Internalizing and externalizing personality subtypes predict differences in functioning and outcomes among veterans in residential substance use disorder treatment.

Abstract

There is a long history of using personality to subtype patients in treatment for substance use disorders (SUD). However, no one has validated a typology of SUD patients using a structural model of normal-range personality, particularly indicating whether subtypes differ on treatment processes and outcomes. We developed a personality-based typology among 196 military veterans enrolled in residential SUD treatment at a Veterans Affairs medical center. Patients were assessed at treatment entry, 1 month into treatment, and at discharge from treatment. Personality was assessed using the Multidimensional Personality Questionnaire-Brief Form at treatment entry. Latent profile analyses identified a 3-group solution consisting of low pathology, internalizing, and externalizing groups. The internalizing group scored lowest on measures of functioning at treatment entry, whereas the externalizing group scored more poorly on treatment processes and outcomes over the course of their residential stay (e.g., more stressful relationships with other residents, lower program alliance). These findings support a clinically meaningful typology of SUD patients based on a 3-factor model of personality and can serve as a guide for future efforts aimed at developing targeted interventions that can address the individual differences of patients in this population. (PsycINFO Database Record

Polysubstance Use by Stimulant Users: Health Outcomes Over Three Years

“…Substance use severity combined four variables: how many days in the past 30 days the participant had (a) used alcohol and (b) drugs; (c) whether the participant met criteria for an alcohol use disorder (yes/no); and (d) the count of how many other substances the participant met criteria for disorders. Each outcome was computed by converting the variables it included to z scores and then taking the mean of the z scores (Blonigen et al, 2005(Blonigen et al, , 2016; for additional detail, see Wo odhead et al, 2018).…”

A scoping review of electroencephalographic (EEG) markers for tracking neurophysiological changes and predicting outcomes in substance use disorder treatment

“…These included an estimated ~20 studies that were: (1) published before 2000 (~5 studies); (2) focused on sleep or neurofeedback (~7 studies); (3) used short-term and/or long-term abstainer samples (~5 studies); (4) used SUD samples that did not receive treatment or abstain (~3 studies). Further, we did not integrate the review findings with current knowledge regarding: (5) intoxication, binge-drinking, and chronic substance use effects on EEG/ERPs; (6) non-EEG treatment outcome predictors such as high impulsivity and low inhibitory control, concepts with an extensive behavioral and brain imaging literature (Vassileva and Conrod, 2019 ; Lees et al, 2021 ; Lutz et al, 2021 ); (7) fMRI-based functional, structural, and connectivity models of SUD treatment changes (Stewart et al, 2019b ; Parvaz et al, 2022 ); and (8) SUD subtypes (Schwartz et al, 2010 ; Blonigen et al, 2016 ; Müller et al, 2020 ) or trajectories (Haller et al, 2010 ; McCabe et al, 2019 ; Infante et al, 2020 ). Moreover, (9) only a dozen of the reviewed studies were from non-Western countries, reflecting a Western bias limiting the generalizability of findings; and (10) the time frames in brain stimulation studies were usually quite brief (i.e., pre- and post- EEG on the same day), and although informative for neuromodulation-mediated changes in brain function, have limited utility in predicting longer-term treatment-related changes or relapse.…”

Longitudinal Health Outcomes and Treatment Utilization Among Emerging, Early-Mid, and Older Rural Adults Using Stimulants

“…The baseline values of the variables that comprised each composite are presented in Table 2. The composites were computed by converting the included variables to z-scores and then taking an average of the z-scores for each composite (Table 1; Blonigen et al 2005Blonigen et al , 2016.…”