Antisocial Personality Disorder and Psychopathy in Cocaine-Dependent Women

• Published in: The American journal of psychiatry 1999-06, Vol.156 (6), p.849-856
• Main Authors: Rutherford, Megan J., Cacciola, John S., Alterman, Arthur I.
• Format: Article
• Language: English
• Subjects: Abusers; Adult; Adult and adolescent clinical studies; Antisocial personality disorder; Antisocial Personality Disorder - diagnosis; Antisocial Personality Disorder - epidemiology; Antisocial Personality Disorder - psychology; Behavior disorders; Biological and medical sciences; Child; Cocaine; Cocaine-Related Disorders - epidemiology; Cocaine-Related Disorders - psychology; Comorbidity; Conduct Disorder - diagnosis; Conduct Disorder - epidemiology; Conduct Disorder - psychology; Diagnosis, Differential; Drug addiction; Female; Humans; Medical sciences; Personality; Personality Inventory - statistics & numerical data; Psychiatric Status Rating Scales - statistics & numerical data; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Psychopathy; Sex Factors; Social behavior disorders. Criminal behavior. Delinquency; Terminology as Topic; Women
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/ajp.156.6.849

OBJECTIVE: The goal of this study was to examine the lifetime prevalence of antisocial personality disorder according to five diagnostic systems and the prevalence of psychopa­thy in a study group of women. The relationship between antisocial personality disorder and psychopathy was also examined. Finally, differences in treatment admission variables based on the presence or absence of antisocial personality disorder and or psychopathy were evaluated. METHOD: Antisocial personality disorder was diagnosed in 137 treatment-seeking, cocaine-dependent women according to the Feighner criteria, Research Diagnostic Criteria (RDC), and DSM-III, DSM-III-R, and DSM-IV criteria. Psychopathy was assessed by the Revised Psychopathy Checklist. RESULTS: Rates of antisocial personality disorder varied from 76% according to the Feighner criteria to 11% for the RDC. Nineteen percent (N=26) of the women scored in the moderate to high range on the Revised Psychopathy Checklist. All of these women were diagnosed with antisocial personality disorder according to DSM-III and Feighner criteria, but only 15 of the 26 were diagnosed according to DSM-III-R, 12 according to DSM-IV, and six with the RDC. Moderate levels of psychopa­thy were associated with a history of illegal activity at treatment admission, whereas antisocial personality disorder was not. CONCLUSIONS: There was relatively little diagnostic agreement between classification systems. This study indicates that antisocial personality disorder and psychopathy are not synonymous terms for the same disorder. Findings support a need to redefine antisocial personality disorder diagnostic criteria to make them gender neutral by including behaviors associated specifically with antisociality in women.