Development of Adult Antisocial Behavior Chapter 14 Thomas J. Dishion and Kristina Hiatt Racer

HISTORICAL CONTEXT Historically, there have been two predominant philosophical perspectives on the origins of antisocial behavior: Antisocial qualities are considered to be innate and characterological. Antisocial qualities are acquired through poor socialization. A more current transactional or diathesis–stress perspective incorporates the idea that the same outcome (e.g., persistent antisocial behavior) may be due, across individuals, to a relatively greater contribution of either internal vulnerabilities or environmental risks.

Terminological, Conceptual, and Diagnostic Issues Current DSMV-IV diagnostic criteria for ASPD include a pervasive pattern of disregard for and violation of the rights of others, as indicated by three or more of the following: Failure to conform to social norms regarding lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal pleasure or profit Impulsivity or failure to plan ahead Irritability and aggressiveness, as indicated by repeated physical fights or assaults Reckless disregard for the safety of self or others Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

Terminological, Conceptual, and Diagnostic Issues Among children and adolescents, persistent antisocial behavior may lead to a diagnosis of ODD or CD. In individuals age 18 years or older, persistent antisocial behavior may lead to a diagnosis of ASPD. Discussion of ASPD overlaps to some degree with the terms dyssocial personality, sociopathy, and psychopathy. There continues to be active debate about the DSM ASPD construct and whether it should remain behavioral and objective or include some or all of the personality characteristics of psychopathy.

Prevalence The 2001 to 2002 National Epidemiologic Survey indicated a lifetime prevalence rate of 3.6% for ASPD, with risk being 3 times greater among men than among women (Compton, Conway, Stinson, Colliver, & Grant, 2005; Grant et al., 2004). The lifetime prevalence of adult antisocial behavior only (not meeting the childhood CD criterion) was 12.3%, and the prevalence of retrospectively reported CD in childhood without antisocial behavior in adulthood was 1.1% (Compton et al., 2005). Estimates of ASPD prevalence within incarcerated populations range from 49% to 80% (Widiger & Corbitt, 1995).

Risk Factors Childhood conduct problems are perhaps the best single predictor of adult ASPD. Earlier onset of conduct problems is associated with greater risk of persistence into adulthood (Moffitt, 1993, 2006). Not all youth with conduct problems continue to show antisocial behavior in adulthood. Childhood abuse and neglect may be particularly important in the etiology of ASPD.

Risk Factors Neurobiological risk factors may play a role in early-onset and persisting antisocial behavior (Moffitt, 1993). Antisocial behavior tends to run in families (Farrington et al., 1996). G x E Genetic risk for problem behavior in adolescence and adulthood was completely eliminated by parental monitoring practices in adolescence (Dick et al., 2009). Substance use and abuse

Etiology and Transactional Progressions Onset Pattern The most important etiological consideration is when the antisocial behavior emerged during development and the transactional factors that account for amplification of childhood antisocial behaviors through adolescence to more serious forms in adulthood. Parenting Coercion Theory During childhood to adolescence, caregivers giving negative feedback reinforces the problem behavior. Coercive interactions between the parent and child consist of a cycle of intrusive demands, compliance refusals, escalating distress and negative affect, and finally, withdrawal of the demand.

Etiology and Transactional Progressions A core feature of antisocial behavior in adulthood, believed to be linked to psychopathy, is callousness/lack of remorse. Peer-related pathways: Antisocial behavior interferes with positive peer relations, depriving children of the positive benefits of peer learning and confining them within marginal social niches. Children may act as models and a source of reinforcement for antisocial behavior. As children develop friendship networks, support for antisocial behavior is established by providing both reinforcement and opportunity for such behavior within networks of deviant peers.

Etiology and Transactional Progressions Figure 14.1. A model for the amplification of antisocial behavior to violence.

Comorbidity, Sex Differences, and Cultural Considerations ASPD may co-occur with any one or more of the following: ADHD, substance abuse, externalizing syndromes, anxiety disorders, depression. Men are 2 to 3 times more likely to receive a diagnosis of ASPD (Hesselbrock, Meyer, & Keener, 1985). The prognosis and correlates of ASPD appear to be similar for men and women (Cale & Lilienfeld, 2002). Family- and neighborhood-level risk factors, such as poverty, unemployment, single parenthood, and low income, often co-occur with ethnic minority status.

Theoretical Synthesis and Future Directions Figure 14.2 A model for self-regulation in the development of problem behavior. Adapted from Dishion and Patterson, 2006.

Theoretical Synthesis and Future Directions Relationship Dynamics Dynamic systems approach can produce measures such as stable relationship patterns (attractors), abrupt changes in the system (phase transitions), and the overall predictability of the system (entropy). Self-Regulation Moderator of relationship dynamics Cultural differences Biosocial Factors Linking G × E interactions with behavioral and physiological measures.

Theoretical Synthesis and Future Directions Sociocultural Factors Systematically apply and evaluate systems-level policies and interventions for improving sociocultural contexts and reducing antisocial behavior. Defining Disorders Future research must build upon the ASPD construct to examine issues such as: Whether ASPD differs in nature from less severe or persistent forms of antisocial behavior Whether the development (and treatment) of persistent antisocial behavior can be better understood by disaggregating ASPD into more homogenous groupings