The association between personality disorders with alcohol use and misuse: A population-based twin study

E. C. Long, S. H. Aggen, M. C. Neale, G. P. Knudsen, R. F. Krueger, S. C. South, N. Czajkowski, R. Nesvåg, E. Ystrom, F. A. Torvik, K. S. Kendler, N. A. Gillespie, T. Reichborn-Kjennerud

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background 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. Methods 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. Results 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. Conclusions 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.

Original languageEnglish (US)
Pages (from-to)171-180
Number of pages10
JournalDrug and alcohol dependence
StatePublished - May 1 2017

Bibliographical note

Funding Information:
We acknowledge funding from the US National Institutes of Health and National Institute on Drug Abuse (1R01DA037558-01A1 and 12R01DA018673), the Norwegian Research Council, the Norwegian Foundation for Health and Rehabilitation, the Norwegian Council for Mental Health, and the European Commission under the program ?Quality of Life and Management of the Living Resources? of the Fifth Framework Program (QLG2-CT-2002-01254). NAG had full access to all the data in this study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Publisher Copyright:
© 2017 Elsevier B.V.


  • Alcohol use
  • Alcohol use disorder
  • Personality disorders
  • Twin research


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