The association between personality disorders with alcohol use and misuse: A population-based twin study.
A clearer understanding of the etiological overlap between DSM-IV personality disorders (PDs) and alcohol use (AU) and alcohol use disorder (AUD) is needed. To our knowledge, no study has modeled the association between all 10 DSM-IV PDs and lifetime AU and AUD. The aim of the present study is to identify which PDs are most strongly associated with the phenotypic, genetic, and environmental risks of lifetime AU and AUD, and to determine if these associations are stable across time.



Participants were Norwegian twins assessed at two waves. At Wave 1, 2801 twins were assessed for all 10 DSM-IV PD criteria, lifetime AU, and DSM-IV AUD criteria. At Wave 2, six of the 10 PDs were again assessed along with AU and AUD among 2393 twins. Univariate and multiple logistic regressions were run. Significant predictors were further analyzed using bivariate twin Cholesky decompositions.



Borderline and antisocial PD criteria were the strongest predictors of AU and AUD across the two waves. Despite moderate phenotypic and genetic correlations, genetic variation in these PD criteria explained only 4% and 3% of the risks in AU, and 5% to 10% of the risks in AUD criteria, respectively. At Wave 2, these estimates increased to 8% and 23% for AU, and 17% and 33% for AUD.



Among a large Norwegian twin sample, borderline and antisocial PD criteria were the strongest predictors of the phenotypic and genotypic liability to AU and AUD. This effect remained consistent across time.
Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA. Electronic address: longe@vcu.edu.
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Long
Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
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Aggen
Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA; Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA.
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Neale
Department of Mental Disorders, Norwegian Institute of Public Health, Norway.
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Knudsen
Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
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Krueger
Department of Psychological Sciences, Purdue University, IN, USA.
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South
Department of Mental Disorders, Norwegian Institute of Public Health, Norway; Department of Psychology, University of Oslo, Oslo, Norway.
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Czajkowski
Department of Mental Disorders, Norwegian Institute of Public Health, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
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Nesvåg
Department of Mental Disorders, Norwegian Institute of Public Health, Norway; Department of Psychology, University of Oslo, Oslo, Norway; School of Pharmacy, University of Oslo, Oslo, Norway.
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Ystrom
Department of Mental Disorders, Norwegian Institute of Public Health, Norway; Department of Psychology, University of Oslo, Oslo, Norway.
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Torvik
Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA; Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA.
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Kendler
Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
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Gillespie
Department of Mental Disorders, Norwegian Institute of Public Health, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Reichborn-Kjennerud
D000328:Adult; D000428:Alcohol Drinking / Q000235:genetics*; D019973:Alcohol-Related Disorders / Q000150:complications* / Q000235:genetics; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D010554:Personality Disorders / Q000150:complications* / Q000235:genetics; D012931:Social Environment; D014427:Twins; D055815:Young Adult
Alcohol use; Alcohol use disorder; Personality disorders; Twin research