Preventing Antisocial Personality Disorder

Preventing the development of antisocial personality disorder before it fully develops is of considerable clinical interest, particularly because effective interventions for this disorder in adolescents and adults are lacking. To assess the effectiveness of an early prevention program, researchers conducted follow-ups of two controlled trials.

One study involved 120 children, aged 3 to 7 years, whose antisocial behaviors averaged above the 97th percentile and who were initially referred to a clinic by family physicians. Parents received 13 to 16 weeks of evidence-based parent-training group programming (mean sessions attended, 74%), waiting list, or treatment as usual. At an average of 8 years later, 78% of children were reassessed (mean age, 13).

The other study involved 109 students screened at eight schools whose behavior severity was above the 82nd percentile. Parents received the same program (mean sessions attended, 55%) or were offered a telephone helpline. At an average of 6 years later, 83% of children were reassessed (mean age, 11).

At follow-up, the clinic-referred program was associated with medium-to-large effects for improved oppositional-defiant symptoms, fewer antisocial traits, fewer parent-reported behavior problems, better reading, and (on some measures) improved parenting. However, teacher reports and adolescent self-reports of improvement were weaker or nonsignificant. In the school-screened group, no lasting effects were seen on any measure.