The link between early adolescent alcohol abuse and adult antisocial behaviour: A hypothesis revisited

Abstract

Ten years ago the author advanced a novel hypothesis that proposed a causal link between childhood conduct disorder (CD) and early alcohol abuse in the genesis of adult antisocial behavior. In the context of antecedent CD, progressive and accelerating use of alcoholand other drugs in adolescence was said to result in increasing disinhibition and progressive misuse of alcohol. Exposure of the vulnerable adolescent brain to excessive amounts of alcohol and other substances putatively results in structural and functional changes in the brain, particularly in those areas involved in emotional selfregulation. As a consequence, such individuals emerge into adulthood as emotionally impulsive and at high risk of serious antisocial conduct. Evidence is here reviewed that supports several propositions. arising from this hypothesis: 1. The transition from childhood conduct disorder (CD) to adult antisocial behavior is mediated and moderated by early alcohol abuse. 2. Emotional impulsiveness is a core feature of severe personality disorder. 3. Severe personality disorder and emotional impulsiveness are associated with severe criminal violence. 4. Reoffending in patients with personality disorders is associated with severe drug and alcohol abuse, adult antisocial personality with severe CD, and severe borderline personality disorder. 5. Emotional impulsiveness as seen in severe personality disorder commonly manifests in anger. 6. An emotionally impulsive brain can be trained to be less impulsive.