Antisocial behavioral syndromes and additional psychiatric comorbidity in posttraumatic stress disorder among u.s. Adults: results from wave 2 of the national epidemiologic survey on alcohol and related conditions.

Background: Despite the relatively high prevalence of antisocial personality disorder (ASPD) in individuals with posttraumatic stress disorder (PTSD), associations of ASPD with clinical presentation of PTSD, including additional comorbidity, have not been investigated.

Objective: To present nationally representative findings on associations of DSM-IV ASPD versus syndromal adult antisocial behavior without conduct disorder before age 15 with additional psychiatric disorders among U.S. adults with PTSD.

Methods: Face-to-face interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (n=34,653).

Results: After adjustment for sociodemographics and additional comorbidity, both antisocial syndromes were significantly associated with bipolar I, attention-deficit/hyperactivity, substance use, and paranoid, schizoid, histrionic, and obsessive-compulsive personality disorders among respondents with PTSD. Odds of major depressive and generalized anxiety disorders were significantly reduced among men with ASPD.

Conclusions: Interventions targeting PTSD may require attention to co-occurring antisociality and additional comorbidity.