Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-Out

Connectomics modeling of regional networks of white-matter fractional anisotropy to predict the severity of young adult drinking

Background

Alcohol use impacts brain structure, including white matter integrity, which can be quantified by fractional anisotropy (FA) in diffusion tensor imaging (DTI). This study explored the relationship between the severity of alcohol consumption and white matter FA changes, and its sex differences, in young adults, using data from the Human Connectome Project.

Methods

We analyzed DTI data from 949 participants (491 females) and used principal component analysis (PCA) of 15 drinking metrics to quantify drinking severity. Connectome-based predictive modeling (CPM) was employed to predict the principal component of drinking severity from network FA values in a matrix of 116×116 regions. Mediation analyses were conducted to explore the interrelationships among networks identified by CPM, drinking severity, and rule-breaking behavior.

Results

Significant correlations were found between drinking severity and network FA values. Both men and women showed significant correlations between negative network connectivity and drinking severity (men: r=0.15, P=0.001; women: r=0.30, P<0.001). Sex differences were observed in the brain regions contributing to drinking severity predictions. Mediation analyses revealed significant inter-relationships between network features, drinking severity, and rule-breaking behavior.

Conclusions

The connectomics of white matter FA can predict the severity of alcohol consumption, and by incorporating brain network pathways, identify sex differences. This approach provides new clues to the biological basis of alcohol abuse and evaluates how these regions interact in broader brain networks for understanding alcohol misuse and its comorbidities.

Clinical characteristics of adults with alcohol dependence syndrome comorbid with antisocial personality disorder: a cross-sectional study

Introduction

Antisocial Personality Disorder (ASPD) is characterized by a pervasive pattern of disregard for and violation of the rights of others, typically emerging by age 15 years and involving behaviors such as deceitfulness, impulsivity, and aggressiveness. The present study sought to examine the prevalence of the comorbid ASPD in adult people with Alcohol Dependence Syndrome (ADS) and identify clinical characteristics associated with ASPD.

Methods

A cross-sectional study of 100 consecutive subjects diagnosed with ADS was conducted. Subjects were examined between August 2023 and September 2023. Various assessments and questionnaires were employed, including the Montreal Cognitive Assessment (MoCA), Alcohol Use Disorders Identification Test (AUDIT), and Structured Clinical Interview for DSM-IV (SCID-II). A computed tomography (CT) scan of the brain was performed on 47.5% participants.

Results

Out of the 100 individuals screened for the study, 20 were excluded. The study found that 35% of the examined study participants had a comorbid ASPD. Individuals with both ADS and ASPD were more likely to be younger, started drinking at an earlier age, had higher hospitalization rates, and scored higher on the AUDIT test (all P < 0.05%). Also, they had lower education levels, higher rates of unemployment, and lower marriage rates (all P < 0.05%). In addition, they reported more family members with ADS, incarceration, or mental illness and a higher frequency of traumatic experiences (all P < 0.05%). Depression, anxiety, stress (all P < 0.05%), and sleep problems (P = 0.058) were correlated with ASPD. Participants with the comorbid ASPD had lower MoCA scores (P = 0.046) and struggled with attention and linguistic subtests compared to subjects with ADS only.

Conclusion

The study highlights the high prevalence of comorbid ASPD in participants with ADS, shedding light on their demographic and psychometric characteristics. Individuals with the comorbid ASPD are more likely to face cognitive deficits, especially in linguistic and attention-related tasks. The findings underline the importance of considering the comorbidity of ASPD in ADS subjects. The study implies that the understanding of the associated risk factors can aid in developing more targeted treatment interventions.

Antisocial Personality Traits, Substance Use, and Somatization: A Brief Consideration of Their Interrelation

The relationship between antisocial personality traits and the expression of somatic symptoms has been the subject of several theoretical and empirical investigations. The present study sought to advance the understanding of the relationship between these variables by testing two moderation models. It was hypothesized that the relationship between antisocial traits and somatization would be moderated by alcohol use, such that the presence of alcohol dependence would strengthen the relationship between antisocial traits and somatization. It was also hypothesized that gender would play a moderating role in the relationship between ASPD and somatization, such that the relationship would be stronger among women than among men. These models were tested in a sample of 787 criminal offenders. Gender did not emerge as a significant moderator in the relationship between antisocial traits and somatization. Although substance use did significantly moderate the relationship between antisocial traits and somatization, the direction of the effect ran counter to expectations: among participants reporting a history of alcohol dependency, the relationship between antisocial features and somatization was diminished. The implications of these findings are discussed.