Development of antisocial personality disorder in detained youths: The predictive value of mental disorders.

Abstract

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 youth involved in the juvenile justice system is critical for prevention. This study used a stratified random sample of 1112 detained youth to examine the development of APD at a three-year followup 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 five 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. Keywords conduct disorder; antisocial personality disorder; mental disorder; detained youth; longitudinal Persistent antisocial behavior places a heavy burden on the community, the justice system, and the public health system (Miller, Cohen, & Wiersema, 1996). Adults with antisocial personality disorder (APD) are likely to experience a range of problematic behaviors and outcomes: criminal and violent behavior, substance use, early death, divorce, unemployment, and homelessness (Black, Baumgard, Bell, & Kao, 1996;Hodgins & Cote, 1993;Jainchill, Hawke, & Yagelka, 2000;Robins, Tipp, & Przybeck, 1991;Westermeyer & Thuras, 2005).Corresponding Author: Jason J. Washburn, PhD, ABPP, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 710 N. Lakeshore Drive, Suite 900, Chicago, IL 60611. Phone: 312-503-3500. Fax: 312-503-3535. j-washburn@northwestern.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/journals/ccp. Considering the high social and financial costs associated with APD, identifying youth at risk for this disorder is critical for prevention (Loeber, Green, & Lahey, 2003;Offord, 2000). NIH Public AccessAmong many of the factors hypothesized to affect the development of APD are mental disorders in childhood and adolescence. Conduct disorder (CD) in childhood and adolescence is the factor most often associated with the development of APD (Abramowitz, Kosson, & Seiden...

Quand la réadaptation blesse ? Éducateurs victimes de violence

“…Chez les enfants, des études ont montré que les troubles d'anxiété s'associent aux comportements agressifs (Washburn et al, 2007). Il est également démontré qu'il existe une comorbidité entre les troubles d'anxiété et les comportements perturbateurs (Dodge et al, 1997 ;Vitaro et al, 2002).…”

Antisocial personality disorder: Co‐morbid Axis I mental disorders and health service use among a national household population

“…This observation corresponds to studies of persistent violent offenders who demonstrate a stable pattern of antisocial behaviour since adulthood, and where a subgroup is characterized by the presence of co-morbid anxiety disorders and displays high levels of distress, neuroticism, disability and a poor quality of life (Sareen et al, 2004). Longitudinal studies have also shown that generalized anxiety disorder constitutes one risk factor for the development of antisocial personality disorder in adulthood (Washburn et al, 2007). Furthermore, in a national co-morbidity survey (Goodwin & Hamilton, 2003), more than half of those with diagnosis of antisocial personality disorder had a lifetime co-morbid anxiety disorder.…”

Attention Deficit Hyperactivity Disorder and Males in the Juvenile Justice System

“…In summary, if approximately 28% of those who enter the juvenile justice system have a prior formal diagnosis of ADHD, if the vast majority of 53% plus of juveniles in the system with CD would also be diagnosed with ADHD (if they were properly assessed), if the reported rates of 17.1% for males in the best study to date (Washburn et al, 2007) are an underestimate because of the inadequacies of assessment for ADHD, then a conservative prevalence estimate of 25% would seem to be reasonable.…”

“…In these studies, as previously discussed, the vast majority of those with CD were also diagnosed with ADHD. If this finding is applied to the 53% of males and females in detention or incarceration who have CD (Washburn et al, 2007) [note that 53% is an underestimate as it is based on self-report], then the vast majority of the 53% with CD would also presumably be diagnosed with ADHD if they were properly evaluated. Second, all studies that have assessed for ADHD in adolescents in all settings suffer from another limitation that results in an underestimation of true prevalence.…”

“…This study will assume special importance in interpreting the various foregoing estimates because it is the single best study to date as its large sample of 1,829 randomly selected youths is most representative of the entire country for the following reasons: a) most juvenile detainees nationwide live in or are detained in urban areas, b) Cook County is racially/ethnically diverse, c) the juvenile system in Cook County is typical of most other states, and d) the gender, age, and offense distributions in the detention center are similar to those detained nationwide (Washburn et al, 2007).…”