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Ciesinski NK, Drabick DAG, Berman ME, McCloskey MS. Personality Disorder Symptoms in Intermittent Explosive Disorder: A Latent Class Analysis. J Pers Disord 2024; 38:34-52. [PMID: 38324246 PMCID: PMC11323261 DOI: 10.1521/pedi.2024.38.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Intermittent explosive disorder (IED) is characterized by recurrent reactive aggression. IED is associated with significant personality pathology that is suggestive of higher levels of general personality disorder (PD). However, little is known about how personality factors impact the severity and presentation of IED. The present study employed a latent class analysis to assess for distinct PD symptom classes within IED and to evaluate whether these classes differed in terms of severity and behavioral presentation. Statistical and clinical indicators revealed a four-class model, with latent classes distinguished primarily on general levels of PD symptoms (low, moderate, high). However, the two moderate PD symptom classes were distinguished from other classes on avoidant PD. In addition, classes differed in terms of severity and presentation, suggesting important implications for both general PD and avoidant PD comorbidity within IED. Results provide further insight into the heterogeneity within IED and suggest a more nuanced approach in treating this serious condition.
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Affiliation(s)
- Nicole K Ciesinski
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania
| | - Deborah A G Drabick
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania
| | - Mitchell E Berman
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi
| | - Michael S McCloskey
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania
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2
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Blanchard AE, Keenan G, Heym N, Sumich A. COVID-19 prevention behaviour is differentially motivated by primary psychopathy, grandiose narcissism and vulnerable Dark Triad traits. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023; 204:112060. [PMID: 36588787 PMCID: PMC9794185 DOI: 10.1016/j.paid.2022.112060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/02/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Abstract
Dark Triad traits (psychopathy, narcissism) are associated with nonadherence to COVID-19 prevention measures such as social distancing and wearing face masks, although the psychological mechanisms underpinning this relationship remain unclear. In contrast, high threat-sensitivity may motivate compliance, and maybe seen in relation to vulnerable dark traits (secondary psychopathy, vulnerable narcissism and borderline personality disorder). The relationship between vulnerable dark traits and COVID-19 prevention behaviour has not been examined. During April 2021, participants (n = 263) completed an online psychometric study assessing engagement with COVID-19 prevention behaviour, traditional DT traits (primary psychopathy; grandiose narcissism) and vulnerable DT traits. Potential indirect effects were fear of COVID-19, perceived coronavirus severity, belief in COVID-19 conspiracy theories and altruism. Model of path analysis identified predictors of engagement in disease prevention behaviour. Primary psychopathy, grandiose narcissism, secondary psychopathy and BPD were associated with less COVID-19 prevention behaviour, with an indirect effect of reduced coronavirus severity. Grandiose narcissism and BPD were also motivated by COVID-19 conspiracy theories, and increased prevention behaviour when fear of COVID-19 was higher. No direct or indirect effects were observed for vulnerable narcissism. The current study is the first to elucidate psychological mechanisms linking vulnerable dark traits with COVID-19 prevention behaviour.
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Affiliation(s)
- Alyson E Blanchard
- School of Health and Society, University of Salford, Manchester, M6 6PU, United Kingdom
| | - Greg Keenan
- Department of Psychology, Liverpool Hope University, Liverpool L16 9JD, United Kingdom
| | - Nadja Heym
- Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, United Kingdom
| | - Alex Sumich
- Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, United Kingdom
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Guillot CR, Lucke HR, Ramsey AJ, Kearns NT, Blumenthal H, Berman ME. Cluster-b personality disorder traits and impulsivity: Indirect associations with alcohol use severity through positive alcohol expectancies. Exp Clin Psychopharmacol 2023; 31:423-432. [PMID: 36048108 PMCID: PMC9975115 DOI: 10.1037/pha0000598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Prior theory and research suggest that both Cluster-B personality pathology and trait impulsivity are indirectly associated with alcohol use through positive alcohol expectancies. Yet, no prior study has investigated whether features of each of the Cluster-B personality disorders (PDs) (i.e., antisocial, borderline, histrionic, and narcissistic) and rash impulsiveness are indirectly associated with alcohol use severity through positive alcohol expectancies. In a cross-sectional design, social drinkers (N = 200; 51% female; Mage = 26 years) completed self-report measures of trait (rash) impulsivity, Cluster-B personality disorder (PD) traits, positive alcohol expectancies, and alcohol use severity. Simple and serial mediation analyses were used to test positive alcohol expectancies and the association between trait impulsivity and alcohol expectancies as potential mediators of personality disorder trait relations with alcohol use severity. Simple mediation analyses evidenced that trait impulsivity and traits specific to each of the Cluster-B (PDs) were indirectly associated with alcohol use severity through positive alcohol expectancies. Serial mediation analyses further evidenced that the Cluster-B (PD) traits were indirectly associated with alcohol use severity via positive alcohol expectancies both uniquely from and together with trait impulsivity. Current findings are novel and suggest that positive alcohol expectancies may be important to connecting the rashly impulsive aspects of Cluster-B (PDs) with greater alcohol use severity. However, current findings also suggest that features of the Cluster-B (PDs) probably increase risk for alcohol use disorder due to other reasons (e.g., other aspects of personality or forms of impulsivity). (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Juarros-Basterretxea J, Herrero J, Escoda-Menéndez P, Rodríguez-Díaz FJ. Cluster B Personality Traits and Psychological Intimate Partner Violence: Considering the Mediational Role of Alcohol. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP1566-NP1587. [PMID: 32538293 DOI: 10.1177/0886260520922351] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The study of intimate partner violence (IPV) has evolved into more complex and integrative models to better understand the explanatory mechanisms of IPV perpetration. Nevertheless, integrative models rarely permit an in-depth analysis of a large number of relevant variables, and more specific approximations are required as basis of them. In this sense, the individual approach is the most productive research line. From the individual perspective and using data from imprisoned male offenders, the present study aimed to analyze the potential mediating role of alcohol dependence in the association of Cluster B personality traits and psychological IPV. The sample included 196 male inmates of the Penitentiary Center of Villabona (Asturias, Spain). Structural equation modeling was used to test the hypothetical and alternative models. First, model results only showed an indirect effect of antisocial and borderline personalities mediated by alcohol dependence. Nevertheless, fitting of the model to the data was poor. Second, a fully saturated model was calculated, revealing a direct effect of histrionic personality on psychological IPV. Finally, an alternative model was tested adding to first model the direct effect of histrionic personality on psychological IPV. The fitting of the alternative model to the data was good. Antisocial and borderline personalities predicted psychological IPV when mediated by alcohol dependence, while histrionic personality had a direct effect on psychological IPV. Narcissistic personality did not affect psychological IPV. These results support the hypothesis regarding the use of alcohol as a coping mechanism in antisocial and borderline individuals, acting as a disinhibitory factor which increases the likelihood of psychological IPV occurrence. Contrary to previous research, a clear direct effect of histrionic personality and psychological IPV was obtained. This association can be explained by the necessity of attention of histrionic individuals and the type (psychological) of violence studied.
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Abstract
PURPOSE OF REVIEW This review examines the prevalence of personality disorder in those with mental state disorder. Some challenges disentangling these psychopathologies are delineated and advances in understanding broadly are reviewed. RECENT FINDINGS Recent taxonomic changes to a dimensionally based classification system in the ICD-11 and DSM of mental disorders-V's alternative model of personality disorder include requiring cut offs to examine clinical outcomes akin to those in hypertension. These new criteria affect personality disorder prevalence where it is comorbid with mental state disorder, although more robust the dimensional approach complicates understanding both theoretically and practically. Such issues include: deciding the cut off for 'pathology', understanding if psychopathology is related to mental state disorder, personality disorder or both, and consideration of the clinical value of comorbidity. SUMMARY There is overlap between personality pathology and all types of mental state disorder. However, the shift to a dimensional framework of personality pathology means new methods to define and measure this comorbidity are needed. Dimensional conceptualisation of personality pathology challenges the underlying ontology of comorbidity in this area.
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Affiliation(s)
| | - Sara Austin
- Northwestern University, Evanston, Illinois, USA
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Kour P, Lien L, Kumar B, Nordaunet OM, Biong S, Pettersen H. Health Professionals' Experiences with Treatment Engagement Among Immigrants with Co-occurring Substance Use- and Mental Health Disorders in Norway. Subst Abuse 2021; 15:11782218211028667. [PMID: 34285497 PMCID: PMC8264731 DOI: 10.1177/11782218211028667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 06/07/2021] [Indexed: 12/11/2022]
Abstract
Immigrants face barriers in seeking and accessing mental health and addiction services. Health professionals are crucial in providing and promoting healthcare and it is important to understand their experiences in order to enhance the access of mental healthcare. The aim of this paper is to explore and describe health professionals' experiences with treatment engagement among immigrants with co-occurring substance use disorders (SUD) and mental health disorders (MHD) in Norwegian mental health and addiction services. Within a collaborative approach, 3 focus group interviews were conducted with health professionals, who had provided various mental health and addiction care services to immigrants with co-occurring SUD and MHD. The focus group interviews were transcribed verbatim and analyzed using systematic text condensation. The analysis resulted in 5 main categories: (1) difficulties due to language barriers, (2) difficulties due to lack of culturally competent services, (3) difficulties due to social factors, (4) being curious and flexible improves the user-provider relationship, and (5) increasing access to mental health and addiction services. This study provides an enhanced understanding of how health professionals' experienced treatment engagement among immigrants with co-occurring SUD and MHD in the Norwegian context. Implications of the findings for clinical practice and future research are discussed.
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Affiliation(s)
- Prabhjot Kour
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (NK-ROP), Innlandet Hospital Trust, and University of South-Eastern Norway, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (NK-ROP), Innlandet Hospital Trust, and Faculty of Health and Social Sciences, Norway University of Applied Sciences, Norway
| | | | | | | | - Henning Pettersen
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (NK-ROP), Innlandet Hospital Trust, and Faculty of Health and Social Sciences, Norway University of Applied Sciences, Norway
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Personality Pathology and Substance Misuse in Later Life: Perspectives from Interviewer-, Self-, and Informant-Reports. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021; 43:597-619. [DOI: 10.1007/s10862-020-09862-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Moraleda-Barreno E, Cáceres Pachón MDP, Lozano ÓM, Pérez Moreno PJ, Lorca Marín JA, Fernández-Calderón F, Díaz Batanero C, Gómez-Bujedo J. Impairments in Executive Functioning in Patients with Comorbid Substance Use and Personality Disorders: A Systematic Review. J Dual Diagn 2021; 17:64-79. [PMID: 33092494 DOI: 10.1080/15504263.2020.1829769] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The purpose of this systematic review was to examine the evidence for impaired executive functioning in patients diagnosed with a dual pathology of personality disorder (PD) and substance use disorder, and to identify whether differences exist in comparison to those with a single diagnosis. Methods: A systematic search was conducted to identify studies using measures of executive functioning in patients with PD-substance use disorder dual pathology. Sixteen studies were selected. Results: The results indicate that dual pathology patients with Cluster C personality disorder do not differ from controls, and that the presence of dual pathology does not influence the updating domain of executive functioning. The findings were inconclusive with regard to dual pathology patients with Cluster B personality disorders. Whilst the various studies consistently show that these patients show worse performance than the control groups, here are contradictory results with regard to whether Cluster B personality disorders add more alterations in executive functioning to those that already appear in substance use disorder. Conclusions: The results suggest the need for further research that more adequately controls variables such as time in treatment, medication, and sample size, whilst there is also a need to employ longitudinal designs that include more patients from Clusters A and C.
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Affiliation(s)
- Enrique Moraleda-Barreno
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | | | - Óscar M Lozano
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Pedro J Pérez Moreno
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - José Andrés Lorca Marín
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Carmen Díaz Batanero
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Jesús Gómez-Bujedo
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
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Høye A, Jacobsen BK, Bramness JG, Nesvåg R, Reichborn-Kjennerud T, Heiberg I. Total and cause-specific mortality in patients with personality disorders: the association between comorbid severe mental illness and substance use disorders. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1809-1819. [PMID: 33677644 PMCID: PMC8429406 DOI: 10.1007/s00127-021-02055-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/24/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the mortality in both in- and outpatients with personality disorders (PD), and to explore the association between mortality and comorbid substance use disorder (SUD) or severe mental illness (SMI). METHODS All residents admitted to Norwegian in- and outpatient specialist health care services during 2009-2015 with a PD diagnosis were included. Standardized mortality ratios (SMRs) with 95% confidence intervals (CI) were estimated in patients with PD only and in patients with PD and comorbid SMI or SUD. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% CIs in patients with PD and comorbid SMI or SUD compared to patients with PD only. RESULTS Mortality was increased in both in- and outpatients with PD. The overall SMR was 3.8 (95% CI 3.6-4.0). The highest SMR was estimated for unnatural causes of death (11.0, 95% CI 10.0-12.0), but increased also for natural causes of death (2.2, 95% CI 2.0-2.5). Comorbidity was associated with higher SMRs, particularly due to poisoning and suicide. Patients with comorbid PD & SUD had almost four times higher all-cause mortality HR than patients with PD only; young women had the highest HR. CONCLUSION The SMR was high in both in- and outpatients with PD, and particularly high in patients with comorbid PD & SUD. Young female patients with PD & SUD were at highest risk. The higher mortality in patients with PD cannot, however, fully be accounted for by comorbidity.
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Affiliation(s)
- Anne Høye
- Department of Clinical Medicine, UiT-The Arctic University of Norway, pb 6124, 9291, Tromsø, Norway.
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway.
- Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway.
| | - Bjarne K Jacobsen
- Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
- Centre for Sami Health Research, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Jørgen G Bramness
- Department of Clinical Medicine, UiT-The Arctic University of Norway, pb 6124, 9291, Tromsø, Norway
- Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway
| | - Ragnar Nesvåg
- Department of Clinical Medicine, UiT-The Arctic University of Norway, pb 6124, 9291, Tromsø, Norway
- Norwegian Medical Association, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ina Heiberg
- Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway
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Kour P, Lien L, Kumar B, Biong S, Pettersen H. Treatment Experiences with Norwegian Health Care among Immigrant Men Living with Co-Occurring Substance Use- and Mental Health Disorders. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2020; 14:1178221820970929. [PMID: 33281448 PMCID: PMC7691914 DOI: 10.1177/1178221820970929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022]
Abstract
Immigrants are considered at risk of psychological distress and therefore
involvement in substance abuse, due to a variety of pre- and post-migration
factors. Further, there is lower treatment engagement, a higher dropout rate,
and less frequent hospitalizations among this group compared to the general
population. There are few studies on the subjective understanding of
co-occurring substance use disorder (SUD) and mental health disorder (MHD) among
immigrants in Norway. This qualitative study aims to explore the treatment
experiences of immigrant men living with co-occurring SUD and MHD. Within a
collaborative approach, individual interviews were conducted with 10 men of
immigrant background, living with co-occurring SUD and MHD, who had treatment
experiences from the Norwegian mental health and addiction services. Data were
analyzed using a systematic text condensation. The analysis yielded 6 categories
where participants described their treatment experiences in mental health and
addiction services in Norway as: lack of connection, lack of individually
tailored treatment, stigma and discrimination preventing access to treatment,
health professionals with multi-cultural competence, care during and after
treatment, and raising awareness and reducing stigma. A significant finding was
the mention by participants of the value of being seen and treated as a “person”
rather than their diagnosis, which may increase treatment engagement. They
further mentioned aftercare as an important factor to prevent relapse. This
study provides an enhanced understanding of how immigrant men living with
co-occurring SUD and MHD experienced being treated in Norwegian healthcare
settings. These experiences may add to the knowledge required to improve
treatment engagement.
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Affiliation(s)
- Prabhjot Kour
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (NK-ROP), Innlandet Hospital Trust and University of South-Eastern Norway, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (NK-ROP) Innlandet Hospital Trust; and Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Norway
| | | | - Stian Biong
- University of South-Eastern Norway, Kongsberg, Norway
| | - Henning Pettersen
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (NK-ROP) Innlandet Hospital Trust; and Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Norway
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Río-Martínez L, Marquez-Arrico JE, Prat G, Adan A. Temperament and Character Profile and Its Clinical Correlates in Male Patients with Dual Schizophrenia. J Clin Med 2020; 9:jcm9061876. [PMID: 32560099 PMCID: PMC7356598 DOI: 10.3390/jcm9061876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/07/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023] Open
Abstract
Personality traits are relevant in understanding substance use disorders (SUD) and schizophrenia (SZ), but few works have also included patients with dual schizophrenia (SZ+) and personality traits. We explored personality profile in a sample of 165 male patients under treatment, using the Temperament and Character Inventory-Revised. The participants were assigned to three groups of 55 patients each, according to previous diagnosis: SUD, SZ- and SZ+ (without/with SUD). We analyzed their clinical characteristics, relating them to personality dimensions. The SUD and SZ+ groups scored higher than SZ- in Novelty/Sensation Seeking. SZ- and SZ+ presented higher Harm Avoidance and lower Persistence than the SUD group. SZ+ patients showed the lowest levels of Self-directedness, while SZ- and SZ+ had higher scores in Self-transcendence than the SUD group. Several clinical characteristics were associated with personality dimensions depending on diagnosis, and remarkably so for psychiatric symptoms in the SZ- and SZ+ groups. The three groups had a maladaptive personality profile compared to general population. Our results point to different profiles for SUD versus SZ, while both profiles appear combined in the SZ+ group, with extreme scores in some traits. Thus, considering personality endophenotypes in SZ+ could help in designing individualized interventions for this group.
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Affiliation(s)
- Laura Río-Martínez
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain; (L.R.-M.); (J.E.M.-A.); (G.P.)
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
| | - Julia E. Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain; (L.R.-M.); (J.E.M.-A.); (G.P.)
| | - Gemma Prat
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain; (L.R.-M.); (J.E.M.-A.); (G.P.)
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain; (L.R.-M.); (J.E.M.-A.); (G.P.)
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
- Correspondence: ; Tel.: +34-9331-25060
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Koļesņikova J, Perepjolkina V, Sudraba V, Mārtinsone K, Stepens A. Relationship Between Personality Disorders Scales, Pathological Personality Traits, and Six Domains of Functioning in Sample With Alcohol Use Disorder. Front Psychiatry 2020; 11:498. [PMID: 32581874 PMCID: PMC7291949 DOI: 10.3389/fpsyt.2020.00498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/15/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Studies reveal a functional impairment in patients with personality disorders (PDs), but there is not enough information to form conclusions about this relation in patients with alcohol use disorder (AUD). The aim of this study was to investigate to what extent a personality disorders scales including pathological personality traits (PPTs) predict six domains of functioning in patients with AUD. METHODS In total, 48 patients with AUD diagnosis, who were treated in the psychiatric clinics, aged 20 to 65 years [M = 37.5; SD = 12.08; 12 (25%) females and 36 (75%) males], filled out the demographic questionnaire, WHO Disability Assessment Schedule 2.0 (WHODAS 2.0, Latvian version) and Latvian Clinical Personality Inventory (LCPI v2.1.). All respondents signed the informed consent form. RESULTS Stepwise regression analysis showed that PD Avoidant scale positively predicts impairment in Cognition and Getting along domains of functioning in AUD patients, but, on the PPTs level, it was found that Social withdrawal along with Irresponsibility and Guilt/Shame positively predict impairment in Cognition domain of functioning, and Social withdrawal along with Depressivity and Irresponsibility positively predict impairment in Getting along domain of functioning. The results of the study showed that PPT Orderliness negatively predicts impairment in Live activities domain of functioning. The PD Dependent scale and PPT Separation insecurity positively predict impairment in Participation domain of functioning. CONCLUSIONS Obtained results add deeper insight into understanding of the relationship between personality disorders scales including pathological personality traits and six domains of functioning in patients with AUD.
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Affiliation(s)
- Jeļena Koļesņikova
- Department of Health Psychology and Paedagogy, Psychology Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, Riga, Latvia
| | - Viktorija Perepjolkina
- Department of Sociology and Psychology, Faculty of Communications, Riga Stradiņš University, Riga, Latvia
| | - Velga Sudraba
- Department of Nursing and Midwifery, Faculty of Public Health and Social Welfare, Riga Stradiņš University, Riga, Latvia
| | - Kristīne Mārtinsone
- Department of Health Psychology and Paedagogy, Faculty of Public Health and Social Welfare, Riga Stradiņš University, Riga, Latvia
| | - Ainārs Stepens
- Centre for Military Medicine Research, Riga Stradiņš University, Riga, Latvia
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Cavicchioli M, Prudenziati F, Movalli M, Ramella P, Maffei C. The Severity of Personality Pathology: A Risk Factor for Concurrent Substance Use Disorders in Alcohol Use Disorder. J Dual Diagn 2019; 15:159-171. [PMID: 31088228 DOI: 10.1080/15504263.2019.1612131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective: Co-occurrence of substance use disorders (CO-substance use disorders) among individuals with alcohol use disorder (AUD) is largely recognized as a critical clinical issue. However, the specific clinical variables involved are still unclear. The recent findings are controversial in pointing out the unique contribution of both impulsivity and emotion dysregulation on CO-substance use disorders. Furthermore, the co-variation between AUD and other substance use disorders includes different aspects of maladaptive personality functioning (i.e., overall severity and specific features). Therefore, this study aims at clarifying the role of impulsivity, emotional dysregulation, and severity of personality pathology on CO-substance use disorders among treatment-seeking individuals with AUD. Methods: One hundred ninety-three treatment-seeking individuals with AUD (DSM-IV-TR) were consecutively recruited. Impulsivity (Barratt Impulsiveness Scale [BIS-11]), emotional dysregulation (Difficulties in Emotion Regulation Scale [DERS]), and personality pathology (Structured Clinical Interview for DSM-IV Axis II Personality Disorder [SCID-II]) were assessed after a 2-week detoxification period. The analyses were based on several stepwise forward logistic regressions. The total score of BIS-11 and DERS together with the number of SCID-II criteria were considered, in following the order, as independent variables controlling for the comorbidity with other lifetime Axis I disorders. CO-substance use disorders was the dependent variable (i.e., any CO-substance use disorders, benzodiazepine and cannabis/cocaine use disorders). Results: The number of SCID-II criteria was the only significant predictor of overall CO-substance use disorders, odds ratio (OR) = 1.16; 95% confidence interval (CI) [1.07, 1.26], p < .01, and cannabis/cocaine use disorders, OR = 1.19; 95% CI [1.08, 1.31], p < .01. On the contrary, DERS total score was the most robust predictor of benzodiazepine use disorder, OR = 1.02; 95% CI [1.01, 1.04], p < .01, albeit the severity of maladaptive personality functioning was also significantly associated with this disorder, OR = 1.09; 95% CI [1.00, 1.18], p < .05. Conclusions: The severity of maladaptive personality pathology represents one of the main aspects involved in CO-substance use disorders among individuals with AUD. This dimension predicts the CO-substance use disorders above and beyond specific personality dimensions and other psychiatric conditions. Therefore, personality functioning should be precisely assessed and personality pathology should be addressed in the framework of AUD treatments for promoting effective long-term outcomes.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
| | - Francesca Prudenziati
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
| | - Pietro Ramella
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
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14
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Rosenström T, Czajkowski NO, Ystrom E, Krueger RF, Aggen SH, Gillespie NA, Eilertsen E, Reichborn-Kjennerud T, Torvik FA. Genetically Informative Mediation Modeling Applied to Stressors and Personality-Disorder Traits in Etiology of Alcohol Use Disorder. Behav Genet 2018; 49:11-23. [PMID: 30536213 DOI: 10.1007/s10519-018-9941-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 11/27/2018] [Indexed: 01/10/2023]
Abstract
A statistical mediation model was developed within a twin design to investigate the etiology of alcohol use disorder (AUD). Unlike conventional statistical mediation models, this biometric mediation model can detect unobserved confounding. Using a sample of 1410 pairs of Norwegian twins, we investigated specific hypotheses that DSM-IV personality-disorder (PD) traits mediate effects of childhood stressful life events (SLEs) on AUD, and that adulthood SLEs mediate effects of PDs on AUD. Models including borderline PD traits indicated unobserved confounding in phenotypic path coefficients, whereas models including antisocial and impulsive traits did not. More than half of the observed effects of childhood SLEs on adulthood AUD were mediated by adulthood antisocial and impulsive traits. Effects of PD traits on AUD 5‒10 years later were direct rather than mediated by adulthood SLEs. The results and the general approach contribute to triangulation of developmental origins for complex behavioral disorders.
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Affiliation(s)
- Tom Rosenström
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.
| | - Nikolai Olavi Czajkowski
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, USA
| | - Steven H Aggen
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Nathan A Gillespie
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Espen Eilertsen
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fartein Ask Torvik
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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15
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Testing Genetic and Environmental Associations Between Personality Disorders and Cocaine Use: A Population-Based Twin Study. Twin Res Hum Genet 2018; 21:24-32. [PMID: 29369040 DOI: 10.1017/thg.2017.73] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Until now, data have not been available to elucidate the genetic and environmental sources of comorbidity between all 10 DSM-IV personality disorders (PDs) and cocaine use. Our aim was to determine which PD traits are linked phenotypically and genetically to cocaine use. Cross-sectional data were obtained in a face-to-face interview between 1999 and 2004. Subjects were 1,419 twins (µage = 28.2 years, range = 19-36) from the Norwegian Institute of Public Health Twin Panel, with complete lifetime cocaine use and criteria for all 10 DSM-IV PDs. Stepwise multiple and Least Absolute Shrinkage and Selection Operator (LASSO) regressions were used to identify PDs related to cocaine use. Twin models were fitted to estimate genetic and environmental associations between the PD traits and cocaine use. In the multiple regression, antisocial (OR = 4.24, 95% CI [2.66, 6.86]) and borderline (OR = 2.19, 95% CI [1.35, 3.57]) PD traits were significant predictors of cocaine use. In the LASSO regression, antisocial, borderline, and histrionic were significant predictors of cocaine use. Antisocial and borderline PD traits each explained 72% and 25% of the total genetic risks in cocaine use, respectively. Genetic risks in histrionic PD were not significantly related to cocaine use. Importantly, after removing criteria referencing substance use, antisocial PD explained 65% of the total genetic variance in cocaine use, whereas borderline explained only 4%. Among PD traits, antisocial is the strongest correlate of cocaine use, for which the association is driven largely by common genetic risks.
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16
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Bronchain J, Chabrol H, Raynal P. Could schizotypy protect against the negative outcomes of borderline traits on alcohol consumption? A cluster analytic study. Psychiatry Res 2018; 269:21-24. [PMID: 30145296 DOI: 10.1016/j.psychres.2018.08.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 05/21/2018] [Accepted: 08/13/2018] [Indexed: 11/19/2022]
Abstract
Schizotypal and borderline personality traits seem to be differently associated to alcohol use in young adult. However, no study has explored co-occurring schizotypal and borderline traits in their link with alcohol consumption. Participants were 1572 students from different French universities who completed self-report questionnaires assessing these three dimensions. A cluster analysis based on the borderline and schizotypal traits scores yielded four distinct groups characterized by low schizotypal and borderline traits (LT), high borderline traits (HB), high schizotypal and borderline traits (HT) and high schizotypal traits (HS). The HS cluster had significantly lower alcohol use than the other three groups. LT and HT clusters did not differ significantly in their alcohol use. Comparison between clusters suggests that schizotypal traits may be protective against the negative impact of borderline traits on alcohol consumption. In the context of a co-occurrence between borderline and schizotypal traits, this study provides important information about their link with alcohol consumption.
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Affiliation(s)
- Jonathan Bronchain
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse, UT2J, France.
| | - Henri Chabrol
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse, UT2J, France
| | - Patrick Raynal
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse, UT2J, France
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17
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Gillespie NA, Aggen SH, Neale MC, Knudsen GP, Krueger RF, South SC, Czajkowski N, Nesvåg R, Ystrom E, Kendler KS, Reichborn-Kjennerud T. Associations between personality disorders and cannabis use and cannabis use disorder: a population-based twin study. Addiction 2018; 113:1488-1498. [PMID: 29500852 PMCID: PMC6043378 DOI: 10.1111/add.14209] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/26/2016] [Accepted: 02/23/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND AIMS Individual differences in DSM-IV personality disorders (PDs) are associated with increased prevalence of substance use disorders. Our aims were to determine which combination of PDs trait scores best predict cannabis use (CU) and cannabis use disorder (CUD), and to estimate the size and significance of genetic and environmental risks in PD traits shared with CU and CUD. DESIGN Linear mixed-effects models were used to identify PD traits for inclusion in twin analyses to explore the genetic and environmental associations between the traits and cannabis use. SETTING Cross-sectional data were obtained from Norwegian adult twins in a face-to-face interview in 1999-2004 as part of a population-based study of mental health. PARTICIPANTS Subjects were 1419 twins (μage = 28.2 years, range = 19-36) from the Norwegian Institute of Public Health Twin Panel with complete PD and cannabis data. MEASUREMENTS PD traits were assessed using DSM-IV criteria. Life-time CU and CUD were based on DSM-IV abuse and dependence criteria, including withdrawal and craving. FINDINGS After adjusting for age and sex, antisocial [β = 0.23, 95% confidence interval (CI) = 0.19-0.28] and borderline PDs (β = 0.20, 95% CI = 0.14-0.26) were associated strongly with CU. Antisocial (β = 0.26, 95% CI = 0.21-0.31) and borderline PDs (β = 0.12, 95% CI = 0.06-0.18) were also linked strongly to CUD. Genetic risks in antisocial and borderline PD traits explained 32-60% of the total variance in CU and CUD. Dependent and avoidant PDs explained 11 and 16% of the total variance in CU and CUD, respectively. CONCLUSIONS Individual differences in the liability to cannabis use and cannabis use disorder appear to be linked to genetic risks correlated with antisocial and borderline personality disorder traits.
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Affiliation(s)
- Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Steven H Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Gun Peggy Knudsen
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Susan C South
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Nikolai Czajkowski
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ragnar Nesvåg
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
- Section of Health, Developmental and Personality Psychology, Department of Psychology, University of Oslo, Norway
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Norway
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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18
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Borderline personality disorder and substance use disorders: an updated review. Borderline Personal Disord Emot Dysregul 2018; 5:15. [PMID: 30250740 PMCID: PMC6145127 DOI: 10.1186/s40479-018-0093-9] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/03/2018] [Indexed: 12/23/2022] Open
Abstract
For decades, clinicians and researchers have recognized that borderline personality disorder (BPD) and substance use disorders (SUDs) are often diagnosed within the same person (e.g., (Gunderson JG. Borderline personality disorder: A clinical guide. Washington, D.C.: American Psychiatric Press, 2001; Leichsenring et al., Lancet 377:74-84, 2011; Paris J. Borderline personality disorder: A multidimensional approach. American Psychiatric Pub, 1994; Trull et al., Clin Psychol Rev 20:235-53, 2000)). Previously, we documented the extent of this co-occurrence and offered a number of methodological and theoretical explanations for the co-occurrence (Trull et al., Clin Psychol Rev 20:235-53, 2000). Here, we provide an updated review of the literature on the co-occurrence between borderline personality disorder (BPD) and substance use disorders (SUDs) from 70 studies published from 2000 to 2017, and we compare the co-occurrence of these disorders to that documented by a previous review of 36 studies over 15 years ago (Trull et al., Clin Psychol Rev 20:235-53, 2000).
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19
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Rosenström T, Torvik FA, Ystrom E, Czajkowski NO, Gillespie NA, Aggen SH, Krueger RF, Kendler KS, Reichborn-Kjennerud T. Prediction of alcohol use disorder using personality disorder traits: a twin study. Addiction 2018; 113:15-24. [PMID: 28734091 PMCID: PMC5725242 DOI: 10.1111/add.13951] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/27/2017] [Accepted: 07/14/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIMS The DSM-IV personality disorders (PDs) are comorbid with alcohol use disorder (AUD) and with each other. It remains unclear which PD criteria are most likely to drive onset and recurrence of AUD and which are merely confounded with those criteria. We determine which individual PD criteria predict AUD and the degree of underlying genetic and/or environmental aetiology. DESIGN A prospective observational twin study. SETTING Norway 1999-2011. PARTICIPANTS A total of 2528 and 2275 Norwegian adult twins in waves 1 and 2 variable-selection analyses, and 2785 in biometric analyses. MEASUREMENTS DSM-IV PDs and their 80 criteria were assessed using a structured personal interview, and AUD using the World Health Organization's Composite International Diagnostic Interview. FINDINGS In a variable-selection analysis, two PD criteria were associated with AUD even after taking all the other criteria into account: criterion 8 of antisocial PD (childhood conduct disorder) and criterion 4 of borderline PD (self-damaging impulsive behaviours). Adjusting for each other, their respective odds ratios were 3.4 [confidence interval (CI) = 2.1-5.4] and 5.0 (CI = 3.3-7.7). Endorsement strength of the criteria was associated with AUD in a dose-response manner and they explained 5.5% of variation in AUD risk-more than the full diagnoses of antisocial and borderline PDs together (0.5%). The association between borderline criterion 4 and AUD 10 years later derived mainly from their overlapping genetic factors, whereas the association between antisocial criterion 8 and AUD 10 years later was due to both genetic and non-genetic factors. CONCLUSIONS Conduct disorder and self-harming impulsivity are the foremost risk traits for alcohol use disorder among the 80 personality disorder criteria of DSM-IV, predicting alcohol use disorder more effectively than personality disorder diagnoses. The twin-study analysis suggested that conduct disorder represents a joint genetic and developmental risk for alcohol use disorder and that impulsivity is a genetic risk.
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Affiliation(s)
- Tom Rosenström
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Correspondence:
| | - Fartein Ask Torvik
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Department of Psychology, University of Oslo, Norway
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Department of Psychology, University of Oslo, Norway,PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Norway
| | - Nikolai Olavi Czajkowski
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Department of Psychology, University of Oslo, Norway
| | - Nathan A. Gillespie
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Steven H. Aggen
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Deparment of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Norway
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20
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Marquez-Arrico JE, Río-Martínez L, Navarro JF, Prat G, Adan A. Personality Profile and Clinical Correlates of Patients With Substance Use Disorder With and Without Comorbid Depression Under Treatment. Front Psychiatry 2018; 9:764. [PMID: 30687142 PMCID: PMC6336829 DOI: 10.3389/fpsyt.2018.00764] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 12/20/2018] [Indexed: 01/05/2023] Open
Abstract
Background: Among patients with substance use disorder (SUD), major depressive disorder (MDD) is highly prevalent. Even though, personality plays an important role in treatment outcomes for individuals with SUD and SUD + MDD, few studies have explored personality characteristics in these samples. This study aims to describe personality for patients with SUD taking into account the comorbid MDD, using the Alternative Five Factor Model (AFFM). We also aim to compare SUD + MDD patients with population norms and to elucidate possible personality clinical correlates. Methods: For our study, 116 male patients undergoing for SUD treatment were divided in two groups: SUD only (N = 58) and SUD + MDD (N = 58). To examine personality, we used the Zuckerman-Kuhlman Personality Questionnaire and multiple analyses of covariance were performed to identify differences. In a first analysis, age was introduced as a covariate whereas in a second analysis the continuous variables that showed to have a discriminant value for the groups were added as covariates. Variables predicting the presence of dual diagnosis and personality clinical correlates were analyzed by logistic and linear regression models, respectively. We observed that patients with SUD + MDD show distinctive personality characteristics compared with patients with SUD only and population norms. Results: According to the AFFM, SUD + MDD patients are characterized by higher Neuroticism-Anxiety (positively associated to depressive symptoms) and Impulsivity; and by lower Parties and Friends. Moreover, the probability of having a dual depressive disorder was represented by the amount of medications and substances used. The preference for hard work and the energy self-reported levels (Work Activity trait) are linked to these clinical variables rather than to the presence/absence of a dual depressive disorder. Conclusions: Even when controlling clinical variables related to a higher probability of having a dual depressive disorder, the Neuroticism-Anxiety is a personality trait that strongly differentiates between SUD only and SUD + MDD patients. Further investigation is needed to explore the role of this personality trait as endophenotype in dual depressive men. Our results underline the importance of a dimensional understanding of personality and its clinical correlates among patients with SUD + MDD; this approach could provide us information on specific treatment strategies to improve the prognosis of patients.
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Affiliation(s)
- Julia Elena Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
| | - Laura Río-Martínez
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
| | | | - Gemma Prat
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
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