Drinking motives as mediators in the relation between personality disorder symptoms and alcohol use disorder

Narcissism and alcohol use: The mediating role of drinking motives among college students

Objective: The current study examined associations between grandiose and vulnerable subclinical narcissistic traits and alcohol use among college students and whether drinking motives mediated these associations.

Methods and Participants: Young adult college students who reported past month alcohol use were invited to complete self-report online surveys (N = 406; 81% female; Mage = 20.13, SD = 1.69; 10% Hispanic; 85% White).

Results: Results from path analysis using structural equation modeling indicated that there were no direct associations between grandiose or vulnerable subclinical narcissistic traits and alcohol use. However, several drinking motives mediated these associations. Specifically, the association between grandiose traits and alcohol use was mediated by enhancement and social motives. Similarly, the association between vulnerable traits and alcohol use was mediated by enhancement, social and coping motives.

Conclusions: Findings highlight a potential mechanism by which personality traits may contribute to a health risk behavior among young people.

OPRM1 Gene Polymorphism in Women with Alcohol Use Disorder

The main aims of the present study were to explore the relationship of the OPRM1 gene rs1074287 polymorphism in alcohol-dependent women with their personality traits and to try to find out whether any specific features may influence alcohol cravings and be a prognostic for alcohol dependency and treatment in AUD women. Our study found a notable correlation between openness and the interaction of the ORIM1 gene and AUD. The alcohol use disorder subjects with genotype AG showed a higher level of openness compared to the control group with genotypes AG (p = 0.0001) and AA (p = 0.0125). The alcohol use disorder subjects with the AA genotype displayed higher levels of openness than the control group with genotype AG (p = 0.0271). However, the alcohol use disorder subjects with the AA genotype displayed lower levels of openness than the control group with genotype GG (p = 0.0212). Our study indicates that openness as a personality trait is correlated with the OPRM1 gene rs1074287 polymorphism in alcohol-dependent women. These are the first data and results exploring such a relationship between opioid and alcohol pathways and the mental construction of AUD women. Personality traits such as openness to experience and neuroticism might play major roles in the addiction mechanism, especially in genetically predisposed females, independent of the reward system involved in the emotional disturbances that coexist with anxiety and depression.

Self-management with alcohol over lifespan: psychological mechanisms, neurobiological underpinnings, and risk assessment

Self-management includes all behavioural measures and cognitive activities aimed at coping with challenges arising throughout the lifespan. While virtually all of these challenges can be met without pharmacological means, alcohol consumption has long been instrumentalized as a supporting tool to help coping with problems arising selectively at adolescence, adulthood, and ageing. Here, we present, to our knowledge, the first systematic review of alcohol instrumentalization throughout lifespan. We searched MEDLINE, Google Scholar, PsycINFO and CINAHL (from Jan, 1990, to Dec, 2022) and analysed consumption patterns, goals and potential neurobiological mechanisms. Evidence shows a regular non-addictive use of alcohol to self-manage developmental issues during adolescence, adulthood, and ageing. Alcohol is selectively used to overcome problems arising from dysfunctional personality traits, which manifest in adolescence. A large range of psychiatric disorders gives rise to alcohol use for the self-management of distinct symptoms starting mainly in adulthood. We identify those neuropharmacological effects of alcohol that selectively serve self-management under specific conditions. Finally, we discuss the adverse effects and associated risks that arise from the use of alcohol for self-management. Even well-controlled alcohol use adversely impacts health. Based on these findings, we suggest the implementation of an entirely new view. Health policy action may actively embrace both sides of the phenomenon through a personalized informed use that allows for harm-controlled self-management with alcohol.

Cluster-b personality disorder traits and impulsivity: Indirect associations with alcohol use severity through positive alcohol expectancies

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).

The effect of impulsivity and drinking motives on alcohol outcomes in college students: a 3-year longitudinal analysis

Objective: Substance use is a public health concern and cross-sectional studies have found that impulsivity and drinking motives influence substance use in emerging adults. Despite these findings, longitudinal studies with nuanced measures of impulsivity and drinking motives are needed. Participants: The current study investigated the three-year relationship between impulsivity-related traits, drinking motives, sex, and drinking outcomes in a sample of 509 college students (47.47% male; 81% White). Methods: The effects of impulsivity traits and drinking motives on problematic drinking outcomes were evaluated using linear mixed effects models. Results: The results confirmed the hypothesized relationship between traits of impulsivity, drinking motives, and alcohol outcomes over time. Further, sex significantly interacted with drinking motives longitudinally in its relationship with alcohol use outcomes. Conclusions: These results indicate that intervention efforts may need to be tailored to specific individual attributes to target direct correlates of alcohol use behavior to increase effectiveness.

Determinants of Cue-Elicited Alcohol Craving and Perceived Realism in Virtual Reality Environments among Patients with Alcohol Use Disorder

The identification of variables that can modulate the efficacy of cue exposure using virtual reality (VR) is crucial. This study aimed to explore determinant variables of cue-elicited alcohol craving and perceived realism (PR) of environments and alcoholic beverages during a VR cue-exposure session among alcohol use disorder (AUD) outpatients. A prospective cohort study was conducted amongst 72 outpatients with AUD from a clinical setting. Alcohol craving experienced during VR exposure and PR of virtual environments and alcoholic drinks were evaluated after a VR session of exposure to alcohol-related contexts and cues. Sociodemographic, psychological and consumption characteristics were examined as possible predicting variables. Multiple linear regression analyses showed that the AUD severity and PR of beverages were predictors of cue-elicited alcohol craving. Educational level, PR of beverages and age were predictors of the PR of VR environments. In relation to the PR of VR beverages, cue-elicited alcohol craving and the PR of environments were predictors. A simple mediational model was also performed to analyze the influence of the PR of beverages on the relationship between the AUD severity and alcohol craving experienced during VR exposure: an indirect or mediational effect was found. PR of alcoholic beverages was (1) a key predictor of the PR of VR environments (and vice versa) and the alcohol craving (and vice versa) experienced during VR cue-exposure sessions using ALCO-VR software among AUD patients and (2) a mediator between AUD severity and cue-elicited alcohol craving.

Motives for opioid use explain the relation between borderline personality disorder pathology and opioid use problems

Despite the established relations between borderline personality disorder (BPD) and substance use problems in general, there is a dearth of research on the relation between BPD pathology and opioid use problems, as well as factors that may explain this relation. Therefore, this study examined the indirect relations of BPD pathology to opioid use problems (i.e., prescription opioid misuse, apprehension about prescription opioid use, and opioid cravings) through motives for opioid use (i.e., coping, enhancement, social, and conformity motives) among 68 patients endorsing prescription opioid misuse in a residential correctional substance use disorder (SUD) treatment facility. Participants completed measures of BPD pathology, motives for opioid use, and opioid use problems. Findings revealed significant indirect relations of BPD pathology to opioid misuse through coping and enhancement motives, apprehension about opioid use through coping, enhancement, and social motives, and opioid cravings through coping motives within this SUD sample. Results illustrate the relevance of both emotion- and interpersonal-related motives for opioid use to opioid use problems among patients with BPD pathology in SUD treatment.

Drinking motives moderate daily-life associations between affect and alcohol use in individuals with borderline personality disorder

People often report drinking to cope with negative affect (NA) or to enhance positive affect (PA). However, findings from daily life studies examining the interaction of motives and affect to predict alcohol use are mixed. Individuals with borderline personality disorder (BPD) may be particularly susceptible to drinking for the purpose of changing affective states, representing a population in which these patterns may be more readily identifiable in daily life. We tested whether drinking motives moderate daily life associations between affect and drinking in individuals with BPD. Regular drinkers with BPD (N = 54; 81.5% female) completed ecological momentary assessments approximately 6-10 times daily for 21 days. We tested whether the interactions between (a) person-level coping motives and NA so far that day (i.e., cumulative-average NA), and (b) person-level enhancement and cumulative-average PA were associated with subsequent drinking. We also tested whether effects differed for the initiation versus continuation of a drinking episode. Using generalized estimating equations, the interaction between coping and cumulative-average NA was positively associated with momentary drinking, with some evidence for a stronger relation during the continuation of drinking. The interaction between enhancement motives and cumulative-average PA was positively associated with initiation but negatively associated with continuation of drinking. Our novel approach of using cumulative-average affect and distinguishing initiation and continuation of drinking allowed us to examine differential momentary patterns across the drinking episode, and results suggest that awareness of motives as well as affect leading up to and during drinking may be a useful intervention target. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Coping motives mediate the relationship between borderline personality features and alcohol, cannabis, and prescription opioid use disorder symptomatology in a substance use disorder treatment sample

Borderline personality disorder and substance use disorder co-occur at a high rate. However, little is known about the mechanisms driving this association. This study examined substance use motives for 3 common substance use disorders among 193 individuals in substance use disorder treatment. We found that the coping motive consistently mediated the relationship between borderline personality and alcohol, cannabis, and prescription opioid use disorders. For this substance use disorder treatment sample, our findings support the self-medication model of substance use, and that interventions aimed at coping-related substance use would be helpful among these patients. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Borderline personality disorder features and drinking, cannabis, and prescription opioid motives: Differential associations across substance and sex

INTRODUCTION

Drinking motives have shown meaningful associations with borderline personality disorder (BPD) features. However, it is unknown whether other common substances of abuse (namely cannabis and prescription opioids) have the same associations with BPD features. In the present study, we tested associations between BPD features and motives across three substances: alcohol, cannabis, and prescription opioids. The purpose of the study was to determine whether BPD showed similar patterns of associations across drugs, or whether some substances serve particular functions for individuals with BPD features, and whether this also varies by sex in a college student sample.

METHOD

Five-hundred ninety-four college students completed online questionnaires measuring demographics, borderline personality disorder features, substance use, and substance specific motives for alcohol, cannabis, and prescription opioid use.

RESULTS

BPD was most strongly associated with coping motives across all substances. For both alcohol and cannabis, this was true for both males and females, along with conformity motives. For prescription opioids, coping, social, enhancement, and pain motives were only significantly related to BPD features for females. When compared statistically, it was found that the associations with coping drinking motives and opioid pain motives were higher among females.

CONCLUSIONS

This pattern of results suggests that negatively reinforcing motives (coping and conformity) play a similar functional role in borderline personality and substance use disorder pathology for alcohol and cannabis, but for prescription opioids the negative reinforcement motives (coping and pain) were only evident in females.

Daily relationship between positive affect and drinking to cope: the moderating role of difficulties regulating positive emotions

BACKGROUND

Alcohol use is highly prevalent and linked to a wide range of negative outcomes among college students. Although emotion dysregulation has been theoretically and empirically linked to alcohol use, few studies have examined emotion dysregulation stemming from positive emotions.

OBJECTIVE

The goal of the current study was to extend extant research by using daily diary methods to examine the potentially moderating role of difficulties regulating positive emotions in the daily relation between positive affect and alcohol use to cope with social and non-social stressors.

METHODS

Participants were 165 college students (M age = 20.04; 55.2% male) who completed a baseline questionnaire assessing difficulties regulating positive emotions. Participants then responded to questions regarding state positive emotions and alcohol use once a day for 14 days.

RESULTS

Difficulties regulating positive emotions moderated the daily relation between positive affect stemming from social stressors and alcohol use to cope with social stressors. Positive affect stemming from social stressors predicted alcohol use to cope with social stressors with high (but not low) levels of difficulties regulating positive emotions.

CONCLUSIONS

Findings underscore the potential utility of targeting difficulties regulating positive emotions in treatments aimed at reducing alcohol use to cope with social stressors among college students.

Unidirectionality Between Borderline Personality Disorder Traits and Psychopathology in a Residential Addictions Sample: A Short-Term Longitudinal Study

Borderline personality disorder (BPD) is a barrier to treatment, yet the relationship between BPD features and other psychopathology symptoms in residential addictions treatment samples is understudied. Using a sample of adults enrolled in a residential drug treatment facility measured at baseline and 2-3 month follow-up, the authors examined the prospective relationship between BPD features and five indices of psychopathology: depression, anxiety, interpersonal sensitivity, hostility, and psychoticism, as well as psychopathology global severity. There was no effect of time on any of the forms of psychopathology, but females reported higher levels of BPD features, anxiety symptoms, and interpersonal sensitivity than males. A series of latent change score models indicated that BPD features predicted increases in all psychopathology scales at follow-up, while the reverse was not true. These results suggest that targeting BPD features in residents of drug treatment facilities may reduce the emergence of new psychopathology in the short term.

Relapse (number of detoxifications) in abstinent male alcohol-dependent patients as related to personality traits and types of tolerance to frustration

BACKGROUND

Personality traits like depression on the one hand and aggression and impulsivity on the other are assumed to be predisposing factors for different types of alcohol dependence. Both types are associated with sensitivity to frustration, but this may be different for the two types of personality according to whether they are confronted with frustrations caused by withdrawal from positive or infliction of negative events. It has not been shown so far if both types of personality factors and the two different sources of frustration are differently relevant for the propensity of relapse. This was investigated here in a study on 60 abstinent male alcohol-dependent patients.

METHODS

Correlations between the number of previous detoxifications reflecting liability to relapse and questionnaire scores on personality factors and on reactions to frustration were computed.

RESULTS

Bonferroni-corrected correlations yielded significant relationships between the number of detoxifications and the personality factor of aggression as well as pronounced depressive reactions to frustrating conditions of non-reward caused by humans. Controlling for impulsivity, aggression and depression revealed that depressive reactions to frustration are genuine predictors for probability of relapse independent of underlying personality factors. Persons particularly sensitive to frustrations from human denial of positive reinforcers are liable to relapse which fits the theory of sensitivity to reward in drug-addicted individuals.

CONCLUSION

Results demonstrate that relapse is clearly more related to aggression than to impulsivity, depression and anxiety and may be facilitated if persons are sensitive to frustrating conditions of non-reward caused by social partners.

An examination of risky drinking behaviors and motivations for alcohol use in a college sample

OBJECTIVE

The current study examined (1) drinking motives as a mediator of risky drinking behaviors (ie, pregaming and drinking games) and alcohol-related problems and (2) whether gender moderates the association between risky drinking behaviors and negative consequences.

PARTICIPANTS

Participants (N = 368; 68% female) were drinkers aged 18 to 25. Data were collected from September to November 2010 and January to May 2011.

METHODS

Participants completed measures regarding typical pregaming and drinking game alcohol consumption, drinking motives, and alcohol-related consequences.

RESULTS

Social, coping, and enhancement motives partially explained relationships, with enhancement motives explaining the most variance for pregaming (31%) and drinking games (44%). Relationships between risky drinking and consequences were not moderated by gender.

CONCLUSIONS

Drinking to enhance positive affect may be the most salient motivation for drinking related to pregaming and drinking games for college drinkers. Findings have implications for interventions tailored to students engaging in various heavy drinking practices.

Longitudinal twin study of borderline personality disorder traits and substance use in adolescence: developmental change, reciprocal effects, and genetic and environmental influences

Although the comorbidity between borderline personality disorder (BPD) and substance abuse is well established, there are few longitudinal studies that have examined its developmental origins or whether the comorbidity is due to common genetic or environmental risk factors. To fill this gap, we used a large sample of female adolescent twins (N = 1,280) to examine the developmental course, reciprocal influences, and the genetic and environmental factors underlying the co-occurrence of BPD traits and substance use from age 14 to 18. Rank-order stability was moderate to high for both BPD traits (r = .58) and substance use (r = .51), whereas mean levels of substance use increased substantially from age 14 to 18 (d = 0.77) and BPD traits showed a small decline (d = -0.21). BPD traits and substance use exhibited concurrent and prospective associations; however, the longitudinal associations dropped to nonsignificance after accounting for the temporal stability of each trait. Twin analyses revealed that shared environmental factors accounted for the association between BPD traits and substance use at age 14, but genetic factors accounted for the association at age 18. These results indicate that, at least in adolescence, the comorbidity between BPD traits and substance use is a consequence of common risk factors rather than due to one being a casual antecedent of the other.

Frontal brain dysfunction in alcoholism with and without antisocial personality disorder

Alcoholism and antisocial personality disorder (ASPD) often are comorbid conditions. Alcoholics, as well as nonalcoholic individuals with ASPD, exhibit behaviors associated with prefrontal brain dysfunction such as increased impulsivity and emotional dysregulation. These behaviors can influence drinking motives and patterns of consumption. Because few studies have investigated the combined association between ASPD and alcoholism on neuropsychological functioning, this study examined the influence of ASPD symptoms and alcoholism on tests sensitive to frontal brain deficits. The participants were 345 men and women. Of them, 144 were abstinent alcoholics (66 with ASPD symptoms), and 201 were nonalcoholic control participants (24 with ASPD symptoms). Performances among the groups were examined with Trails A and B tests, the Wisconsin Card Sorting Test, the Controlled Oral Word Association Test, the Ruff Figural Fluency Test, and Performance subtests of the Wechsler Adult Intelligence Scale. Measures of affect also were obtained. Multiple regression analyses showed that alcoholism, specific drinking variables (amount and duration of heavy drinking), and ASPD were significant predictors of frontal system and affective abnormalities. These effects were different for men and women. The findings suggested that the combination of alcoholism and ASPD leads to greater deficits than the sum of each.