scholarly journals Impulsive Lifestyle Counselling Versus Treatment as Usual to Reduce Offending in People with Co-Occurring Antisocial Personality Disorder and Substance Use Disorder: A Post Hoc Analysis - BMC

2021 ◽  
Author(s):  
Morten Hesse ◽  
Birgitte Thylstrup
Keyword(s):  
Substance Use ◽  
Personality Disorder ◽  
Antisocial Personality Disorder ◽  
Driving Under The Influence ◽  
Antisocial Personality ◽  
Random Assignment ◽  
Criminal Records ◽  
Treatment As Usual ◽  
Lifestyle Counselling ◽  
The Impact

Abstract Objectives: To assess the impact of a psychoeducation for antisocial personality disorder on offending after randomization to treatment.Design: Multicentre, superiority, non-blinded randomized controlled trial. Random assignment was conducted in blocks of varying sizes at a central randomization centre.Setting: Nine outpatient uptake areas in Denmark.Participants: One hundred and seventy six patients with antisocial personality disorder in treatment for substance use disorders were randomized to treatment as usual or ILC (n=80; n=96). A total of 165 patients could be linked to criminal records collected between randomization and November 2019 (n=91; n=74).Intervention: The Impulsive Lifestyle Counselling program (ILC), is a brief psycho-educational program targeting antisocial behavior. The trial was conducted between January of 2012 and June 2014, and participants were tracked until December 2018, migration, or death, whichever occurred first. Outcomes: Number of offences in the 12 months following trial randomization from official national registers.Results: The mean number of offences was 2.76 in the TAU group (95% Poisson confidence interval [CI]=2.39, 3.16) and 1.87 in the ILC group (CI=0.97, 1.43). Negative binomial regression was used to assess number of convictions within the first year; violent, property, driving under the influence, and drug-related convictions. In both adjusted and unadjusted analyses, random assignment to ILC was associated with a lower number of total (incremental risk ration [IRR]=0.43, p=.013; adjusted IRR=0.33, p<.001), violent (IRR=0.19, p=.001; adjusted IRR=0.16, p=.018). Results were not significant for driving under the influence (unadjusted IRR=0.60, p=.371; adjusted IRR=0.87, p=.521), or drug offences (unadjusted IRR =1.06, p=.905; adjusted IRR=0.50, p=.180).Conclusions: The ILC program shows promise in reducing offending behavior in people with comorbid substance use and antisocial personality disorder.Trial registration: ISRCTN registry, ISRCTN67266318, 17/7/2012, https://doi.org/10.1186/ISRCTN67266318.

scholarly journals The Salience of Antisocial Personality Disorder for Predicting Substance Use and Violent Behavior: The Moderating Role of Deviant Peers

2019 ◽  
Vol 50 (1) ◽  
pp. 35-50
Author(s):  
Thomas W. Wojciechowski
Keyword(s):  
Substance Use ◽  
Personality Disorder ◽  
Antisocial Personality Disorder ◽  
Negative Binomial ◽  
Marijuana Use ◽  
Deviant Peers ◽  
Antisocial Personality ◽  
Violent Offending ◽  
Peer Association ◽  
The Impact

Deviant peer association and antisocial personality disorder are risk factors for drug use and violent offending. However, there has yet to be research that focuses on how deviant peer association may moderate the impact of antisocial personality disorder on these outcomes. Data from Wave 10 of the Pathways to Desistance dataset were used in analyses. Negative binomial regression was used to estimate the effects of covariates on violent offending. Ordered logistic regression was used to estimate the effects of covariates on substance use outcomes. Results indicated that deviant peer association moderated the impact of antisocial personality disorder on violent offending frequency and marijuana use frequency. The direction of this interaction effect was positive for marijuana use. The direction of this moderation was negative for violent offending, indicating that antisocial personality disorder–diagnosed individuals commit fewer violent offenses at similar levels of deviant peer association as nonafflicted participants.

Reaching Out to Patients with Antisocial Personality Disorder with Brief Psychoeducation

2017 ◽  
Vol 41 (S1) ◽  
pp. S70-S71
Author(s):  
M. Hesse ◽  
B. Thylstrup
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Personality Disorder ◽  
Substance Abuse Treatment ◽  
Substance Use Disorders ◽  
Antisocial Personality Disorder ◽  
Antisocial Personality ◽  
Treatment As Usual ◽  
Abuse Treatment

IntroductionPatients with antisocial personality disorder incur high costs on society, and are at high risk of dropping out of treatment and are often excluded from treatment, yet very little research has been conducted on how to best help these patients.ObjectivesTo test a six-session psychoeducation program, Impulsive Lifestyle Counselling, in outpatients with substance use disorders and antisocial personality disorder.AimsTo test the efficacy of the intervention versus treatment as usual in community outpatient treatment for substance use disorders.MethodsPragmatic randomized trial in 13 outpatient community substance abuse treatment uptake areas. Patients were interviewed by blinded interviewers 3, 9 and 15 months post-randomization and tracked through a national substance abuse treatment register. Mixed effects regression were used to assess substance use and self-reported aggression and Cox regression was used to assess risk of dropout.ResultsA total of 175 patients was randomized. At 3-month follow-up, patients randomized to intervention reported more days abstinent and less drug use severity than patients randomized to treatment as usual. In addition, patients randomized to intervention were at lower risk of dropout after intervention. In addition, patients randomized to intervention were more likely to report having received help for antisocial personality disorder at follow-up interviews.ConclusionsA brief psychoeducational intervention may improve outcomes for outpatients with antisocial personality disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Reaching out to patients with antisocial personality disorder in substance use disorder treatment: interactions between counsellors and clients in a psycho-educational intervention

2016 ◽  
Vol 9 (2/3) ◽  
Author(s):  
Morten Hesse ◽  
Birgitte Thylstrup
Keyword(s):  
Substance Use ◽  
Personality Disorder ◽  
Substance Use Disorder ◽  
Antisocial Personality Disorder ◽  
Design Methodology ◽  
Lifestyle Changes ◽  
Antisocial Personality ◽  
Lifestyle Counselling ◽  
Evidence Based Treatments ◽  
Overall Functioning

Purpose This article presents the Impulsive Lifestyle Counselling program, a time-limited psychoeducational approach to increasing patient awareness of antisocial personality disorder and its consequences. Design/methodology/approach This article describes the ILC program, a program developed as an add-on to treatment for substance use disorders, gives examples of issues and patient-counsellor interactions in the ILC sessions. Findings During the ILC sessions the patients engaged with the counsellors in diverse ways, reflecting the varying levels of psychopathology and overall functioning and barriers and incentive for lifestyle changes. Originality/value Patients with substance use disorder and comorbid antisocial personality disorder can receive better care with brief counselling that focuses on antisocial behavior and thinking. More diverse evidence-based treatments are needed for this disorder.

scholarly journals Clinical and behavioral correlates in adult methamphetamine users with childhood exposure to household drug and alcohol use

2022 ◽  
Vol 9 (2) ◽  
pp. 77-84
Author(s):  
Wanida Rattanasumawong ◽  
Robert T. Malison ◽  
Joel Gelernter ◽  
Yaira Nunez ◽  
Rasmon Kalayasiri
Keyword(s):  
Personality Disorder ◽  
Antisocial Personality Disorder ◽  
Antisocial Personality ◽  
Behavioral Correlates ◽  
Cross Sectional ◽  
Childhood Exposure ◽  
Frequent Use ◽  
History Of ◽  
Self Harm ◽  
The Impact

Aims: To describe and compare methamphetamine (MA) users with and without a family history of alcohol or drug () use in the household. Design:  A total of 1144 Thai-speaking MA users in Thailand were recruited for a cohort study. Cross-sectional baseline data were analyzed according to their exposure to FAOD use (FAOD+/FAOD-). The Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA) was utilized to collect baseline socio-demographic information and variables known to be associated with the impact of FAOD use. Findings:  FAOD+ participants had lower average years of education (p<0.01), fewer average months of employment in the past year (p<0.01) and reported higher rates of self-harm experience (p<0.001), gambling (p=0.018) and antisocial personality disorder  (p=0.015). FAOD+ participants had more severe clinical, adverse consequences. FAOD+ significantly predicted episodes of lifetime MA use (R2 =0.004,  p=0.032), the largest number of drinks ever had in a 24-hour period (R2 =0.01, p=0.001), paranoid experiences ([OR]=1.090, p=0.004), alcohol dependence ([OR]=1.112, p=0.001) and antisocial personality disorder ([OR]=1.139, p=0.015). FAOD+ participants who were exposed to alcohol only were more likely to report a significantly higher number of drinks ever had in a 24-hour periods (p<0.005). Similarly, FAOD+ participants who were exposed to MA use only were significantly more likely to report more frequent use of MA (p<0.005). Conclusions:  FAOD+ participants were characterized by a generally more severe clinical presentation than FAOD- participants. Moreover, we show the specificity of drug type mattered, with family exposure of alcohol and MA associated with greater subsequent use of the respective drugs.

Mechanisms of impulsivity in bipolar disorder and related illness

2010 ◽  
Vol 19 (2) ◽  
pp. 120-130 ◽  
Author(s):  
Alan C. Swann
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Personality Disorder ◽  
Substance Use Disorders ◽  
Antisocial Personality Disorder ◽  
Suicide Attempts ◽  
Affective State ◽  
Rapid Response ◽  
Antisocial Personality ◽  
Course Of Illness

SummaryAims – Impulsivity is a multifaceted aspect of behavior that is prominent in psychiatric disorders and has serious behavioral consequences. This paper reviews studies integrating behavioral and physiological mechanisms in impulsivity and their role in severity and course of bipolar and related disorders. Methods – This is a review of work that used questionnaire, human behavioral laboratory, and neurophysiological measurements of impulsivity or related aspects of behavior. Subjects included individuals with bipolar disorder, substance-use disorders, antisocial personality disorder, and healthy controls. Results – Models of impulsivity include rapid-response impulsivity, with inability to reflect or to evaluate a stimulus adequately before responding, and reward-based impulsivity, with inability to delay response for a reward. In normal subjects, rapid-response impulsivity is increased by yohimbine, which increases norepinephrine release. Impulsivity is increased in bipolar disorder, whether measured by questionnaire, by measures of rapid-response impulsivity, or by measures of ability to delay reward. While affective state has differential effects on impulsivity, impulsivity is increased in bipolar disorder regardless of affective state or treatment. Impulsivity, especially rapid-response, is more severe with a highly recurrent course of illness or with comorbid substance-use disorder, and with history of medically severe suicide attempt. In antisocial personality disorder, rapid-response impulsivity is increased, but rewardbased impulsivity is not. In general, impulsivity is increased more in bipolar disorder than in antisocial personality disorder. In combined bipolar disorder and antisocial personality disorder, increased impulsivity is associated with substance-use disorders and suicide attempts. Conclusions – Impulsivity is associated with severe behavioral complications of bipolar disorder, antisocial personality disorder, and substance-use disorders.

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