Borderline personality disorder and substance use disorders: an updated review

Trull, Timothy J.; Freeman, Lindsey K.; Vebares, Tayler J.; Choate, Alexandria M.; Helle, Ashley C.; Wycoff, Andrea M.

doi:10.1186/s40479-018-0093-9

Cited by 118 publications

(89 citation statements)

References 101 publications

(46 reference statements)

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“…Comorbidity with substance use disorders and Cluster B PDs are common. Up to 80% of subjects with borderline PD have been reported as having a comorbid diagnosis of substance use disorder at lifetime . The most consistent correlates of risky driving patterns are shown to be antisocial behavior, antisocial peers, and binge drinking .…”

Section: Discussionmentioning

confidence: 97%

Personality disorders of drivers killed in fatal motor vehicle accidents in Finland during 1990–2011

Räisänen

Hakko

Riipinen

et al. 2019

Acta Psychiatr Scand

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Objective: To examine the association of personality disorders (PDs) to deaths of drivers in fatal motor vehicle accidents (FMVAs) and analyze gender differences in lifetime psychiatric disorders and medico-legal findings at the time of accident. Method: The study sample consisted of 4810 Finnish drivers killed in FMVAs in Finland between 1990 and 2011. Doctor-diagnosed PD was found in 146 drivers (118 men and 28 women). The information of psychiatric morbidity was obtained from the Finnish Care Register for Health Care. Results: The proportion of deceased drivers with PDs had increased significantly over the study period, particularly among females and those with PD not otherwise specified (NOS). Suicidality and use of medication affecting driving ability were more common among females with PD compared to males with PD. 88% of all deceased drivers with PD had comorbid psychiatric disorders. Conclusion: Our findings indicate that PDs may predispose drivers to FMVAs, particularly females. This study emphasizes the importance of evaluating the fitness-to-drive of subjects with PD and especially comorbid substance use disorders, which may relate to an increased risk of fatal motor accidents. Significant outcomes• In Finland, the proportion of deceased drivers with hospital-treated personality disorders (PDs) has significantly increased during the years 1990 to 2011.• The increase was emphasized in female drivers with PD. • Suicidality and medication use were more common among female drivers with PD. Limitations• Personality disorders (PDs) are underestimated in register-based data.• This study lacks of alive control population with PD.

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Section: Discussionmentioning

confidence: 97%

Personality disorders of drivers killed in fatal motor vehicle accidents in Finland during 1990–2011

Räisänen

Hakko

Riipinen

et al. 2019

Acta Psychiatr Scand

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“…Diagnostic co-occurrence tended to be most pronounced for Cluster B personality disorders, particularly ASPD and BPD, which are characterized by disinhibited and antagonistic forms of externalizing traits and behaviors. Recent reviews have indicated that of those individuals who met diagnostic criteria for BPD, 46% to 49% also met diagnostic criteria for current AUD, and 59% met diagnostic criteria for lifetime AUD 17. The prevalence of AUD among those diagnosed with ASPD was about 68% 18.…”

Section: Epidemiology Of Co-occurring Aud and Personality Disordersmentioning

confidence: 99%

Alcohol Use Disorder and Antisocial and Borderline Personality Disorders

Helle

Watts

Trull

et al. 2019

ARCR

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Alcohol use disorder (AUD) frequently co-occurs with other psychiatric disorders, including personality disorders, which are pervasive, persistent, and impairing. Personality disorders are associated with myriad serious outcomes, have a high degree of co-occurrence with substance use disorders, including AUD, and incur significant health care costs. This literature review focuses on co-occurring AUD and personality disorders characterized by impulsivity and affective dysregulation, specifically antisocial personality disorders and borderline personality disorders. Prevalence rates, potential explanations and causal models of co-occurrence, prognoses, and the status of existing treatment research are summarized. Several important future research considerations are relevant to these complex, co-occurring conditions. Research assessing mechanisms responsible for co-occurring AUD and antisocial personality disorder or borderline personality disorder will further delineate the underlying developmental processes and improve understanding of onset and courses. In addition, increased focus on the efficacy and effectiveness of treatments targeting underlying traits or common factors in these disorders will inform future prevention and treatment efforts, as interventions targeting these co-occurring conditions have relatively little empirical support.

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“…Further illustrating the role of disinhibition within these disorders is examining the psychiatric comorbidity among disinhibition-laden disorders. For example, SUDs are highly comorbid with AUDs (Grant et al, 2015) and other disinhibition-centered disorders, such as ASPD and BPD (Trull, Jahng, Tomko, Wood, & Sher, 2010;Trull et al, 2018). For example, comorbidity rates of APD with lifetime AUD and SUD in a general population sample are approximately 50% and 23%, respectively (Trull et al 2010).…”

Section: Disinhibition and Other Psychological Constructsmentioning

confidence: 99%

Disinhibition as a unifying construct in understanding how personality dispositions undergird psychopathology

Mullins‐Sweatt

DeShong

Lengel

et al. 2019

Journal of Research in Personality

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Disinhibition has been a construct of interest for decades, as evidenced by its inclusion in most prominent models of general personality functioning and its link to personality pathology, other psychopathology, health behaviors, and public health concerns. Disinhibition is manifest in behavioral, task based, and physiological measures, and common etiologies are a major reason for the coherence of the domain across a variety of assessment modalities. The current review will provide a summary of the conceptualization of the construct across prominent models, its link to psychopathology and maladaptive behaviors, and its etiology. Finally, we provide discussion on its clinical application utilizing disinhibition to aid in understanding comorbid psychopathology and through a description of its potential use in treatment. Keywords disinhibition; general personality; dimensional model Conceptualization of Disinhibition The construct disinhibition (versus constraint) is a broad personality trait that refers to individual differences in the ability to self-regulate or control one's behavior, and ranges from undercontrolled to overcontrolled (Clark & Watson, 2008). Individuals high in disinhibition often act spontaneously without considering potential long-term consequences

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Borderline personality disorder and substance use disorders: an updated review

Cited by 118 publications

References 101 publications

Personality disorders of drivers killed in fatal motor vehicle accidents in Finland during 1990–2011

Personality disorders of drivers killed in fatal motor vehicle accidents in Finland during 1990–2011

Alcohol Use Disorder and Antisocial and Borderline Personality Disorders

Disinhibition as a unifying construct in understanding how personality dispositions undergird psychopathology

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