Linking antisocial behavior, substance use, and personality: An integrative quantitative model of the adult externalizing spectrum.

Abstract

Antisocial behavior, substance use, and impulsive and aggressive personality traits often co-occur, forming a coherent spectrum of personality and psychopathology. In the current research, the authors developed a novel quantitative model of this spectrum. Over 3 waves of iterative data collection, 1,787 adult participants selected to represent a range across the externalizing spectrum provided extensive data about specific externalizing behaviors. Statistical methods such as item response theory and semiparametric factor analysis were used to model these data. The model and assessment instrument that emerged from the research shows how externalizing phenomena are organized hierarchically and cover a wide range of individual differences. The authors discuss the utility of this model for framing research on the correlates and the etiology of externalizing phenomena. Keywords drug; alcohol; impulsivity; aggression; classificationThe existence of individual differences in the tendency to contain versus express impulses has been recognized in academic psychology since its inception as a discipline (James, 1890(James, /1983. In more recent times, this domain has been instantiated in psychological constructs ranging from disinhibition (Clark & Watson, 1999;Gorenstein & Newman, 1980) to impulsivity (Barratt, 1994;Dickman, 1990;Gray, 1981;Whiteside & Lynam, 2001), ego control (J. Block, 1965; J. H. Block & Block, 1980), constraint (Tellegen, 1985), the problem behavior syndrome (Jessor & Jessor, 1977), sensation seeking (Zuckerman & Kuhlman, 2000), and novelty seeking (Cloninger, Svrakic, & Przybeck, 1993). In addition, a dimension of effortful control is a salient feature of childhood temperament that likely relates to these disinhibitory personality characteristics in adulthood (Rothbart, Ahadi, & Evans, 2000). Robust correlations have also been observed between these disinhibitory personality constructs and mental disorders involving substance problems and antisocial behavior (for a review, see Sher & Trull, 1994).In spite of these rich interrelations, many of these constructs continue to be studied and conceptualized as separate entities, in separate literatures. A major reason for this fragmentation is the lack of an integrative model of this domain (Widiger & Clark, 2000). The purpose of the current research is to further the development of an empirically based model of NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript this broad domain of personality and psychopathology, which we term the externalizing spectrum (Krueger, Markon, Patrick, & Iacono, 2005). Origins of the Externalizing Spectrum ConceptualizationAs applied to adult psychopathology, the externalizing spectrum conceptualization emerged initially from research on mental disorders defined within current nosologies. In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text. rev.; DSM-IV-TR; American Psychiatric Association, 2000), various forms of substance problems are conceptualized as discrete disorder...

Externalizing proneness and brain response during pre-cuing and viewing of emotional pictures

“…Further, the effect of reduced responsiveness to reward is consistent with data from patient populations (Barkley et al, 2001;Demurie et al, 2012;White et al, 2014). Regarding the scale measure of disinhibition we used, this measure was carefully designed to index liability toward externalizing problems (Krueger et al, 2007;Patrick et al, 2013), and prior research has shown that scores on this scale covary substantially with interview-assessed externalizing symptoms-largely as a function of shared genetic influences that covary in turn with brain response . As such, this scale measure provides an effective vehicle for bridging between brain response measures and clinical problems .…”

“…Trait disinhibition was operationalized by scores on a scale measure consisting of 30 items from the Externalizing Spectrum Inventory (Krueger et al, 2007). For details regarding scale content and properties, see Supplementary Methods.…”

“…Externalizing proneness, or trait disinhibition 1 (Sher and Trull, 1994;Patrick et al, 2013), represents a prominently heritable liability for a number of dysfunctional behaviors of high societal and personal relevance, including conduct problems in childhood, impulsive-aggressive behavior in adulthood, and substance-related addictions (Krueger et al, 2002(Krueger et al, , 2007. This dispositional liability can be assessed in a number of ways, including through diagnostic interview, self-report questionnaire, lab task performance, and psychophysiological reactivity (Young et al, 2009;Patrick et al, 2012Patrick et al, , 2013.…”

Temperament and character traits associated with the use of alcohol, cannabis, cocaine, benzodiazepines, and hallucinogens: evidence from a large Brazilian web survey

“…5,6,8 In general terms, traits related to appetitive and unconstrained behavioral tendencies have been identified in the personality profile of subjects with harmful patterns of substance use and general externalizing problems. [9][10][11][12] Among the constellation of traits related to appetitive and unconstrained dispositions, two have gained particular attention in the literature: novelty seeking (NS) 8 and sensation seeking (SS). 13 Both of these traits have been considered major personality variables when related to alcohol and drug consumption for empirical and conceptual reasons.…”

The joint structure of major depression, anxiety disorders, and trait negative affect

“…[1][2][3][4] These efforts have been directed at addressing inherent limitations associated with pervasive clinical heterogeneity and diagnostic comorbidity, [5][6][7][8] along with the fact that covariance patterns among differing psychopathologies and temperament/personality traits are not addressed by dominant classification systems of mental disorders. 9,10 In response to these limitations, different researchers have modeled the underlying structure of common psychiatric conditions to characterize diagnostic overlap using structural equation modeling techniques.…”