Personality Disorders

The assumption that alcoholism and personality traits are linked in some fashion has a long history. Earlier editions of the DSM (DSM-I and DSM-II) classified alcoholism along with personality disorders. By 1980, with publication of DSM-III, substance use disorders (including alcoholism) were understood as entities independent of the personality disorders.

Generally, antisocial personality disorder (APD) is the most prevalent personality disorder associated with alcoholism when samples from public treatment centers are studied, and borderline personality disorder (BPD) is the most common disorder in studies from private treatment facilities. In a private psychiatric hospital sample, 57% of substance-abusing patients met DSM-III-R criteria for a personality disorder; with BPD being the most commonly occurring personality disorder (Nace, Davis, & Gaspari, 1991).

Personality disorder occurs more commonly in alcoholics than in the general population. A prospective long-term study of a nonclinical sample (Drake & Vaillant, 1985) determined that by age 47, 23% of males met criteria for a personality disorder. However, the alcoholic males in the sample met criteria for a personality disorder in 37% of cases. In a review of over 2,400 psychiatric patients (Koenigsberg, Kaplan, Gilmore, & Cooper, 1985), 36% were found to have a personality disorder. The alcoholics in this clinical sample, however, had a personality disorder in 48% of cases. ECA study data document APD in 15% of alcoholic men and 4% of alcoholic women. These prevalences exceed the rate of APD in the total population four times for men and 12 times for women (Helzer & Pryzbeck, 1988).

Cloninger (1987) has empirically determined type I, or milieu-limited alcoholism, that affects both men and women typically after age 25. Type II, or male-limited alcoholism, occurs predominately in males, develops before age 25, and is associated with severe medical and social consequences. In an extensive review, Howard, Kivlahan, and Walker (1997) determined that novelty-seeking traits predict early-onset criminality, alcoholism, and other forms of substance abuse. Furthermore, children of alcoholic parents tend to be higher in novelty seeking and lower in reward dependence than children of nonalcoholic parents. The traits of reward dependence and harm avoidance are more typical of the type I milieu-limited alcoholic and high novelty seeking, with low scores on reward dependence and harm avoidance being found more commonly in the aggressive early-onset type II male form of alcoholism.

Alcohol No More

Alcohol No More

Do you love a drink from time to time? A lot of us do, often when socializing with acquaintances and loved ones. Drinking may be beneficial or harmful, depending upon your age and health status, and, naturally, how much you drink.

Get My Free Ebook


Post a comment