Altered affective modulation of the startle reflex in alcoholics with antisocial personality disorder.

Background: Individual differences in neural circuitry that regulate emotional reactivity may be associated with alcoholism and antisocial personality disorder (ASPD), a common comorbid condition. The emotion-modulated startle reflex was used to investigate emotional reactivity among alcohol-dependent (AD) men with and without ASPD.

Methods: Sixty-two men were tested: (1) AD (n = 24), (2) AD-ASPD (n = 17), and (3) non-AD, non-ASPD controls (n = 21). Participants completed self-report instruments and clinical interviews and had eye-blink electromyograms measured in response to acoustic startle probes while viewing color photographs rated as affectively pleasant, neutral, and unpleasant.

Results: Startle blink magnitudes were larger during unpleasant as compared with pleasant slides for control and AD groups, resulting in significant linear trend effects (p < 0.001) and nonsignificant quadratic trend effects. In contrast, AD-ASPD did not show a significant difference in blink magnitude during unpleasant and pleasant slides and did not show a significant linear valence trend or quadratic trend effect (p > 0.6). Subjective valence and arousal ratings of the photographs were similar across groups.

Conclusions: Adult male alcoholics with ASPD have abnormal emotional responsiveness to both pleasant and unpleasant stimuli relative to alcoholics without ASPD and to controls.