Am J Psychiatry 1995; 152:1309-1316
Copyright © 1995 by American Psychiatric Association
Gender differences in diagnosing antisocial personality disorder in methadone patients
MJ Rutherford, AI Alterman, JS Cacciola and EC Snider
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
OBJECTIVE: The goal of this study was to evaluate gender differences in the
prevalence rates, short-term reliability, and internal consistency of the
diagnosis of antisocial personality disorder for DSM-III-R, DSM- III, and
Research Diagnostic Criteria (RDC). METHOD: A total of 37 men and 57 women
methadone patients were diagnosed according to DSM-III-R, DSM-III, and RDC
antisocial personality disorder criteria. RESULTS: The diagnostic rates,
reliability, and internal consistency were lower for women than for men in
all systems. DSM-III criteria resulted in the highest reliability for
women, but for men, the DSM-III criteria were the least reliable.
Examination of endorsement rates of individual antisocial personality
disorder criteria revealed several significant gender differences on the
majority of childhood criteria and on several adult criteria. Item-total
correlations revealed that for women, the violent and aggressive childhood
criteria in DSM-III-R that had not been included in DSM-III or RDC had a
negative or no correlation to the assessment of antisocial personality
disorder for women. CONCLUSIONS: The change in DSM-III-R from DSM-III
childhood criteria appears to have resulted in a decrease in internal
consistency and rates of antisocial personality disorder for women, but not
for men. The results of this investigation indicate that the psychometric
properties of the current antisocial personality disorder scales are weak
for women, compared with men. To assess antisocial personality disorder in
women it may be necessary to revise current, or develop new, diagnostic
criteria.
