Goldstein Risë B, Grant Bridget F, Huang Boji, Smith Sharon M, Stinson Frederick S, Dawson Deborah A, Chou S Patricia
Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-9304, USA.
Compr Psychiatry. 2006 Jul-Aug;47(4):289-97. doi: 10.1016/j.comppsych.2005.11.002. Epub 2006 Apr 19.
The purpose of this study was to compare sociodemographic and family history correlates, symptomatic presentation, and comorbidity with Axis I and Axis II disorders, in an epidemiologic sample of adults with DSM-IV antisocial personality disorder (ASPD) who lacked, vs those who did not lack, remorse.
This study is based on a nationally representative sample of adults. Lifetime prevalences of each ASPD diagnostic criterion and each comorbid mood, anxiety, substance use, and personality disorder were estimated. Logistic regression was used to examine associations of lack of remorse with ASPD symptom patterns and comorbid disorders. Diagnoses were made using the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version.
Among the 1422 respondents with ASPD, 728 (51%) lacked remorse. Respondents who lacked remorse were younger and more often reported a family history of drug problems than those who did not. More often than remorse-positive respondents, those who were remorse-negative met diagnostic criteria involving violence against persons and less often met criteria involving offenses against property. Remorse was not associated with cruelty to animals, nor with most nonviolent antisocial behaviors. Remorse-negative respondents endorsed more total lifetime violent behaviors than those who were remorse-positive. Lack of remorse was not associated with any lifetime comorbid Axis I or Axis II disorder. Patterns of findings were generally similar between men and women.
Lack of remorse appears to identify at best a modestly more symptomatically severe and violent form of ASPD in nonclinical populations.
本研究旨在比较在缺乏与不缺乏悔恨感的患有DSM-IV反社会型人格障碍（ASPD）的成年流行病学样本中，社会人口学和家族史相关性、症状表现以及与轴I和轴II障碍的共病情况。
本研究基于全国具有代表性的成年样本。估计了每种ASPD诊断标准以及每种共病的情绪、焦虑、物质使用和人格障碍的终生患病率。使用逻辑回归来检验缺乏悔恨感与ASPD症状模式及共病障碍之间的关联。诊断采用美国国立酒精滥用与酒精中毒研究所酒精使用障碍及相关残疾访谈表-DSM-IV版。
在1422名患有ASPD的受访者中，728名（51%）缺乏悔恨感。与不缺乏悔恨感的受访者相比，缺乏悔恨感的受访者更年轻，且更常报告有药物问题的家族史。与有悔恨感的受访者相比，缺乏悔恨感的受访者更常符合涉及对人暴力的诊断标准，而较少符合涉及财产犯罪的标准。悔恨感与虐待动物无关，也与大多数非暴力反社会行为无关。缺乏悔恨感的受访者终生认可的暴力行为总数比有悔恨感的受访者更多。缺乏悔恨感与任何终生共病的轴I或轴II障碍均无关联。男性和女性的研究结果模式总体相似。
在非临床人群中，缺乏悔恨感似乎最多只能识别出一种症状稍重且更具暴力性的ASPD形式。
