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Personality Pathology and Substance Misuse in Later Life: Perspectives from Interviewer-, Self-, and Informant-Reports

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Abstract

Research indicates a robust association between personality and substance use and misuse. The high prevalence and pervasive detrimental impacts of alcohol use disorder (AUD) and smoking of tobacco necessitate more studies designed to identify factors closely associated with these outcomes in specific populations. The analyses reported in the present paper concern the relative utilities of five measures of personality and personality pathology rated by three sources (self, informant, and interviewer) in predicting AUD and regular smoking in a representative sample of 987 older adults, an understudied and uniquely vulnerable population. All measures and sources contributed to the predictions, with notable parallels as well as some important differences identified across substances and sources of information. In particular, low agreeableness robustly predicted AUD and smoking across self- and informant-reports. High interviewer-rated borderline personality pathology also strongly predicted AUD. Model fit indices suggested that measures of personality and personality pathology have stronger utility in predicting AUD as compared to regular smoking. These findings have important implications for the assessment of older adults in research and clinical settings and for the understanding of enduring risk factors for substance misuse later in life. Multi-source personality information is valuable for generating a complete picture of the relationship between personality and substance misuse.

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Notes

  1. It should be noted that these results are sometimes non-significant (e.g., Kotov et al. 2010).

  2. Although it would have been useful to examine late-onset AUD (i.e., meeting criteria for the first time at FU10) or recurrent AUD (i.e., meeting criteria in the past and at FU10, but not meeting criteria at some point in between), we were unfortunately underpowered to do so (e.g., only 14 individuals experienced late-onset AUD).

  3. We also calculated the McFadden pseudo R2 (McFadden 1973), which is straightforward to interpret and easily adjusted to compensate for additional parameters (Mittlböck and Heinzl 2004) albeit subject to debate regarding validity (for a review, see Hemmert et al. 2018). Results of these calculations are reported in the Appendix.

  4. Computation of NRMSE involves calculating the mean and variance over all missing data points (see Oba et al. 2003).

  5. Post hoc examinations of potential effects of the informant relationship on informant-reported personality and personality pathology associations with AUD status did not yield any robust findings. Specifically, when the degree to which the informant reported knowing the participant (i.e., 5-point Likert-type scale from “Not well” to “Better than anyone else) was interacted with informant-rated personality and, separately, informant-rated personality pathology one effect was found. The better the informants reported knowing the participants, the less negative the association was between Agreeableness and current AUD (p = 0.04), but no other significant attenuations or increases were identified. Similarly, when analyzing data exclusively in participants whose informants reported knowing the participants either “Very well” or “Better than anyone else,” the only significant effect was found for Antisocial personality pathology and former AUD (OR = 1.65, p = 0.007). The same effect was found in the full dataset but was statistically significant only prior to correction for multiple testing (Table 5).

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Funding

This research was supported by a funding from the National Institute on Aging (NIA RO1-AG056517, and NIA RO1-AG045231).

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Authors and Affiliations

  1. Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, 1125 One Brookings Drive, St. Louis, MO, 63130, USA

    Sarah E. Paul & Thomas F. Oltmanns

  2. Missouri Institute of Mental Health, St. Louis, MO, USA

    Rachel P. Winograd

Authors
  1. Sarah E. Paul
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  2. Rachel P. Winograd
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  3. Thomas F. Oltmanns
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by the SPAN Study. Data analysis was performed by Sarah E. Paul. The first draft of the manuscript was written by Sarah E. Paul and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sarah E. Paul.

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Disclosure of Potential Conflicts of Interest

Sarah E. Paul, Rachel P. Winograd and Thomas F. Oltmanns declare that they have no conflicts of interest.

Research Involving Human Participants and/or Animals

The study was approved by the Institutional Review Board at Washington University in St. Louis.

Informed Consent

Each participant provided written informed consent to the study.

Ethics Approval

The study was approved by the Institutional Review Board at Washington University in St. Louis.

Consent to Participate

Each participant provided written informed consent to the study.

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Appendix 1

Appendix 1

Table 7 Likelihood ratio tests comparing the utility of each personality measure in predicting alcohol use disorder and regular smoking
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Paul, S.E., Winograd, R.P. & Oltmanns, T.F. Personality Pathology and Substance Misuse in Later Life: Perspectives from Interviewer-, Self-, and Informant-Reports. J Psychopathol Behav Assess 43, 597–619 (2021). https://doi.org/10.1007/s10862-020-09862-z

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