What are the factors that contribute to aggression in patients with co-occurring antisocial personality disorder and substance abuse?

BÜLENT DEVRIM AKÇAY,DUYGU AKÇAY

doi:10.1590/0101-60830000000240

Abstract

Background A significant number of individuals with high levels of aggression have substance use disorder problems. Objective This study aimed to evaluate the effect of substance use disorder on aggression in young men with Antisocial personality disorder (ASPD). Methods This cross-sectional study included 328 patients and were diagnosed with ASPD with a comorbidity of substance use disorder, along with 111 healthy young male subjects. Results The total aggression scores of the patients with a diagnosis of ASPD were significantly higher than those of the healthy group (p < 0.001). Mean scores of aggression subscale, except for indirect aggression, were higher in patients diagnosed with ASPD (p < 0.05). There was a positive correlation between aggression scores and total API scores in patients diagnosed with ASPD (p < 0.001). Aggression scores were higher when subjects were using volatile substances compared to other substances (p < 0.05). Aggression scores increased with duration of substance use disorder (p < 0.001). Discussion Substance use disorder should be treated first to mitigate aggression in individuals with ASPD. Patients with severe addiction to volatile substances should be given treatment priority. Further studies are necessary to determine the cause of aggression in individuals who abuse substances.

Highlights

Aggression, or behavior intended to cause harm, is a common symptom of many psychiatric and personality disorders, antisocial personality disorder (ASPD) – a condition that is significantly hard to treat due to patient- and provider-related difficulties[1]
Considering these effects and the fact that persons with Antisocial personality disorder (ASPD) are at higher risk for substance abuse, the evaluation of the relationships between ASPD, substance abuse and aggression may increase our understanding of the conditions and may prove useful for the determination of risk factors
Young men with ASPD and a comorbid substance use disorder were found to have significantly higher aggression compared to controls, as measured by the Buss-Perry Aggression Scale

Summary

Introduction

Aggression, or behavior intended to cause harm, is a common symptom of many psychiatric and personality disorders, antisocial personality disorder (ASPD) – a condition that is significantly hard to treat due to patient- and provider-related difficulties[1]. Substance use disorder can lead to changes in attitude and may provoke new behavior including violence, lying, stealing, damaging property, refusing to comply with rules in the school, home or society; they are known to have a tendency for aggression, demonstrate confrontational behavior against authority figures and look for excuses to fight[9,10,11] Considering these effects and the fact that persons with ASPD are at higher risk for substance abuse, the evaluation of the relationships between ASPD, substance abuse and aggression may increase our understanding of the conditions and may prove useful for the determination of risk factors. Further studies are necessary to determine the cause of aggression in individuals who abuse substances

Objectives

Methods

Results

Conclusion