The Severe 5%: A Latent Class Analysis of the Externalizing Behavior Spectrum in the United States

OBJECTIVE: Criminological research consistently demonstrates that approximately 5% of study populations are comprised of pathological offenders who account for a preponderance of antisocial behavior and violent crime. Unfortunately, there have been no nationally representative epidemiological studies characterizing the severe 5% group. MATERIALS AND METHODS: Data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of 43,093 non-institutionalized U.S. residents aged 18 years and older were analyzed using latent class analysis to assess sociodemographic, psychiatric, and behavioral characteristics. RESULTS: Four-classes of respondents were identified vis-à-vis lifetime externalizing behaviors. A normative class (66.1% of respondents) demonstrated little involvement in antisocial conduct. A low substance use/high antisocial behavior class (20.7% of respondents) and high substance use/moderate antisocial behavior (8.0% of respondents) class evinced diverse externalizing and psychiatric symptoms. Finally, a severe class (5.3% of respondents) was characterized by pathological involvement in more varied and intensive forms of antisocial and externalizing behaviors and extensive psychiatric disturbance. CONCLUSIONS: The current study is the first nationally representative epidemiological study of criminal careers/externalizing behavior spectrum in the United States and validates the existence of the 5% pathological group demonstrated by prior research.