Substance Use Disorders and Personality Disorders
frequently occur together. A research study by Zimmerman and Coryell (1989) found that about 43-77% of people diagnosed with personality disorders would also meet the criteria for an alcohol use disorder at some point during their lives. Other researchers, such as Verheul and colleagues (1995, 1998), have looked at the co-occurrence between personality disorders and substance use disorders from the opposite angle. They reported that 44% of people with alcohol use disorders would meet the criteria for a personality disorder. Furthermore, 77% of people who abuse opiates would meet the criteria for a personality disorder. In particular, two personality disorders frequently co-occur with substance use disorders. These are antisocial personality disorder and borderline personality disorder (Verheul, van den Brink & Hartgers, 1995).
Antisocial personality disorder is the adult version of a childhood disorder called conduct disorder. People with these disorders demonstrate a repeated pattern of disregard for others. This lack of disregard is evidenced by a failure to conform to social norms; repeated lying; impulsivity; aggressiveness; violence; irresponsibility; and a lack of remorse for the mistreatment of others. Research has found that first-degree relatives of people with antisocial personality disorder have a much higher risk of developing both antisocial personality disorder and substance-use disorders (DSM-IV-TR, 2000).
People with borderline personality disorder have unstable relationships and intense, unregulated emotions. People with borderline personality disorder are at greater risk for substance use disorders than the general population. Like many substance use disorders, borderline personality disorder is characterized by intense anger, mood swings, and impulsive, risky behavior.
Is there an "addictive personality"?
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Contrary to popular belief, research has been unable to identify an "addictive personality." However, some personality traits are more commonly observed in people with substance use disorders. Most of the research regarding addiction and personality traits has been conducted with people who have alcohol use disorders. Nonetheless, we observe many of these traits in people with other substance use disorders as well. The most common of these personality traits include nonconformity; impulsivity; sensation- or thrill-seeking; emotional dysregulation, negative affect (e.g., depression, anxiety); low self-esteem; and an external locus of control.