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Adult antisocial syndrome with comorbid borderline pathology: Association with severe childhood conduct disorder

Rick Howard, PhD

University of Nottingham, Nottingham, UK, Peaks Academic Research Unit, Rampton Hospital, Retford, UK

Nick Huband, PhD

Division of Forensic Mental Health, Nottinghamshire Healthcare NHS Trust, Nottingham, UK

Conor Duggan, PhD, FRCPsych

University of Nottingham, Nottingham, UK, Division of Forensic Mental Health, Nottinghamshire Healthcare NHS Trust, Nottingham, UK

BACKGROUND: This study tested the hypothesis that adult antisocial syndrome co-concurrent with borderline personality disorder (AAS+BPD) would be associated with greater conduct disorder (CD) severity than AAS alone.

METHODS: Sixty-nine personality disordered individuals exhibited a sufficient number of adult antisocial traits to meet DSM-IV criterion A for antisocial personality disorder (AsPD). These were subdivided into those who did (AAS+BPD) or did not (AAS alone) meet DSM-IV criteria for a BPD diagnosis. We then compared the 2 groups on CD symptoms and historical, clinical, and self-report measures.

RESULTS: The mean number of CD criteria met and the total number of individual CD symptoms were significantly greater in the AAS+BPD group compared with the AAS alone group. The former also were more likely to be female, to have self-harmed, to show greater personality disorder comorbidity, and to self-report greater anger.

CONCLUSIONS: The functional link between CD and adult antisocial symptoms appears to be mediated, or at least moderated, by co-occurring borderline pathology.

KEYWORDS: adult antisocial syndrome; conduct disorder; borderline personality disorder


CORRESPONDENCE: Richard Howard, PhD, Forensic Mental Health, Institute of Mental Health, University of Nottingham Innovation Park, Sir Colin Campbell Building, Triumph Road, Nottingham NG7 2TU United Kingdom E-MAIL:
Annals of Clinical Psychiatry ©2012 Quadrant HealthCom Inc.

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