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AFFECTIV TEMPERAMENTS AND PERSONALIY TRAITS IN ADDICT SUBJECTS

Alexander KELEMEN 1

Maria PUSCHITA Delia PODEA

ABSTRACT Drug abuse is a phenomenon that can be found in almost all studied societies from

antiquity to nowadays. Much of the designed literature has described personality disorder constructs for addict subjects (Vincent, 2009). Building on previous work, and after reviewing the theory of affective temperaments of Akiskal and Mallya, we examined the relevance of affective temperament and personality measures in patients with alcohol and heroin addictions. The patients were compared, regarding affective temperaments and personality lines, according to the Akiskal formulation and EPQ questionnaire, in which 50 were heroin addicts and 50 were alcohol addict people, both of them sharing similar backgrounds. As a result no differences were observed between heroin addicts and alcohol users on either cyclothymic or hyperthymic scales. Significant discrepancies were noted in depressive and irritability scales, on which heroin addicts scored higher. In a multivariate discriminant analysis, mainly depressive and irritable traits show a distinction between heroin addicts and alcohol users. Our data suggest a new hypothesis, stating that some of hyperthymic and irritable traits, could represent the temperamental profile of heroin addicts. Personality traits are also associated with heroin and alcohol use and extroversion and psycho-emotional instability are common features; the motivation for testing is higher in heroin users and alcohol abusers tend to dissimulate more frequently.

KEY WORDS: alcohol abusers, heroin addicts, affective temperaments and personality

JEL: I10 INTRODUCTION

The temperament and personality characteristics of alcoholics and drug addicts

have been a major issue in the field of substance abuse research, but the results reported are seldom comparable, on account of the differences in the means of assessment and the conceptualizations used (Basiaux et al, (2001) ). Difficult temperament, antisocial personality disorder and borderline, or affectively unstable profiles have been associated with alcohol abuse (De Jong et al, (1993) ). Alcohol abuse has also been linked to axis I mood instability while the role of axis II mood instability remained unclear and defined along different constructs. More recently, some authors have been building on the concept of an affective spectrum, meaning by tha, that a group of syndromes varying in severity and symptom quality, but all representing degrees, stages, or variants of the same basic biological

1 PhD. Faculty of Medicine, Vasile Goldis Western University of Arad, Romania, e-mail: [email protected]

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substrate (Perugi et al, (2002) ). The study of temperaments can play a crucial role in identifying predictors of affective instability in healthy individuals. Temperamental traits also appear to be important as putative prognostic and therapeutic variables in patients with full-blown affective disorders (Cassano et al, (1992) ). The International Consortium of Psychiatric Epidemiology has confirmed the high comorbidity in community-drawn samples between substance use disorders and affective temperaments lines. In the same way, associations between substance use and specific personality traits (such as novelty seeking, harm avoidance or antisocial personality) have also been extensively documented (Chakroun, 2004). Much of the designed literature has described personality disorder constructs for addict subjects (Vincent, (2009) ). The present paper is design to be a psychological study, which consists in examine the relevance of affective temperament and personality measures in alcohol and heroin use subjects. Temperament is defined as a biological disposition, corresponding to a constitutional substrate. Temperament is expressed through a series of signs and features usually manifested by a certain stability of mood, attitudes towards the environment, sensitivity to external stimulus and characteristic modes of reaction (Vincent, (2013) ). Most clinicians agree that early-age experiences account for a wide variability of adult individual personality traits, so the development of personality traits is usually considered to be primarily through crucial environmental challenges and experiences. Nevertheless, since the '80s several authors have maintained that some early and stable personality traits exist, which can be described as features of premorbid phases of major Psychiatric Illnesses (Maremmani et al, (2009) ). Consistent with the concept of an affective spectrum, the study of temperaments is crucial, in the context of identify early predictors of future affective instability even in healthy individuals. Temperamental traits of personality, also prove important as putative prognostic and therapeutic variables in patients with alcohol and heroin addiction. OBJECTIVES: Our study first objective is the evaluation of the affective temperamental traits and the personality traits in alcohol and heroin addicted patients; the second objective is the evaluation of differences between alcohol addicted patients and heroin users. METHODS:

The sample is composed of 100 adult patients (50 with a alcohol and 50 heroin addiction diagnosis), enrolled at the Department of Psychiatry of the Municipal Clinic Hospital, Cluj. Patients have fill out the TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris and San Diego - autoquestionnaire version) and the EPQ questionnaire, so we compared, regarding affective temperaments and personality lines, according to the Akiskal formulation and Eysenck personality questionnaire formulation. All patients included in the study signed informed consent. Both the consent form and the experimental procedures were approved by the competent ethics committees in accordance with internationally accepted criteria for ethical research. The research was conducted in accordance with the ethical standards of the Declaration of Helsinki (1964). The study was conducted with the approval of the Ethics and Research

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Committee of the Vasile Goldis Western University of Arad and Cluj Municipal Hospital. All patients were evaluated during the stabilization phase to avoid possible interferences due to the acute phase of their illness in the temperament and personality questionnaires (TEMPS-A and EPQ). To achieve the research objectives, subjects were evaluated once during the 12 months. Each subject was interviewed and completed all scales above, as paper and pencil, so were assessed personality traits in terms of the psychometrics scale, respectively affective temperament types by Akiskal scale. Data Analysis:

Analyzes based on scores E, N, L and P (EPQ questionnaire's dimensions) indicates the fact that the majority of respondents can be classified as extroverted persons, highly unstable psycho-emotional and almost the lack of some schizoid tendencies from the sample. Out of the 100 individuals, more then half (64 %) have obtained an E score of 9 points, denoting that they can be characterized as persons with more accelerate processes of excitement and inhibitions of the SNC, who tend to adopt easier risky and scandalous behavior, with a lower control of the emotional reactions and a lower tolerance to frustration, which they associate as their lifestyle. The following table consist of the exacts distribution of the 100 respondents involved in the study and highlights that the majority obtain a 9 points score, meanwhile only 16 subjects obtained higher scores.

Table 1. Distribution of individuals according to the score E

Frequency Percent Valid Percent

Cumulative Percent

Valid 3 10 10.0 10.0 10.0

5 1 1.0 1.0 11.0

6 9 9.0 9.0 20.0

9 64 64.0 64.0 84.0

11 1 1.0 1.0 85.0

12 2 2.0 2.0 87.0

13 7 7.0 7.0 94.0

14 1 1.0 1.0 95.0

15 2 2.0 2.0 97.0

16 2 2.0 2.0 99.0

17 1 1.0 1.0 100.0

Total 100 100.0 100.0

Source: Carried out by the Author, Own calculation, 2013

Histogram corresponding variable gives us an image regarding the respondents

distribution according to the score obtained for E category, being easy to observe that the majority of the respondents s

Source: Carried out by the Author, Own calculation, 2013 Regarding this research, is noticeable that the most common value for dimension

N was 12 points, 25 % of the re We find that the distribution of one variable is abnormal, 25 % of the subjects are placed in the middle range (at the value of 23 points), but more than half of all (52%) stand near the maximum value of the range (getting sc also noted a tremendous difference between the range’s limits, the minimum value being 4 points and the maximum 23 points. The existing data reveal that most subjects are supra react strongly to stimulus various emotional experiences.

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Histogram corresponding variable gives us an image regarding the respondents distribution according to the score obtained for E category, being easy to observe that the majority of the respondents stand around the value of 9 points.

Respondents distribution for E scale

Source: Carried out by the Author, Own calculation, 2013

Regarding this research, is noticeable that the most common value for dimension N was 12 points, 25 % of the respondents getting that value.

We find that the distribution of one variable is abnormal, 25 % of the subjects are placed in the middle range (at the value of 23 points), but more than half of all (52%) stand near the maximum value of the range (getting scores of over 20 points). Is also noted a tremendous difference between the range’s limits, the minimum value being 4 points and the maximum 23 points.

The existing data reveal that most subjects are supra-emotional persons, who and who find it hard to come back to their balance after

various emotional experiences.

Histogram corresponding variable gives us an image regarding the respondents distribution according to the score obtained for E category, being easy to observe that

Figure 1. Respondents distribution for E scale

Source: Carried out by the Author, Own calculation, 2013

Regarding this research, is noticeable that the most common value for dimension

We find that the distribution of one variable is abnormal, 25 % of the subjects are placed in the middle range (at the value of 23 points), but more than half of all

ores of over 20 points). Is also noted a tremendous difference between the range’s limits, the minimum value

emotional persons, who and who find it hard to come back to their balance after

315

Table 2. Distribution of individuals according to the score N

Frequency Percent Valid Percent Cumulative Percent

Valid 4 2 2.0 2.0 2.0

6 1 1.0 1.0 3.0

7 10 10.0 10.0 13.0

9 1 1.0 1.0 14.0

10 2 2.0 2.0 16.0

12 25 25.0 25.0 41.0

14 2 2.0 2.0 43.0

16 5 5.0 5.0 48.0

21 20 20.0 20.0 68.0

22 22 22.0 22.0 90.0

23 10 10.0 10.0 100.0

Total

100 100.0 100.0

Source: Carried out by the Author, Own calculation, 2013

Histogram corresponding variable provides us an image regarding the distribution of respondents according the score obtained for N category.

Figure 2. Respondents distribution for N scale

Source: Carried out by the Author, Own calcula In a multivariate discriminant analysis, mainly depressive and irritable traits

show a distinction between heroin addicts and alcohol users . respondents 78 % have offered positive answers to questions which give a profile with saddest mood, ruminative and willing to apprehension. Out of these, 55% are part of the alcohol consumers category and 45% are part of the heroin consumers category. We can state that alcoholic respondents tend to be in a sad mood. In terms of frequenc irritable-choleric disposition, measured trough the confession of the respondents regarding on how often they get irritable, choleric, we notice that 84% of the subjects have given us answers positive rated as irritable than half belong to the alcohol consumers category, therefore we conclude that alcohol consumers category tend to be more often choleric than the heroin consumers category. Conclusions:

Our data suggest a new hypothesis: • some of hyperthymic

profile of heroin addicts. • some of depressive and irritable traits, could represent the temperamental

profile of heroin addicts. • personality traits are associated with heroin and alcohol use. • extroversion and psycho • the motivation for testing is higher in heroin users, alcohol abusers tend to

dissimulate more frequently. Considerations:

The scientific community has recently examined whether correlations between affective temperaments and substance abuse disorders. We try to summarized some of these correlations, comparing two groups of addict subjects (heroin vs alcohol).

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Source: Carried out by the Author, Own calculation, 2013

In a multivariate discriminant analysis, mainly depressive and irritable traits show a distinction between heroin addicts and alcohol users . Out of the 100 respondents 78 % have offered positive answers to questions which give a profile with saddest mood, ruminative and willing to apprehension. Out of these, 55% are part of the alcohol consumers category and 45% are part of the heroin consumers category. We can state that alcoholic respondents tend to be in a sad mood. In terms of frequenc

choleric disposition, measured trough the confession of the respondents regarding on how often they get irritable, choleric, we notice that 84% of the subjects have given us answers positive rated as irritable-choleric disposition. Out of than half belong to the alcohol consumers category, therefore we conclude that alcohol consumers category tend to be more often choleric than the heroin consumers category.

Our data suggest a new hypothesis: some of hyperthymic and irritable traits, could represent the temperamental profile of heroin addicts. some of depressive and irritable traits, could represent the temperamental profile of heroin addicts. personality traits are associated with heroin and alcohol use.

roversion and psycho-emotional instability are common features the motivation for testing is higher in heroin users, alcohol abusers tend to dissimulate more frequently.

The scientific community has recently examined whether correlations between affective temperaments and substance abuse disorders.

We try to summarized some of these correlations, comparing two groups of addict subjects (heroin vs alcohol).

tion, 2013

In a multivariate discriminant analysis, mainly depressive and irritable traits Out of the 100

respondents 78 % have offered positive answers to questions which give a profile with a saddest mood, ruminative and willing to apprehension. Out of these, 55% are part of the alcohol consumers category and 45% are part of the heroin consumers category. We can state that alcoholic respondents tend to be in a sad mood. In terms of frequency of

choleric disposition, measured trough the confession of the respondents regarding on how often they get irritable, choleric, we notice that 84% of the subjects

choleric disposition. Out of these more than half belong to the alcohol consumers category, therefore we conclude that alcohol consumers category tend to be more often choleric than the heroin consumers category.

and irritable traits, could represent the temperamental

some of depressive and irritable traits, could represent the temperamental

emotional instability are common features the motivation for testing is higher in heroin users, alcohol abusers tend to

The scientific community has recently examined whether correlations exist

We try to summarized some of these correlations, comparing two groups of

317

The correlation between affective temperaments line, personality traits and substance abuse disorders is generally accepted. Some of these can be considered expressions of the heroin and alcohol use. In heroin addicts and alcoholics the role of “these traited” can be extended from the area of full-blown affective disorders to that of affective temperaments (Maremmani, 2005). What emerges is the central role of cyclothymia, with irritable traits discovered in a group of heroin addicts, and depressive traits in alcoholics. While the cyclothymic temperament qualifies as a real temperamental risk factor for the development of these diseases, irritable and depressive traits, which differentiated these two groups of subjects, may be considered not so much a premorbid condition, but, rather, as a simple association (Vincent, 2013). After reviewing the theory of affective temperaments of Akiskal and Mallya, we will discuss affective temperaments in heroin addicts and alcoholics, with the aim of providing an “at-risk temperamental profile” for the development of substance abuse disorders. A working hypothesis is then formulated to help explain how temperamental profile may promote the initiation of substance use and contribute to the development of addiction.

REFERENCES Akiskal H.S., Placidi G.F., Signoretta S., Liguori A., Gervasi R., Maremmani I., Mallya

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Akiskal H.S., Akiskal K.K., Haykal R.F., Manning J.S., Connor P. (2005). TEMPS-A: progress towards validation of a self-rated clinical version of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire. J. Affect. Disorders. 85, 3-16.

Hagop S. Akiskal MD; Robert M. A. Hirschfeld MD; Boghos I. Yerevanian MD. (2005) "The Relationship of Personality to Affective Disorders." N.p., n.d. Web.

Kaplan H., Sadock B.J. (2000) “Substance Related Disorders”, Comprehensive Textbook of Psychiatry, Seventh Edition, Vol. I, Ed. Lippincott Williams & Wilkins, Philadelphia, USA, 11: 924-1095.

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Perez-Rios M., Santiago-Perez M.I., Alsonso B., Malvar A., Hervada X., deLeon, J. (2009). Fagerstrom Test for Nicotine Dependence vs heavy smoking index in a general population survey. BMC Public Health 9, 493.

Perugi G., Toni C., Travierso M.C., Akiskal H.S. (2003). The role of cyclothymia in atypical depression: toward a data-based reconceptualization of the borderline-bipolar II connection. Journal of Affective Disorders 73, 87–98.

Umee, "Affective Temperaments in Alcoholic Patients." Scribd. N.p., n.d. Web. 17 Sept. 2013.

Http://lib.bioinfo.pl/pmid:20414155. N.p., n.d. Web. 17 Sept. 2013.

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