Columbia-Presbyterian researchers have found that personality disorders among youths may increase risk for criminal and violent behavior during adolescence and young adulthood.

In a long-term study, Jeffrey Johnson and colleagues at Columbia and the New York State Psychiatric Institute, Mount Sinai Medical Center followed a representative sample of teens from upstate New York through early adulthood. Over more than a decade, 717 families from the general population were interviewed. Both youths and mothers were questioned periodically to assess personality disorders and violent or criminal behaviors. Youths with narcissistic, paranoid, or passive-aggressive personality disorders were found to be four times more likely than those without these disorders to start physical fights, to threaten, injure, mug, rob, or assault others, and to commit arson, theft, and breaking and entering.

The study, published in the September 2000 issue of the American Journal of Psychiatry, suggests that early intervention and therapy for youths with personality disorders may reduce crime among juveniles and young adults. Although it has long been known that adults with antisocial personality disorder have a propensity to commit violent or criminal acts, no previous study examined crime risk among adolescents with personality disorders.

According to the researchers, their findings suggest that increased effort should be devoted to the recognition and treatment of narcissistic, paranoid and passive-aggressive personality disorders among adolescents. "There has been a lot of research suggesting that all three of these personality disorders can be effectively treated with psychotherapy," said Johnson, assistant professor of clinical psychiatry at Columbia's College of Physicians & Surgeons. "Treatment promoting improved social relationships and greater empathy may help many youths to avoid violent behavior."

Because effective treatments are available for many personality disorders, identifying such disorders in youths may help reduce criminal behavior among teens and young adults. Unfortunately, in many jurisdictions, youths entering the system are not routinely assessed or referred for therapy. "That's an opportunity to intervene and, by identifying and treating these personality disorders at an early age, it may be possible to prevent many crimes from occurring. Because the social costs of crime are incalculable, it may be worthwhile for society to invest in screening and therapy for these youths," said Johnson.