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Transdiagnostic Impulsivity-Relevant Phenotypes and the Comorbidity of Personality Disorders with Substance and Alcohol Use Disorders

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Abstract

Purpose of Review

Personality disorders (PDs) are frequently comorbid with substance use disorders (SUDs) including alcohol use disorder (AUD), but the factors explaining their comorbidity are not yet fully understood. This article reviews recent research on the co-occurrence of PD and SUD/AUD and discusses how contemporary research on impulsivity-related personality and psychopathology dimensions might partially account for their high comorbidity.

Recent Findings

Comorbidity between PDs and SUDs/AUD is substantial across population-based and clinical studies and is most apparent in Cluster B PDs. Studies of trait-based impulsivity suggest this comorbidity may be partly explained by UPPS-P model of impulsivity factors (e.g., negative urgency). Research consistent with the Hierarchical Taxonomy of Psychopathology suggests that impulsivity-relevant psychopathology dimensions, including broader symptom domains (e.g., disinhibited externalizing) and narrower symptom components and maladaptive traits (e.g., risk-taking, delay-discounting), contribute to PD and SUD/AUD comorbidity.

Summary

Impulsive personality traits and psychopathology dimensions partially account for the high comorbidity between PD and SUD/AUD diagnoses.

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Notes

  1. In this article, we use the term “substance use disorder” broadly to include alcohol and other substances, and we distinguish among the substances, where relevant.

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Funding

JWK is supported by a Graduate Grant from the Branch Out Neurological Foundation.

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Authors and Affiliations

  1. Department of Psychological Clinical Science, University of Toronto, Toronto, Canada

    Jacob W. Koudys, Cody Cane & Anthony C. Ruocco

  2. Department of Psychiatry, University of Toronto, Toronto, Canada

    Yuliya S. Nikolova & Anthony C. Ruocco

  3. Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Canada

    Yuliya S. Nikolova & Anthony C. Ruocco

  4. Department of Psychology, University of Toronto Scarborough, Toronto, Canada

    Anthony C. Ruocco

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Koudys, J.W., Cane, C., Nikolova, Y.S. et al. Transdiagnostic Impulsivity-Relevant Phenotypes and the Comorbidity of Personality Disorders with Substance and Alcohol Use Disorders. Curr Addict Rep 10, 122–130 (2023). https://doi.org/10.1007/s40429-023-00483-6

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