Personality Traits among the Various Profiles of Substance Use Disorder Patients: New Evidence Using the DSM-5 Section III Framework

Background: The specialized literature provides solid evidence that substance use disorders (SUD) and personality disorders (PD) are interrelated. Given the relative novelty of the Alternative Model for PD, there are still few studies that have analyzed the relationship between the different facets, substance use disorder, and the various consumption profiles. Objective: This paper analyzes the relationship between the facets of the Alternative Model for PD and different substance use disorder profiles, using the facet scores obtained in a sample of substance use disorder patients and comparing these with normative scores. A comparison is also conducted between types of patients. Method: The Personality Inventory for DSM-5-SF was administered to a sample of 289 patients diagnosed with SUD who began treatment for alcohol (ALC), cannabis (CAN), cocaine (COC), or heroin (HER) use disorder. A latent class analysis was conducted and scores obtained for each of the classes were compared with normative scores. Logistic regression analyzes were carried out to determine which facets and domains show the greatest explanatory capacity of belonging to each latent class. Results: Four patient profiles were identified on the basis of their SUD: polydrug use (POLY), COC-HER, ALC, and CAN. When comparing the groups with the normative population, POLY presented higher scores on all the domains, COC-HER and ALC on all domains except antagonism, and CAN showed higher scores on detachment and psychoticism. The CAN cluster presented lower scores than the other 3 groups in different domains. No statistically significant differences were observed on any domain between the groups POLY and COC – HER, while differences were found between the classes POLY and ALC for the detachment domain. Conclusions: The results help to identify the personality profiles associated with various SUD profiles. In particular, patients from the groups POLY, COC-HER, and ALC present high scores on pathological facets related to borderline PD and schizotypal PD (all 3), and antisocial PD (POLY), while the CAN cluster is more normalized and its pathological facets are related to the schizotypal PD. Patients with POLY have a greater tendency toward pathological personality, with the involvement of a large number of facets, while COC-HER and ALC show a slightly less severe profile, and CAN users are characterized by lower scores, but high detachment and psychoticism.