The dark path to antisocial personality disorder

February 7, 2012

With no lab tests to guide the clinician, psychiatric diagnostics is challenging and controversial. Antisocial personality disorder is defined as "a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood," according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association.

DSM-IV provides formal diagnostic criteria for every psychiatric disorder. This process may be guided by rating scales that measure the traits and features associated with a personality disorder. But, until now, no one has studied the dimensional structure associated with the DSM antisocial personality disorder criteria.

Dr. Kenneth Kendler of Virginia Commonwealth University and colleagues examined questionnaire and from adult twins. They found that the DSM-IV criteria do not reflect a single dimension of liability but rather are influenced by two dimensions of reflecting aggressive-disregard and disinhibition.

"When psychiatrists, as clinicians or researchers, think about our psychiatric disorders, we tend to think of them as one thing – one kind of disorder – a reflection of one underlying dimension of liability," said Dr. Kendler. "This is also true of genetics researchers. We tend to want to identify and then detect 'the' risk genes underlying disorder X or Y."

Kendler added, "What is most interesting about the results of this paper is that they falsify this inherent and rather deeply held assumption. Genetic risk factors for antisocial personality disorder are not one thing. Rather, the disorder, as conceptualized by DSM-IV, reflects two distinct genetic dimensions of risk."

"The findings from this study make sense. The distinction between the two sets of heritable traits contributing to , aggressive-disregard and disinhibition, highlights the complexity of unraveling the genes contributing to this personality style. We now have some puzzle pieces, but we have a long way to go to fit these pieces together," commented Dr. John Krystal, editor of Biological Psychiatry.

Explore further: If bipolar disorder is over-diagnosed, what are the actual diagnoses?

More information: The article is "A Multivariate Twin Study of the DSM-IV Criteria for Antisocial Personality Disorder" by Kenneth S. Kendler, Steven H. Aggen, and Christopher J. Patrick (doi:10.1016/j.biopsych.2011.05.019). The article appears in Biological Psychiatry, Volume 71, Issue 3 (February 1, 2012)

Related Stories

Is it really bipolar disorder?

March 25, 2010

A study from Rhode Island Hospital has shown that a widely-used screening tool for bipolar disorder may incorrectly indicate borderline personality disorder rather than bipolar disorder. In the article that appears online ...

Study looks more closely at personality disorders

September 21, 2011

A newly published paper from Rhode Island Hospital argues against the proposed changes to redefine the number of personality disorders in the upcoming Diagnostic Statistical Manual, 5th edition (DSM-5). In their study, the ...

DSM-5 proposed criteria for autism spectrum disorder diagnosis

January 23, 2012

(Medical Xpress) -- The American Psychiatric Association (APA) has proposed new diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for autism. While final decisions ...

Recommended for you

Psychosis associated with low levels of physical activity

August 25, 2016

A large international study of more than 200,000 people in nearly 50 countries has revealed that people with psychosis engage in low levels of physical activity, and men with psychosis are over two times more likely to miss ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.