Psychoticism and neuroticism predict cocaine dependence and future cocaine use via different mechanisms

Abstract Background Personality characteristics have been associated with cocaine use. However, little is known about the mechanisms through which personality could impact drug use. The present study investigated the cross-sectional and prospective relationships between personality dimensions (i.e., impulsivity, neuroticism) and problematic cocaine use. Reactivity to a pharmacological stressor as a potential mediator of the relationship between neuroticism and future cocaine use was also examined. Methods Participants were 53 cocaine-dependent individuals and 47 non-dependent controls. Subjects completed the Eysenck Personality Questionnaire (EPQ) at baseline and were administered i.v. corticotrophin releasing hormone (CRH; 1 μg/kg). Cocaine use in the 30 days following CRH administration was measured. Results Cocaine-dependent individuals had higher scores on the psychoticism (i.e., impulsivity, aggression; p = 0.02) and neuroticism ( p < 0.01) scales of the EPQ than non-dependent controls. Cocaine-dependent individuals also had a greater subjective stress response to CRH than controls ( p < 0.01). Cocaine-dependent individuals with elevated psychoticism used significantly more cocaine over the follow-up period ( p < 0.05), whereas individuals with elevated neuroticism trended towards using cocaine more frequently over the follow-up ( p = 0.07). Finally, there was a trend for an indirect effect of neuroticism on frequency of cocaine use through subjective reactivity to CRH. Conclusions The findings extend past research on the association between personality and cocaine use, and suggest that motives for cocaine use may systematically vary across personality characteristics. Moreover, tailoring therapeutic interventions to individuals’ personalities may be an area that warrants further investigation.