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

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.

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