Sevecke Kathrin, Kosson David S, Krischer Maya K
Clinic of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Robert-Koch-Strasse 10, 50931 Cologne, Germany.
Behav Sci Law. 2009 Jul-Aug;27(4):577-98. doi: 10.1002/bsl.870.
Although ADHD and CD are apparent risk factors for adult psychopathy, there are three distinct perspectives regarding their relationships to psychopathy: (1) ADHD may contribute uniquely to the development of psychopathy or (2) its contribution may reflect its high comorbidity with CD. Alternatively, (3) the comorbid presence of ADHD and CD may confer unique risk for the development of psychopathy. Although prior adult studies have yielded conflicting findings, no prior studies of adolescents address this issue. We examined these three hypotheses and the possibility of sex differences using cross-sectional analyses in 90 male and 123 female incarcerated adolescents. Among males the influence of ADHD was largely attributable to the overlap between ADHD and CD, whereas among females ADHD contributed independently to psychopathy scores and to scores on several dimensions of psychopathy. In addition, among females, the ADHD x CD interaction was significant for the total score and the antisocial component of psychopathy and in a direction opposite to that predicted by the comorbid subtype hypothesis. These findings indicate that there may be sex-specific pathways to elevations in psychopathic traits and suggest that the comorbid subtype hypothesis is probably not correct for either boys or girls.
虽然注意力缺陷多动障碍（ADHD）和对立违抗障碍（CD）显然是成人精神病态的风险因素，但关于它们与精神病态的关系存在三种不同观点：（1）ADHD可能对精神病态的发展有独特影响，或者（2）其影响可能反映出它与CD的高共病率。另外，（3）ADHD和CD的共病可能为精神病态的发展带来独特风险。尽管先前针对成人的研究结果相互矛盾，但此前尚无针对青少年的研究探讨这个问题。我们在90名男性和123名女性被监禁青少年中进行横断面分析，检验了这三种假设以及性别差异的可能性。在男性中，ADHD的影响很大程度上归因于ADHD和CD之间的重叠，而在女性中，ADHD独立地影响精神病态得分以及精神病态几个维度的得分。此外，在女性中，ADHD与CD的交互作用对精神病态总分和反社会成分具有显著影响，且方向与共病亚型假设所预测的相反。这些发现表明，精神病态特质升高可能存在性别特异性途径，并且提示共病亚型假设可能对男孩或女孩都不正确。
