Concurrent and predictive validity of antisocial personality disorder subtyping among substance abusers

Three hundred seventy inpatient and outpatient substance abusers were divid ed according to presence and subtype of antisocial personality disorder (AP D) into groups comparing: a) adult antisocial behavior (AAB) versus full AP D; b) APD with low versus high sociopathy; c) APD with versus without lifet ime depression; and d) APD with versus without other axis II disorders. Mul tivariate regression was used to predict the unique contribution to the var iance in baseline and 12-month follow-up measures of substance use, psychia tric severity, and personality. The presence of comorbid axis II pathology was the strongest predictor of baseline severity in all three domains. APD substance abusers with Lifetime depression exhibited greater baseline to fo llow-up reductions in psychiatric severity than those APD substance abusers without a history of depression. All APD subtypes improved over time with treatment, suggesting that this diagnosis does not necessarily indicate poo r prognosis.