Progression from conduct disorder to antisocial personality disorder following treatment for adolescent substance abuse.
Progression from conduct disorder to antisocial personality disorder following treatment for adolescent substance abuse.
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DOI：
10.1176/ajp.155.4.479
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发表时间：
1998-04
期刊：
影响因子：
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通讯作者：
M. Myers;David G. Stewart;S. Brown
中科院分区：
文献类型：
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作者：
M. Myers;David G. Stewart;S. Brown
目的探讨青少年药物滥用患者从品行障碍到反社会人格障碍的发展过程。这个问题很重要，因为在患有反社会病理的人中，在治疗酒精和药物问题后观察到的结果很差。在治疗时评估的因素在预测成人反社会人格障碍进展方面的效用是在反社会行为的发展模式的背景下评估的。方法对137名平均年龄15.9岁、符合DSM-III-R品行障碍诊断标准的青少年进行前瞻性纵向研究。连续入院的患者是从两个青少年酒精和药物治疗机构招募的。受试者在治疗4年后再次接受采访。结果治疗4年后，研究组61%的患者符合DSM-III-R反社会人格障碍诊断标准。Logistic回归分析结果表明，越轨行为在10岁或之前开始，越轨行为的多样性越大，治疗前药物使用越广泛，最好地预测进展为反社会人格障碍。在4年的随访中，被诊断为反社会人格障碍的受试者比没有反社会人格障碍的受试者表现出更多的酗酒和吸毒行为，以及在重要生活领域的功能较差。结论本研究发现在滥用药物的青少年中有很高的反社会性人格障碍的进展，并确定了预测这一进展的因素。在治疗时仔细评估品行障碍病史可能对治疗计划和干预有价值。
OBJECTIVE This study investigated the progression from conduct disorder to antisocial personality disorder among individuals treated for adolescent substance abuse. This issue is important because of the poor outcomes observed among individuals with antisocial pathology after treatment for alcohol and drug problems. The utility of factors assessed at the time of treatment in predicting progression to adult antisocial personality disorder was evaluated in the context of developmental models of antisocial behavior. METHOD This was a prospective longitudinal study of 137 substance-abusing adolescents (53 female and 84 male), whose average age was 15.9 years and who met the DSM-III-R criteria for conduct disorder. Consecutively admitted patients were recruited from two adolescent inpatient alcohol and drug treatment facilities. Participants were interviewed again 4 years after treatment. RESULTS Four years after treatment, 61% of the study group met the DSM-III-R criteria for antisocial personality disorder. Results of a logistic regression analysis indicated that onset of deviant behavior at or before age 10, a greater diversity of deviant behavior, and more extensive pre-treatment drug use best predicted progression to antisocial personality disorder. At 4-year follow-up, the subjects with an antisocial personality disorder diagnosis exhibited more involvement with alcohol and drugs and poorer functioning across important life domains than the subjects without antisocial personality disorder. CONCLUSIONS This study found a high rate of progression to antisocial personality disorder among substance-abusing adolescents and identified factors predictive of this progression. Careful assessment of conduct disorder history at the time of treatment may be valuable for treatment planning and intervention.