Reactive and Regulative Temperament in Relation to Clinical Symptomatology and Personality Disorders in Patients with a Substance Use Disorder

Abstract

Temperament and personality traits are important factors underlying the vulnerability for both the initiation and continuation of addictive behaviors. We investigated the influence of reactive and regulative temperament and their interaction in relation to clinical symptomatology and personality disorders (PDs) in a sample of 841 inpatients (68.1% males) with a substance use disorder (SUD). To assess reactive temperament we used the Behavioral Inhibition and Behavioral Activation Scales (BISBAS) and to assess regulative temperament we used the Effortful Control Scale. Clinical symptomatology and personality traits were measured by means of the Symptom Checklist-90 (SCL-90) and the Assessment of ADP-IV Personality Disorders (ADP-IV). Hierarchical regression analyses showed that both, clinical symptomatology and PDs were related to low levels of effortful control (EC). None of the two-way interactions (BIS × EC, BAS × EC) however were significantly related to psychopathology. Current findings highlight the role of effortful control (EC) in the expression of psychopathology in an adult sample of inpatients with SUD. Therapeutic interventions aiming at strengthening EC can possibly result in better treatment outcomes for both the addiction and the comorbid psychopathology.

A Multi-Level Analysis of Biological, Social, and Psychological Determinants of Substance Use Disorder and Co-Occurring Mental Health Outcomes

“…Substance use disorder can be viewed as a complex intertwining of behavior, personality, and psychopathology. The co-occurrence of substance use and psychopathology (dual diagnosis) can be explained by shared risk factors such as socioeconomic status and personality traits [30][31][32]. Many people with SUDs show psychiatric comorbidity, personality, mood, and anxiety disorders [12,[30][31][32][33], especially in cases of poly-drug use, where eating disorders, psychotic symptoms, schizophrenia [2], and PTSD (Post-Traumatic Stress Disorder) [4,34] can also be found; in some cases, the dual diagnosis of SUD and ASD (Autism Spectrum Disorder) is also found [35].…”

“…According to several surveys, approximately 10-20% of the population suffers from an addiction-related problem [31], and half of the people with a substance use disorder experience other mental disorders during their lifetime, and vice versa [36], as the relationship between the two would appear to be bidirectional [2]. A positive association was found between anxiety, depression, and craving intensity.…”

“…Temperament and personality traits represent crucial factors that contribute to the development and persistence of addiction-related behaviors [31,32]. Among these traits, disinhibition and lack of self-control, which are intended to be the ability to regulate one's behavior, emotions, and cognition, represent key elements.…”

“…Among these traits, disinhibition and lack of self-control, which are intended to be the ability to regulate one's behavior, emotions, and cognition, represent key elements. Self-control is considered a transdiagnostic dimension; its absence can manifest in both externalized behaviors, as in substance-related disorders and Attention Deficit Hyperactivity Disorder (ADHD), and internalizing behaviors, as in mood or anxiety disorders [31]. In addition, high levels of behavioral activation (BAS) and low levels of self-control (EC) have been associated with Cluster B of personality disorders, while high levels of behavioral inhibition (BIS) and low levels of self-control (EC) have been linked to Cluster C. As for Cluster A, a mixed pattern of BAS and BIS has been observed [31,32].…”

“…The development of clinical symptoms, especially anxiety and depression, and the manifestation of personality disorders both correlated with low levels of self-control (effortful control-EC) and high levels of behavioral inhibition (BIS) in people with SUD [31,32]. Hence, there is a greater inclination to neuroticism, which is considered an additional personality trait that represents a vulnerability factor for the development and persistence of SUD [30].…”