Antisocial Personality Disorder With or Without Antecedent Conduct Disorder: The Differences Are Psychiatric and Paraphilic

Abstract

Antisocial personality disorder (ASPD) requires a childhood diagnosis of conduct disorder (CD); however, some adult offenders are nevertheless diagnosed with ASPD without antecedent CD. The current study used a population of federal correctional clients to examine psychiatric and paraphilic conditions that potentially differentiate these offenders. Attention deficit hyperactivity disorder (ADHD) was associated with a 120% increased likelihood of ASPD with prior CD, but a 75% reduced likelihood of ASPD without CD. Bipolar I disorder was associated with a 328% increased likelihood, frotteurism conferred a 311% increased likelihood, and sexual sadism conferred a 1,033% increased likelihood of ASPD without CD. The findings provide specificity to the heterogeneous ASPD population and help to clarify its equifinality. Implications for correctional practice are that prior psychiatric diagnoses and paraphilic disorders can help to understand the development of serious criminal behavior occurring among adult offenders even if they lacked CD.