Addressing Personality Disorders and Co-occurring Substance Abuse

There is much evidence to suggest that personality disorders and substance abuse are interconnected, though it can often be challenging to discern which condition came first.

Substance use disorders and personality disorders

Plenty of research has shown a strong correlation between substance use disorders and personality disorders. 

However, since the risk factors and causes of substance use disorders are so diverse, it is often hard to tell whether one illness triggers the other or not.

This article will explore the definition of personality disorders and how such disorders might get linked to addiction and substance abuse.

What is the definition of personality disorders?

Broadly, personality disorders are mental disorders that affect a person’s emotions, thoughts and behaviour.

Such personality traits widely differ from cultural norms and societal expectations. 

As a result, people diagnosed with a personality disorder think, feel and act entirely differently from those who do not have the condition.

Personality disorder complications

Personality disorders can cause severe problems and complications – affecting an individual’s relationships, work, and overall quality of life. Essentially, personality disorders are a group of mental illnesses that involve chronic patterns of destructive thoughts and behaviours that are unhealthy and inflexible.

Personality disorder types

According to the fifth edition of the diagnostic and statistical manual (DSM -5), there are ten personality disorders and three different subcategories or ‘’clusters’’ belonging to each condition.

For example, each personality disorder type belongs to its cluster, i.e. clusters A, B, and C.

Personality disorder clusters

Personality disorders have specific characteristics that allow mental health professionals to diagnose people accurately. Such conditions get categorised into the following three clusters:

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Cluster A personality disorder types:

  • Paranoid personality disorder: people with this disorder exhibit unfounded trust and are highly suspicious of others
  • Schizoid personality disorder: involves having an indifferent attitude toward other people and social withdrawal or isolation.
  • Schizotypal personality disorder: features irregular routine and lifestyle patterns and significant difficulties in relationships

Cluster B personality disorder types:

  • Antisocial personality disorder: personality characteristics involve the propensity to exploit or violate other peoples’ rights and manipulative behaviours
  • Borderline personality disorder: an individual with a borderline personality disorder may experience turbulent and unstable emotions, behaviours and relationships.
  • Histrionic personality disorder: a person diagnosed with histrionic personality disorder usually displays emotional or dramatic behaviours to draw attention to the self
  • Narcissistic personality disorder: perhaps the most popular personality disorder in pop culture, someone with a narcissistic personality disorder usually possesses an inflated ego and a profound obsession with the self.

Cluster C personality disorder types: 

  • Avoidant personality disorder: personality characteristics associated with avoidant personality disorder are profound shyness, fear of rejection and inadequacy
  • Dependent personality disorder: a person with a dependent personality disorder is highly reliant on others and dislikes being alone. Other features marked by this disorder are a deep fear of abandonment and idealisation toward caregivers. 
  • Obsessive-compulsive personality disorder: this disorder primarily features a need for control, rules and orderliness

Varying symptoms

It is common for people diagnosed with any of the above personality disorders to experience varying symptoms.

For example, some people may experience severe personality disorder symptoms, whereas others may only experience minor difficulties.

Typically, people with a personality disorder appear on various ends of the spectrum. 

Their lives are either drastically impacted by the condition or only minimally impacted; it can be challenging to predict how someone will be affected.

Personality disorder and substance abuse statistics

Plenty of statistics illustrate a strong correlation between substance abuse and personality disorders.

Much of the data and samples studied show a direct association between personality disorders and substance addiction.

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For example, one study showed a 50 – 75% chance that an alcoholic or drug addict will also suffer from one or more personality disorders.

Interestingly, the same study showed that certain personality traits associated with these afflictions could be observed in an individual while in adolescence.

However, the researchers noted that personality traits could be challenging to differentiate, particularly in young adults or teenagers. 

It can be hard to discern between typical teenage traits or prevalent symptoms linked to substance abuse and personality disorders.

Personality disorders linked to specific drug use

Other studies examined personality disorders that may get linked to taking a particular substance. 

For example, some personality disorders have been connected to an increased risk of drug abuse.

Alcohol abuse and obsessive-compulsive personality disorder

One study examined people diagnosed with obsessive-compulsive personality disorder and found that 28.0% were alcohol dependent.

Cocaine and alcohol abuse

Another study looked at people who abuse drugs like alcohol and cocaine and found that:

  • 14.5% of the sample studied were narcissistic
  • 11.3% had received a diagnosis of borderline personality disorder
  • 21% had received a diagnosis of antisocial personality disorder
Personality Disorders and Co-occurring Substance Abuse

Teenagers and young adults

It can be challenging for researchers and mental health professionals to determine whether personality disorders cause substance abuse or the other way around, especially in teenagers and young adults.

It is not uncommon for teenagers and young adults to demonstrate specific characteristics and traits as they develop into adulthood.

For example, traits like rebelliousness and impulsivity are common characteristics in teenagers, particularly in times of stress, like exam time.

The above traits may also get linked to substance abuse like drug-taking and alcohol consumption.

Conduct disorder

Some research shows that conduct disorder may be associated with a higher risk of addiction and substance abuse in teenagers and young adults.

A fascinating component of the literature illustrated that personality disorders in teenagers were more likely to result in alcohol abuse than the other way around.

For instance, 38% of the studied sample with personality disorders admitted consuming alcohol regularly. 

In comparison, 92% diagnosed with a personality disorder had consumed alcohol the year before the study.

Antisocial and borderline personality disorders

Researchers noted that personality disorders such as antisocial and borderline are strongly correlated to a higher risk of alcohol abuse.

Substance abuse and concurrent disorders

Researchers found a direct correlation between patients with substance use disorders and at least one co-occurring personality disorder. 

Statistics for patients with concurrent disorders were anywhere between 65 – 90%.

Additionally, there is a significant overlap between cluster C disorders and alcohol dependence.

For people diagnosed with cluster B personality disorders, illicit drugs like cocaine were prevalent for people in this group.

Cluster B personality traits and illicit drug-taking

Researchers explain that cluster B patients are more likely to engage in illicit drug abuse due to their condition.

For example, those with cluster B personality disorders are prone to act compulsively, a risk factor in developing substance abuse and addiction.

Much research and data suggest that alcohol and drug abuse do not cause personality disorders. 

Still, addiction is a profound factor in developing some personality disorders.

Support and guidance

If you think you may have any of the signs and symptoms mentioned in this article, help and support are available.

At Camino Recovery, we treat various personality disorders and substance and behavioural addictions. 

Our specialist team recognises the profound link between substance abuse and mental health disorders such as depression, anxiety, personality disorders and trauma.

The first step to getting proper treatment is always the hardest but worth it in the long – run. 

Contact the Camino Recovery team today to begin your transformation.

David Scourfield

David Scourfield is a Camino Recovery team member since 2017, focused on facilitating communication with Clinical and other professionals to ensure a comprehensive understanding of Camino's program.

Combining his marketing skills and lived experiences, he joined Camino in 2017, contributing to external publications and the Camino website. With a strong belief in solidarity during the recovery process, David helps clients build support networks by connecting them with others in recovery.

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