Personality Disorders Among Alcohol-Dependent Patients Manifesting or not Manifesting Cocaine Abuse: A Comparative Pilot Study

Echeburúa, Enrique; Medina, Ricardo Bravo de; Aizpiri, Javier

doi:10.1080/10826080802494735

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…This makes cocaine a particularly apt choice for patients with NPD since it propels their vulnerable selves to a desired superiority (39,40). Stimulants or cocaine may in fact increase performance and enjoyment of work, as well as prolong work hours, which may contribute to a faulty perception of those stimulants' benefits, thus making it challenging to give them up.…”

Section: More Time"mentioning

confidence: 96%

Narcissistic Personality Disorder: Progress in Recognition and Treatment

Ronningstam¹,

Weinberg²

2013

FOC

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This review will address pathological narcissism and narcissistic personality disorder (NPD)-the clinical presentation, the challenges involved in diagnosing NPD, and significant areas of co-occurring psychopathology (i.e., affective disorder, substance usage, and suicide). Major depressive disorder is the most common comorbid disorder in patients with pathological narcissism or NPD. Need for self-enhancement and chronic disillusionment with self make these individuals particularly susceptible to substance use. Suicidal preoccupation in these patients is characterized by the absence of depression, lack of communication, self-esteem dysregulation, and life events that decrease self-esteem. The diagnostic focus on patients' external characteristics and interpersonal behavior tends to dismiss the importance of their internal distress and painful experiences of self-esteem fluctuations, self-criticism, and emotional dysregulation. A collaborative and exploratory diagnostic approach to pathological narcissism and NPD is outlined that aims at engaging the patients and promoting their curiosity, narration, and self-reflection. Alliance building with a narcissistic patient is a slow and gradual process and mistakes are common. A central task is to balance these patients' avoidance and sudden urges to reject the therapist and drop out of treatment with the goal of encouraging and enabling them to face and reflect upon their experiences and behavior. Implications for treatment and possible areas or indications of change include: interpersonal and vocational functioning; sense of agency and self-direction; emotion regulation and ability to understand, tolerate, and modulate feelings; reflective ability; and ability to mourn the loss of wished for or unreachable internal self-states, relationships, and external ideals.

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Section: More Time"mentioning

confidence: 96%

Narcissistic Personality Disorder: Progress in Recognition and Treatment

Ronningstam¹,

Weinberg²

2013

FOC

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“…Of the 1,648 cocaine-dependent patients in the national Drug Abuse Treatment Outcomes Studies (DATOS), 51% were also alcohol-dependent [22] and in a study of 158 alcohol-dependent outpatients, 62 of them also manifested cocaine abuse [23]. This study was conducted in accordance with the recommendations of the US Panel on Cost-Effectiveness in Health and Medicine [24].…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Peer-Delivered Interventions for Cocaine and Alcohol Abuse among Women: A Randomized Controlled Trial

et al. 2012

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AimsTo determine whether the additional interventions to standard care are cost-effective in addressing cocaine and alcohol abuse at 4 months (4 M) and 12 months (12 M) from baseline.MethodWe conducted a cost-effectiveness analysis of a randomized controlled trial with three arms: (1) NIDA's Standard intervention (SI); (2) SI plus a Well Woman Exam (WWE); and, (3) SI, WWE, plus four Educational Sessions (4ES).ResultsTo obtain an additional cocaine abstainer, WWE compared to SI cost $7,223 at 4 M and $3,611 at 12 M. Per additional alcohol abstainer, WWE compared to SI cost $3,611 and $7,223 at 4 M and 12 M, respectively. At 12 M, 4ES was dominated (more costly and less effective) by WWE for abstinence outcomes.ConclusionsTo our knowledge, this is the first cost-effectiveness analysis simultaneously examining cocaine and alcohol abuse in women. Depending on primary outcomes sought and priorities of policy makers, peer-delivered interventions can be a cost-effective way to address the needs of this growing, underserved population.Trial RegistrationClinicalTrials.gov NCT01235091

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“…Studies investigating the associations of narcissism and substance-related problems rarely disentangled the degree of substance use and substance-related problems and typically report categorical analyses based on SUD groups. For grandiose narcissism, the majority of the evidence relies on cross-sectional comorbidities between NPD and SUD [ 5 , 15 , 32 , 33 ]. Furthermore, NPD longitudinally predicted the transition from being a non-user to being a “problematic user” (binary coding, minimum one substance-related problem; [ 34 ]), and an increased probability of having an SUD diagnosis [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

Impulsivity mediates the association between narcissism and substance-related problems beyond the degree of substance use: a longitudinal observational study

Hildebrandt,

Noack,

Wuellhorst

et al. 2024

BMC Psychiatry

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Background Narcissism has been implied as a putative risk factor for substance use disorders (SUDs). However, previous research did not disentangle the degree of substance use from substance-related problems, the symptoms of SUDs. This preregistered study addressed the open question whether grandiose and vulnerable narcissism and their constituent traits convey specific SUD risk, that is, explain substance-related problems beyond the degree of use. Furthermore, we tested whether impulsivity or substance use motives linked to narcissistic self-regulation mediate this association. Methods Narcissism, impulsivity, substance use motives, past-year substance use, and substance-related problems were assessed in 139 (poly-)substance users, 121 of whom completed a one-year follow-up. For significant longitudinal associations between narcissism factors and substance-related problems controlled for the degree of use, we tested impulsivity and substance use motives as mediators. Results Grandiose narcissism (r =.24, p =.007) and its constituent factors antagonistic (r =.27, p =.003) and agentic narcissism (r =.18, p =.050), but not vulnerable narcissism, prospectively predicted substance-related problems beyond the degree of substance use. Associations of grandiose narcissism and antagonistic narcissism with substance-related problems were fully mediated by impulsivity, but not substance use motives. Impulsivity explained roughly one third of the association of both grandiose (P̂M = 0.30) and antagonistic narcissism (P̂M = 0.26) with substance-related problems. Discussion We demonstrate that grandiose narcissism– particularly antagonistic but also agentic narcissism– is specifically linked to substance-related problems beyond the degree of substance use. The mediating effect of impulsivity but not substance use motives suggests that impulsivity may be a more important mechanism than narcissistic self-regulation in promoting SUD in narcissism. However, future studies may use more targeted measures than substance use motives to further probe the role of self-regulation. Similar result patterns for alcohol compared to all substances together indicate that mechanisms may be alike across substances. In conclusion, narcissistic individuals may not use substances more but have a higher SUD risk, informing prevention and treatment.

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Personality Disorders Among Alcohol-Dependent Patients Manifesting or not Manifesting Cocaine Abuse: A Comparative Pilot Study

Cited by 10 publications

References 16 publications

Narcissistic Personality Disorder: Progress in Recognition and Treatment

Narcissistic Personality Disorder: Progress in Recognition and Treatment

Cost-Effectiveness of Peer-Delivered Interventions for Cocaine and Alcohol Abuse among Women: A Randomized Controlled Trial

Impulsivity mediates the association between narcissism and substance-related problems beyond the degree of substance use: a longitudinal observational study

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