CLONINGER TRIDIMENSIONAL THEORY OF PERSONALITY AND PSYCHOPATHOLOGY - APPLICATIONS TO SUBSTANCE USE DISORDERS

Objective. To evaluate studies that applied Cloninger's tridimensional theory of personality to substance abusers. Method: Medline and Psych Info data bases were searched for studies published between 1986 and m id-1995 that used the Tridimensional Personality Questionnaire (TPQ). A supplemental manual search was conducted to identify additional eval uations of the tridimensional theory. Reports were reviewed if they in cluded substance abusers or related tridimensional traits to substance use measures. Results: Factor analyses did not consistently support t he tridimensionality of the TPQ. Novelty Seeking (NS) traits distingui shed alcoholics from nonalcoholics, Type B and Type 2 alcoholics from their Type A and Type 1 counterparts, smokers from nonsmokers, and ind ividuals (substance abusers and nonabusers) with and without antisocia l personality disorder (ASPD). Tridimensional traits independently pre dicted early onset alcohol abuse and serious delinquency in studies th at did not employ the TPQ and were significantly associated with concu rrent substance abuse among adolescents. Most studies that compared no nalcoholic youth with positive and negative family histories of alcoho lism reported nonsignificant TPQ differences or very small effects. Fe w alcoholics, cigarette smokers or sons of alcoholics displayed Type 1 (low novelty seeking, high harm avoidance, high reward dependence) or Type 2 (high novelty seeking, low harm avoidance, low reward dependen ce) TPQ profiles, but rarely were levels of tridimensional traits dete rmined by reference to established norms. Conclusions: NS predicts ear ly onset alcohol abuse and criminality and discriminates alcoholics ex hibiting antisocial behavior and persons with ASPD from their nonantis ocial counterparts. Findings for the Harm Avoidance (HA) and Reward De pendence TPQ subscales are much less consistent. Some support for the role of elevated HA in intensity of substance use has been adduced. At present, the utility of the TPQ for prevention or clinical purposes i s not well established.