OBJECTIVE: It has been argued that among the homeless many of the
features of antisocial personality may be artifacts of homelessness and
that strict application of the diagnostic criteria may be insensitive to
social and cultural factors in this group. The authors studied a large
group of homeless men and women to investigate the appropriateness of the
diagnosis of antisocial personality disorder among the homeless. METHOD:
Six hundred homeless men and 300 homeless women were randomly selected from
shelters and street locations in St. Louis and interviewed with the
National Institute of Mental Health Diagnostic Interview Schedule. RESULTS:
In this sample of homeless men and women, most, but not all, adult symptoms
of antisocial personality disorder were significantly associated with
number of childhood conduct disorder symptoms. The onset of symptoms of
antisocial personality disorder usually preceded the onset of homelessness.
The rates of antisocial personality disorder were not significantly
affected by discounting the antisocial disorder symptoms thought to be
confounded with homelessness. CONCLUSIONS: Overall, the data support the
appropriateness of the diagnosis of antisocial personality disorder among
homeless populations. It cannot be said from these data that homelessness
often leads to antisocial behaviors.
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