The adult antisocial syndrome with and without antecedent conduct disorder: Comparisons from an adoption study

DSM antisocial personality disorder (ASPD) requires a retrospective diagnos is of conduct disorder-historical behavior not present in everyone with adu lt ASPD criteria. Using adoption study data, we examined the impact of this requirement on biological and environmental risk associations. We also com pared clinical correlates of adult antisocial behavior with and without pri or conduct disorder, We defined three subgroups: DSM-III ASPD (n = 30), adu lt antisocials without conduct disorder(n = 25), and controls (n = 142). By design, the sample, had a high incidence of biological parent ASPD, which was partially confounded with fetal alcohol exposure. We compared the assoc iations of both of these putative risk factors with subgroup membership aft er controlling for gender and adverse adoptive environment. We also examine d differences in two sociopathy scales and the incidence of co-occurring af fective, alcohol, and other substance use disorders. Finally, we explored d ifferences in individual antisocial symptoms. Having an antisocial biologic al parent was a specific risk factor for ASPD. In contrast, fetal alcohol e xposure, male gender, and adverse environment were associated with the adul t antisocial syndrome, regardless of conduct disorder history. The two anti social groups were similar with respect to sociopathy scales, co-occurring diagnoses, and the incidence of most individual symptoms. However, several adult and conduct disorder symptoms had significant specific associations w ith biological or environmental background or their interaction. Phenotypic expression of the biological-possibly genetic-risk for ASPD appears to be manifest before adulthood. The influence of other risk factors may not depe nd on antecedent conduct disorder. Despite this, we could not detect clinic ally important differences between the two sociopathic groups. The conduct disorder requirement therefore may be more relevant to etiological than cli nical understanding of adult antisocial behavior. Copyright (C) 2001 by W.B . Saunders Company.