A behavioral treatment for opioid-dependent patients with antisocial personality

Karin J. Neufeld, Michael S. Kidorf, Kenneth Kolodner, Van L. King, Michael Clark, Robert K. Brooner

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Antisocial personality disorder (APD) is associated with increased problem severity in treatment-seeking opioid-dependent patients. Treatment studies have reported mixed results but generally show that patients with APD make progress that is often comparable to drug-dependent patients without the personality disorder. Much of this work is based on secondary analyses of studies evaluating responses to a variety of drug abuse treatment interventions. This study reports on a randomized prospective trial evaluating a behavioral approach for managing opioid-dependent patients with APD. Subjects (N = 100) met Diagnostic and Statistical Manual of Mental Disorders criteria for opioid dependence and APD using a structured clinical interview and were randomly assigned to either an experimental condition (n = 51), which used a highly structured contingency management intervention, or a control condition (n = 49), which reflected standard methadone treatment. Subjects in the experimental group had significantly better counseling attendance and some indication of lower psychosocial impairment compared to the control group. The experimental intervention increased attendance in subjects with low and high levels of psychopathy and with and without other psychiatric comorbidity. These findings support the development of interventions more tailored to drug-dependent patients with APD.

Original languageEnglish (US)
Pages (from-to)101-111
Number of pages11
JournalJournal of Substance Abuse Treatment
Issue number1
StatePublished - Jan 2008


  • Antisocial personality disorder
  • Contingency management
  • Drug dependence
  • Treatment outcome

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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