		Thomas S. May, M.A. Medical Writer
Home Portfolio Contact		Born to be High: Are Some People Destined to Become Addicts? *By Thomas S. May, Medical Writer* Jonathan Hall (not his real name) is a stocky man in his early thirties. He admits, with a smile on his face, that he can't resist temptation. He smokes at least one pack of cigarettes a day, and he can hardly wait to down a few glasses of his favorite Scotch after getting home from work. Jonathan also likes to light up a joint once or twice a month, and he doesn't deny having tried harder drugs like heroin and cocaine. His brother Steven, on the other hand, is repulsed by the smell of smoke, and the hardest drug he has ever tried was a small glass of champagne, which he drank at his brother's wedding. What makes these two men behave so differently? Obviously, they have different personalities, but can drug addiction be blamed on personality alone? Is there such a thing as an addiction-prone or addictive personality? Although most experts agree that there is no such psychiatric illness as an "addictive personality disorder," recent research indicates that there are certain personality characteristics that make it easier for some people to become addicted to drugs. No Evidence for "Addictive Personality" It is common knowledge that some types of addictions tend to occur together, within the same individuals. For example, heavy drinkers are also likely to be smokers, and they are often addicted to other drugs as well. Furthermore, many studies have found that there is an increased prevalence of psychiatric disorders among drug addicts. Specifically, drug abusers are often diagnosed with one or more personality disorders such as antisocial, narcissistic, or avoidant personality disorder. What complicates matters, however, is that different addicts have different personality disorders and many of them have none at all. As a result, most experts now agree that there is no single "addictive personality," which might predispose a person to abuse alcohol or other drugs. "There is not much evidence for a general addiction-prone personality," says Paul Rozin, PhD, a professor of psychology at the University of Pennsylvania. Patricia Conrod, PhD, a clinical psychologist and addiction expert at State University of New York at Stony Brook agrees: "The notion of the 'addictive personality' derived from psychoanalytic theory and was the dominant hypothesis for much of the first part of the [twentieth] century," she says. "However, extensive research in the 1970s and 1980s focusing on identification of the 'addictive personality' failed to provide support for a single predisposing personality type," Dr. Conrod explains. Some are more Susceptible than Others Although most experts agree that an "addictive personality disorder" does not exist, researchers have recently been able to identify certain personality characteristics that may contribute to the development of some addictions. "A number of personality risk factors for drug abuse have been identified, and a recent trend in this field is to investigate how different personality traits are associated with different reasons for drug use and abuse," according to Dr. Conrod. "Anxiety sensitivity, impulsivity, sensation seeking, introversion, and interpersonal sensitivity have all been shown to be associated with increased risk for one type of drug abuse pattern or another," she says. In a study published in the Psychology of Addictive Behaviors (September 2000), Dr. Conrod and her colleagues examined the personality characteristics of 293 substance-abusing women. The investigators found that the women were addicted to different kinds of drugs depending on their dominant personality traits. For example, "impulsivity" was associated with cocaine and alcohol dependence, "sensation seeking" was associated with exclusive alcohol dependence, and "the anxiety-sensitive subtype demonstrated greater lifetime risk for anxiolytic [anxiety-reducing] drug dependence." Three Paths to Addiction The above findings by Dr. Conrod and her colleagues appear to provide support for a theory of addiction proposed by Roel Verheul, PhD, a clinical psychologist with the Amsterdam Institute for Addiction Research in the Netherlands. In a recently published article, Dr. Verheul suggests that there are at least three different paths through which pathological personality characteristics can contribute to the development of addictions. He refers to the three pathways as the "behavioral disinhibition pathway," the "stress reduction pathway," and the "reward sensitivity pathway." The behavioral disinhibition pathway to addiction involves people "scoring high on traits such as antisociality and impulsivity, and low on constraint or harm avoidance." These individuals are often diagnosed with "antisocial personality disorder" or "borderline personality disorder," and they have "lower thresholds to deviant behaviors" in general, including alcohol and drug abuse, Dr. Verheul writes. The stress reduction pathway to addiction is associated with people "scoring high on traits such as stress reactivity, anxiety sensitivity, and neuroticism." These individuals may be diagnosed as having "avoidant," or "schizotypal" personality disorder, according to Dr. Verheul, and they are at high risk of abusing alcohol, heroin, and/or prescription drugs, especially tranquilizers. Finally, the reward sensitivity pathway involves people scoring high on traits such as novelty seeking, reward seeking, and extraversion. These individuals are sometimes diagnosed with "histrionic" or "narcissistic" personality disorder, and they are at an increased risk of becoming addicted to alcohol, as well as stimulants like cocaine and amphetamines," Dr. Verheul argues. Although he believes that certain personality characteristics may predispose some people to become addicted to drugs, Dr. Verheul points out that many people "become addicted for other reasons and do not display any of the personality traits mentioned above." He also says that nobody is "destined" to become an addict--even if he or she has some of the above mentioned personality traits. Home Portfolio Contact

Thomas S. May, M.A.

Medical Writer

Born to be High: Are Some People Destined to Become Addicts?

By Thomas S. May, Medical Writer

Jonathan Hall (not his real name) is a stocky man in his early thirties. He admits, with a smile on his face, that he can't resist temptation. He smokes at least one pack of cigarettes a day, and he can hardly wait to down a few glasses of his favorite Scotch after getting home from work. Jonathan also likes to light up a joint once or twice a month, and he doesn't deny having tried harder drugs like heroin and cocaine.

His brother Steven, on the other hand, is repulsed by the smell of smoke, and the hardest drug he has ever tried was a small glass of champagne, which he drank at his brother's wedding.

What makes these two men behave so differently? Obviously, they have different personalities, but can drug addiction be blamed on personality alone? Is there such a thing as an addiction-prone or addictive personality?

Although most experts agree that there is no such psychiatric illness as an "addictive personality disorder," recent research indicates that there are certain personality characteristics that make it easier for some people to become addicted to drugs.

No Evidence for "Addictive Personality"

It is common knowledge that some types of addictions tend to occur together, within the same individuals. For example, heavy drinkers are also likely to be smokers, and they are often addicted to other drugs as well.

Furthermore, many studies have found that there is an increased prevalence of psychiatric disorders among drug addicts. Specifically, drug abusers are often diagnosed with one or more personality disorders such as antisocial, narcissistic, or avoidant personality disorder.

What complicates matters, however, is that different addicts have different personality disorders and many of them have none at all. As a result, most experts now agree that there is no single "addictive personality," which might predispose a person to abuse alcohol or other drugs.

"There is not much evidence for a general addiction-prone personality," says Paul Rozin, PhD, a professor of psychology at the University of Pennsylvania.

Patricia Conrod, PhD, a clinical psychologist and addiction expert at State University of New York at Stony Brook agrees:

"The notion of the 'addictive personality' derived from psychoanalytic theory and was the dominant hypothesis for much of the first part of the [twentieth] century," she says. "However, extensive research in the 1970s and 1980s focusing on identification of the 'addictive personality' failed to provide support for a single predisposing personality type," Dr. Conrod explains.

Some are more Susceptible than Others

Although most experts agree that an "addictive personality disorder" does not exist, researchers have recently been able to identify certain personality characteristics that may contribute to the development of some addictions.

"A number of personality risk factors for drug abuse have been identified, and a recent trend in this field is to investigate how different personality traits are associated with different reasons for drug use and abuse," according to Dr. Conrod. "Anxiety sensitivity, impulsivity, sensation seeking, introversion, and interpersonal sensitivity have all been shown to be associated with increased risk for one type of drug abuse pattern or another," she says.

In a study published in the Psychology of Addictive Behaviors (September 2000), Dr. Conrod and her colleagues examined the personality characteristics of 293 substance-abusing women. The investigators found that the women were addicted to different kinds of drugs depending on their dominant personality traits. For example, "impulsivity" was associated with cocaine and alcohol dependence, "sensation seeking" was associated with exclusive alcohol dependence, and "the anxiety-sensitive subtype demonstrated greater lifetime risk for anxiolytic [anxiety-reducing] drug dependence."

Three Paths to Addiction

The above findings by Dr. Conrod and her colleagues appear to provide support for a theory of addiction proposed by Roel Verheul, PhD, a clinical psychologist with the Amsterdam Institute for Addiction Research in the Netherlands.

In a recently published article, Dr. Verheul suggests that there are at least three different paths through which pathological personality characteristics can contribute to the development of addictions. He refers to the three pathways as the "behavioral disinhibition pathway," the "stress reduction pathway," and the "reward sensitivity pathway."

The behavioral disinhibition pathway to addiction involves people "scoring high on traits such as antisociality and impulsivity, and low on constraint or harm avoidance." These individuals are often diagnosed with "antisocial personality disorder" or "borderline personality disorder," and they have "lower thresholds to deviant behaviors" in general, including alcohol and drug abuse, Dr. Verheul writes.

The stress reduction pathway to addiction is associated with people "scoring high on traits such as stress reactivity, anxiety sensitivity, and neuroticism." These individuals may be diagnosed as having "avoidant," or "schizotypal" personality disorder, according to Dr. Verheul, and they are at high risk of abusing alcohol, heroin, and/or prescription drugs, especially tranquilizers.

Finally, the reward sensitivity pathway involves people scoring high on traits such as novelty seeking, reward seeking, and extraversion. These individuals are sometimes diagnosed with "histrionic" or "narcissistic" personality disorder, and they are at an increased risk of becoming addicted to alcohol, as well as stimulants like cocaine and amphetamines," Dr. Verheul argues.

Although he believes that certain personality characteristics may predispose some people to become addicted to drugs, Dr. Verheul points out that many people "become addicted for other reasons and do not display any of the personality traits mentioned above." He also says that nobody is "destined" to become an addict--even if he or she has some of the above mentioned personality traits.

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