Antisocial personality disorder and psychopathy in cocaine-dependent women

Objective: The goal of this study was to examine the lifetime prevalence of antisocial personality disorder according to five diagnostic systems and t he prevalence of psychopathy in a study group of women. The relationship be tween antisocial personality disorder and psychopathy was also examined. Fi nally, differences in treatment admission variables based on the presence o r absence of antisocial personality disorder and/or psychopathy were evalua ted. Method: Antisocial personality disorder was diagnosed in 137 treatment -seeking, cocaine-dependent women according to the Feighner criteria, Resea rch Diagnostic Criteria (RDC), and DSM-III, DSM-III-R, and DSM-IV criteria. Psychopathy was assessed by the Revised Psychopathy Checklist. Results: Ra tes of antisocial personality disorder varied from 76% according to the Fei ghner criteria to 11% for the RDC. Nineteen percent (N=26) of the women sco red in the moderate to high range on the Revised Psychopathy Checklist. All of these women were diagnosed with antisocial personality disorder accordi ng to DSM-III and Feighner criteria, but only 15 of the 26 were diagnosed a ccording to DSM-III-R, 12 according to DSM-IV, and six with the RDC. Modera te levels of psychopathy were associated with a history of illegal activity at treatment admission, whereas antisocial personality disorder was not. C onclusions: There was relatively little diagnostic agreement between classi fication systems. This study indicates that antisocial personality disorder and psychopathy are not synonymous terms for the same disorder, Findings s upport a need to redefine antisocial personality disorder diagnostic criter ia to make them gender neutral by including behaviors associated specifical ly with antisociality in women.