Early Intervention May Prevent Antisocial Personality Disorder

For some children with severely antisocial behavior, an early intervention of group parent training may prevent development of antisocial personality disorder, according to The American Journal of Psychiatry. 

Researchers carried out two follow-up studies of randomized trials of group parent training. One study involved 120 children ages three to seven who were referred for treatment by a clinic, and the second study included 109 high-risk children ages four to six who were selectively screened from the community and had elevated antisocial behavior. Ninety-three children from the first study were reassessed between ages 10 and 17, and ninety children in the second study were reassessed between ages nine and 13. 

The intervention group in each study underwent group parent training with  a videotape offering instruction in play, praise and rewards, setting limits, and dealing with misbehavior. Participants in the control group received usual care. 

Investigators evaluated whether the intervention was linked with any change in the two elements of antisocial personality—antisocial behavior and antisocial character traits. These outcomes were assessed by diagnostic interview and questionnaire, respectively. 

Reading achievement and the quality of adolescents’ relationship with parents were also assessed. 

Results were promising for children who were referred for treatment. In that group, elements of antisocial personality improved at the long-term follow-up, compared with controls. In addition, reading ability improved, parents expressed emotion in a warmer way, and parents more closely supervised children. However, teacher-rated and self-rated antisocial behavior did not change. 

In the selective high-risk sample, early intervention was not associated with better long-term outcomes. 

“Early intervention with severely antisocial children for whom treatment is indicated may prevent the development of antisocial personality in adolescence and may improve academic performance. In contrast, early intervention with selective high-risk samples may be ineffective,” the researchers concluded. 

—Lauren LeBano 

Reference

1.Scott S, Briskman J, O'Connor TG. Early prevention of antisocial personality: long-term follow-up of two randomized controlled trials comparing indicated and selective approaches. Am J Psychiatry. 2014 Mar 14;[Epub ahead of print].