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Personality Profiles of Individuals with Substance Use Disorders: Historical Overview and Current Directions Jeffrey S Nevid JS, Gordon AJ, Miele AS, Keating LH. Personality Profiles of Individuals JOURNAL OF MENTAL HEALTH with Substance Use Disorders: Historical Overview and Current Directions. J Ment AND CLINICAL PSYCHOLOGY Health Clin Psychol (2020) 4(2): 38-44 www.mentalhealthjournal.org Review Article Open Access Personality Profiles of Individuals with Substance Use Disorders: Historical Overview and Current Directions Jeffrey S. Nevid*, Alexander J. Gordon, Andrew S. Miele, Luke H. Keating St. John’s University, New York Article Info Abstract Article Notes Efforts to understand personality features of people who use psychoactive Received:April 7, 2020 substances have a long history, dating back to early psychoanalytic Accepted: May 27, 2020 conceptualizations. Advancements in the field have focused on applying *Correspondence: multidimensional personality inventories to better understand personality Jeffrey S. Nevid, Ph.D, Department of Psychology, St. John’s differences between substance users and non-users, and between different University, Queens, NY 11439; Email: [email protected]. substance use types, with respect to both psychopathological traits and broad dimensional factors. A brief review of this evidence highlights personality © 2020 Nevid JS. This article is distributed under the terms of features of persons with alcohol and other substance use problems and the Creative Commons Attribution 4.0 International License. between users of different types of substances, especially alcohol and opioid substance use disorder patients. A better understanding of personality profiles of substance use disorder groups may be useful in tailoring treatment approaches based on profile characteristics. Medical and psychological research literature documents a long associated with problematic substance use. Approaches to this questionhistory of haveattempts varied, to identify utilizing and objective, characterize projective, personality dimensional, profiles and categorical measures of personality as well as psychoanalytic formulation of substance use behavior. Studies initially focused on examining evidence for the existence of an “alcoholic” or “addictive” personality structure that may predispose individuals to engage in problematic alcohol and drug use. Research efforts have shifted away from attempts to identify an overriding concept of a single personality type1. More recent work seeks to develop etiologic predictive models that identify between users of different substances. Furthermore, these newer approachesand compare have personality increasingly profiles used moreof users complex and andnonusers integrative and models incorporating both biological and socioeconomic factors. The current paper provides a brief narrative review of research substance use disorders as well as differences in personality traits amongevidence users exploring of different personality substances. profiles Understanding of individuals differences with in personality patterns may help inform targeted intervention efforts to address personality-level factors that underpin substance use and risk factors in substance use disorders, which may differ among individuals who use different substances. Psychoanalytic Approaches Early psychoanalytic approaches emphasized drives toward the basis for addiction and substance use2-4 libidinal gratification and defenses against aggressive impulses as . Moreover, fixation at Page 38 of 44 Nevid JS, Gordon AJ, Miele AS, Keating LH. Personality Profiles of Individuals with Substance Use Disorders: Historical Overview and Current Directions. J Ment Journal of Mental Health & Clinical Psychology Health Clin Psychol (2020) 4(2): 38-44 the oral stage of psychosexual development was thought to behaviors (i.e., obesity, anorexia)12,13. Factor analysis of lead to development of oral-dependent personality traits, the MAC delineated six subscales: Risk Taking, Cognitive such as dependence and depression, as well as to behavioral Impairment, School Maladjustment, Interpersonal Competence, Extroversion and Exhibitionism, and Moral excessive drinking or smoking. Indignation11. High scores on the MAC are related to patterns in adulthood aimed at oral gratification, such as impulsivity, issues with authority and antisocial tendencies, Although persons who develop alcohol use disorder and extraversion, representing a substrate of personality or other forms of substance misuse may show dependent traits often associated with problem drinking and other traits, it remains unclear whether dependence leads to problematic substance use14. alcoholism or stems from downward movement in social status associated with problem drinking, largely as a Cloninger’s (1987)15 tridimensional model of result of unemployment, which likely renders people more dependent on others. Nor does demonstrating a statistical development of etiological models identifying personality association between dependence and alcoholism establish patternspersonality in substancehas been use particularly populations. influentialEach dimension in the of the model (novelty-seeking, harm-avoidance, and reward- to problems in early psychosexual development. It is dependence) has been demonstrated to be predictive of later noteworthythat alcoholism that represents later psychodynamic an oral fixation models or ofcan personality be traced substance use based on childhood measures16. Cloninger’s functioning of substance users put a greater emphasis on typology of alcoholism subtypes provides a useful heuristic framework for distinguishing different alcoholic types toward self-medication of emotional distress5. More based on substance use behaviors, underlying biological deficitsrecently, in th egoere hasstrength been aand shift self-regulation in focus from understandingdriving efforts processes, and distinguishing personality features. The personality dynamics in substance use to using objective type I alcoholic personality, which is associated with use of alcohol as self-medication and an anxious or neurotic associated with substance use and substance use disorders. Moreover,personality contemporary inventories toresearchers identify personalityhave focused profiles more novelty seeking (NS), high harm avoidance (HA) and high attention on comorbidity between personality disorders rewardpersonality dependence profile, (RD) is frequently17. The type IIcharacterized alcoholic personality, by low and substance use disorders. described in terms of antisocial personality features and characterized by impulsivity, is often associated with the Personality Profiles Researchers have consistently demonstrated links Other researchers also emphasize heterogeneity within between substance use and diagnoses of borderline and opposite personality profile (high NS, low HA, and low RD). populations of individuals with substance use disorders. antisocial personality disorders6-9. Although antisocial For example, Babor and colleagues18 conducted a cluster personality disorder is often associated with patterns of analysis with a sample of individuals with alcohol use drug use and misuse, debate has centered around its lack the high rates of antisocial personality features among coursedisorder. of Their disease. findings Other showed researchers two definable have exploredclusters of specificity10 in predicting substance use behavior due to non-users . In part due to the predictive limitations of dimensionalhaving distinct factors risk relating factors, to personalitysubstance use, profiles, converging and diagnosis-level information, a growing body of literature has favored trait-level dimensional conceptions of and disinhibition and negative emotionality19-22,25,58. These constructson a profile have characterized been linked toby several high levels aspects of of impulsivity substance with substance use disorders. misuse, including severity of dependence, age of onset, personality in developing personality profiles of individuals The MacAndrew Alcoholism Scale (MAC) of the and substance use etiology21 Minnesota Multiphasic Personality Inventory (MMPI) levels of alcohol involvement are frequently associated with is an early notable example of a dimensional approach low levels of conscientiousness,. Applying agreeableness, a five-factor and model, high to measurement of personality traits used to predict levels of neuroticism22,23. These traits are in line with earlier problematic substance use potential11. The scale was research on etiological models of alcohol use16. Researchers developed using 44 items from the original version of the have also adopted an integrative, multidimensional view of 24,25 MMPI that, although not related to drinking behaviors personality traits associated with substance use . For per se, were differentially endorsed by alcohol users as example, investigators incorporated biological correlates compared to normative samples. Although originally and gene-environment interactions that contextualize 26,27 developed to predict proneness to alcoholism, studies personality and substance use behavior . Multidimensional personality inventories have been use of other substances, such as opioids, as well as with introduced that better capture a wider range of personality markershave found of addictivethe MAC tobehaviors be nonspecifically related to associatedproblem eating with traits in relation to substance use disorders, including Page 39 of 44 Nevid JS, Gordon AJ, Miele AS, Keating LH. Personality Profiles of Individuals with Substance Use Disorders: Historical Overview and Current
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