STUDY CHARACTERISITCS OF RISK FACTORS FOR DEVELOPING ANTISOCIAL PERSONALITY DISORDER

National Collaborating Centre for Mental Health (UK)

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National Collaborating Centre for Mental Health (UK). Antisocial Personality Disorder: Treatment, Management and Prevention. Leicester (UK): British Psychological Society; 2010. (NICE Clinical Guidelines, No. 77.)

See 2013 Partial Update

March 2013: Some recommendations in sections 5.3.9, 5.4.9, 5.4.14, 5.4.19, 5.4.24 and 8.2 have been removed from this guideline by NICE. August 2018: Some recommendations have been updated to link to NICE topic pages.

March 2013: Some recommendations in sections 5.3.9, 5.4.9, 5.4.14, 5.4.19, 5.4.24 and 8.2 have been removed from this guideline by NICE. August 2018: Some recommendations have been updated to link to NICE topic pages.

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Antisocial Personality Disorder: Treatment, Management and Prevention.

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APPENDIX 17STUDY CHARACTERISITCS OF RISK FACTORS FOR DEVELOPING ANTISOCIAL PERSONALITY DISORDER

Study ID	Country	Population	Age of recruitment to follow-up	Risk factors	Outcome
BABINSKI1999 Quality assessed: +	US, San Francisco	N = 360; male and female Selection criteria: All the public and private schools were listed, 40 schools each were randomly selected, one sample for each grade level up to grade 5 was selected	9 – 26 years	Child factors: - Conduct problems - Hyperactive-impulsive behaviour - Conduct problems + hyperactive-impulsive behaviour	Offending behaviour: - Official records - Self-report
BIEDERMAN1996 Quality assessed: +	US	N = 260; male Selection criteria: Children with and without ADHD (DSM-III-R)	Recruited from ages 6 – 17 years Followed up between ages 16 and 27 years	Child factors: - ADHD - Oppositional defiant disorder - Conduct disorder	Diagnosis (DSM- IV): - ADHD - Oppositional defiant disorder - Conduct disorder
BOR2004 (The Mater University Study of Pregnancy) Quality assessed: +	Australia, Brisbane	N = 5278; male and female Selection criteria: Women in 1981 who gave birth to a live, singleton baby and completed postnatal surveys 3 to 5 days after the birth	Prenatal to 14 years	Child factors at 5 years: - Behaviour problems (parent- rated/CBCL) - Academic (Peabody Picture Vocabulary Test-Revised) Family factors from prenatal to 5 years: - Harsh discipline Social factors from prenatal to 5 years: - Family income - Perinatal factors	Behaviour problems: - Parent-rated (CBCL)
FARAONE1997 Quality assessed: +	US	N = 260; female Selection criteria: Psychiatrically referred females from lists of consecutive ADHD patients from paediatric psychopharmacology clinics. Controls from lists of outpatient at paediatric medical clinics	Age at recruitment: 6 – 17 years Age at follow-up: 10 and 21 years	Family factors: - Parents who had oppositional defiant disorder - Parents who had conduct disorder - Parent who had/have ADHD	Diagnosis: - ADHD + conduct disorder - ADHD + oppositional defiant disorder - ADHD only
FARMER2004 Quality assessed: +	US, North Carolina	N = 475; male and female Selection criteria: Participants in 7th grade from three schools in North Carolina	13 – 24 years	Child factors: - Aggression	Offending behaviour: - Official arrests
FARRINGTON1989 (Cambridge Study in Delinquent Development) Quality assessed: +	UK, London	N = 411; males Selection criteria: Living in a working class area of London, 8 years of age and on the registers of six state primary schools within a one-mile radius of the research office	8 – 32 years	Child factors: - Impulsivity: at ages 8–10 - IQ: at ages 8–10 Social factors: - Family income: at age 8 - Social class: ages 8–10 Family factors: - Harsh discipline: at age 8 - Parental disagreement: at age 8 - Divorce: by age 10	Behaviour problems: - Teacher reports - Self-report Offending behaviour - Official offences/convictions Diagnosis: - Antisocial personality disorder
FERGUSSON1994 (Christchurch Multidisciplinary Health and Development Study) Quality assessed: +	New Zealand, Christchurch	N = 1265 Selection criteria: Birth cohort	Birth to 16 years	Child factors (between 7 and 9 years): - Behaviour problems (parent- and teacher-rated) - Reading ability: at age 8 - Academic ability Social factors (between 7 and 9 years): - Family and childhood adversity Family factors: - Parental separation: between the ages of 0 – 5; 5 – 10; 10 – 15 years	Behaviour problems: - Self-report - Parent-report (Revised Behaviour Problem Checklist) - Teacher-report - Self-report Diagnosis: - Conduct disorder (DSM-III-R)
HELGELAND2005 Quality assessed: +	Norway, Oslo	N = 148; males and females Selection criteria: Consecutive admissions of patients to the adolescent unit of the National Centre for Child and Adolescent Psychiatry	15 – 43 years	Child factors: - Any personality disorder - Any cluster A - Any cluster B - Any cluster C	Diagnosis (DSM-IV): - Any personality disorder - Any cluster A - Any cluster B - Any cluster C
HERRENKOHL2000 (Seattle Social Development Project) Quality assessed: +	US, Seattle	N = 808; male and female Selection criteria: 5th graders from 18 Seattle public elementary schools serving high crime areas	10 – 18 years	Child factors: - Hyperactivity (parent- and teacher-rated): at age 10, 14 and 16 years - Behaviour problems (teacher-rated): at age 10, 14 and 16 years Social factors: - Peer delinquency: at age 10, 14 and 16 years - Socioeconomic status (community): at age 10, 14 and 16 years Family factors: - Parent conflict: at age 10, 14 and 16 years - Parent criminality: at age 10, 14 and 16 years	Behaviour problems: - Self-report (violence)
KLEIN1997 Quality assessed: +	US	N = 132; male and female Selection criteria: Local newspapers and advertisement requesting mothers and adolescents to participate in parent-adolescent interaction study	14 – 20 years	Family factors: - Single parents - Parent conflict	Behaviour problems: - Self-report (National Youth Survey) Offending Behaviour: - Self report (arrests/convictions)
KOSKINEN2001 Quality assessed: +	Finland	N = 5589; male Selection criteria: Birth cohort of 1966	Prenatal to 14 years	Family factors: - Single parent: throughout - Single parent: at birth but remarried - Divorced/separated: at any point between birth and 14 years	Offending behaviour: - Official offences
KRATZER1997 Quality assessed: +	Sweden, Stockholm	N = 12, 717; male and female Selection criteria: Unselected birth cohort	Prenatal to 30 years	Child factors: - Conduct problems at school: ages 12 – 13 and 15 – 16 years and/or in the community: before age 15 Social factors: - Social class	Offending behaviour: - Official records
LOEBER1991 (Pittsburgh Youth Study) Quality assessed: +	US	N = 205 males Selection criteria: 4^th, 7^th and 10th graders from 21 schools	Age at recruitment: 10 – 16 years Age at follow-up: 15 – 21 years	Child factors: - Behaviour problems (parent- rated/retrospective): between ages 1 – 5 years - Behaviour problems (parent- rated): between ages 10 and 16 years - Aggression/hyperactivity Social factors: - Deviant peers Family factors: - Discipline (inconsistent)	Behaviour problems: - Aggression (self-report) Offending behaviour: - Official arrests - any - Self-report - theft
LOEBER1995 Quality assessed: +	US	N=96; all male Selection criteria: Disruptive behavior disorder	Age at recruitment: Mean of 10 years (range: 7 – 12 years) Age at follow up: 16 years	Child factors: - Behavioural problems - ADHD - oppositional defiant disorder Family factors: - Parent with antisocial personality disorder - Parental substance misuse - Poor communication - Poor marital relations	Behaviour problems: Conduct disorder
LUNTZ1994 Quality assessed: +	US	N = 699; male and female Selection criteria: Abused and/or neglected children and a comparison group	20 years after their childhood victimisation Age at follow-up: ages 18 – 35 years	Family and/or social factors: - Physical/sexual abuse - Neglect from parents	Diagnosis: - Antisocial personality disorder
MANNUZZA1998 Quality assessed: +	US	N = 158; males Selection criteria: ADHD participant recruited from psychiatric research clinic and a comparison group recruited from a non- psychiatric outpatient clinic	7 – 24 years	Child factors: - ADHD - Conduct disorder - Oppositional defiant disorder	Diagnosis: - Antisocial personality disorder (DSM-III-R) - Conduct disorder
MCCABE2005 (Patterns of Youth Mental Health Care in Public Service Systems Study) Quality assessed: +	US, California	N = 423; male and female Selection criteria: Sub-sample from Patterns of Care study of participants who were 12 or older at baseline and 17 or younger at follow-up	12 – 17 years	Child factors: - Behaviour problems (CBCL) - Conduct disorder (DSM-IV) Social factors: - Income	Behaviour problems: - Parent-report (CBCL) Diagnosis: - Conduct disorder (DSM-IV)
MOFFITT2002 (Dunedin Multidisciplinary Health and Development Study) Quality assessed: +	New Zealand, Dunedin	N = 1037; male and female Selection criteria: Dunedin birth cohort of all births between 1 April 1972 and 31 March 1973	3 – 32 years	Child factors (between ages 7 and 9 years): - Behaviour problems (Rutter) - Reading ability (Burt Reading Test)	Behaviour problems: - Self-report - Parent-report (Revised Behaviour Problem Checklist)
PAKIZ1997 Quality assessed: +	US	N = 375; male and female Selection criteria: in public kindergarten in the north-eastern US in 1977	5 – 21 years	Child factors: - Behaviour problems (teacher-report/Kindergarten Behaviour Questionnaire): at age 5 years - Behaviour problems (teacher-report/Child and Adolescent Adjustment Profile): at age 9 years - Behaviour problems (self-report/CBCL-YSR): at ages 15 and 18 years	Diagnosis: - Antisocial personality disorder (DSM-III-R)
RAINE1994 Quality assessed: +	Denmark, Copenhagen	N = 4269; males Selection criteria: All male consecutive births in a state university hospital between 1959 and 1961	Prenatal to 17 – 19 years	Social factors: - Peer rejection: at age 1 year - Birth complications	Offending behaviour: - Official violent offences
RITTER2002 Quality assessed: +	US	N = 109; 48 males; 61 females (results analysed separately by gender) Selection criteria: Participant not exposed to familial alcoholism and those who are exposed	15 – 21 years	Child factors: - Conduct disorder (DSM-II-R/DSM-IV) Family factors: - Conflict	Behaviour problems: - Conduct disorder (DSM-II-R/DSM-IV)
SATTERFIELD1997 Quality assessed: +	US, California	N = 254; males only Selection criteria: Consecutive referrals of hyperactive boys to psychiatric outpatient clinics and boys from public schools matched to the at-risk group	7 – 37 years	Child factors: - ADHD (DSM-III)	Offending behaviour: - Official arrests - Official incarcerations
SOURANDER2006 (Epidemiological Multicentre Child Psychiatry study in Finland) Quality assessed: +	Finland	N = 2713; male Selection criteria: Finnish birth cohort born during 1981	8 years to late adolescence	Child factors: - Behaviour problems: parent- and teacher-report (Rutter Scale) Family factors: - Single family	Offending behaviour - Official offences
STEVENSON2001 Quality assessed: +	UK, London	N = 828; male and female Selection criteria: One-in-four random sample of cohort of children born in 1969 – 1970 living in borough of London	3 – 23/24 years	Child factors: - Behaviour problems	Offending behaviour: - Official offences
TREMBLAY1994 (Montreal Longitudinal Study) Quality assessed:+	Canada, Quebec	N = 957 males; 645 females Selection criteria: Schools with the lowest socioeconomic index, both biological parents were born in Canada and their mother tongue was French	6 – 17 years	Child factors: - Impulsivity: at age 6 years - Behaviour problems: at age 6 years - IQ (verbal): at age 13 years Social factors: - Family income: 10 to 16 years Family factors: - Divorce: between 6 and 11 years and 12 and 15 years	Behaviour problems: - Self-report Diagnosis (DSM-III-R): - Conduct disorder
WALKER1997 (Oregon Youth Study) Quality assessed: +	US	N = 80 Selection criteria: Sub-sample of antisocial adults and control group from the Oregon Youth study (WIESNER2003A)	10 – 17 years	Child factors: - Antisocial personality disorder construct - Delinquency - Academic skills Social factors: - Deviant peers	Offending behaviour: - Official arrests
WHITE2001 Quality assessed: +	US	N=698; all male Selection criteria: Representative sample of New Jersey adolescents	Age at recruitment: 12 – 18 years Age at follow up: 25 – 31 years	Child factors: - Neuropsychological risk (low birth weight, premature birth) - Verbal ability/executive functioning - Impulsivity Family factors: - Single parent - Parent hostility Social factors - Socioeconomic status	Offending behaviour: - Self-report
WIESNER2003A (Oregon Youth Study) Quality assessed: +	US	N = 206; males Selection criteria: Two successive grade 4 (age 9–10 years) recruited from 1983 to 1985 from schools in the higher crime areas of a medium-sized metropolitan region	9/10 to 23/24 years	Child factors: - Behaviour problems (combined parent-, teacher- and self-report) Family factors: - Harsh/inconsistent discipline - Parent’s offending behaviour - Single parent Social factors: - Deviant peers	Offending behaviour: - Self-report of arrests (Elliot Delinquency Scale) - Official arrests
WIESNER2003B Quality assessed: +	Germany	N = 318; male and female Selection criteria: Representative sample of East and West German children	Age at recruitment: 10 – 13 years (mean = 11) Age at follow-up: 13 – 17 years (mean = 15)	Child factors: - Behaviour problems (self-report) Social/family factors: - Early adversities	Offending behaviour: - Self-report

References of included studies

BABINSKI1999

Babinski LM, Hartsough CS, Lambert NM. Childhood conduct problems, hyperactivity-impulsivity, and inattention as predictors of adult criminal activity. Journal of Child Psychiatry. 1999;40:347–355. [PubMed: 10190336]

BIEDERMAN1996

Biederman J, Faraone SV, Milberger S, et al. Is childhood oppositional defiant disorder a precursor to adolescent conduct disorder? Findings from a four-year follow-up study of children with ADHD. Journal of American Academy of Child and Adolescent Psychiatry. 1996;35:1193–1204. [PubMed: 8824063]

BOR2004

Bor W, McGee TR, Fagan AA. Early risk factors for adolescent antisocial behaviour: an Australian longitudinal study. Australian and New Zealand Journal of Psychiatry. 2004;38:365–372. [PubMed: 15144516]

FARAONE1997

Faraone SV, Biederman J, Jetton JG, et al. Attention deficit disorder and conduct disorder: longitudinal evidence for a familial subtype. Psychological Medicine. 1997;27:291–300. [PubMed: 9089822]

FARMER2004

Farmer TW, Price LN, O’Neal KK, et al. Exploring risk in early adolescent African American youth. American Journal of Community Psychology. 2004;33:51–59. [PubMed: 15055754]

FARRINGTON1989

Farrington DP. Early predictors of adolescent aggression and adult violence. Violence and Victims. 1989;4:79–100. [PubMed: 2487131]

FERGUSSON1994

Fergusson DM, Horwood JL, Lynskey MT. The childhoods of multiple problem adolescents: a 15 year longitudinal study. Journal of Child Psychology and Psychiatry. 1994;32:1123–1140. [PubMed: 7995847]

HELGELAND2005

Helgeland MI, Kjelsberg E, Torgersen S. Continuities between emotional and disruptive behavior disorders in adolescence and personality disorders in adulthood. American Journal of Psychiatry. 2005;10:1941–1947. [PubMed: 16199842]

HERRENKOHL2000

Herrenkohl TI, Maguin E, Hill KG, et al. Developmental risk factors for youth violence. Journal of Adolescent Health. 2000;26:176–186. [PubMed: 10706165]

KLEIN1997

Klein K, Forehand R, Armistead L, et al. Delinquency during the transition to early adulthood: family and parenting predictors from early adolescence. Adolescence. 1997;32:61–79. [PubMed: 9105492]

KOSKINEN2001

Koskinen O, Sauvola A, Valonen P, et al. Increased risk of violent recidivism among adult males is related to single-parent family during childhood: the Northern Finland 1966 birth cohort study. Journal of Forensic Psychiatry. 2001;12:539–548.

KRATZER1997

Kratzer L, Hodgins S. Adult outcomes of child conduct problems: a cohort study. Journal of Abnormal Child Psychology. 1997;25:65–81. [PubMed: 9093901]

LOEBER1991

Loeber R, Stouthamer-Loeber M, van Kamen W, et al. Initiation, escalation, and desistance in juvenile offending and its correlates. Journal of Criminal Law and Criminology. 1991;82:36–82.

LOEBER1995

Loeber R, Stouthamer-Loeber M, Green SM. Age at onset of problem behaviour in boys, and later disruptive and delinquent behaviours. Criminal Behaviour and Mental Health. 1995;1:289–246.

LUNTZ1994

Luntz BK, Widom CS. Antisocial personality disorder in abused and neglected children grown up. American Journal of Psychiatry. 1994;151:670–674. [PubMed: 8166307]

MANNUZZA1998

Mannuzza S, Klein RG, Bessler A, et al. Adult psychiatric status of hyperactive boys grown up. American Journal of Psychiatry. 1998;155:493–498. [PubMed: 9545994]

MCCABE2005

McCabe KM, Lucchini SE, Hough RL, et al. The relation between violence exposure and conduct problems among adolescents: a prospective study. American Journal of Orthopsychiatry. 2005;75:575–584. [PubMed: 16262515]

MOFFITT2002

Moffitt TE, Capsi A, Harrington H, et al. Males on life-course-persistent and adolescence-limited antisocial pathways: follow-up at age 26 years. Development and Psychopathology. 2002;14:179–207. [PubMed: 11893092]
Moffitt TE, Capsi A, Dickson N, et al. Childhood-onset antisocial conduct problems in males: natural history from ages 3 to 18 years. Development and Psychopathology. 1996;8:399–424.

PAKIZ1997

Pakiz B, Reinherz HZ, Giaconia RM. Early risk factors for serious antisocial behaviour at age 21: a longitudinal community study. American Journal of Orthopsychiatry. 1997;67:92–101. [PubMed: 9034025]

RAINE1994

Raine A, Brennan P, Mednick SA. Birth complications combined with early maternal rejection at age 1 year predispose to violent crime at age 18 years. Archives of General Psychiatry. 1994;51:984–988. [PubMed: 7979887]

RITTER2002

Ritter J, Stewart M, Bernet C, et al. Effects of childhood exposure to familial alcoholism and family violence on adolescent substance use, conduct problems and self-esteem. Journal of Traumatic Stress. 2002;15:113–122. [PubMed: 12013062]

SATTERFIELD1997

Satterfield JH, Schell A. A prospective study of hyperactive boys with conduct problems and normal boys: adolescent and adult criminality. Journal of American Child and Adolescent Psychiatry. 1997;36:1726–1735. [PubMed: 9401334]

SOURANDER2006

Sourander A, Elonheimo H, Niemela S, et al. Childhood predictors of male criminality: a prospective population based follow up study from age 8 to late adolescence. Journal of the American Academy of Child and Adolescent Psychiatry. 2006;45:578–586. [PubMed: 16670652]

STEVENSON2001

Stevenson J, Goodman R. Association between behavior at age 3 years old and adult criminality. British Journal of Psychiatry. 2001;179:197–202. [PubMed: 11532795]

TREMBLAY1994

Tremblay RE, Pihl RO, Vitaro F, et al. Predicting early onset of male antisocial behaviour from preschool behavior. Archives of General Psychiatry. 1994;51:732–739. [PubMed: 8080350]

WALKER1997

Walker HM, Stieber S, Bullis M. Longitudinal correlates of arrest status among at-risk males. Journal of Child and Family Studies. 1997;6:289–309.

WHITE2001

White HR, Bates ME, Buyske S. Adolescent-limited versus persistent delinquency: extending Moffitt’s hypothesis into adulthood. Journal of Abnormal Psychology. 2001;110:600–609. [PubMed: 11727949]

WIESNER2003A

Wiesner M, Silbereisen RK. Trajectories of delinquent behaviour in adolescent and their covariates: relations with initial and time-averaged factors. Journal of Adolescence. 2003;26:753–771. [PubMed: 14643745]

WIESNER2003B

Wiesner M, Capaldi DM. Relations of childhood and adolescent factors to offending trajectories of young men. Journal of Research in Crime and Delinquency. 2003;40:231–262.

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