Antisocial Personality Disorder

F. Gerard Moeller, M.D., and Donald M. Dougherty, Ph.D.
Epidemiologic studies and laboratory research consistently link alcohol use with aggression. Not all people, however, exhibit increased aggression under the influence of alcohol. Recent research suggests that people with antisocial personality disorder (ASPD) may be more prone to alcohol-related aggression than people without ASPD. As a group, people with ASPD have higher rates of alcohol dependence and more alcohol -related problems than people without ASPD. Likewise, in laboratory studies, people with ASPD show greater increases in aggressive behavior after consuming alcohol than people without ASPD. The association between ASPD and alcohol-related aggression may result from biological factors, such as ASPD-related impairments in the functions of certain brain chemicals (e.g., serotonin) or in the activities of higher reasoning, or “executive,” brain regions. Alternatively, the association between ASPD and alcohol -related aggression may stem from some as yet undetermined factor(s) that increase the risk for aggression in general. KEY WORDS: antisocial personality disorder; aggressive behavior; AODR (alcohol or other drug [AOD] related) behavioral problem; personality trait; AODR violence; expectancy theory of AODU (AOD use, abuse, and dependence); disinhibition theory of AODU; neurobiological theory of AODU; brain function; AODE (effects of AOD use, abuse, and dependence) on emotion

Numerous studies indicate an association between alcohol consumption and aggressive behavior. Not all people who consume alcohol, however, become aggressive. In trying to elucidate the relationship between alcohol consumption and aggression, researchers have suggested that people with a psychiatric condition called antisocial personality disorder (ASPD) may be particularly susceptible to alcohol-related aggression. This article explores that association in more detail. First, the article describes the distinguishing features of ASPD. Then it reviews the findings of epidemiologic and laboratory studies that have investigated the link between ASPD and aggression. Finally, the article presents several mechanisms that may contribute to differences between people with and without ASPD with respect to alcohol-related aggression.
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