Psychiatric heterogeneity in antisocial alcoholics: relation to familial alcoholism

There is some indication that addicts who qualify for a diagnosis of antisocial personality disorder (ASP) do not comprise a homogeneous group with respect to psychopathology. This preliminary study attempted to determine the extent to which DSM-III diagnosed ASP alcoholics with alcoholism on both sides of their family could be differentiated with respect to childhood behavioral problems and additional adult psychopathology from ASP alcoholics with low degrees of familial alcoholism. Two groups of ASP alcoholic patients were compared: (1) 11 high familial (bilineal) alcoholics, and (2) 22 low familial (nonfamilial or unilineal) alcoholics. Few group differences were found in sociodemographic or alcohol-related characteristics, although the high familial group tended to be younger. However, the high familial alcoholism group tended to report more childhood antisocial behaviors and more childhood behavior problems overall. The high familial alcoholism group also reported more psychopathology on three of the 10 Minnesota Multiphasic Personality Inventory (MMPI) clinical scales, paranoia (P less than .05), schizophrenia (P less than .06), and masculine-feminine (P less than .025). Effect sizes for these three variables were in the moderate range. The group MMPI profile of the high familial alcoholism group was indicative of serious characterological disturbances, while that of the low familial alcoholism group was much more normal. The results of this preliminary study provided evidence suggesting that antisocial individuals with a high degree of familial alcoholism are more likely to manifest psychopathology than antisocial individuals with a lesser degree of familial alcoholism.