Bucholz K K, Hesselbrock V M, Heath A C, Kramer J R, Schuckit M A
Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108-1334, USA.
Addiction. 2000 Apr;95(4):553-67. doi: 10.1046/j.1360-0443.2000.9545537.x.
To determine if there are subtypes of Antisocial Personality Disorder (ASPD), as manifested by distinctive symptom profiles or by associations with alcohol, other drug dependence or other psychiatric disorders.
Data on 38 symptoms of ASPD (including childhood conduct disorder) obtained from probands, their relatives and controls (2834 females and 3488 males) recruited for the Collaborative Study on the Genetics of Alcoholism (COGA) were analyzed using latent class analysis. Associations of the resulting latent classes with alcohol dependence (AD) and other psychiatric disorders were examined.
Among women, a 4-class solution was obtained in which conduct disorder and ASPD were found almost exclusively in the most severely affected class with two additional classes with mild and moderate behavior problems also identified. A strong linear trend (p < 0.001) for AD was observed, with each successive class manifesting a higher prevalence than the previous class. Milestones of drinking careers and dependence on other drugs also showed a strong association with class severity. Among men, a 5-class solution was obtained and, like women, the highest prevalence of ASPD (74.6%) was found in the most severely affected class. Somewhat unexpected was the observation that prevalence of AD was equivalent in the two most severe classes. The data for men indicated a class with a milder spectrum of childhood misbehaviors but with an adult ASPD profile--as well as other psychiatric co-morbidity--that was comparable to the most severe class.
Overall, findings from both men and women did not support the existence of subtypes of ASPD, but rather indicated a disorder distributed on a severity spectrum.
确定反社会型人格障碍（ASPD）是否存在亚型，其表现为独特的症状特征或与酒精、其他药物依赖或其他精神障碍相关。
使用潜在类别分析对从参与酒精中毒遗传学合作研究（COGA）招募的先证者、其亲属和对照（2834名女性和3488名男性）中获得的38种ASPD症状（包括儿童期品行障碍）的数据进行分析。检查所得潜在类别与酒精依赖（AD）和其他精神障碍的关联。
在女性中，得到了一个4类解决方案，其中品行障碍和ASPD几乎只出现在受影响最严重的类别中，还确定了另外两个有轻度和中度行为问题的类别。观察到AD有强烈的线性趋势（p < 0.001），每个连续类别表现出比前一个类别更高的患病率。饮酒生涯的里程碑和对其他药物的依赖也与类别严重程度有很强的关联。在男性中，得到了一个5类解决方案，与女性一样，ASPD患病率最高（74.6%）出现在受影响最严重的类别中。有点出乎意料的是，观察到在两个最严重的类别中AD患病率相当。男性的数据表明存在一个儿童期行为不端较轻但具有成人ASPD特征以及其他精神共病的类别，其与最严重的类别相当。
总体而言，男性和女性的研究结果均不支持ASPD存在亚型，而是表明该障碍是在严重程度谱上分布的。
