Adult onset of severe and pervasive antisocial behavior: A distinct syndrome?
Data from the Duke Epidemiologic Catchment Area (ECA) study were used to determine if persons reporting a pervasive pattern of severe adult antisocial behavior always report a similar pattern of antisocial behavior in childhood. Roughly half of persons reporting severe adult antisocial behavior reported onset in adulthood. Adult onset antisocial behavior would not meet criteria for a DSM-IIIR diagnosis, yet childhood and adult onset antisocials differed little in sociodemographic factors, psychiatric comorbidity, antisocial symptom profiles, or severity of the disorder. The nosologic implications of these findings are discussed. Further research is needed to confirm these findings and to determine if the childhood and adult onset antisocials differ with respect to risk factors, prognosis, and response to treatment; this will help in deciding whether adult onset antisocial behavior warrants a separate diagnostic caterory.
Tweed, JL; George, LK; Blazer, D; Swartz, M; MacMillan, J
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