Adult antisocial behavior and its relationship to the diagnosis of antisocial personality disorder in a longitudinal study of homelessness

Objectives: The relationship of adult antisocial behavior to the diagnosis of ASPD has not been investigated in homeless populations. This study examined ASPD and adult-only antisocial behavior in a 2-year prospective longitudinal study of literally homeless individuals in St. Louis, Missouri in 1999-2001. Methods: A subsample of 241 provided complete data from 3 annual interviews from a baseline systematically selected sample of 400 participants. The Diagnostic Interview Schedule provided psychiatric diagnoses; residential and criminal history were obtained by self report; and urine drug testing for illicit substances was completed at each assessment. Analyses compared substance use and criminal behavior among three subgroups: 1) those fulfilling both adult antisocial and child conduct components for ASPD (N = 56), 2) with the adult antisocial component, but not the child conduct one (adult-only: N = 128), and 3) with neither (N = 57). Results: The adult-only subgroup was consistently intermediate between the ASPD subgroup and the subgroup with neither component; however, all were disproportionately deviant on substance abuse and criminal involvement. Conclusion: Antisocial behavior patterns are far more prevalent than ASPD in homeless populations. Differences between individuals with adult-only antisocial behavior and ASPD in homeless populations indicate needs for different approaches.