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Personality Disorders and Addiction Disorders

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Textbook of Addiction Treatment: International Perspectives
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1 Introduction

The population with dual disorders /pathology (addiction and other mental disorders) is heterogeneous and the prevalence of comorbidity differs according to diagnostic groups. One of the overarching issues in relation to comorbidity is the nature of the connection between addiction disorders and other psychiatric disorders. The rapid development of technical advances in neuroscience has led to a better understanding of the molecular biology, neurotransmitter systems, and neural circuitry involved in substance use disorders and other mental disorders.

Addictive behaviors associated with other psychiatric disorders, which we refer to as dual pathology, are probably neurodevelopmental disorders (Szerman et al. 2013). These are disorders that begin very early in development and may present with different phenotypes, such as addiction-related or other psychiatric symptoms, at different stages during a person’s lifetime.

From the clinical point of view, we know that one of the...

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References

  • Agrawal A, Narayanan G, Oltmanns TF (2013) Personality pathology and alcohol dependence at midlife in a community sample. Pers Disord 4(1):55–61

    Article  Google Scholar 

  • Alia-Klein N, Goldstein RZ, Tomasi D, Woicik PA, Moeller SJ, Williams B, Craig IW, Telang F, Biegon A, Wang GJ, Fowler JS, Volkow ND (2009) Neural mechanisms of anger regulation as a function of genetic risk for violence. Emotion 9(3):385–396

    Article  PubMed Central  PubMed  Google Scholar 

  • American Psychiatric Association (1994) DSM-IV Diagnostic and statistical manual of mental disorders. Washington DC

    Google Scholar 

  • Anglin DM, Corcoran CM, Brown AS, Chen H, Lighty Q, Brook JS, Cohen PR (2012) Early cannabis use and schizotypal personality disorder symptoms from adolescence to middle adulthood. Schizophr Res 137(1–3):45–49

    Article  PubMed Central  PubMed  Google Scholar 

  • Badiani A, Belin D, Epstein D, Calu D, Shaham Y (2011) Opiate versus psychostimulant addiction: the differences do matter. Nat Rev Neurosci 12:685–700

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Bahlmann M, Preuss UW, Soyka M (2002) Chronological relationship between antisocial personality disorder and alcohol dependence. Eur Addict Res 8(4):195–200

    Article  CAS  PubMed  Google Scholar 

  • Bailey EL, Swallow BL (2004) The relationship between cannabis use and schizotypal symptoms. Eur Psychiatry 19(2):113–114

    Article  PubMed  Google Scholar 

  • Barr CS, Schwandt ML, Lindell SG, Higley JD, Maestripieri D, Goldman D, Suomi SJ, Heilig M (2008) Variation at the mu-opioid receptor gene (OPRM1) influences attachment behavior in infant primates. Proc Natl Acad Sci U S A 105(13):5277

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Blair JR (2003) Neurobiological basis of psychopathy. Br J Psychiatry 182:5–7

    Article  PubMed  Google Scholar 

  • Blair JR (2012) Cortical thinning and functional connectivity in psychopathy. Editorial. Am J Psychiatry 169:684–687

    Article  CAS  PubMed  Google Scholar 

  • Bohus M, Limberger M, Ebner U, Glocker FX, Schwarz B, Wernz M, Lieb K (2000) Pain perception during self-reported distress and calmness in patients with borderline personality disorder and self-mutilating behavior. Psychiatry Res 11, 95(3):251–260

    Article  CAS  Google Scholar 

  • Buckner JD, Heimberg RG, Schneier FR, Liu SM, Wang S, Blanco C (2012) The relationship between cannabis use disorders and social anxiety disorder in the National Epidemiological Study of Alcohol and Related Conditions (NESARC). Drug Alcohol Depend 124(1–2):128–134

    Article  PubMed Central  PubMed  Google Scholar 

  • Charles NE, Acheson A, Mathias CW, Michael FR, Dougherty DM (2012) Psychopathic traits and their association with adjustment problems in girls. Behav Sci Law 30:631–642

    Article  PubMed Central  PubMed  Google Scholar 

  • Chemerinski E, Triebwasser J, Roussos P, Siever LJ (2012) Schizotypal personality disorder. J Pers Disord 26:1–27

    Article  Google Scholar 

  • Cloninger CR (1987) Neurogenetic adaptive mechanisms in alcoholism. Science 236(4800):410–416

    Article  CAS  PubMed  Google Scholar 

  • Cohen P, Chen H, Crawford TN, Brook JS, Gordon K (2007) Personality disorders in early adolescence and the development of later substance use disorders in the general population. Drug Alcohol Depend 88(Suppl 1):S71–S84

    Article  PubMed Central  PubMed  Google Scholar 

  • Cohen AS, Buckner JD, Najolia GM, Stewart DW (2011) Cannabis and psychometrically-defined schizotypy: use, problems and treatment considerations. J Psychiatr Res 45(4):548–554

    Article  PubMed  Google Scholar 

  • Darke S, Ross J, Williamson A, Teesson M (2005) The impact of borderline personality disorder on 12-month outcomes for the treatment of heroin dependence. Addiction 100(8):1121–1130

    Article  PubMed  Google Scholar 

  • De Moor MHM, Costa PT, Terraciano A, Krueger RF, de Geus EJC et al (2012) Meta-analysis of genome-wide association studies for personality. Mol Psychiatry 1(17):337–349

    Article  Google Scholar 

  • Easton CJ, Oberleitner LM, Scott MC, Crowley MJ, Babuscio TA, Carroll KM (2012) Differences in treatment outcome among marijuana-dependent young adults with and without antisocial personality disorder. Am J Drug Alcohol Abuse 38(4):305–313

    Article  PubMed Central  PubMed  Google Scholar 

  • Ersche KD, Jones PS, Williams GB, Turton AJ, Robbins TW, Bullmore ET (2012a) Abnormal brain structure implicated in stimulant drug addiction. Science 335(6068):601–604

    Article  CAS  PubMed  Google Scholar 

  • Ersche KD, Turton AJ, Chamberlain SR, Müller U, Bullmore ET, Robbins TW (2012b) Cognitive dysfunction and anxious-impulsive personality traits are endophenotypes for drug dependence. Am J Psychiatry 169(9):926–936

    Article  PubMed Central  PubMed  Google Scholar 

  • Esterberg ML, Goulding SM, McClure-Tone EB, Compton MT (2009) Schizotypy and nicotine, alcohol, and cannabis use in a non-psychiatric sample. Addict Behav 34(4):374–379

    Article  PubMed  Google Scholar 

  • Fenton MC, Keyes K, Geier T, Greenstein E, Skodol A, Krueger B, Grant BF, Hasin DS (2012) Psychiatric comorbidity and the persistence of drug use disorders in the United States. Addiction 107(3):599–609

    Article  PubMed Central  PubMed  Google Scholar 

  • Fervaha G, Remington G (2012) Neuroimaging findings in schizotypal personality disorder: a systematic review. Prog Neuropsychopharmacol Biol Psychiatry 5(43C):96–107

    Google Scholar 

  • Gelhorn HL, Sakai JT, Price RK, Crowley TJ (2007) DSM-IV conduct disorder criteria as predictors of antisocial personality disorder. Compr Psychiatry 48(6):529–538

    Article  PubMed Central  PubMed  Google Scholar 

  • Grant BF, Stinson FS, Dawson DA, Chou SP, Ruan WJ (2005) Co-occurrence of DSM-IV personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Compr Psychiatry 46(1):1–5

    Article  PubMed  Google Scholar 

  • Gunderson J (2009) Borderline personality disorder: ontogeny of a diagnosis. Am J Psychiatry 166(5):530–539

    Article  PubMed Central  PubMed  Google Scholar 

  • GWAS. Psychiatric GWAS Consortium Coordinating Committee (2009) Genomewide association studies: history, rationale, and prospects for psychiatric disorders. Am J Psychiatry 166:540–556

    Article  Google Scholar 

  • Hare RD, Hart SD, Harpur TJ (1991) Psychopathy the DSM-IV criteria for antisocial personality disorder. J Abnorm Psychol 100(3):391–398

    Article  CAS  PubMed  Google Scholar 

  • Hasin D, Fenton MC, Skodol A, Krueger R, Keyes K, Geier T, Greenstein E, Blanco C, Grant B (2011) Personality disorders and the 3-year course of alcohol, drug, and nicotine use disorders. Arch Gen Psychiatry 68(11):1158–1167

    Article  PubMed Central  PubMed  Google Scholar 

  • Hopley AA, Brunelle C (2012) Personality mediators of psychopathy and substance dependence in male offenders. Addict Behav 37(8):947–955

    Article  PubMed  Google Scholar 

  • Hummelen B, Pedersen G, Karterud S (2012) Some suggestions for the DSM-5 schizotypal personality disorder construct. Compr Psychiatry 53(4):341

    Article  PubMed  Google Scholar 

  • Insel TR, Wang PS (2010) Rethinking mental illness. JAMA 303:1970–1971

    Article  CAS  PubMed  Google Scholar 

  • Jahng S, Solhan MB, Tomko RL, Wood PK, Piasecki TM, Trull TJ (2011) Affect and alcohol use: an ecological momentary assessment study of outpatients with borderline personality disorder. J Abnorm Psychol 120(3):572–584

    Article  PubMed Central  PubMed  Google Scholar 

  • James LM, Taylor J (2007) Impulsivity and negative emotionality associated with substance use problems and Cluster B personality in college students. Addict Behav 32(4):714–727

    Article  PubMed  Google Scholar 

  • Johnson BA, Cloninger CR, Roache JD, Bordnick PS, Ruiz P (2000) Age of onset as a discriminator between alcoholic subtypes in a treatment-seeking outpatient population. Am J Addict 9(1):17–27

    Article  CAS  PubMed  Google Scholar 

  • Khalifa N, Duggan C, Howard R, Lumsden J (2012) The relationship between childhood conduct disorder and adult antisocial behavior is partially mediated by early-onset alcohol abuse. Pers Disord 3:423–432

    Article  Google Scholar 

  • Kuepper R, Morrison PD, van Os J, Murray RM, Kenis G, Henquet C (2010) Does dopamine mediate the psychosis-inducing effects of cannabis? A review and integration of findings across disciplines. Schizophr Res 121(1–3):107–117

    Article  PubMed  Google Scholar 

  • Langås AM, Malt UF, Opjordsmoen S (2011) Comorbid mental disorders in substance users from a single catchment area – a clinical study. BMC Psychiatry 11(25)

    Google Scholar 

  • Lehtonen M, Storvik M, Tupala E, Hyytiä P, Tiihonen J, Callaway JC (2010) Endogenous cannabinoids in post-mortem brains of Cloninger type 1 and 2 alcoholics. Eur Neuropsychopharmacol 20(4):245–252

    Article  CAS  PubMed  Google Scholar 

  • Lev-Ran S, Imtiaz S, Rehm J, Le Foll B (2013) Exploring the association between lifetime prevalence of mental illness and transition from substance use to substance use disorders: results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Am J Addict 22(2):93–98

    Article  PubMed  Google Scholar 

  • Love TM, Stohler CS, Zubieta JK (2009) Positron emission tomography measures of endogenous opioid neurotransmission and impulsiveness traits in humans. Arch Gen Psychiatry 66(10):1124–1134

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Lubman DI, Hall K, Pennay A, Rao S (2011) Managing borderline personality disorder and substance use- an integrated approach. Aust Fam Physician 40(6):376–381

    PubMed  Google Scholar 

  • Ly M, Motzkin JC, Philippi CL, Kirk GR, Newman JP, Kiehl KA, Koenigs M (2011) Cortical thinning in psychopathy. Am J Psychiatry 169(7):743–749

    Article  Google Scholar 

  • Mariani JJ, Horey J, Bisaga A, Aharonovich E, Raby W, Cheng WY, Nunes E, Levin FR (2008) Antisocial behavioral syndromes in cocaine and cannabis dependence. Am J Drug Alcohol Abuse 34(4):405–414

    Article  PubMed Central  PubMed  Google Scholar 

  • Markon KE, Krueger RF (2005) Categorical and continuous models of liability to externalizing disorders: a direct comparison in NESARC. Arch Gen Psychiatry 62(12):1352–1359

    Article  PubMed Central  PubMed  Google Scholar 

  • Miranda R Jr, MacKillop J, Meyerson LA, Justus A, Lovallo WR (2009) Influence of antisocial and psychopathic traits on decision-making biases in alcoholics. Alcohol Clin Exp Res 33(5):817–825

    Article  PubMed Central  PubMed  Google Scholar 

  • Monterrubio S, Solowij N (2006) Chronic stress and adaptation. Am J Psychiatry 163(3):553

    Article  PubMed  Google Scholar 

  • Moss HB, Chen CM, Yi HY (2010) Prospective follow-up of empirically derived Alcohol Dependence subtypes in wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC): recovery status, alcohol use disorders and diagnostic criteria, alcohol consumption behavior, health status, and treatment seeking. Alcohol Clin Exp Res 34(6):1073–1083

    Article  PubMed  Google Scholar 

  • New AS, Stanley B (2010) An opioid deficit in borderline personality disorder: self-cutting, substance abuse and social dysfunction. Editorial. Am J Psychiatry 167(8):882–885

    Article  PubMed  Google Scholar 

  • Nigg JT, Goldsmith HH (1994) Genetic of personality disorders: perspectives from personality and psychopathological research. Psychol Bull 115:346–380

    Article  CAS  PubMed  Google Scholar 

  • Oscar-Berman M, Valmas MM, Sawyer KS, Kirkley SM, Gansler DA, Merritt D, Couture A (2009) Frontal brain dysfunction in alcoholism with and without antisocial personality disorder. Neuropsychiatr Dis Treat 5:309–326

    Article  PubMed Central  PubMed  Google Scholar 

  • Prossin AR, Love TM, Koeppe RA, Zubieta JK, Silk KR (2010) Dysregulation of regional endogenous opioid function in borderline personality disorder. Am J Psychiatry 167(8):925–933

    Article  PubMed  Google Scholar 

  • Pulay AJ, Stinson FS, Ruan WJ, Smith SM, Pickering RP, Dawson DA, Grant BF (2010) The relationship of DSM-IV personality disorders to nicotine dependence-results from a national survey. Drug Alcohol Depend 108(1–2):141–145

    Article  PubMed Central  PubMed  Google Scholar 

  • Raballo A, Parnas J (2011) The silent side of the spectrum: schizotypy and the schizotaxic self. Schizophr Bull 37(5):1017–1026

    Article  PubMed Central  PubMed  Google Scholar 

  • Ruocco AC, Amirthavasagam S, Choi-Kain LW, McMain SF (2013). Neural correlates of negative emotionality in borderline personality disorder: an activation-likelihood-estimation meta-analysis. Biol Psychiatry 15, 73(2):153–156

    Article  Google Scholar 

  • Schiffman J, Nakamura B, Earleywine M, LaBrie J (2005) Symptoms of schizotypy precede cannabis use. Psychiatry Res 134(1):37–42

    Article  PubMed  Google Scholar 

  • Schmahl C, Bohus M, Esposito F, Treede RD, Di Salle F, Greffrath W, Ludaescher P, Jochims A, Lieb K, Scheffler K, Hennig J, Seifritz E (2006). Neural correlates of antinociception in borderline personality disorder. Arch Gen Psychiatry, 63(6):659–667.

    Article  PubMed  Google Scholar 

  • Schreckenberger M, Klega A, Gründer G, Buchholz HG, Scheurich A, Schirrmacher R, Schirrmacher E, Müller C, Henriksen G, Bartenstein P (2008) Opioid receptor PET reveals the psychobiologic correlates of reward processing. J Nucl Med 49(8):1257–1261

    Article  PubMed  Google Scholar 

  • Sebastian A, Jacob G, Lieb K, Tüscher O (2013) Impulsivity in borderline personality disorder: a matter of disturbed impulse control or a facet of emotional dysregulation? Curr Psychiatry Rep 15(2):339

    Article  PubMed  Google Scholar 

  • Skodol AE, Bender DS, Oldham JM (2009) Future directions: toward DSM-V. In: Oldham J, Skodol AE, Bender DS (eds) Essential of personality disorders. American Psychiatric Publishing, Washington, DC, pp 381–392

    Google Scholar 

  • Spreckelmeyer KN, Paulzen M, Raptis M, Baltus T, Schaffrath S, Van Waesberghe J, Zalewski MM, Rösch F, Vernaleken I, Schäfer WM, Gründer G (2011) Opiate-induced dopamine release is modulated by severity of alcohol dependence: an [(18)F] fallypride positron emission tomography study. Biol Psychiatry 70(8):770–776

    Article  CAS  PubMed  Google Scholar 

  • Stanley B, Siever LJ (2010) The interpersonal dimension of borderline personality disorder: toward a neuropeptide model. Am J Psychiatry 167(1):24–39

    Article  PubMed Central  PubMed  Google Scholar 

  • Stein DJ, van Honk J, Ipser J, Solms M, Panksepp J (2007) Opioids: from physical pain to the pain of social isolation. CNS Spectr 12(9):669–670, 672–4

    PubMed  Google Scholar 

  • Szerman N, Martinez-Raga J, Peris L, Roncero C, Basurte I, Vega P, Ruiz P, Casas M (2013) Rethinking dual disorders/pathology. Addict Disord Treat 12(1):1–10

    Article  Google Scholar 

  • Trull TJ, Sher KL, Minks-Brown C, Durbin J, Burr R (2000) Borderline personality disorder and substance use disorders: a review and integration. Clin Psychol Rev 20(2):235–253

    Article  CAS  PubMed  Google Scholar 

  • Tuominen L, Salo J, Hirvonen J, Någren K, Laine P, Melartin T, Isometsä E, Viikari J, Raitakari O, Keltikangas-Järvinen L, Hietala J (2012) Temperament trait harm avoidance associates with μ-opioid receptor availability in frontal cortex: a PET study using [(11)C] carfentanil. Neuroimage 61(3):670–676

    Article  CAS  PubMed  Google Scholar 

  • Verheul R, van den Bosch LMC, Ball SA (2009) Substance abuse. In: Oldham J, Skodol AE, Bender DS (eds) Essential of personality disorders. American Psychiatric Publishing, Washington, DC, pp 361–380

    Google Scholar 

  • Volkow ND, Tomasi D, Wang GJ, Fowler JS, Telang F, Goldstein RZ, Alia-Klein N, Woicik P, Wong C, Logan J, Millard J, Alexoff D (2011) Positive emotionality is associated with baseline metabolism in orbitofrontal cortex and in regions of the default network. Mol Psychiatry 16(8):818–825

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Walter M, Gunderson JG, Zanarini MC, Sanislow CA, Grilo CM, McGlashan TH, Morey LC, Yen S, Stout RL, Skodol AE (2009) New onsets of substance use disorders in borderline personality disorder over 7 years of follow-ups: findings from the Collaborative Longitudinal Personality Disorders Study. Addiction 104(1):97–103

    Article  PubMed Central  PubMed  Google Scholar 

  • Winhusen TM, Somoza EC, Lewis DF, Kropp FB, Horigian VE, Adinoff B (2013) Frontal systems deficits in stimulant-dependent patients: evidence of pre-illness dysfunction and relationship to treatment response. Drug Alcohol Depend 127:94–100

    Article  PubMed Central  PubMed  Google Scholar 

  • Witkiewitz K, King K, McMahon RJ, Wu J, Luk J, Bierman KL, Coie JD, Dodge KA, Greenberg MT, Lochman JE, Pinderhughes EE, Conduct Problems Prevention Research Group (2013) Evidence for a multi-dimensional latent structural model of externalizing disorders. J Abnorm Child Psychol 41(2):223–237

    Article  PubMed Central  PubMed  Google Scholar 

  • Woodward ND, Cowan RL, Park S, Ansari MS, Baldwin RM, Li R, Doop M, Kessler RM, Zald DH (2011) Correlation of individual differences in schizotypal personality traits with amphetamine-induced dopamine release in striatal and extrastriatal brain regions. Am J Psychiatry 168:418–426

    Article  PubMed Central  PubMed  Google Scholar 

  • Zamberletti E, Rubino T, Parolaro D (2012) The endocannabinoid system and schizophrenia: integration of evidence. Curr Pharm Des 18(32):4980–4990

    Article  CAS  PubMed  Google Scholar 

  • Zanarini MC, Frankenburg FR, Weingeroff JL, Reich DB, Fitzmaurice GM, Weiss RD (2011) The course of substance use disorders in patients with borderline personality disorder and Axis II comparison subjects: a 10-year follow-up study. Addiction 106(2):342–348

    Article  PubMed Central  PubMed  Google Scholar 

  • Zimmerman M, Rothchild L, Chelminski I (2005) The prevalence of DSM-IV personality disorders in psychiatric outpatients. Am J Psychiatry 162:1911–1918

    Article  PubMed  Google Scholar 

  • Zimmerman M, Chelminski I, Young D, Dalrymple K, Martinez J (2011) Does DSM-IV already capture the dimensional nature of personality disorders? J Clin Psychiatry 2011(72):1333–1339

    Article  Google Scholar 

  • Zubieta JK, Ketter TA, Bueller JA, Xu Y, Kilbourn MR, Young EA, Koeppe RA (2003) Regulation of human affective responses by anterior cingulate and limbic mu-opioid neurotransmission. Arch Gen Psychiatry 60(11):1145–1153

    Article  CAS  PubMed  Google Scholar 

  • Zubieta JK, Smith YR, Bueller JA, Xu Y, Kilbourn MR, Jewett DM, Meyer CR, Koeppe RA, Stohler CS (2001) Regional mu opioid receptor regulation of sensory and affective dimensions of pain. Science 13, 293(5528):311–315

    Article  CAS  Google Scholar 

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Szerman, N., Peris, L. (2015). Personality Disorders and Addiction Disorders. In: el-Guebaly, N., Carrà, G., Galanter, M. (eds) Textbook of Addiction Treatment: International Perspectives. Springer, Milano. https://doi.org/10.1007/978-88-470-5322-9_120

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