Adverse Childhood Experiences, Personality Disorders and Addiction: Which Relationship?

Abstract

Introduction

Stressful or traumatic events occurred during childhood do have a role in the genesis of personality disorders. Less is known about this remarkable association in people with addictive behaviors.

Aims

This study aims to disentangle the relationship between childhood adverse experiences, personality disorders (PDs) and substance use disorders (SUDs).

Methods

A cross-sectional naturalistic study of 320 consecutive SUDs outpatients attending an Italian addiction service. Participants were clinically evaluated by a semi-structured interview, the SCID-II (Structured Clinical Interview for DSM-IV Axis II PD), and the CECA-Q (Childhood Experience of Care and Abuse-questionnaire). Multivariate logistic regression analyses were used to estimate odds ratio (OR) and 95% confidence intervals (95% CI)

Results

The prevalence rate of PDs in our sample of patients is 62.2%. PDs were associated with a history of physical punishment in childhood (OR = 1.82; CI 95%: 1.05–3.16; P = 0.034). Being exposed to three adverse events increases the risk of Cluster B PD (OR = 5.92; CI 95%: 2.21–15.92; P < 0.001). Heroin addiction increases the risk of Cluster B PD, both as previous (OR = 2.93; CI 95%: 1.49–5.75; P = 0.003) or current (OR = 4.34; IC 95%: 1.97–11.8; P = 0.004) consumption. Childhood institutionalization increases the probability of cluster B PD (OR: 2.15; CI 95%: 1.02–4.54; P = 0.041). Whereas being employed reduces the probability of both PDs and SUDs (OR = 0.54; CI 95%: 0.31–0.93; P = 0.027).

Conclusions

PDs occurred in 62% of patients and were related to adverse childhood experiences and SUDs having detrimental effects on both social and occupational functioning. Being employed could be a protective factor on the development of PDs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.