Transdiagnostic Impulsivity-Relevant Phenotypes and the Comorbidity of Personality Disorders with Substance and Alcohol Use Disorders

Purpose of ReviewPersonality disorders (PDs) are frequently comorbid with substance use disorders (SUDs) including alcohol use disorder (AUD), but the factors explaining their comorbidity are not yet fully understood. This article reviews recent research on the co-occurrence of PD and SUD/AUD and discusses how contemporary research on impulsivity-related personality and psychopathology dimensions might partially account for their high comorbidity.Recent FindingsComorbidity between PDs and SUDs/AUD is substantial across population-based and clinical studies and is most apparent in Cluster B PDs. Studies of trait-based impulsivity suggest this comorbidity may be partly explained by UPPS-P model of impulsivity factors (e.g., negative urgency). Research consistent with the Hierarchical Taxonomy of Psychopathology suggests that impulsivity-relevant psychopathology dimensions, including broader symptom domains (e.g., disinhibited externalizing) and narrower symptom components and maladaptive traits (e.g., risk-taking, delay-discounting), contribute to PD and SUD/AUD comorbidity.Impulsive personality traits and psychopathology dimensions partially account for the high comorbidity between PD and SUD/AUD diagnoses.