD. While CD is a strong predictor of modified APD, when other factors were accounted for in regression analyses, the best predictors were callous/unemotional behaviour, depression and marijuana use. ADHD during ages 13,17 was not significant in the final model. Males with CD during adolescence who progressed to APD tended to commit more violence, as evident from their court records. Conclusions Implications are discussed for the conceptualization of developmental models leading to APD, the strengthening of relevant symptoms of CD predictive of APD, and preventive and remedial interventions. Copyright © 2002 Whurr Publishers Ltd. [source]

A survey of female patients in high security psychiatric care in Scotland

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2001
Dr Lindsay D.G. Thomson MD MPhil MRCPsych Senior Lecturer in Forensic Psychiatry Honorary Consultant Forensic Psychiatrist
Background The State Hospital, Carstairs, is the sole high security psychiatric facility for Scotland and Northern Ireland. Method This study compares the female (n = 28) and male (n = 213) patients resident there between 1992 and 1993 using data derived from case-note reviews and interviews with patients and staff. Results Nearly three-quarters of both the male and female populations had a primary diagnosis of schizophrenia, and secondary diagnoses of substance abuse and antisocial personality disorder were common. Female patients were more frequently admitted from other psychiatric hospitals, had less serious index offences and more minor previous convictions, and were less likely to be subject to a restriction order. They had more often experienced depressive symptoms and had significantly greater histories of self-harm, physical and sexual abuse. At interview, nearly three-quarters had active delusions and over half had recently behaved in an aggressive manner. Almost 90% were said not to require the security of the State Hospital. Conclusions It was concluded that mental illness and adverse social circumstances had combined to create a very disadvantaged group of women in high security psychiatric care in Scotland. As a group these women were inappropriately placed and their requirement was for intensive, rather than high security psychiatric care. Copyright © 2001 Whurr Publishers Ltd. [source]

Alcohol expectancies in convicted rapists and child molesters

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2001
Anu S. Aromäki PhD
Background Previous findings suggest that cognitive factors and expectancies related to drinking can mediate subjective sexual arousal as well as aggression in men. Our aim was to investigate the drinking habits and alcohol-related expectancies that might predispose men to sexually aggress in two groups of sexual offenders. Method Men convicted of rape (n = 10) were compared with men convicted of child molesting (n = 10) and with control subjects (n = 31). Current drinking habits (while not in prison) were assessed by self-report, and the extent of alcohol abuse was mapped by the Michigan Alcoholism Screening Test (MAST; Selzer, 1971). Cognitive expectancies related to alcohol use were explored by the standard Alcohol Expectancy Questionnaire (AEQ; Brown et al., 1980). Results The majority of the men who committed rape (70%) but only a third of the men convicted of child molesting were diagnosed with antisocial personality disorder. Alcohol abuse was common in men convicted of both rape and child molesting and the men convicted of rape expected significantly more positive effects from drinking than the control group. Both sex offender groups were the only groups to express significant alcohol-related cognitive expectancies linked to arousal and aggression. Expectancy patterns were directly linked to the antisocial personality characteristics. Conclusion Alcohol abuse is common in men who commit both rape and child molesting. Heavy drinking and the anticipation of alcohol effects such as sexual enhancement, arousal and aggression may facilitate sexual aggression in offenders with antisocial personality disorder. Copyright © 2001 Whurr Publishers Ltd. [source]

Patterns of comorbidity in panic disorder and major depression: findings from a nonreferred sample

DEPRESSION AND ANXIETY, Issue 2 2005
Joseph Biederman M.D.
Abstract Previous findings in referred adult samples document major depression as having important moderating effects on the patterns of comorbidity for panic disorder and major depression. This study evaluated whether these patterns of comorbidity are moderated by referral bias. Panic disorder (PD) and major depression (MD) were used to predict the risk for comorbid psychiatric disorders and functional outcomes using data from a large sample of adults who had not been ascertained on the basis of clinical referral (N=1,031). Participants were comprehensively assessed with structured diagnostic interview methodology to evaluate childhood and adult comorbid psychiatric disorders. PD increased the risk for anxiety disorders, independently of MD. MD increased the risk for mania, antisocial personality disorder, psychoactive substance use disorder, disruptive behavior disorders, overanxious disorder, social phobia, and generalized anxiety disorder, independently of PD. These results extend to nonreferred samples' previously reported findings documenting that MD has important moderating effects on patterns of comorbidity for PD and indicate that patterns of comorbidity for PD are not due to referral bias. Depression and Anxiety 21:55,60, 2005. © 2005 Wiley-Liss, Inc. [source]

Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illness

ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2010
A. C. Swann
Swann AC, Lijffijt M, Lane SD, Steinberg JL, Moeller FG. Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illness. Objective:, We investigated trait impulsivity in bipolar disorder and antisocial personality disorder (ASPD) with respect to severity and course of illness. Method:, Subjects included 78 controls, 34 ASPD, 61 bipolar disorder without Axis II disorder, and 24 bipolar disorder with ASPD, by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (SCID-I and -II). Data were analyzed using general linear model and probit analysis. Results:, Barratt Impulsiveness Scale (BIS-11) scores were higher in ASPD (effect sizes 0.5,0.8) or bipolar disorder (effect size 1.45) than in controls. Subjects with both had more suicide attempts and previous episodes than bipolar disorder alone, and more substance-use disorders and suicide attempts than ASPD alone. BIS-11 scores were not related to severity of crimes. Conclusion:, Impulsivity was higher in bipolar disorder with or without ASPD than in ASPD alone, and higher in ASPD than in controls. Adverse effects of bipolar disorder in ASPD, but not of ASPD in bipolar disorder, were accounted for by increased impulsivity. [source]

The relationship of behavioural undercontrol to alcoholism in higher-functioning adults

DRUG AND ALCOHOL REVIEW, Issue 5 2006
MARC A. SCHUCKIT
Abstract Externalising behaviours, including the personality characteristics of behavioural undercontrol (BU), represent one of several genetically influenced domains that impact on the alcoholism risk. Because genes explain only about 60% of the vulnerability toward alcohol use disorders (AUDs), an optimal understanding of how such behaviours affect the risk requires evaluation of their impact in the context of additional influences. Few studies have addressed this question regarding BU among relatively well-functioning adults. This paper presents results from testing a BU-based mediational model of risk in men from the San Diego Prospective Study. Structured research instruments were used with 430 adult Caucasian males to evaluate the performance of BU in predicting AUDs at the 15-year follow-up using Pearson product-moment correlations among domains and an AMOS-based structural equation model (SEM). While both the family history of AUDs (FHalc) and BU predicted alcohol-related outcome, BU by itself did not mediate the relationship of the FH to alcohol disorders. The impact of BU on alcohol problems was mediated by alcohol expectancies, peer drinking and by coping. The SEM explained 42% of the variance for AUDs. The current results indicate that BU contributed to the risk for alcohol-related problems, even among more highly functional subjects and after excluding the impact of the antisocial personality disorder, but by itself did not mediate the relationship of FH to outcome in these subjects. [source]

The characteristics of heroin users entering treatment: findings from the Australian Treatment Outcome Study (ATOS)

DRUG AND ALCOHOL REVIEW, Issue 5 2005
JOANNE ROSS
Abstract The current study aimed to describe the characteristics (demographics, drug use, mental and physical health) of entrants to treatment for heroin dependence in three treatment modalities; and to compare these characteristics with heroin users not in or seeking treatment. Participants were 825 current heroin users recruited from Sydney, Adelaide and Melbourne: 277 entering methadone/buprenorphine maintenance treatment (MT), 288 entering detoxification (DTX), 180 entering drug-free residential rehabilitation (RR) and 80 not in treatment (NT). Treatment entrants were generally long-term heroin users with previous treatment experience. The majority of the sample (55%) were criminally active in the month preceding interview. Injection-related health problems (74%) and a history of heroin overdose (58%) were commonly reported. There were high degrees of psychiatric co-morbidity, with 49% reporting severe psychological distress, 28% having current major depression, 37% having attempted suicide and 42% having a lifetime history of post-traumatic stress disorder. Personality disorders were also prevalent, with 72% meeting criteria for antisocial personality disorder and 47% screening positive for borderline personality disorder. Striking similarities were noted between the non-treatment and treatment groups in length of heroin use career, drug use and treatment histories. [source]

Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): report of results from the Australian site

DRUG AND ALCOHOL REVIEW, Issue 3 2005
DAVID A. L. NEWCOMBE
Abstract The concurrent, construct, discriminative and predictive validity of the World Health Organization's Alcohol Substance Involvement Screening Test (ASSIST) were examined in an Australian sample. One hundred and fifty participants, recruited from drug treatment (n = 50) and primary health care (PHC) settings (n = 100), were administered a battery of instruments at baseline and a modified battery at 3 months. Measures included the ASSIST; the Addiction Severity Index-Lite (ASI-Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI-Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsely Addiction Profile (MAP). Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-lite, SDS, AUDIT and DAST; and significantly greater ASSIST scores for those with diagnoses of abuse or dependence. Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems. Participants diagnosed with attention deficit/hyperactivity disorder or antisocial personality disorder had significantly higher ASSIST scores than those not diagnosed as such. Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. ROC analysis was able to establish cut-off scores for an Australian sample, with suitable specificities and sensitivities for most substances. Predictive validity was demonstrated by similarity in ASSIST scores obtained at baseline and at follow-up. The findings demonstrated that the ASSIST is a valid screening test for psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use. [source]

Disinhibitory trait profile and its relation to Cluster B personality disorder features and substance use problems

EUROPEAN JOURNAL OF PERSONALITY, Issue 4 2006
Jeanette Taylor
Abstract Certain personality and motivational traits may present vulnerability towards disinhibitory psychopathology (e.g. antisocial personality disorder, substance abuse). Cluster analysis was used to separately group 306 women and 274 men on impulsivity, Constraint, Negative Emotionality, behavioural activation system (BAS), and behavioural inhibition system (BIS) scores. As expected, a ,disinhibited' group with low Constraint, high impulsivity, weak BIS, and strong BAS emerged that showed elevated drug use problems, and histrionic and antisocial personality disorder features across gender. A ,high affectivity' group with high Negative Emotionality and strong BIS also showed elevated drug use problems and personality disorder features. Results suggested that two different trait profiles are associated with disinhibitory psychopathology and both may present vulnerability toward the development of such disorders. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Are there subgroups of bulimia nervosa based on comorbid psychiatric disorders?

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2005
Alexis E. Duncan MPH
Abstract Objective The current study sought to determine whether there are subtypes of bulimia nervosa (BN) differentiated by comorbid psychiatric disorders. Method Data on comorbid psychiatric diagnoses in female relatives of probands and controls in the Collaborative Study of the Genetics of Alcoholism (COGA) who met criteria for BN (as outlined in the 3rd Rev. ed. of the Diagnostic and Statistical Manual of Mental Disorders) were analyzed using latent class analysis. Resulting latent classes were compared on a variety of variables related to impulsive behaviors and psychological functioning. Results The best-fitting solution, a two-class model, yielded one class (72%) characterized by substance dependence, depression, antisocial personality disorder (ASPD), and anxiety disorders, and another characterized by depression. The highly comorbid class had more suicidality, more daily smokers, sought help for emotional problems, and had lower Global Assessment of Functioning (GAF) scores compared with those in the comorbid depression only class. Discussion Latent class findings suggest the existence of two classes of BN differentiated by substance dependence, impulsive behaviors, and poorer psychological functioning. © 2004 by Wiley Periodicals, Inc. [source]

Screening for antisocial personality disorder in drug users , a qualitative exploratory study on feasibility

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2003
Benedikt Fischer
Abstract Knowledge about co-occurring personality disorders in drug users is important for planning therapy and prevention. The objective of this study was to assess whether the SCID-II (Structured Clinical Interview for DSM-III-R) Screen for antisocial personality disorder was feasible and acceptable in a population of opioid users. A qualitative study on veridicality and emotional quality in responses to SCID-II Screen was carried out by personal interview in a multifunctional addiction centre. The subjects were 10 outpatient participants (six female, four male) in methadone substitution treatment. The SCID-II Screen triggered a high level of emotions. Some questions were mainly interpreted from a victim's perspective, even though the intention was the perpetrator's view. Questions were seen as sex-biased. Provision of support to deal with potential emotional problems should be supplied. Potential revision should be considered to include the female perspective in the screen. Copyright © 2003 Whurr Publishers Ltd. [source]

Emotional processing in psychopathic personality

AGGRESSIVE BEHAVIOR, Issue 5 2002
Ute Habel
Abstract Emotional-processing deficits may be one of the characteristic features of impaired affect in individuals with psychopathy. These include shallowness and profound lack of remorse or empathy. Performances on standardized emotion discrimination tasks and mood induction tasks were compared between 17 patients with antisocial personality disorder (DSM-IV) and 17 nonpsychopaths. Subjects with psychopathic personality demonstrated poorer performance on emotion-discrimination tasks compared with controls. However, higher scores on factor "emotional detachment" of the Psychopathy Checklist (PCL-R) were associated with better discrimination ability. Subjective ratings were comparable between groups during mood induction. Although the findings support the hypothesis of a significant association between impaired emotional processing and psychopathy, they also suggest a relationship between emotional discrimination and the core personality features of psychopathy. Aggr. Behav. 28:394,400, 2002. © 2002 Wiley-Liss, Inc. [source]

Psychopathy: A confusing clinical construct

JOURNAL OF FORENSIC NURSING, Issue 1 2008
BSc. (Hons.) Psych., Christine A. Kirkman C. Psychol., R.M.N.
Abstract Although psychopathy has traditionally been cited as a disorder of personality, confusion arises as the term is used interchangeably with the terms antisocial personality disorder and dissocial personality disorder, both of which are largely behaviorally based. This paper aims to provide an overview of the literature on the topic of psychopathy, which examines this conundrum. Included in the discussion are definitions of psychopathy, incidence, approaches to diagnosis, and the debates that surround causes, manifestations, and treatability. Experimental studies and theoretical papers have been included if considered to be informative and of relevance to forensic nursing practice. The review demonstrates that studies are fragmented and no clear consensus seems to emerge concerning any of the discussion areas or even the construct of psychopathy itself. It is concluded that further research is required in psychopathy as encountered in both institutional and community settings. Until complete clarification is provided by the research community, forensic nurses need to maintain positive views about their own role when working with people with this challenging condition and strive to maintain a therapeutic ward atmosphere. [source]

Prospective Follow-Up of Empirically Derived Alcohol Dependence Subtypes in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC): Recovery Status, Alcohol Use Disorders and Diagnostic Criteria, Alcohol Consumption Behavior, Health Status, and Treatment Seeking

ALCOHOLISM, Issue 6 2010
Howard B. Moss
Background:, We have previously reported on an empirical classification of Alcohol Dependence (AD) individuals into subtypes using nationally representative general population data from the 2001 to 2002 Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and latent class analysis. Our results suggested a typology of 5 separate clusters based upon age of onset of AD, multigenerational familial AD, rates of antisocial personality disorder (ASPD), endorsement of specific AD and Alcohol Abuse (AA) criteria, and the presence of comorbid mood, anxiety, and substance use disorders (SUD). In this report, we focus on the clinical follow-up of these cluster members in Wave 2 of the NESARC (2004 to 2005). Methods:, The mean interval between NESARC Wave 1 and NESARC Wave 2 interviews was 36.6 (SD = 2.6) months. For these analyses, we utilized a Wave 2 NESARC sample that was comprised of a total of 1,172 individuals who were initially ascertained as having past-year AD at NESARC Wave 1 and initially subtyped into one of 5 groupings using latent class analysis. We identified these subtypes as: (i) Young Adult, characterized by very early age of onset, minimal family history, and low rates of psychiatric and SUD comorbidity; (ii) Functional, characterized by older age of onset, higher psychosocial functioning, minimal family history, and low rates of psychiatric and SUD comorbidity; (iii) Intermediate Familial, characterized by older age of onset, significant familial AD, and elevated comorbid rates of mood disorders SUD; (iv) Young Antisocial, characterized by early age of onset and elevated rates of ASPD, significant familial AD, and elevated rates of comorbid mood disorders and SUD; (v) Chronic Severe, characterized by later onset, elevated rates of ASPD, significant familial AD, and elevated rates of comorbid mood disorders and SUD. In this report, we examine Wave 2 recovery status, health status, alcohol consumption behavior, and treatment episodes based upon these subtypes. Results:, Significantly fewer of the Young Adult and Functional subtypes continued to meet full DSM-IV AD criteria in Wave 2 than did the Intermediate Familial, the Young Antisocial, and the Chronic Severe subtypes. However, we did not find that treatment seeking for alcohol problems increased over Wave 1 reports. In Wave 2, Young Antisocial and Chronic Severe subtypes had highest rates of past-year treatment seeking. In terms of health status, the Intermediate Familial, the Young Antisocial, and the Chronic Severe subtypes had significantly worse mental health scores than the Young Adult and Functional subtypes. For physical health status, the Functional, Intermediate Familial, Young Antisocial, and the Chronic Severe subtypes had significantly worse scores than the Young Adult subtype. In terms of alcohol consumption behavior, the Young Adult, Functional, and Young Antisocial subtypes significantly reduced their risk drinking days between Wave 1 and Wave 2, whereas the Intermediate Familial and the Chronic Severe subtypes did not. Discussion:, The results suggest that the empirical AD typology predicts differential clinical outcomes 3 years later. Persistence of full AD, treatment seeking, and worse mental health status were associated most strongly with those subtypes manifesting the greatest degree of psychiatric comorbidity. Reductions in alcohol consumption behavior and good physical health status were seen among the 2 younger subtypes. Overall, the least prevalent subtype, the Chronic Severe, showed the greatest stability in the manifestations of AD, despite having the highest rate of treatment seeking. [source]

The Relationship Between Serotonin Receptor 1B Polymorphisms A-161T and Alcohol Dependence

ALCOHOLISM, Issue 9 2009
Sheng-Yu Lee
Background:, Several studies have suggested that the serotonin receptor 1B gene (5HT1B) may be important in the pathogenesis of alcohol dependence (alcoholism; ALC; AD). We examined whether 5HT1B gene A-161T polymorphisms (rs130058) are a susceptibility factor for total AD and subgroups of AD. We further explored correlation of this 5HT1B gene variant between anxiety,depression alcoholism (ANX/DEP ALC) and antisocial alcoholism (antisocial ALC) subgroups because of the high comorbidity of anxiety,depression, antisocial personality disorder, and AD. Methods:, We recruited 522 Han Chinese in Taiwan for this study: 322 AD patients and 200 controls. The patient group was recruited primarily from medical teaching hospitals; patients with antisocial alcoholism were recruited from Taiwanese prisons. Individuals with AD were classified into 3 homogeneous clinical subgroups,pure alcoholism (pure ALC), ANX/DEP ALC, and antisocial ALC,using DSM-IV diagnosis. The 5HT1B gene A-161T polymorphism was determined using PCR,RFLP. Results:, No significant differences in genotypic and allelic frequencies were found between controls and the total AD group or between controls and the 3 AD subgroups. However, there were significant differences in the 5HT1B gene A-161T polymorphism at both the genotype and allelic levels between the ANX/DEP ALC and antisocial ALC subgroups. Conclusions:, This study suggests that the 5HT1B gene A-161T polymorphism alone is not a risk factor for increasing susceptibility to either AD or its subtypes. However, 5HT1B gene A-161T polymorphisms might be one of the common genetic factors between the ANX/DEP ALC and antisocial ALC subgroups. [source]

MAOA-uVNTR Polymorphism May Modify the Protective Effect of ALDH2 Gene Against Alcohol Dependence in Antisocial Personality Disorder

Influence of Antisocial and Psychopathic Traits on Decision-Making Biases in Alcoholics

ALCOHOLISM, Issue 5 2009
Robert Miranda Jr
Background:, Although decision-making processes have become a principal target of study among addiction researchers, few studies have specifically examined decision-making among individuals with alcohol dependence (AD) and findings to date are mixed. The present study examined the relationship between AD and decision-making, and tested whether different facets of antisocial and psychopathic traits explain this association. Methods:, Participants were men with AD (n = 22), AD and comorbid antisocial personality disorder (AD + ASPD; n = 17), or a history of recreational alcohol use, but no current or lifetime symptoms of a substance use disorder, conduct disorder, or ASPD (n = 21). Decision-making was tested using the Iowa Gambling Task (IGT). Results:, Across groups, participants reported similar levels of awareness of the contingencies of the task, but the AD groups with and without ASPD had poorer IGT performance compared with controls (p < 0.05). A block-by-block analysis revealed that while AD had slow but steady improvement across the task, AD + ASPD exhibited initial improvement followed by a significant decrease in advantageous decision-making during the last 20 trials (p < 0.05). This was further confirmed via evidence that impulsive/antisocial personality traits but not psychopathic traits mediated poor IGT performance beyond ASPD diagnosis. Conclusions:, Alcohol-dependent males favored risky choices regardless of whether they met criteria for ASPD. However, decision-making deficits were more pronounced among those with ASPD, and personality traits characterized by impulsive and antisocial tendencies mediated the relationship between AD and decision-making. [source]

Psychiatric Comorbidity in Long-Term Abstinent Alcoholic Individuals

ALCOHOLISM, Issue 5 2007
Victoria Di Sclafani
Background: A high prevalence of comorbid psychiatric disorders has been demonstrated in individuals with an alcohol use disorder in both community and treatment samples, with higher comorbidity in treatment samples. In this study, we examined lifetime and current psychiatric diagnoses in long-term abstinent alcoholic individuals (LTAA; mean abstinence=6.3 years; n=52) compared with age and gender-comparable non-alcoholic controls (NC; n=48). We asked the following questions: (1) to achieve long-term abstinence, must an individual be relatively psychiatrically healthy (i.e., comparable with NC) and (2) can ongoing abstinence be maintained in the face of a current psychiatric disorder? Methods: Lifetime and current (prior 12 months) psychiatric diagnoses were assessed in the mood, anxiety, and externalizing disorder domains using the computerized Diagnostic Interview Schedule (c-DIS). Results: Over 85% of LTAA had a lifetime psychiatric diagnosis, compared with 50% of NC. Long-term abstinent alcoholic individuals had a higher prevalence than NC of lifetime mood, anxiety, and externalizing disorder diagnoses. Long-term abstinent alcoholic individuals also had a greater prevalence than NC of current mood and anxiety diagnoses. Although LTAA had a greater lifetime prevalence of an antisocial personality disorder (ASPD) than NC, no LTAA or NC had a current ASPD diagnosis. Finally, there was no association of duration of abstinence with lifetime or current psychiatric diagnoses, consistent with psychiatric diagnoses having little effect on relapse. Conclusions: Our results suggest that: (1) the presence of a lifetime psychiatric diagnosis does not militate against achieving long-term abstinence, (2) abstinence can be maintained in the presence of a current mood or anxiety disorder, and (3) a current diagnosis of ASPD may not be compatible with long-term abstinence. The relatively low levels of antisocial behavior compared with preabstinence (as indicated by no LTAA meeting current criteria for ASPD) raises the question of whether the neurobiology underlying antisocial behavior is changed in abstinence, or brought under increased executive control, or both. [source]

Comorbidity of Alcohol Dependence With Attention-Deficit Hyperactivity Disorder: Differences in Phenotype With Increased Severity of the Substance Disorder, but Not in Genotype (Serotonin Transporter and 5-Hydroxytryptamine-2c Receptor)

ALCOHOLISM, Issue 10 2003
Monika Johann
Background: Nearly 50% of subjects with continuing symptoms of attention-deficit hyperactivity disorder (ADHD) in adulthood have been reported to show a comorbid substance use disorder. Both ADHD and alcohol dependence have a high genetic load and might even share overlapping sources of genetic liability. Recently, the functional relevant polymorphism within the promoter region of the serotonin transporter gene (5-HTT) and the 5-hydroxytryptamine-2c (5-HT2c) receptor Cys23Ser have been proposed as candidate genes for both entities. Methods: We investigated phenotype and 5-HTT/5-HT2c genotype characteristics in 314 alcoholics of German descent. Results: There was no significant difference in 5-HTT genotype or 5-HT2c allele distribution between alcoholics and matched controls. Sixty-seven alcoholics fulfilled DSM-IV criteria of ADHD with ongoing symptoms in adulthood and had a Wender Utah Rating Scale score greater than 90. Thirty had ADHD plus antisocial personality disorder. The subgroup of alcoholics with ADHD (ADHD+) showed a significantly higher daily and record ethanol intake per month, an earlier age at onset of alcohol dependence, and a higher frequency of suicidal ideation, court proceedings, and antisocial personality disorder. In our sample, more than 50% of type 2 alcoholics according to Cloninger consist of the ADHD+ and/or antisocial personality disorder-positive subjects. There were no differences in 5-HTT genotype or 5-HT2c allele distribution between the ADHD+ subgroups and alcoholics without comorbidity and matched controls, respectively. Conclusions: Comorbidity of alcoholism and ADHD forms a distinct phenotype that shows an increased severity of the substance disorder. This phenotype contributes substantially to the so-called type 2 alcoholics according to Cloninger. In our sample, the functional relevant 5-HTT promoter and the 5-HT2c receptor Cys23Ser polymorphism do not contribute to the supposed common genetic predisposition of ADHD and alcohol dependence. [source]

Neither Antisocial Personality Disorder Nor Antisocial Alcoholism Is Associated With the MAO-A Gene in Han Chinese Males

Stress Hormone Dysregulation at Rest and After Serotonergic Stimulation Among Alcohol-Dependent Men With Extended Abstinence and Controls

ALCOHOLISM, Issue 5 2001
Robert M. Anthenelli
Background: Alcohol dependence has been associated with long-lasting alterations in limbic-hypothalamic-pituitary-adrenal (LHPA) axis and serotonin (5-hydroxytryptamine [5-HT]) function. Other conditions that are associated with alcoholism (cigarette smoking and antisocial personality disorder [ASPD]) have been linked with disturbances in these interrelated systems. We evaluated the stress hormone response to 5-HTergic stimulation in alcohol-dependent men with extended abstinence (average abstinence duration, 4.3 months) and controls to determine the relative contributions of alcoholism, cigarette smoking, and ASPD on baseline and provoked plasma cortisol and adrenocorticotropin hormone (ACTH) concentrations. Methods: One hundred nine alcohol-abstinent men with alcohol dependence (62%), habitual smoking (70%), and ASPD (43%) received d,l-fenfluramine (100 mg po) in a randomized, double-blind, placebo-controlled, crossover trial. The group of recovering alcohol-dependent individuals included abstinent primary alcohol-dependent men and alcohol-dependent men with ASPD, whereas the group of non-alcohol-dependent men comprised healthy controls and non-alcohol-dependent men with ASPD. Plasma cortisol and ACTH levels were obtained at AM baseline and at half-hour intervals after drug administration. Subjective ratings of drug response and physiological measures were also obtained at baseline and every 30 min. Results: Abstinent alcohol-dependent men had significantly lower (approximately 20%) AM baseline plasma cortisol concentrations than non-alcohol-dependent men on both challenge days; however, no differences between the groups were observed with regard to resting AM plasma ACTH levels. After adjusting for these baseline differences, recovering alcohol-dependent men (area under curve = 35.6 ± 37.4 [,g/dl] × min) had a twofold greater cortisol response to fenfluramine than non-alcohol-dependent men (area under curve = 17.5 ± 32.5 [,g/dl] × min) (F= 5.1;df= 1,105;p < 0.03). The elevated cortisol response, which occurred primarily along the descending limb of the response curve, was paralleled by a nonsignificant statistical trend for alcohol-dependent men to also exhibit a greater ACTH response to fenfluramine at the 210-min (p < 0.07) and 240-min (p < 0.09) time points as compared with non-alcohol-dependent men. Cigarette smoking and ASPD did not affect hormonal responses, nor could the groups' subjective ratings and physiological measures be distinguished. Conclusions: Alcohol-dependent men with extended abstinence differed from age- and race-matched non-alcohol-dependent men in resting AM and fenfluramine-induced plasma cortisol levels. This dysfunction in glucocorticoid homeostatic mechanisms was associated with alcoholism and not with smoking or ASPD. We also observed a nonsignificant statistical trend for plasma ACTH levels to be elevated among alcohol-dependent men along the descending limb of the response curve. Alcohol-dependent men seemed to have inherited or acquired damage to 5-HT-regulated LHPA axis function, the precise mechanisms and sites of which remain to be determined. [source]

Platelet Adenylyl Cyclase Activity as a Trait Marker of Alcohol Dependence

ALCOHOLISM, Issue 6 2000
John A. Menninger
Background: There is compelling evidence that genetic factors play a major role in the development of alcohol dependence. Platelet adenylyl cyclase (AC) activity has been proposed as a biochemical marker for differentiating alcohol-dependent and nondependent subjects, but the sensitivity and specificity of this marker have not been ascertained. The objective of this study was to determine the sensitivity and specificity of platelet AC activity in identifying alcohol-dependent subjects and to ascertain the effect of medical/psychiatric variables, drinking and smoking history, and age and body weight on AC activity. Methods: The cross-sectional study was conducted from 1995 to 1998. Participants were 210 Australian White men who were community volunteers and alcohol treatment inpatients in Sydney, Australia. There were 41 nondrinkers, 140 drinkers, and 29 men who were entering alcohol treatment. The main outcome measure was platelet AC activity. Classification variables were plasma ethanol, ,-glutamyltransferase, aspartate aminotransferase, serum carbohydrate-deficient transferrin (CDT), and urinary5-hydroxytryptophol/5-hydroxyindoleacetic acid (5-HTOL/5-HIAA) levels, and World Health Organization/International Society for Biomedical Research on Alcoholism Interview Schedule variables, which included alcohol use and dependence criteria. Results: Among subjects who reported abstinence for at least 4 days, both cesium fluoride (CsF)- and forskolin-stimulated platelet AC activities were significantly lower in those with a lifetime history of alcohol dependence compared with those with no such history (p < 0.005 and p < 0.05, respectively). The sensitivity and specificity of CsF-stimulated AC activity to discriminate individuals with a lifetime history of alcohol dependence were 75% and 79%, respectively. Similar values for sensitivity and specificity for CsF-stimulated AC activity were calculated when discriminating current alcohol dependence in the subjects in our sample. Irrespective of the history of alcohol dependence, persons who had consumed alcohol recently (within the last 3,4 days) showed significantly higher mean basal, CsF-stimulated, and forskolin-stimulated AC activity (p < 0.001), as did those who had elevated 5-HTOL/5-HIAA ratios or CDT levels, indicative of recent (heavy) drinking. The "normalization" of platelet AC activity to baseline levels after an individual stops drinking may be related to the generation of new platelets during the abstinence period. Conduct disorder and antisocial personality disorder were not associated with low AC activity, but low forskolin-stimulated AC activity was associated with major depression. Conclusions: We found that CsF- and forskolin-stimulated platelet AC activity discriminates between subjects with and without alcohol dependence in a population of subjects who had not consumed significant quantities of ethanol recently. Recent alcohol consumption is a confounding variable that can alter the measured levels of AC activity. Forskolin-stimulated platelet AC activity also may be influenced by a history of major depression. [source]