Substance Use in Association with Personality Disorder Traits and the Effects Mediated by Dysfunctional Coping and Sensation Seeking - Abstract
Many research findings link personality disorders (PDs) with substance use. Another line of evidence relates PDs to sensation seeking and dysfunctional coping. We analysed data from 511 participants, aged 20 to 41 years, in the ZInEP Epidemiology Survey, a comprehensive survey of the general population of Zurich, Switzerland. A series of bivariate generalised linear models revealed that smoking, quantity of alcohol use, cannabis use and other drug use were substantially associated with paranoid, schizotypal, antisocial, borderline, and histrionic PDs. In a multivariate path analysis adjusted for sensation seeking and dysfunctional coping, smoking was mainly associated with borderline PD. Frequency and quantity of alcohol use as well as drug use were uniquely related to sensation seeking. Sensation seeking was mainly predicted by antisocial PD and dysfunctional coping by borderline PD. Sensation seeking was a significant mediator of associations between substance use and cluster B PDs, in particular of antisocial PD. PDs and substance use are consistently associated. Sensation seeking was substantially involved in substance use and cluster B PDs and a strong mediator particularly of antisocial PD. We suggest that impulsivity and disinhibition are the main processes underlying this association and hypothesise that the dopaminergic neurocircuitry plays a major role.