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199999 Antisocial behavioral syndromes in U.S. adults and quality of life at three-year follow-up: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related ConditionsWednesday, November 11, 2009
DSM-IV antisocial personality disorder (ASPD) requires both syndromal antisocial behavior since age 15 (AABS) and conduct disorder with onset before 15. In clinical follow-ups of adults, ASPD predicted poorer quality-of-life (QOL) outcomes. However, previous studies did not control for potential confounders, including comorbid psychopathology. No longitudinal study has examined QOL outcomes among general population antisocial adults. We compared respondents to the National Epidemiologic Survey on Alcohol and Related Conditions who were diagnosed at baseline with ASPD, AABS, or no antisocial syndrome on QOL at 3-year follow-up. Outcomes examined included scores on the Short Form 12 version 2 (SF-12) physical and mental health-related QOL scales, the Perceived Stress Scale-4 (PSS-4), and the Interpersonal Support Evaluation List-12 (ISEL-12). Predictions of QOL outcomes at follow-up by Wave 1 antisocial syndromes were analyzed using normal theory regression. After adjustment for baseline sociodemographics and psychiatric comorbidity, age by antisocial syndrome interactions were observed for most SF-12 physical health scales and the ISEL-12. ASPD and AABS did not predict scale scores at any age, whereas nonantisocial adults demonstrated significant inverse relationships of baseline age to follow-up scores. A sex by antisocial syndrome interaction was observed for the SF-12 Social Functioning scale, ASPD and AABS predicting better scores in men but not women. A sex by age by antisocial syndrome interaction was observed on the PSS-4, with nonantisocial men showing consistent, inverse relationships of perceived stress to age. These unexpected findings may reflect biased reporting by antisocial respondents or early-onset, persistent impairment of QOL associated with antisociality.
Learning Objectives: Keywords: Psychiatric Epidemiology, Quality of Life
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am a Staff Scientist in the Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, at the National Institute on Alcohol Abuse and Alcoholism (NIAAA). I received my Ph.D. in epidemiology and biostatistics from the University of Massachusetts in Amherst, my M.P.H. from the University of Pittsburgh, and my M.S.W. from the University of Washington in Seattle. My career focus has been the application of state-of-the-art methodology to the study of the epidemiology of alcohol and other drug use disorders and other mental disorders, including types and patterns of comorbidity as well as impairment and disability and help seeking. Much of both my past and my current work, including of 25 my 75 peer-reviewed publications, has centered around investigations of the nosology, clinical characteristics, and course of antisocial behavioral syndromes (antisocial personality disorder, conduct disorder, and syndromal antisocial behavior in adulthood without conduct disorder before age 15 years), associations of antisocial syndromes with the clinical presentation and course of substance use disorders, and sex differences and similarities in both substance use disorders and antisocial syndromes. I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation. |
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