title: Adult antisocial syndrome co-morbid with borderline personality disorder is associated with severe conduct disorder, substance dependence and violent antisociality.
abstract: This study tested the hypothesis that syndromal adult antisocial behaviour (AABS) co-morbid with borderline personality disorder (BPD) is a syndrome that emerges from severe conduct disorder (CD) in childhood and adolescence and is strongly associated, in adulthood, with both violence and substance dependence. In a sample of 8 580 community-resident adults screened for the presence of personality disorders, the following predictions arising from this hypothesis were tested: first, that those with AABS co-morbid with BPD would, in comparison with those showing AABS or BPD only, show a high level of antisocial outcomes, including violence; second, that adjusting for co-morbid alcohol dependence would attenuate group differences in many of the antisocial outcomes, and violence in particular; and third, that the AABS/BPD group would show both a high prevalence and a high severity of CD, and that adjusting for co-morbid CD would attenuate any association found between AABS/BPD co-morbidity and violence. Results confirmed these predictions, suggesting that AABS/BPD co-morbidity mediates the relationship between childhood CD and a predisposition to adult violence. The triad of AABS/BPD co-morbidity, alcohol dependence and severe CD is likely associated with the risk of criminal recidivism in offenders with personality disorder following release into the community.
authors.affiliation: Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; North East London Forensic Personality Disorder Service, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Freestone
authors.forename: Rick
authors.initials: R
authors.lastname: Howard
authors.forename: Jeremy W
authors.initials: JW
authors.lastname: Coid
authors.forename: Simone
authors.initials: S
authors.lastname: Ullrich
mesh_terms: D000293:Adolescent; D000328:Adult; D000987:Antisocial Personality Disorder / Q000453:epidemiology*; D001883:Borderline Personality Disorder / Q000453:epidemiology*; D015897:Comorbidity; D019955:Conduct Disorder / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014754:Violence / Q000706:statistics & numerical data*; D014852:Wales / Q000453:epidemiology; D055815:Young Adult