Ehlers Cindy L, Schuckit Marc A, Hesselbrock Victor, Gilder David A, Wills Derek, Bucholz Kathleen
Department of Neurosciences, The Scripps Research Institute, La Jolla, CA, USA.
Department of Psychiatry, UCSD Medical School, San Diego, CA, USA.
J Psychiatr Res. 2022 Jul;151:319-327. doi: 10.1016/j.jpsychires.2022.04.038. Epub 2022 May 2.
To describe the clinical course and symptom profile of DSM-IV Antisocial Personality Disorder (ASPD) and the syndrome of Adult Antisocial Behavior Syndrome (AABS) and determine if they differ based on sex and race.
Using questions from a validated semi-structured interview, data were gathered from 2 independent family studies in: 1) American Indians (AI), and 2) European Americans (EA), African Americans (AA) (total n = 7171) who reported antisocial symptoms.
Within these two samples 1148 (16%) individuals met ASPD criteria, 1932 (27%) met adult ASPD but not childhood conduct disorder (CD) (i.e., AABS). The clinical course of the antisocial behaviors studied did not differ based on race or sex; however, individual symptom counts, and age of onsets of those symptoms, were significantly different across the groups. Women reported fewer symptoms and at an older age (less fights, school suspensions/expulsions, arrests or jail time), than men but were more likely to run away from home. Those with ASPD vs. AABS had more symptoms overall including not experiencing remorse. AA and AI participants and those with ASPD, had more symptoms, and were more likely to be suspended/expelled from school and arrested at a younger age than EA.
In these select samples, the order and sequence of antisocial behaviors did not differ by race, AASB vs. ASPD, or sex; however individual symptom endorsement did, with men (vs. women), those with ASPD (vs. AABS), AI and AA (vs. EA) reporting more suspensions/expulsions from school and arrests. This suggests further study of the possible role of race and sex in the consequences associated with antisocial syndromes is warranted.
描述《精神疾病诊断与统计手册》第四版（DSM-IV）中反社会人格障碍（ASPD）及成人反社会行为综合征（AABS）的临床病程和症状特征，并确定它们在性别和种族上是否存在差异。
使用经过验证的半结构化访谈中的问题，从两项独立的家庭研究中收集数据，研究对象包括：1）美洲印第安人（AI）；2）欧裔美国人（EA）、非裔美国人（AA）（样本总数n = 7171），这些研究对象均报告有反社会症状。
在这两个样本中，1148名（16%）个体符合ASPD标准，1932名（27%）符合成人ASPD但不符合儿童品行障碍（CD）标准（即AABS）。所研究的反社会行为的临床病程在种族或性别上并无差异；然而，各群体的个体症状数量以及这些症状的发病年龄存在显著差异。女性报告的症状较少，发病年龄较大（打架、学校停学/开除、被捕或入狱情况较少），但更有可能离家出走。与AABS患者相比，ASPD患者总体症状更多，包括毫无悔意。非裔美国人和美洲印第安人参与者以及ASPD患者症状更多，比欧裔美国人更有可能在较年轻时被学校停学/开除并被捕。
在这些特定样本中，反社会行为的顺序和序列在种族、AASB与ASPD、或性别方面并无差异；然而，个体症状认可情况存在差异，男性（与女性相比）、ASPD患者（与AABS患者相比）、美洲印第安人和非裔美国人（与欧裔美国人相比）报告的学校停学/开除和被捕情况更多。这表明有必要进一步研究种族和性别在反社会综合征相关后果中可能发挥的作用。
