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Current Neuropharmacology Jan 2015The use of anabolic-androgenic steroids (AASs) by professional and recreational athletes is increasing worldwide. The underlying motivations are mainly performance... (Meta-Analysis)
Meta-Analysis Review
The use of anabolic-androgenic steroids (AASs) by professional and recreational athletes is increasing worldwide. The underlying motivations are mainly performance enhancement and body image improvement. AAS abuse and dependence, which are specifically classified and coded by the DSM-5, are not uncommon. AAS-using athletes are frequently present with psychiatric symptoms and disorders, mainly somatoform and eating, but also mood, and schizophrenia-related disorders. Some psychiatric disorders are typical of athletes, like muscle dysmorphia. This raises the issue of whether AAS use causes these disorders in athletes, by determining neuroadaptive changes in the reward neural circuit or by exacerbating stress vulnerability, or rather these are athletes with premorbid abnormal personalities or a history of psychiatric disorders who are attracted to AAS use, prompted by the desire to improve their appearance and control their weights. This may predispose to eating disorders, but AASs also show mood destabilizing effects, with longterm use inducing depression and short-term hypomania; withdrawal/discontinuation may be accompanied by depression. The effects of AASs on anxiety behavior are unclear and studies are inconsistent. AASs are also linked to psychotic behavior. The psychological characteristics that could prompt athletes to use AASs have not been elucidated.
Topics: Anabolic Agents; Antisocial Personality Disorder; Athletes; Athletic Performance; Humans; Mental Disorders; Psychopathology; Steroids; Substance-Related Disorders; Testosterone Congeners
PubMed: 26074746
DOI: 10.2174/1570159X13666141210222725 -
Revista Brasileira de Psiquiatria (Sao... 2015To identify, by means of a systematic review, the frequency with which comorbid personality disorders (PDs) have been assessed in studies of euthymic bipolar patients. (Review)
Review
OBJECTIVE
To identify, by means of a systematic review, the frequency with which comorbid personality disorders (PDs) have been assessed in studies of euthymic bipolar patients.
METHODS
PubMed, ciELO and PsychINFO databases were searched for eligible articles published between 1997 and 2013. After screening 1,249 empirical papers, two independent reviewers identified three articles evaluating the frequency of PDs in patients with bipolar disorders assessed in a state of euthymia.
RESULTS
The total sample comprised 376 euthymic bipolar patients, of whom 155 (41.2%) had at least one comorbid PD. Among them, we found 87 (23.1%) in cluster B, 55 (14.6%) in cluster C, and 25 (6.6%) in cluster A. The frequencies of PD subtypes were: borderline, 38 (10.1%); histrionic, 29 (7.7%); obsessive-compulsive, 28 (7.4%); dependent, 19 (5%); narcissistic, 17 (4.5%); schizoid, schizotypal, and avoidant, 11 patients each (2.95%); paranoid, five (1.3%); and antisocial, three (0.79%).
CONCLUSION
The frequency of comorbid PD was high across the spectrum of euthymic bipolar patients. In this population, the most common PDs were those in cluster B, and the most frequent PD subtype was borderline, followed by histrionic and obsessive-compulsive.
Topics: Comorbidity; Humans; Obsessive-Compulsive Disorder; Personality Disorders
PubMed: 25946399
DOI: 10.1590/1516-4446-2014-1459 -
Clinical Psychology Review Feb 2015Previous research on the association between socioeconomic status (SES) and child and adolescent antisocial behaviour has produced mixed findings showing variation in... (Meta-Analysis)
Meta-Analysis Review
Previous research on the association between socioeconomic status (SES) and child and adolescent antisocial behaviour has produced mixed findings showing variation in the strength of association. This systematic review and meta-analysis aimed to summarise evidence on the relationship between socioeconomic status and broadly conceptualised antisocial behaviour, investigating variation across a range of antisocial subtypes and other potential moderators, including age, sex and informant. We identified 133 studies containing data suitable for effect size calculation, and 139 independent effect sizes were analysed (total N=339868). The global meta-analysis showed that lower family socioeconomic status was associated with higher levels of antisocial behaviour. Moderation analyses revealed this relationship was stronger where callous-unemotional traits were the outcome, and where antisocial behaviour was reported by parents or teachers rather than self-reported. The relationship between family SES and antisocial behaviour, however, was independent of higher-level constructs such as national income inequality. These results indicate that SES can be considered a robust correlate of broadly conceptualised antisocial behaviour but the strength of this relationship may depend on the antisocial subtype under investigation and the design of the study.
Topics: Adolescent; Adolescent Behavior; Antisocial Personality Disorder; Child; Child Behavior; Female; Humans; Male; Socioeconomic Factors
PubMed: 25483561
DOI: 10.1016/j.cpr.2014.11.003 -
PloS One 2014With the increased knowledge of biological risk factors, interest in including this information in forensic assessments is growing. Currently, forensic assessments are... (Review)
Review
BACKGROUND
With the increased knowledge of biological risk factors, interest in including this information in forensic assessments is growing. Currently, forensic assessments are predominantly focused on psychosocial factors. A better understanding of the neurobiology of violent criminal behaviour and biological risk factors could improve forensic assessments.
OBJECTIVE
To provide an overview of the current evidence about biological risk factors that predispose people to antisocial and violent behaviour, and determine its usefulness in forensic assessment.
METHODS
A systematic literature search was conducted using articles from PsycINFO, Embase and Pubmed published between 2000 and 2013.
RESULTS
This review shows that much research on the relationship between genetic predisposition and neurobiological alterations with aggression is performed on psychiatric patients or normal populations. However, the number of studies comparing offenders is limited. There is still a great need to understand how genetic and neurobiological alterations and/or deficits are related to violent behaviour, specifically criminality. Most studies focus on only one of the genetic or neurobiological fields related to antisocial and/or violent behaviour. To reliably correlate the findings of these fields, a standardization of methodology is urgently needed.
CONCLUSION
Findings from the current review suggest that violent aggression, like all forms of human behaviour, both develops under specific genetic and environmental conditions, and requires interplay between these conditions. Violence should be considered as the end product of a chain of life events, during which risks accumulate and potentially reinforce each other, displaying or triggering a specific situation. This systematic review did not find evidence of predispositions or neurobiological alterations that solely explain antisocial or violent behaviour. With better designed studies, more correlation between diverse fields, and more standardisation, it might be possible to elucidate underlying mechanisms. Thus, we advocate maintaining the current case-by-case differentiated approach to evidence-based forensic assessment.
Topics: Antisocial Personality Disorder; Forensic Genetics; Forensic Psychiatry; Genetic Predisposition to Disease; Humans; PubMed; Risk Factors; Violence
PubMed: 25330208
DOI: 10.1371/journal.pone.0110672 -
Actas Espanolas de Psiquiatria 2012Cocaine consumption can induce transient psychotic symptoms expressed as paranoia or hallucinations. This work reviews that evidence and tries to obtain data regarding... (Review)
Review
OBJECTIVES
Cocaine consumption can induce transient psychotic symptoms expressed as paranoia or hallucinations. This work reviews that evidence and tries to obtain data regarding frequency of psychotic symptoms or cocaine induced psychosis (CIP), risks or associated factors.
METHOD
Systematic review of studies found in PubMed database published until January 2011 where cocaine induced paranoia was present.
RESULTS
Cocaine induced paranoia has a particular clinical presentation. It needs to be clearly identified due to its harmful consequences. The prevalence is between 12% in clinical studies and 100% in experimental studies. The following are considered potential risk factors: age of first use and length, amount of substance, route of administration, body mass index, genetic factors, personal vulnerability and comorbidity with AXIS I (psychosis, ADHD) and AXIS II disorders (antisocial personality disorder).
CONCLUSIONS
It is needed to research with larger samples of cocaine users of different countries and contexts, in order to identify and detail what variables are closely related in the development of cocaine induced paranoia, so the population at risk can be treated earlier.
Topics: Cocaine-Related Disorders; Humans; Prevalence; Psychotic Disorders; Risk Factors
PubMed: 22851479
DOI: No ID Found -
BMJ (Clinical Research Ed.) Jul 2012To investigate the predictive validity of tools commonly used to assess the risk of violence, sexual, and criminal behaviour. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the predictive validity of tools commonly used to assess the risk of violence, sexual, and criminal behaviour.
DESIGN
Systematic review and tabular meta-analysis of replication studies following PRISMA guidelines.
DATA SOURCES
PsycINFO, Embase, Medline, and United States Criminal Justice Reference Service Abstracts.
REVIEW METHODS
We included replication studies from 1 January 1995 to 1 January 2011 if they provided contingency data for the offending outcome that the tools were designed to predict. We calculated the diagnostic odds ratio, sensitivity, specificity, area under the curve, positive predictive value, negative predictive value, the number needed to detain to prevent one offence, as well as a novel performance indicator-the number safely discharged. We investigated potential sources of heterogeneity using metaregression and subgroup analyses.
RESULTS
Risk assessments were conducted on 73 samples comprising 24,847 participants from 13 countries, of whom 5879 (23.7%) offended over an average of 49.6 months. When used to predict violent offending, risk assessment tools produced low to moderate positive predictive values (median 41%, interquartile range 27-60%) and higher negative predictive values (91%, 81-95%), and a corresponding median number needed to detain of 2 (2-4) and number safely discharged of 10 (4-18). Instruments designed to predict violent offending performed better than those aimed at predicting sexual or general crime.
CONCLUSIONS
Although risk assessment tools are widely used in clinical and criminal justice settings, their predictive accuracy varies depending on how they are used. They seem to identify low risk individuals with high levels of accuracy, but their use as sole determinants of detention, sentencing, and release is not supported by the current evidence. Further research is needed to examine their contribution to treatment and management.
Topics: Antisocial Personality Disorder; Crime; Data Interpretation, Statistical; Humans; Mental Disorders; Psychological Tests; Risk Assessment; Sensitivity and Specificity; Sex Offenses; Violence
PubMed: 22833604
DOI: 10.1136/bmj.e4692 -
Psychological Bulletin Mar 2012Unprecedented numbers of children experience parental incarceration worldwide. Families and children of prisoners can experience multiple difficulties after parental... (Meta-Analysis)
Meta-Analysis Review
Unprecedented numbers of children experience parental incarceration worldwide. Families and children of prisoners can experience multiple difficulties after parental incarceration, including traumatic separation, loneliness, stigma, confused explanations to children, unstable childcare arrangements, strained parenting, reduced income, and home, school, and neighborhood moves. Children of incarcerated parents often have multiple, stressful life events before parental incarceration. Theoretically, children with incarcerated parents may be at risk for a range of adverse behavioral outcomes. A systematic review was conducted to synthesize empirical evidence on associations between parental incarceration and children's later antisocial behavior, mental health problems, drug use, and educational performance. Results from 40 studies (including 7,374 children with incarcerated parents and 37,325 comparison children in 50 samples) were pooled in a meta-analysis. The most rigorous studies showed that parental incarceration is associated with higher risk for children's antisocial behavior, but not for mental health problems, drug use, or poor educational performance. Studies that controlled for parental criminality or children's antisocial behavior before parental incarceration had a pooled effect size of OR = 1.4 (p < .01), corresponding to about 10% increased risk for antisocial behavior among children with incarcerated parents, compared with peers. Effect sizes did not decrease with number of covariates controlled. However, the methodological quality of many studies was poor. More rigorous tests of the causal effects of parental incarceration are needed, using randomized designs and prospective longitudinal studies. Criminal justice reforms and national support systems might be needed to prevent harmful consequences of parental incarceration for children.
Topics: Adolescent; Adult; Antisocial Personality Disorder; Australasia; Child; Child Behavior; Child, Preschool; Educational Status; Europe; Female; Humans; Juvenile Delinquency; Life Change Events; Male; Maternal Deprivation; Mental Disorders; Parent-Child Relations; Parents; Paternal Deprivation; Prisoners; Prisons; Psychology, Child; Research Design; Risk Factors; Social Stigma; Stress, Psychological; Substance-Related Disorders; United States
PubMed: 22229730
DOI: 10.1037/a0026407 -
Clinical Psychology Review Dec 2011Women and girls' engagement in antisocial behavior represents a psychological issue of great concern given the radiating impact that women's antisociality can have on... (Review)
Review
Women and girls' engagement in antisocial behavior represents a psychological issue of great concern given the radiating impact that women's antisociality can have on individuals, families, and communities. Despite its importance and relevance for psychological science, this topic has received limited attention to date and no systematic review of risk factors exists. The present paper aims to systematically review the empirical literature informing risk factors relevant to women's antisocial behavior, with a focus on adolescence and adulthood. Primary aims are to 1) review empirical literatures on risk factors for female antisocial behavior across multiple levels of influence (e.g., person-level characteristics, risky family factors, and gender-salient contexts) and fields of study (e.g., psychology, sociology); 2) evaluate the relevance of each factor for female antisocial behavior; and 3) incorporate an analysis of how gender at both the individual and ecological levels shapes pathways to antisocial behavior in women and girls. We conclude that women's antisocial behavior is best-understood as being influenced by person-level or individual vulnerabilities, risky family factors, and exposure to gender-salient interpersonal contexts, and underscore the importance of examining women's antisocial behavior through an expanded lens that views gender as an individual level attribute as well as a social category that organizes the social context in ways that may promote engagement in antisocial behavior. Based on the present systematic review, an integrative pathway model is proposed toward the goal of synthesizing current knowledge and generating testable hypotheses for future research.
Topics: Adolescent; Adolescent Development; Adult; Antisocial Personality Disorder; Female; Humans; Male; Models, Psychological; Risk Factors; Sex Factors; Social Behavior; Young Adult
PubMed: 22001339
DOI: 10.1016/j.cpr.2011.09.002 -
The Cochrane Database of Systematic... Aug 2010Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance misuse, unemployment,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance misuse, unemployment, homelessness and relationship difficulties.
OBJECTIVES
To evaluate the potential beneficial and adverse effects of pharmacological interventions for people with AsPD.
SEARCH STRATEGY
We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 3), MEDLINE (1950 to September 2009), EMBASE (1980 to 2009, week 37), CINAHL (1982 to September 2009), PsycINFO (1872 to September 2009) , ASSIA (1987 to September 2009) , BIOSIS (1985 to September 2009), COPAC (September 2009), National Criminal Justice Reference Service Abstracts (1970 to July 2008), Sociological Abstracts (1963 to September 2009), ISI-Proceedings (1981 to September 2009), Science Citation Index (1981 to September 2009), Social Science Citation Index (1981 to September 2009), SIGLE (1980 to April 2006), Dissertation Abstracts (September 2009), ZETOC (September 2009) and the metaRegister of Controlled Trials (September 2009).
SELECTION CRITERIA
Controlled trials in which participants with AsPD were randomly allocated to a pharmacological intervention and a placebo control condition. Two trials comparing one drug against another without a placebo control are reported separately.
DATA COLLECTION AND ANALYSIS
Three review authors independently selected studies. Two review authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data.
MAIN RESULTS
Eight studies met the inclusion criteria involving 394 participants with AsPD. Data were available from four studies involving 274 participants with AsPD. No study set out to recruit participants solely on the basis of having AsPD, and in only one study was the sample entirely of AsPD participants. Eight different drugs were examined in eight studies. Study quality was relatively poor. Inadequate reporting meant the data available were generally insufficient to allow any independent statistical analysis. The findings are limited to descriptive summaries based on analyses carried out and reported by the trial investigators. All the available data were derived from unreplicated single reports. Only three drugs (nortriptyline, bromocriptine, phenytoin) were effective compared to placebo in terms of improvement in at least one outcome. Nortriptyline was reported in one study as superior for men with alcohol dependency on mean number of drinking days and on alcohol dependence, but not for severity of alcohol misuse or on the patient's or clinician's rating of drinking. In the same study, both nortriptyline and bromocriptine were reported as superior to placebo on anxiety on one scale but not on another. In one study, phenytoin was reported as superior to placebo on the frequency and intensity of aggressive acts in male prisoners with impulsive (but not premeditated) aggression. In the remaining two studies, both amantadine and desipramine were not superior to placebo for adults with opioid and cocaine dependence, and desipramine was not superior to placebo for men with cocaine dependence.
AUTHORS' CONCLUSIONS
The body of evidence summarised in this review is insufficient to allow any conclusion to be drawn about the use of pharmacological interventions in the treatment of antisocial personality disorder.
Topics: Adult; Aggression; Alcohol-Related Disorders; Amantadine; Antisocial Personality Disorder; Anxiety; Bromocriptine; Desipramine; Female; Humans; Male; Nortriptyline; Phenytoin; Psychotropic Drugs; Randomized Controlled Trials as Topic
PubMed: 20687091
DOI: 10.1002/14651858.CD007667.pub2 -
The Cochrane Database of Systematic... Jun 2010Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance use, unemployment,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance use, unemployment, homelessness and relationship difficulties.
OBJECTIVES
To evaluate the potential beneficial and adverse effects of psychological interventions for people with AsPD.
SEARCH STRATEGY
Our search included CENTRAL Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, BIOSIS and COPAC.
SELECTION CRITERIA
Prospective, controlled trials in which participants with AsPD were randomly allocated to a psychological intervention and a control condition (either treatment as usual, waiting list or no treatment).
DATA COLLECTION AND ANALYSIS
Three authors independently selected studies. Two authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data.
MAIN RESULTS
Eleven studies involving 471 participants with AsPD met the inclusion criteria, although data were available from only five studies involving 276 participants with AsPD. Only two studies focused solely on an AsPD sample. Eleven different psychological interventions were examined. Only two studies reported on reconviction, and only one on aggression. Compared to the control condition, cognitive behaviour therapy (CBT) plus standard maintenance was superior for outpatients with cocaine dependence in one study, but CBT plus treatment as usual was not superior for male outpatients with recent verbal/physical violence in another. Contingency management plus standard maintenance was superior for drug misuse for outpatients with cocaine dependence in one study but not in another, possibly because of differences in the behavioural intervention. However, contingency management was superior in social functioning and counselling session attendance in the latter. A multi-component intervention utilising motivational interviewing principles, the 'Driving Whilst Intoxicated program', plus incarceration was superior to incarceration alone for imprisoned drink-driving offenders.
AUTHORS' CONCLUSIONS
Results suggest that there is insufficient trial evidence to justify using any psychological intervention for adults with AsPD. Disappointingly few of the included studies addressed the primary outcomes defined in this review (aggression, reconviction, global functioning, social functioning, adverse effects). Three interventions (contingency management with standard maintenance; CBT with standard maintenance; 'Driving Whilst Intoxicated program' with incarceration) appeared effective, compared to the control condition, in terms of improvement in at least one outcome in at least one study. Each of these interventions had been originally developed for people with substance misuse problems. Significant improvements were mainly confined to outcomes related to substance misuse. No study reported significant change in any specific antisocial behaviour. Further research is urgently needed for this prevalent and costly condition.
Topics: Adult; Aggression; Antisocial Personality Disorder; Cocaine-Related Disorders; Cognitive Behavioral Therapy; Female; Humans; Male; Psychotherapy; Randomized Controlled Trials as Topic; Reward
PubMed: 20556783
DOI: 10.1002/14651858.CD007668.pub2