Components of antisocial personality disorder among women convicted for drunken driving

For women, the temporal relationship between Antisocial Personality Disorder (ASPD) and alcoholism is unclear. Driving while intoxicated is both a symptom of ASPD and the alcohol-related problem most typically reported by women. Accordingly, a period prevalence sample of 33 women incarcerated for drunken driving offenses was assessed with the SCID to identify other symptoms of ASPD. Excluding behaviors that only occurred while drinking, only 1 of the 33 women met DSM-III-R criteria for ASPD. When behaviors while drinking were included, 18.2% (n = 7) met criteria for ASPD by having both a history of childhood conduct disorder and characteristic ASPD behaviors as adults. However, 57.6% of the sample displayed the pattern of adult behavioral symptoms without a history of childhood conduct disorder (n = 19). Women with a history of conduct disorder and ASPD had a younger mean age of onset of alcohol dependence (16.8 vs 25.6 years) and a higher rate of concurrent borderline personality disorder (85.7 vs 42.1%) than did women who had only adult symptoms of ASPD, but a similar rate of reported parental alcoholism (71.4 vs 72.2%). With one exception, women who were diagnosed with full ASPD with childhood conduct disorder (n = 6) had been truant and had run away from home, but none reported cruelty to animals, vandalism, or arson in childhood. Thus, behaviors diagnostic of ASPD were largely consequent to substance abuse, and childhood behaviors were limited predictors of ASPD. Relationships among gender, prodromal behaviors, and substance abuse appear more complex than anticipated, and they indicate the need to recognize adult onset ASPD associated with substance abuse as a legitimate diagnosis manifested differently by women and men.