Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-18T15:01:08.010Z Has data issue: false hasContentIssue false
  • English
  • Français

Co-morbidity of personality disorders in individuals with substance use disorders

Published online by Cambridge University Press:  16 April 2020

R. Verheul
R. Verheul*
Affiliation:
Amsterdam Institute for Addiction Research, Academic Medical Center — University of Amsterdam, Keizersgracht 818, 1017EE, Amsterdam, The Netherlands
*
*Correspondence and reprints. E-mail address:[email protected] (R. Verheul).
Get access

Summary

This review summarizes the recent literature about personality disorders among substance abusers. First, it will be shown that personality disorders are highly prevalent co-morbid conditions among addicted individuals. Second, it is argued that this co-morbidity is likely to be accounted for by multiple complex etiological relationships. Finally, the clinical relevance of routine assessment of (maladaptive) personality traits in individuals admitting for substance abuse treatment will be discussed.

Keywords

key wordskey wordskey words
Type
Original article
Information
European Psychiatry , Volume 16 , Issue 5 , August 2001 , pp. 274 - 282
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alterman, AIRutherford, MJCacciola, JSMcKay, JRBoardman, CR.Prediction of 7 months methadone maintenance treatment response by four measures of antisociality. Drug Alcohol Depend 1998; 49: 217–23.CrossRefGoogle ScholarPubMed
APA (American Psychiatric Association). Diagnostic and statistical manual of mental disorders. 4th. Washington: DC: American Psychiatric Press; 1994.Google Scholar
Ball, SA.Manualized treatment for substance abusers with personality disorders: dual focus schema therapy. Addict Behav 1998; 23: 883–91.CrossRefGoogle ScholarPubMed
Barnes, GE.The alcoholic personality: a reanalysis of the literature. J Stud Alcohol 1979; 40: 571–634.CrossRefGoogle ScholarPubMed
Bernstein, DPStein, JAHandelsman, L.Predicting personality pathology among adult patients with substance use disorders: effects of childhood maltreatment. Addict Behav 1998; 23: 855–68.CrossRefGoogle ScholarPubMed
Brooner, RKKing, VLKidorf, MSchmidt, CWBigelow, GE.Psychiatric and substance use comorbidity among treatment-seeking opioid abusers. Arch Gen Psychiatry 1997; 54: 71–80.CrossRefGoogle ScholarPubMed
Cacciola, JSAlterman, AIRutherford, MJAlterman, AIMcKay, JRSnider, EC.Personality disorders and treatment outcome in methadone maintenance patients. J Nerv Ment Dis 1996; 184: 234–9.CrossRefGoogle ScholarPubMed
Cacciola, JSAlterman, AIRutherford, MJSnider, EC.Treatment response of antisocial substance abusers. J Nerv Ment Dis 1995; 183: 166–71.CrossRefGoogle ScholarPubMed
Cannon, DSKeefe, CKClark, LA.Persistence predicts latency to relapse following inpatient treatment for alcohol dependence. Addict Behav 1997; 22: 535–43.CrossRefGoogle ScholarPubMed
Caspi, ABegg, DDickson, NHarrington, HLangley, JMoffit, TE., et al Personality differences predict health-risk behaviours in young adulthood: evidence from a longitudinal study. J Person Soc Psychol 1997; 73: 1052–63.CrossRefGoogle ScholarPubMed
Cecero, JJBall, SATennen, HKranzler, HRRounsaville, BJ.Concurrent and predictive validity of antisocial personality disorder subtyping among substance abusers. J Nerv Ment Dis 1999; 187: 478–86.CrossRefGoogle ScholarPubMed
Cloninger, CRSigvardsson, SBohman, M.Childhood personality predicts alcohol abuse in young adults. Alcohol Clin Exp Res 1988; 12: 494–505.CrossRefGoogle ScholarPubMed
Cloninger, CR.Neurogenetic adaptive mechanisms in alcoholism. Science 1997; 236: 410–36.CrossRefGoogle Scholar
Conrod, PJPihl, ROVassileva, J.Differential sensitivity to alcohol reinforcement in groups of men at risk for distinct alcoholism subtypes. Alcohol Clin Exp Res 1998; 22: 585–97.CrossRefGoogle ScholarPubMed
Crits-Cristoph, PSiqueland, LBlaine, JFrank, ALuborsky, LOnken, LS., et al Psychosocial treatments for cocaine dependence: NIDA collaborative cocaine treatment study. Arch Gen Psychiatry 1999; 56: 493–502.CrossRefGoogle Scholar
Depue, RALuciana, MArbisi, PCollins, PLeon, A.Dopamine and the structure of personality: relation of agonist-induced dopamine activity to positive emotionality. J Person Soc Psychol 1994; 67: 485–98.CrossRefGoogle ScholarPubMed
Driessen, MVeltrup, CWetterling, TJohn, UDilling, H.Axis I and Axis II comorbidity in alcohol dependence and the two types of alcoholism. Alcohol Clin Exp Res 1998; 22: 77–86.CrossRefGoogle ScholarPubMed
Fisher, LAElias, JWRitz, K.Predicting relapse to substance abuse as a function of personality dimensions. Alcohol Clin Exp Res 1998; 22: 1041–7.CrossRefGoogle ScholarPubMed
Gerstley, LJMcLellan, ATAlterman, AIWoody, GELuborsky, LProut, M.Ability to form an alliance with the therapist: a possible marker of prognosis for patients with antisocial personality disorder. Am J Psychiatry 1989; 146: 508–12.Google ScholarPubMed
Kadden, RMCooney, NLGetter, HLitt, MD.Matching alcoholics to coping skills or interactional therapies: posttreatment results. J Consult Clin Psychol 1989; 57: 698–704.CrossRefGoogle ScholarPubMed
Kokkevi, AStefanis, NAnastasopoulou, EKostogianni, C.Personality disorders in drug abusers: prevalence and their association with Axis I disorders as predictors of treatment retention. Addict Behav 1998; 23: 841–53.CrossRefGoogle ScholarPubMed
Krueger, RFCaspi, AMoffitt, TESilva, PAMcGee, R.Personality traits are differentially linked to mental disorders: a multitrait-multidiagnosis study of an adolescent birth cohort. J Abnorm Psychol 1996; 105: 299–312.CrossRefGoogle ScholarPubMed
Kushner, MGSher, KJBeitman, BD.The relation between alcohol problems and the anxiety disorders. Am J Psychiatry 1990; 147: 685–95.Google ScholarPubMed
Lindström, L.Managing alcoholism: matching clients to treatments. Oxford: Oxford University Press; 1992.Google Scholar
Linehan, MM.Cognitive-behavioral treatment of borderline personality disorder. New York: The Guilford Press; 1993.Google Scholar
Longabaugh, RRubin, AMalloy, PBeattie, MClifford, PRNoel, N.Drinking outcomes of alcohol abusers diagnosed as antisocial personality disorder. Alcohol Clin Exp Res 1994; 18: 778–85.CrossRefGoogle ScholarPubMed
Marlowe, DBKirby, KCFestinger, DSHusband, SDPlatt, JJ.Impact of comorbid personality disorders and personality disorders symptoms on outcomes of behavioral treatment for cocaine dependence. J Nerv Ment Dis 1997; 185: 483–90.CrossRefGoogle ScholarPubMed
Masse, LCTremblay, RE.Behaviour of boys in kindergarten and the onset of substance use during adolescence. Arch Gen Psychiatry 1997; 54: 62–8.CrossRefGoogle Scholar
McGue, MSlutske, WIacono, WG.Personality and substance use disorders: II. Alcoholism versus drug use disorders. J Consult Clin Psychol 1999; 67: 394–404.CrossRefGoogle ScholarPubMed
Merikangas, KRMehta, RLMolnar, BEWalters, EESwendsen, JDAguilar-Gaziola, S., et al Comorbidity of substance use disorders with mood and anxiety disorders: results of the international consortium in psychiatric epidemiology. Addict Behav 1998; 23: 893–907.CrossRefGoogle ScholarPubMed
Merikangas, KRStevens, DEFenton, BStolar, MO’Malley, SSWoods, SW., et al Co-morbidity and familial aggregation of alcoholism and anxiety disorders. Psychol M 1998; 28: 773–88.CrossRefGoogle ScholarPubMed
Morgenstern, JLangenbucher, JLabouvie, EMiller, KJ.The comorbidity of alcoholism and personality disorders in a clinical population: prevalence rates and relation to alcohol typology variables. J Abnorm Psychol 1997; 106: 74–84.CrossRefGoogle Scholar
Nace, E.P.Substance abuse and personality disorder. J Chem Depend Treatment 1990: 183–97.CrossRefGoogle Scholar
Penick, ECPowell, BJCampbell, JLiskow, BINickel, EJDale, TM., et al Pharmacological treatment for antisocial personality disorder alcoholics: a preliminary study. Alcohol Clin Exp Res 1996; 20: 477–84.CrossRefGoogle ScholarPubMed
Powell, BJPenick, ECNickel, EJLiskow, BIRiesenmy, KDCampion, SL., et al Outcomes of comorbid alcoholic men: a 1-year follow-up. Alcohol Clin Exp Res 1992; 16: 131–8.CrossRefGoogle Scholar
Project Match Research Group. Matching alcoholism treatments to client heterogeneity: project match posttreatment drinking outcomes. J Stud Alcohol 1997; 58: 7–29.Google Scholar
Project Match Research Group. Project MATCH secondary a priori hypotheses. Addiction 1998; 92: 1671–98.Google Scholar
Reich, JHVasile, RG.Effect of personality disorders on the treatment outcome of Axis I conditions: an update. J Nerv Ment Dis 1993; 181: 475–84.CrossRefGoogle ScholarPubMed
Robinson, TEBerridge, KC.The neural basis of craving: an incentive-sensitization theory of addiction. Brain Res Rev 1993; 18: 247–91.CrossRefGoogle Scholar
Rounsaville, BJKranzler, HRBall, SATennen, HPoling, JTriffleman, E.Personality disorders in substance abusers: relation to substance use. J Nerv Ment Dis 1998; 186: 87–95.CrossRefGoogle ScholarPubMed
Schuckit, MAHesselbrock, V.Alcohol dependence and anxiety disorders: what is the relationship?. Am J Psychiatry 1994; 151: 1723–34.Google ScholarPubMed
Schuckit, MAKlein, JTwitchell, GSmith, T.Personality test scores as predictors of alcoholism almost a decade later. Am J Psychiatry 1994; 151: 1038–42.Google ScholarPubMed
Sellman, JDMulder, RTSullivan, PFJoyce, PR.Low persistence predicts relapse in alcohol dependence following treatment. J Stud Alcohol 1997; 58: 257–63.CrossRefGoogle ScholarPubMed
Sher, KJTrull, TJ.Personality and disinhibitory psychopathology: alcoholism and antisocial personality disorder. J Abnorm Psychol 1994; 103: 92–102.CrossRefGoogle ScholarPubMed
Siever, LJDavis, KL.A psychobiological perspective on the personality disorders. Am J Psychiatry 1991; 148: 1647–58.Google ScholarPubMed
Skodol, AEOldham, JMGallaher, PE.Axis II comorbidity of substance use disorders among patients referred for treatment of personality disorders. Am J Psychiatry 1999; 156: 733–8.Google ScholarPubMed
Strand, JGBenjamin, LS.Resistance to change in individuals with personality disorder. Curr Opin Psychiatry 1997; 10: 132–5.CrossRefGoogle Scholar
Sutker, PBAllain, AN.Issues in personality conceptualizations of addictive behaviors. J Consult Clin Psychol 1988; 56: 172–82.CrossRefGoogle ScholarPubMed
Tarter, REVanyukov, MM.Alcoholism: a developmental disorder. J Consult Clin Psychol 1994; 62: 189–96.CrossRefGoogle ScholarPubMed
Thomas, VHMelchert, TPBanken, JA.Substance dependence and personality disorders: comorbidity and treatment outcome in an inpatient treatment population. J Stud Alcohol 1999; 60: 271–7.CrossRefGoogle Scholar
Verheul, RBall, SAvan den Brink, W.Substance abuse and personality disorders. In: Kranzler, H.RRounsaville, B.J, Eds. Dual diagnosis and treatment: substance abuse and comorbid medical and psychiatric disorders. New York: Marcel Dekker, Inc.; 1997. 317–63.Google Scholar
Verheul, RBrink van den, W.Geerlings, PJ.A three-pathway psychobiological model of craving for alcohol. Alcohol Alcohol 1999; 34: 197–222.CrossRefGoogle ScholarPubMed
Verheul, RBrink van den, W.Persoonlijkheidsstoornissen. In: de Jong, Avan den Brink, WOrmel, JWiersma, D, Eds. MaarssenHandboek Psychiatrische Epidemiologie. Amsterdam: Elsevier/De Tijdstroom; 1999. 347–8.Google Scholar
Verheul, RBrink van den, W.The role of personality pathology in the etiology and treatment of substance use disorders. Curr Opin Psychiatry 2000; 13: xxx.CrossRefGoogle Scholar
Verheul, RHartgers, Cvan den Brink, WKoeter, MWJ.The effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of personality disorders in alcoholics. J Stud Alcohol 1998; 59: 227–36.CrossRefGoogle ScholarPubMed
Verheul, RKranzler, HRPoling, JTennen, HBall, SARounsaville, BJ.Axis I and Axis II disorders in substance abusers: fact or artifact? J Stud Alcohol, in press.Google Scholar
Verheul, Rvan den Brink, WHartgers, CKoeter, MWJ.Antisocial alcoholic patients show as much improvement at 14-month follow-up as non-antisocial alcoholic patients. Am J Addict 1999; 8: 24–33.Google ScholarPubMed
Verheul, Rvan den Brink, WHartgers, C.Personality disorders predict relapse in alcoholic patients. Addict Behav 1998; 23: 869–82.CrossRefGoogle ScholarPubMed
Verheul, Rvan den Brink, WHartgers, C.Prevalence of personality disorders among alcoholics and drug addicts: an overview. Eur Addict Res 1995; 1: 166–77.CrossRefGoogle Scholar
Wills, TAWindle, MCleary, SD.Temperament and novelty seeking in adolescent substance use: convergence of dimensions of temperament with constructs from Cloninger's theory. J Person Soc Psychol 1998; 74: 387–406.CrossRefGoogle ScholarPubMed
Zimmerman, MCoryell, W.DSM-III personality disorder diagnoses in a nonpatient sample: demographic correlates and comorbidity. Arch Gen Psychiatry 1989; 46: 682–9.CrossRefGoogle Scholar
Zuckerman, M.Vulnerability to psychopathology: a biosocial model. Washington, DC: American Psychological Association; 1999.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.