{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:40:24Z","timestamp":1780065624226,"version":"3.54.0"},"reference-count":69,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The relationship between antisocial personality traits and the expression of somatic symptoms has been the subject of several theoretical and empirical investigations. The present study sought to advance the understanding of the relationship between these variables by testing two moderation models. It was hypothesized that the relationship between antisocial traits and somatization would be moderated by alcohol use, such that the presence of alcohol dependence would strengthen the relationship between antisocial traits and somatization. It was also hypothesized that gender would play a moderating role in the relationship between ASPD and somatization, such that the relationship would be stronger among women than among men. These models were tested in a sample of 787 criminal offenders. Gender did not emerge as a significant moderator in the relationship between antisocial traits and somatization. Although substance use did significantly moderate the relationship between antisocial traits and somatization, the direction of the effect ran counter to expectations: among participants reporting a history of alcohol dependency, the relationship between antisocial features and somatization was diminished. The implications of these findings are discussed.<\/jats:p>","DOI":"10.3390\/ijerph21010061","type":"journal-article","created":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T05:50:38Z","timestamp":1704261038000},"page":"61","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Antisocial Personality Traits, Substance Use, and Somatization: A Brief Consideration of Their Interrelation"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9314-6911","authenticated-orcid":false,"given":"Eamonn","family":"Arble","sequence":"first","affiliation":[{"name":"Department of Psychology, Eastern Michigan University, Ypsilanti, MI 48197, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"132","DOI":"10.3928\/0048-5713-19890301-07","article-title":"Prevalence and Comorbidity of Personality Disorders","volume":"19","author":"Widiger","year":"1989","journal-title":"Psychiatr. Ann."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.mppsy.2008.01.010","article-title":"Comorbidity of personality disorders and mental illnesses","volume":"7","author":"Hayward","year":"2008","journal-title":"Psychiatry"},{"key":"ref_3","unstructured":"Diagnostic and Statistical Manual of Mental Disorders (2023, October 04). DSM Library. Available online: https:\/\/dsm.psychiatryonline.org\/doi\/book\/10.1176\/appi.books.9780890425787."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1521\/pedi.2012.26.5.775","article-title":"Personality Disorders, Violence, and Antisocial Behavior: A Systematic Review and Meta-Regression Analysis","volume":"26","author":"Yu","year":"2012","journal-title":"J. Personal. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1521\/pedi.2010.24.6.709","article-title":"Are Personality Disorders Associated with Social Welfare Burden in the United States?","volume":"24","author":"Vaughn","year":"2010","journal-title":"J. Personal. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"368","DOI":"10.4088\/JCP.v69n0305","article-title":"Antisocial Behavioral Syndromes and Past-Year Physical Health among Adults in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions","volume":"69","author":"Goldstein","year":"2008","journal-title":"J. Clin. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"195","DOI":"10.3928\/00485713-20150401-08","article-title":"Epidemiology, Comorbidity, and Behavioral Genetics of Antisocial Personality Disorder and Psychopathy","volume":"45","author":"Werner","year":"2015","journal-title":"Psychiatr. Ann."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1007\/s10802-013-9749-5","article-title":"Psychopathy as Predictor and Moderator of Multisystemic Therapy Outcomes among Adolescents Treated for Antisocial Behavior","volume":"41","author":"Manders","year":"2013","journal-title":"J. Abnorm. Child Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1080\/j.1440-1614.2006.01834.x","article-title":"Psychopathy\/Antisocial Personality Disorder Conundrum","volume":"40","author":"Ogloff","year":"2006","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1177\/0963721415580297","article-title":"Successful Psychopathy: A Scientific Status Report","volume":"24","author":"Lilienfeld","year":"2015","journal-title":"Curr. Dir. Psychol. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1017\/S0033291721004177","article-title":"Somatic symptom disorder: A scoping review on the empirical evidence of a new diagnosis","volume":"52","author":"Levenson","year":"2022","journal-title":"Psychol. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jpsychores.2015.07.012","article-title":"Somatic symptoms and psychological concerns in a general adolescent population: Exploring the relevance of DSM-5 somatic symptom disorder","volume":"79","author":"Rydelius","year":"2015","journal-title":"J. Psychosom. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1176\/ajp.143.6.718","article-title":"The relationship of histrionic personality disorder to antisocial personality and somatization disorders","volume":"143","author":"Lilienfeld","year":"1986","journal-title":"Am. J. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1027\/0227-5910.25.1.3","article-title":"Suicide Risk in Patients with Somatization Disorder","volume":"25","author":"Chioqueta","year":"2004","journal-title":"Crisis"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1007\/s10862-007-9052-2","article-title":"Comorbidity of personality disorders and somatization disorder: A meta-analytic review","volume":"30","author":"Bornstein","year":"2008","journal-title":"J. Psychopathol. Behav. Assess"},{"key":"ref_16","unstructured":"Cloninger, C.R. (1978). Psychiatric Diagnosis: Exploration of Biological Predictors, Spectrum Publications."},{"key":"ref_17","first-page":"e9318","article-title":"A systematic literature review of the association between somatic symptom disorder and antisocial personality disorder","volume":"12","author":"Espiridion","year":"2020","journal-title":"Cureus"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/0272-7358(92)90136-V","article-title":"The association between antisocial personality and somatization disorders: A review and integration of theoretical models","volume":"12","author":"Lilienfeld","year":"1992","journal-title":"Clin. Psychol. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1037\/0033-2909.96.3.465","article-title":"Negative affectivity: The disposition to experience aversive emotional states","volume":"96","author":"Watson","year":"1984","journal-title":"Psychol. Bull."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1023\/A:1011035306061","article-title":"Psychopathic personality traits and somatization: Sex differences and the mediating role of negative emotionality","volume":"23","author":"Lilienfeld","year":"2001","journal-title":"J. Psychopathol. Behav. Assess"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association Publishing. DSM-5-TR.","DOI":"10.1176\/appi.books.9780890425787"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1521\/pedi.1996.10.1.56","article-title":"Comorbidity of Antisocial Personality and Mood Disorders among Psychoactive Substance-Dependent Treatment Clients","volume":"10","author":"Flynn","year":"1996","journal-title":"J. Personal. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1002\/(SICI)1097-4679(199706)53:4<301::AID-JCLP2>3.0.CO;2-S","article-title":"Gender and drug differences in antisocial personality disorder","volume":"53","author":"Brown","year":"1997","journal-title":"J. Clin. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1521\/pedi.1996.10.1.41","article-title":"Psychopathy, Gender, and Gender Roles: Implications for Antisocial and Histrionic Personality Disorders","volume":"10","author":"Hamburger","year":"1996","journal-title":"J. Personal. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1023\/A:1022825415137","article-title":"Gender, somatization, and psychopathic traits in a college sample","volume":"21","author":"Wilson","year":"1999","journal-title":"J. Psychopathol. Behav. Assess"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2147\/SAR.S296526","article-title":"Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-Out","volume":"12","author":"Pandey","year":"2021","journal-title":"Subst. Abus. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1002\/pmh.1415","article-title":"The prevalence of comorbid alcohol use disorder in the presence of personality disorder: Systematic review and explanatory modelling","volume":"12","author":"Guy","year":"2018","journal-title":"Personal. Ment. Health"},{"key":"ref_28","first-page":"116","article-title":"Substance use disorders and personality disorders","volume":"2","author":"Trull","year":"2016","journal-title":"Oxf. Handb. Subst. Use Subst. Use Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.cobeha.2016.11.014","article-title":"Antisocial pathways associated with substance use disorders: Characterizing etiological underpinnings and implications for treatment","volume":"13","author":"Brennan","year":"2017","journal-title":"Curr. Opin. Behav. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.jadohealth.2022.06.007","article-title":"Cascades from early adolescent impulsivity to late adolescent antisocial personality disorder and alcohol use disorder","volume":"71","author":"Defoe","year":"2022","journal-title":"J. Adolesc. Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1037\/a0027178","article-title":"Longitudinal twin study of borderline personality disorder traits and substance use in adolescence: Developmental change, reciprocal effects, and genetic and environmental influences","volume":"4","author":"Bornovalova","year":"2013","journal-title":"Personal. Disord. Theory Res. Treat."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1037\/abn0000258","article-title":"The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies","volume":"126","author":"Kotov","year":"2017","journal-title":"J. Abnorm. Psychol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/070674371005500202","article-title":"Personality Disorders among Alcoholic Outpatients: Prevalence and Course in Treatment","volume":"55","author":"Zikos","year":"2010","journal-title":"Can. J. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1111\/j.1530-0277.2007.00364.x","article-title":"Antisocial Behavioral Syndromes and DSM-IV Alcohol Use Disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions","volume":"31","author":"Goldstein","year":"2007","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_35","first-page":"5","article-title":"Antisocial personality disorder, alcohol, and aggression","volume":"25","author":"Moeller","year":"2001","journal-title":"Alcohol. Res. Health J. Natl. Inst. Alcohol. Abuse Alcohol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1097\/PSY.0b013e31815b00d7","article-title":"Somatoform and Substance Use Disorders","volume":"69","author":"Hasin","year":"2007","journal-title":"Psychosom. Med."},{"key":"ref_37","first-page":"135","article-title":"The risks associated with alcohol use and alcoholism","volume":"34","author":"Rehm","year":"2011","journal-title":"Alcohol. Res. Health J. Natl. Inst. Alcohol. Abuse Alcohol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.paid.2015.09.007","article-title":"Keep calm and don\u2019t worry: Different Dark Triad traits predict distinct coping preferences","volume":"88","year":"2016","journal-title":"Personal. Individ. Differ."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1002\/smi.2692","article-title":"A Model of First-responder Coping: An Approach\/Avoidance Bifurcation: First-responder Coping","volume":"33","author":"Arble","year":"2017","journal-title":"Stress Health"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"126","DOI":"10.15288\/jsa.2004.65.126","article-title":"The daily stress and coping process and alcohol use among college students","volume":"65","author":"Park","year":"2004","journal-title":"J. Stud. Alcohol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0306-4603(97)00015-4","article-title":"A prospective evaluation of the relationship between reasons for drinking and DSM-IV alcohol-use disorders","volume":"23","author":"Carpenter","year":"1998","journal-title":"Addict. Behav."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.addbeh.2012.04.007","article-title":"The Great Recession, somatic symptomatology and alcohol use and abuse","volume":"37","author":"Vijayasiri","year":"2012","journal-title":"Addict. Behav."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1111\/j.1360-0443.2005.01151.x","article-title":"Antisocial personality disorder is associated with increased severity of gambling, medical, drug and psychiatric problems among treatment-seeking pathological gamblers","volume":"100","author":"Pietrzak","year":"2005","journal-title":"Addiction"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1177\/1541204004265864","article-title":"Theory and Research on Desistance from Antisocial Activity among Serious Adolescent Offenders","volume":"2","author":"Mulvey","year":"2004","journal-title":"Youth Violence Juv. Justice"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1177\/1541204004265875","article-title":"Operational Lessons from the Pathways to Desistance Project","volume":"2","author":"Schubert","year":"2004","journal-title":"Youth Violence Juv. Justice"},{"key":"ref_46","unstructured":"Morey, L.C. (1991). Personality Assessment Inventory, Psychological Assessment Resources. Available online: https:\/\/paa.com.au\/wp-content\/uploads\/2020\/10\/PAI_Plus_Interpretive_PiC.pdf."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1002\/jclp.20209","article-title":"The Personality Assessment Inventory with chronic pain patients: Psychometric properties and clinical utility","volume":"61","author":"Karlin","year":"2005","journal-title":"J. Clin. Psychol."},{"key":"ref_48","unstructured":"Morey, L.C. (2007). Personality Assessment Inventory Professional Manual, Psychological Assessment Resources. [2nd ed.]."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1017\/S0033291700048017","article-title":"The brief symptom inventory: An introductory report","volume":"13","author":"Derogatis","year":"1983","journal-title":"Psychol. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1002\/pon.1069","article-title":"Screening childhood cancer survivors with the brief symptom inventory-18: Classification agreement with the symptom checklist-90-revised","volume":"16","author":"Recklitis","year":"2007","journal-title":"Psychooncology"},{"key":"ref_51","unstructured":"Mulvey, E.P. (2023, October 04). Available online: https:\/\/www.icpsr.umich.edu\/web\/NAHDAP\/studies\/29961\/versions\/V2."},{"key":"ref_52","unstructured":"Smeets, R.M.W., and Dingemans, P. (1993). Composite International Diagnostic Interview (CIDI), Version 1.1, World Health Organization."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1002\/mpr.44","article-title":"To what degree does the Composite International Diagnostic Interview (CIDI) correctly identify DSM-IV disorders? Testing validity issues in a clinical sample","volume":"7","author":"Reed","year":"1998","journal-title":"Int. J. Methods Psychiatr. Res."},{"key":"ref_54","unstructured":"(IBM SPSS Statistics for Windows [Computer Software], 2021). IBM SPSS Statistics for Windows [Computer Software], Version 28.0."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses","volume":"41","author":"Faul","year":"2009","journal-title":"Behav. Res. Methods"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1038\/nmeth.3812","article-title":"Analyzing outliers: Influential or nuisance?","volume":"13","author":"Altman","year":"2016","journal-title":"Nat. Methods."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1111\/adb.12414","article-title":"Harm reduction\u2014A systematic review on effects of alcohol reduction on physical and mental symptoms: Effects of alcohol reduction","volume":"22","author":"Charlet","year":"2017","journal-title":"Addict. Biol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1017\/S0033291706008245","article-title":"Is antisocial personality disorder continuous or categorical? A taxometric analysis","volume":"36","author":"Marcus","year":"2006","journal-title":"Psychol. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s11920-013-0427-7","article-title":"Antisocial Personality Disorder: A Current Review","volume":"15","author":"Glenn","year":"2013","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.jcrimjus.2015.04.004","article-title":"Capturing clinical complexity: Towards a personality-oriented measure of psychopathy","volume":"43","author":"Cooke","year":"2015","journal-title":"J. Crim. Justice"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1108\/JFP-07-2020-0030","article-title":"From research to practice: A multifaceted and dimensional approach to psychopathy","volume":"23","author":"Steinert","year":"2021","journal-title":"J. Forensic. Pract."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/0191-8869(80)90028-8","article-title":"A research scale for the assessment of psychopathy in criminal populations","volume":"1","author":"Hare","year":"1980","journal-title":"Personal. Individ. Differ."},{"key":"ref_63","first-page":"6534","article-title":"Primary versus secondary psychopathy: Coping styles as a mediator between psychopathy and well-being","volume":"41","year":"2020","journal-title":"Curr Psychol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1207\/s15327027hc1901_1","article-title":"Social Distance, Perceived Drinking by Peers, and Alcohol Use by College Students","volume":"19","author":"Yanovitzky","year":"2006","journal-title":"Health Commun."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/00004583-199604000-00012","article-title":"DSM-III-R and DSM-III Criteria for Conduct Disorder in Preadolescent Girls: Specific But Insensitive","volume":"35","author":"Zoccolillo","year":"1996","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/S0272-7358(01)00125-8","article-title":"Sex differences in psychopathy and antisocial personality disorder: A review and integration","volume":"22","author":"Cale","year":"2002","journal-title":"Clin. Psychol. Rev."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1159\/000508538","article-title":"An Overview of the DSM-5 Alternative Model of Personality Disorders","volume":"53","author":"Krueger","year":"2020","journal-title":"Psychopathology"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0165-1781(02)00320-7","article-title":"Lifetime comorbidity of antisocial personality disorder and anxiety disorders among adults in the community","volume":"117","author":"Goodwin","year":"2003","journal-title":"Psychiatry Res."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"102087","DOI":"10.1016\/j.cpr.2021.102087","article-title":"Race bias and gender bias in the diagnosis of psychological disorders","volume":"90","author":"Garb","year":"2021","journal-title":"Clin. Psychol. Rev."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/1\/61\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:39:00Z","timestamp":1760103540000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/1\/61"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,3]]},"references-count":69,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["ijerph21010061"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21010061","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,3]]}}}