A latent class analysis of antisocial personality disorder symptom data from a multi-centre family study of...

To determine if there are subtypes of Antisocial Personality Disorder (ASPD), as manifested by distinctive symptom profiles or by associations with alcohol, other drug dependence or other psychiatric disorders.

Data on 38 symptoms of ASPD (including childhood conduct disorder) obtained from probands, their relatives and controls (2834 females and 3488 males) recruited for the Collaborative Study on the Genetics of Alcoholism (COGA) were analyzed using latent class analysis. Associations of the resulting latent classes with alcohol dependence (AD) and other psychiatric disorders were examined.

Among women, a 4-class solution was obtained in which conduct disorder and ASPD were found almost exclusively in the most severely affected class with two additional classes with mild and moderate behavior problems also identified. A strong linear trend (p < 0.001) for AD was observed, with each successive class manifesting a higher prevalence than the previous class. Milestones of drinking careers and dependence on other drugs also showed a strong association with class severity. Among men, a 5-class solution was obtained and, like women, the highest prevalence of ASPD (74.6%) was found in the most severely affected class. Somewhat unexpected was the observation that prevalence of AD was equivalent in the two most severe classes. The data for men indicated a class with a milder spectrum of childhood misbehaviors but with an adult ASPD profile--as well as other psychiatric co-morbidity--that was comparable to the most severe class.

Overall, findings from both men and women did not support the existence of subtypes of ASPD, but rather indicated a disorder distributed on a severity spectrum.