Adult antisocial syndrome co-morbid with borderline personality disorder is associated with severe conduct disorder, substance dependence and violent antisociality

What is it about?

• In a sample of 8 580 community‐resident adults screened for the presence of personality disorders, the following predictions were made: first, that those with adult antisocial behavior syndrome (AABS) co‐morbid with borderline personality disorder (BPD would), in comparison with those showing AABS or BPD only, show a high level of antisocial outcomes, including violence; • second, that adjusting for co‐morbid alcohol dependence would attenuate group differences in many of the antisocial outcomes, and violence in particular; • third, that the co-morbid (AABS+BPD) group would show both a high prevalence and a high severity of CD, and that adjusting for co‐morbid CD would attenuate any association found between AABS/BPD co‐morbidity and violence. • Results confirmed these predictions, suggesting that AABS/BPD co‐morbidity mediates the relationship between childhood CD and a predisposition to adult violence. • The triad of AABS/BPD co‐morbidity, alcohol dependence and severe CD is likely associated with the risk of criminal recidivism in offenders with personality disorder following release into the community.

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Why is it important?

A "toxic triad" comprising substance dependence, severe antisocial personality disorder (including severe conduct disorder), and severe borderline personality disorder (including substance use disorder) predisposes to criminality, including violent criminality.

Perspectives