Several studies indicate the correlation between disorders associated with substance abuse and personality disorders. The prevalence of personality disorders depends on the drugs being analyzed. The behaviors that are most affiliated with personality disorders include hysterical, antisocial, dependent, obsessive-compulsive, avoidant and paranoid (Verheul & Brink, 2007). The increase in the co-occurrence rate between substance use disorders and personality disorders imply that there is a causal association between the two conditions. Various research studies indicate the causality whereby personality characteristics result in the occurrence of substance abuse disorders (Verheul & Brink, 2007). Also, existing data highlight a heuristic model on three developmental methods that include reduction of stress, reward sensitivity, and behavioral disinhibition. It is perceived that personality pathology can be viewed as a transformer of treatment reactions, symptoms, the development of a substance abuse disorder and the outcome and hence illustrate a significant connection between personality disorders and substance abuse disorders. Verheul and Brink (2007) state, This possibility does not involve a causal relationship but may have important implications for treatment planning. The analysis entails a literature review on the current psychological studies and literature on substance addiction and comorbidities with personality disorders focusing on borderline personality disorder and narcissistic personality disorder.
Borderline Personality disorder
Borderline personality disorder is described as a severe and complex mental problem that includes various symptoms in addition to maladaptive behavior. According to the description by the DSM-V borderline personality disorder, the condition is A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts. The DSM-V suggest particular symptoms that should be present for one to be diagnosed with the conditions by which the presence of five or more symptoms imply that one has the condition. They include; immense efforts to prevent being abandoned, a sequence of bad interpersonal relationships that include an alternation between devaluation and idealism extremes, disturbance of identity, impulsivity in two self-damaging areas such as sex and substance abuse, frequent suicidal tendencies, affective instability, long-lasting emotions on emptiness, immense anger and paranoid ideation which is related to stress. The name emanates from the view that the illness is between neurotic and psychotic mental issues. It is mainly characterized by efforts to prevent abandonment, plenty of problems in relationships, management of behavior and emotions, self-identity in addition to suicidal tendencies. Individuals suffering from borderline personality disorder tend to have mental problems and more personality disorders in addition to alcohol and other forms of substance abuse. Be that as it may, their condition has effective treatments which easily manage the condition.
Narcissistic Personality disorder
Narcissistic personality disorder refers to a mental condition whereby people tend to exhibit an exaggerated sense of self, a high desire for admiration from others in addition to not empathizing with others (Vaglum, 1999). Nonetheless, the exaggeration of a sense of self-masks a naive self-esteem which can be easily put down by any form of criticism. According to the DSM V, The vital components of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits.
Links and causes between substance addiction and comorbidity with borderline personality disorder and narcissistic personality disorder
Personality disorders are mental illnesses in which a persons emotions, behavior, and thoughts differ drastically from cultural and social norms (Verheul, 2007). These disorders often occur together with substance use disorders. In fact, a lot of studies have been done to establish the connection between individuals who have personality disorders and those who abuse alcohol and drugs. Based on the individuals studied, the findings of these studies revealed that there is a 55 percent to 80 percent chance that alcohol or a drug addict is likely to suffer one or multiple personality disorders. Moreover, a comprehensive research was done on people who abuse both alcohol and cocaine, and it was found that 15% of them were narcissistic, 11% percent had borderline personality disorder, and approximately 20 percent were antisocial (Dehghani-Arani, 2016). But which one comes first is it the substance abuse or the personality disorder? Well, I believe it depends on the person involved. A substance addict will often medicate himself/herself in an attempt to stabilize his/her emotional condition. On the other hand, excessive substance abuse can distort the brain chemistry to the extent that it triggers the occurrence of a personality disorder (Genetics of Addiction, 2017). In both scenarios, it is essential to treat both the personality disorder and substance abuse to ensure full recovery of the patient. According to Levin (2014), personality disorders are some of the factors that cause alcohol abuse in adolescents and not the other way round. He explained that approximately 90 percent of people who had been diagnosed with personality disorders had used alcohol in the previous year before the research was conducted. He also adds that there was some convincing evidence showing that individuals who suffered from borderline personality disorder were also alcohol addicts. It is vital to clarify that alcohol and drugs do not necessarily cause personality disorder, however, substance abuse is closely related to personality disorders.
According to Moller (2012), about two-thirds of people with borderline personality disorder abuse alcohol, drugs or both. Individuals with borderline personality disorder usually have unregulated emotions and intense and unstable relationships. Personality and substance abuse disorders are connected in multiple ways. In fact, it is possible that genetic components that promote alcohol and drug addiction also inspire the development of personality disorders. There are high chances that the psychological trauma encountered by a lot of people with personality disorder results to a higher rate of drug addiction and alcoholism (Mulder, 2009). This is because substance abuse tends to reduce the anxiety, emotional pain, and distress of personality disorders. For instance, individuals with borderline personality disorder may want to get intoxicated as a way of filling the sense of emptiness they feel or even as means of self-destruction (Newton-Howes, 2014).
Based on Murray (1988) findings, personality disorders increase the risk of substance abuse. However, different personality disorders have different risk levels. However, in this article, we are concerned with two types of personality disorders: the narcissism and the borderline personality disorder. People with narcissistic personality disorder feel a great sense of importance and they thrive on the admiration and praise of others (Ronningstam, 2011). They have an inflated opinion of their positive abilities. Even though they may be highly intelligent, beautiful and talented, most narcissists see themselves as exceptional compared to everyone else. However, narcissists are specifically vulnerable to depression if their world crumbles. In events where things get out of hand, and they hit rock bottom, that is when depression hits them very hard. This may result to self-medicating with drugs or alcohol and can also lead to suicidal actions and thoughts. In general, we notice that there is a very close relationship between substance addiction and the borderline and narcissistic personality disorders. That is, substance addiction may result to a personality disorder, and a personality disorder may lead to substance addiction (Stone, 2005).
The gaps in the current research
A lot of studies have been conducted to establish the relationship between substance addiction and personality disorders, and indeed significant progress has been made regarding the creation of effective therapies. However, I strongly believe that the research has not been able to determine the nature of the addictive personality. An addictive personality is a collection of personality features that make a person more prone to develop addictions to alcohol, drugs or other habit-forming behaviors (Davis, 2016). A lot of addictive personalitys traits are commonly seen in individuals with substance addiction. Although this disorder is a common concept, little has been done scientifically or medically to determine its impacts on the well-being of an individual. Addiction can be influenced by several aspects in ones life including family, social environment, biology, and psychology. Some of the personality traits that result to addiction include sensation-seeking behavior, impulsivity, neuroticism, negative urgency, aggression, narcissism, disagreeableness, and the negative effect. Therefore, more studies need to be conducted in this particular field to determine the connection between substance addiction and addictive personality disorder since little is known about this disorder.
Limitations of the current research
The main challenge facing the researchers is the nature of the personality disorder. For instance, the Borderline personality disorder is a severe and complex psychiatric disorder characterized by impulse control, self-image, pervasive instability in the regulation of emotion and interpersonal relationships. Although borderline personality disorder is usually studied in clinical settings, there is insufficient information about its comorbidity, prevalence, disability, and correlates in general population samples (Widiger, 2000). Lack of detailed and comprehensive information on Narcissistic and Borderline personality disorder represents a gap in our knowledge relevant to treatment, prevention, and economic costs. Because of these flaws, researchers have little information about comorbidity and socio-demographic characteristics of Borderline personality disorder with other disorders. Moreover, a lot of studies were restricted to specific geographical locations.
Significance of the links and areas of future research
It is essential to understand the links between substance addiction and personality disorders because there are multiple stages to the treatment of substance abuse and personality disorders. Moreover, substance addiction together with other personality disorder can be lethal since the victims are more likely to be impulsive and suicidal. Personality traits or Behavioral tendencies such as sensation-seeking and impulsivity have been linked with several substance-use disorder such as tobacco, alcohol, cocaine, and opiates. These links also enable us to understand that the substance addiction occurs when people are unable to manage some drugs they introduce into their bodies. A large number of people entering both personality disorder and substance addiction treatment programs indicate that indeed there is a co-occurring disorder. To further improve our current understanding of causes and links between substance addiction and comorbidity with narcissistic and borderline personality disorders, it is vital that more research on the prevalence of these personality disorders be conducted. Treating and diagnosing these disorders may be an uphill task, however researchers are required to utilize the current facilities that provide a dual diagnosis for s...
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