Childhood maltreatment and prospectively observed quality of early care as predictors of antisocial personality disorder features

Few studies have evaluated the separate contributions of maltreatment and ongoing quality of parentchild interaction to the etiology of antisocial personality features using a prospective longitudinal design. One hundred twenty low-income young adults (aged 1823) were assessed for extent of antisocial personality disorder (ASPD) features on the Structured Clinical Interview for Diagnosis (M.B. First, R.L. Spitzer, M. Gibbon, & J.B.W. Williams, 1997) for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994) Axis II, for presence of maltreatment on the Conflict Tactics Scale (M.A. Straus, S.L. Hamby, D. Finkelhor, D.W. Moore, & D. Runyan, 1998), Traumatic Experiences Scale (L. Dutra, J.F. Bureau, B. Holmes, A. Lyubchik, & K. Lyons-Ruth, 2009), and Adult Attachment Interview (C. George, N. Kaplan, & M. Main, 1984), and for referral in infancy to parentinfant clinical services. Fifty-six of these families had been studied longitudinally since the first year of life. In infancy, attachment disorganization and disrupted motherinfant interaction were assessed; in middle childhood, disorganized-controlling attachment behaviors were reliably rated. In kindergarten and second grade, behavior problems were assessed by teacher report. In cross-sectional analyses, maltreatment was significantly associated with ASPD features, but did not account for the independent effect of early referral to parentinfant services on ASPD features. In longitudinal analyses, maternal withdrawal in infancy predicted the extent of ASPD features 20 years later, independently of childhood abuse. In middle childhood, disorganized attachment behavior and maladaptive behavior at school added to prediction of later ASPD features. Antisocial features in young adulthood have precursors in the minute-to-minute process of parentchild interaction beginning in infancy.