Department of Psychology, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Potsdam, Germany.
Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117 Berlin, Germany.
Psychol Med. 2024 Jul;54(9):1905-1929. doi: 10.1017/S003329172400093X. Epub 2024 Apr 22.
Heavy substance use (SU) and substance use disorders (SUD) have complex etiologies and often severe consequences. Certain personality traits have been associated with an increased risk for SU(D), but far less is known about personality changes related to SU(D). This review aims to synthesize the existing literature on this research question. A systematic literature search was conducted from November 2022 to February 2023 in PubMed, EbscoHost, and Web of Science. Peer-reviewed original papers on SU(D)-related personality changes were included. Of 55 included studies, 38 were observational population-based studies and 17 were intervention studies. Overall, personality and SU measures, samples, study designs, and statistical approaches were highly heterogenous. In observational studies, higher SU was most consistently related to increases in impulsivity-related traits and (less so) neuroticism, while interventions in the context of SU(D) were mostly associated with increases in conscientiousness and self-efficacy and lasting decreases in neuroticism. Findings for traits related to extraversion, openness, conscientiousness, and agreeableness were mixed and depended on SU measure and age. Studies on bidirectional associations suggest that personality and SU(D) both influence each other over time. Due to their strong association with SU(D), impulsivity-related traits may be important target points for interventions. Future work may investigate the mechanisms underlying personality changes related to SU(D), distinguishing substance-specific effects from general SU(D)-related processes like withdrawal, craving, and loss of control. Furthermore, more research is needed to examine whether SU(D)-related personality changes vary by developmental stage and clinical features (e.g. initial use, onset, remission, and relapse).
重度物质使用（SU）和物质使用障碍（SUD）具有复杂的病因，通常会产生严重的后果。某些人格特质与 SU(D)的风险增加有关，但人们对与 SU(D)相关的人格变化知之甚少。本综述旨在综合现有关于这一研究问题的文献。从 2022 年 11 月至 2023 年 2 月，在 PubMed、EbscoHost 和 Web of Science 中进行了系统的文献检索。纳入了与 SU(D)相关的人格变化的同行评审原始论文。在纳入的 55 项研究中，38 项为观察性基于人群的研究，17 项为干预研究。总体而言，人格和 SU 测量、样本、研究设计和统计方法高度异质。在观察性研究中，较高的 SU 与冲动相关特质的增加（较少）和神经质的增加最一致相关，而在 SUD 背景下的干预主要与尽责性和自我效能的增加以及神经质的持续下降有关。与外向性、开放性、尽责性和宜人性相关的特质的研究结果喜忧参半，这取决于 SU 测量和年龄。关于双向关联的研究表明，人格和 SUD 随着时间的推移相互影响。由于它们与 SUD 强烈相关，与冲动相关的特质可能是干预的重要目标点。未来的工作可能会研究与 SUD 相关的人格变化的潜在机制，区分物质特异性效应与一般的 SUD 相关过程，如戒断、渴望和失控。此外，需要更多的研究来检查 SUD 相关的人格变化是否因发育阶段和临床特征（例如初始使用、发病、缓解和复发）而异。
