Personality Factors, Substance Misuse, and Violence

1. Personality Factors, Substance Misuse, and Violence Theodore M. Godlaski University of Kentucky College of Social Work

2. Personality Factors, Substance Misuse and Violence • The question here is: “Are there identifiable factors in the personalities of individuals that cause them to be at higher risk for substance misuse and the perpetration of violence?” • Can personality help explain why different individuals, faced with the same situation, act differently? • Can personality help us understand why specific individuals act violently when using a substance? • Can personality factors help us predict who is at greatest risk of perpetration? • Can personality factors help us understand what intervention strategies are most appropriate?

3. Personality Physical & Psychological Abuse Substance Abuse Physical & Psychological Abuse Personality Substance Abuse Personality Physical & Psychological Abuse Substance Abuse Specific Personality Factors & Substance Abuse Physical & Psychological Abuse Broad Personality Traits

4. Varieties of Violence • Our previous studies have largely focused on reactive violence. • Issues related to neurobiological factors and developmental factors largely address what may make an individual prone to react with aggression and violence to a perceived threat. • It might be argued that some of these approaches also relate to a kind of “preventative” violence: violence that anticipates a threat and is proactive.

5. Varieties of Violence • In examining personality factor related to violence and substance misuse, we encounter instrumental violence. • This is violence as a tool that serves another purpose – control. • This is a valuable distinction so long as we recognize that the dividing line is somewhat fuzzy.

6. Two Minute Paper • Take one or two minutes to think and jot down an answer to the following question. • “ What does a male batterer look like? That is, how would you describe this person in a word picture?” • Discuss your thoughts with a partner and be ready to share them with the class.

7. A Basic Typology Holtzworth-Munroe, A, & Stuart, G.L. (1994).Typologies of male batterers: Three subtypes and the differences among them. Psychological Bullitin, 116, 476-497.

8. Holtzworth-Munroe, A, & Stuart, G.L. (1994).Typologies of male batterers: Three subtypes and the differences among them. Psychological Bullitin, 116, 476-497.

9. Some Necessary Definitions • Personality Trait • A hypothetical dimension of personality that is present from early life, remains fairly stable, and can be generalized across a variety of situations. • Personality State • The way in which a personality trait expresses itself in a specific situation.

10. Some Necessary Definitions • Personality Characteristic • A personality trait and its potential. The trait speaks to how an individual usually responds in a given set of circumstances, the potential speaks to the maximum expression of the trait in a given set of circumstances. • Personality Factor • Encompasses both the trait and the state.

11. Some Necessary Definitions • Dimensional Approach • Accepts that personality traits differ from one individual to another along a continuum • Categorical Approach • Focuses on personality types that differ qualitatively in kind rather than by degree. • Personality Types • Discrete categories that can involve a constellation of personality characteristics that are present in an all-or-nothing way.

12. Borderline • A pervasive pattern of interpersonal relationships, self-image, and affects, and marked impulsivity beginning in early adulthood and present in a variety of contexts as indicated by five (or more) of the following: • Frantic efforts to avoid real or imagined abandonment; • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation;

13. Borderline • Identity disturbance: markedly and persistently unstable self image or sense of self; • Impulsivity in at least two areas that are potentially self-damaging; • Recurrent suicidal behavior, gestures or threats, or self-mutilating behavior; • Affective instability due to marked reactivity of mood; • Chronic feeling of emptiness; • Inappropriate intense anger, or difficulty controlling anger; • Transient stress-related paranoid ideation or severe dissociative symptoms.

14. Antisocial • There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following: • Failure to conform to social norms with respect to lawful behavior as indicated by repeatedly performing acts that are grounds for arrest; • Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure;

15. Antisocial • Impulsivity or failure to plan ahead; • Irritability and aggressiveness, as indicated by repeated fights or assaults; • Reckless disregard for safety of self and others; • Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations; • Lack of remorse as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from others

16. Antisocial • The individual is at least are 18 years; • There is evidence of conduct disorder with onset before age 15 years; • The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or manic episodes.

17. Two Minute Paper • Take one or two minutes to think and jot down an answer to the following question. • “ What does a female batterer look like? That is, how would you describe this person in a word picture?” • Discuss your thoughts with a partner and be ready to share them with the class.

18. Passive Aggressive Personality • A pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following: • Passively resists fulfilling routine social and occupational tasks; • Complains of being misunderstood and unappreciated by others;

19. Passive Aggressive Personality • Is sullen and argumentative; • Unreasonably criticizes and scorns authority; • Expresses envy and resentment toward those apparently more fortunate; • Voices exaggerated and persistent complaints of personal misfortune; • Alternates between hostile defiance and contrition • Does not occur exclusively during major depressive episodes and is not better accounted for by dysthymic disorder.

20. Other Personality Factors • Trait Anger and Hostility • There is evidence, although not unequivocal, that links trait hostility, substance misuse, and aggression. • Defensiveness, impulsivity, and aggression have been shown to be predictors (although weak) of violence in both men and women. • Measures of hostility in women have been predictors of a punitive style of child rearing.

21. Other Personality Factors • Need for control and power • This is not a trait but a need that stems from a personality type (categorical). • These two factors are linked. • Proactive instrumental violence may be associated with these needs. • High need for power is associated with both aggressiveness and substance misuse.

22. An Aside • Laboratory research on normals using an aggression paradigm has indicated that increased aggression is linked to the ingestion of alcohol, opiates, and benzodiazapines but not to the ingestion of stimulant drugs. • It has been postulated that this is due to dampening of the cue for punishment or the pain system.

23. An Aside • Milkman and Frosch and later Milkman and Sunderwerth developed the notion that individuals choose specific drugs because they make them more the way they are already. • Individuals who are passive in dealing with reality choose “satiation” drugs like opiates. • Individuals who are aggressive in dealing with reality choose “arousal” drugs like cocaine or amphetamine. Milkman, H. Frosch, W. (1977). The drug of choice. Journal of Psychoactive Drugs, 9 (1), 11-20

24. An Aside • It is entirely possible that regular drug users might respond quite differently on aggression tests when under the influence of their drug of choice than normals. • This could explain why stimulants are not associated with aggression in the lab but are in the real world.

25. Personality, Stress, and Coping Model • This model links personality constructs that are dimensional in nature, interpersonal stress (in its origin, perception, and response), coping styles and strategies to both chronic and situation substance misuse and violence.

26. Personality Factor • psychopathic personality • -perfectionistic overcontroll • -hostile depression Coping -antisocial -emotion oriented -substance use -prob. solving skills/confidence Interpersonal Stress -stress generation -stress reactivity -stress appraisal Physical and emotional abuse Chronic Substance Misuse

27. Psychopathic Personality • Associated with antisocial personality traits • Antisocial behaviors are non specific and may involve violent and criminal behaviors within and outside the home. • However, they may simply tend to be self-centered and solve problems with minimal consideration for empathy and the rights or needs of others.

28. Perfectionistic Overcontroll • Perfectionism can be self-oriented, other-oriented, or socially prescribed. • Other-oriented and socially prescribed perfectionism is most clearly linked with intimate violence. • Borderline personality is most clearly related to perfectionistic overcontroll. • Individuals with a rigid schema about how things should be who become enraged when reality does not conform to their schema.

29. Perfectionistic Overcontroll • Many victim first person accounts of spouse and child abuse identify the abuser’s expectation of perfection as a consistent theme. • There appears to be a subtype that is more oriented toward self and socially prescribed perfectionism • Such individuals have unrealistic expectations of themselves and their intimates, when they fail, as they must, they blame spouse and children for not rescuing them.

30. Hostile, Depressive Personality • Socially prescribed perfectionism is a feature of hostile depression. • Such individuals have high interpersonal sensitivity and respond with hostility and aggression to perceived mistreatment. • Hostility and depression are linked with substance misuse. • Hostile depression may be linked to violence most specifically in situations where there is high perceived demand for performance.

31. Stress Factors • Events that present the perceived potential for humiliation seem to be specifically prone toward violent response. • Interpersonal stress is interactive • The tendency to relate to others with hostility provokes hostility in response. • The lack of empathy in interaction leads to non-empathic response from others. • Expectations, arising from personality characteristics, determine interpretation of stressful situations.

32. Coping Factors • Child abuse has been linked with emotion-oriented and avoidance-oriented coping as well as lower confidence in problem solving skills. • A general lack of problem solving skills or a sense of inefficacy in coping and solving problems is more likely to result in hostile responses and the use of substances as part of the coping response.

33. Coping Factors • Antisocial coping tends to take the most direct route to eliminating the perceived source of the problem without reference to empathy or the rights of others. • Antisocial coping is more prevalent in men than in women. • It might be helpful to conceptualize coping styles as a continuum.

34. Personality Factor • psychopathic personality • -perfectionistic overcontroll • -hostile depression Coping -antisocial -emotion oriented -substance use -prob. solving skills/confidence Interpersonal Stress -stress generation -stress reactivity -stress appraisal Physical and emotional abuse Chronic Substance Misuse

35. Personality Factor • psychopathic personality • -perfectionistic overcontroll • -hostile depression Coping -antisocial -emotion oriented -substance use -prob. solving skills/confidence Interpersonal Stress -stress generation -stress reactivity -stress appraisal Physical and emotional abuse Depending on whether the coping style is emotionally charged and prone toward aggression or prosocial, and whether confidence in the effectiveness of the coping skills is low or high, there is increased or decreased probability of abuse. Although the risk for abuse is substantial, it is not necessarily critical. Generally these Personality Factors tend to increase interpersonal stress on all levels. The degree of distress will, most likely, relate to the degree to which the Personality Factor dominates the personality structure of the individual.

36. Personality Factor • psychopathic personality • -perfectionistic overcontroll • -hostile depression Coping -antisocial -emotion oriented -substance use -prob. solving skills/confidence Interpersonal Stress -stress generation -stress reactivity -stress appraisal Physical and emotional abuse Chronic Substance Misuse Once regular misuse of substances enters the picture, it both increases and exaggerates interpersonal stress on all levels, impairs the use of coping skills and tends to displace prosocial coping, and decreases impulse control creating a much more critical likelihood of abuse.

37. Two Minute Paper • Take one or two minutes to think and jot down an answer to the following question. • “ What are some concrete behaviors to look for when attempting to assess the risk for possible intimate violence?” • Discuss your thoughts with a partner and be ready to share them with the class.

38. Addendum • There is another way of conceptualizing personality factors that is dimensional, that is the identification of general traits that are present to a greater or lesser degree in all individuals. • This is the OCEAN model or the Five Factor Model. • The factors are stable, hereditable, adaptive, and universal.

39. Five Factor Model • Openness to Experience • This trait reflects 'open-mindedness' and interest in culture. High scorers tend to be imaginative, creative, and to seek out cultural and educational experiences. Low scorers are more down-to-earth, less interested in art and more practical in nature. • original, imaginative, creative, perceptive, sophisticated, knowledgeable, cultured, artistic, curious, analytical, liberal • Conscientiousness • This trait reflects how organized and persistent we are in pursuing our goals. High scorers are methodical, well organized and dutiful. Low scorers are less careful, less focused and more likely to be distracted from tasks. • conscientious, practical, cautious, serious, reliable, organized, careful, dependable, hardworking, ambitious

40. Five Factor Model • Extroversion • This trait reflects preference for, and behavior in, social situations. People high in extraversion are energetic and seek out the company of others. Low scorers (introverts) tend to be more quiet and reserved. • sociable, talkative, active, bold, fun-loving, spontaneous, adventurous, enthusiastic, person-oriented, assertive • Agreeableness • This trait reflects how we tend to interact with others. People high in agreeableness tend to be trusting, friendly and cooperative. Low scorers tend to be more aggressive and less cooperative. • warm, generous, trustful, courteous, agreeable, cooperative, flexible, forgiving, cheerful, humble

41. Five Factor Model • Neuroticism • This trait reflects the tendency to experience negative thoughts and feelings. High scorers are prone to insecurity and emotional distress. Low scorers tend to be more relaxed, less emotional and less prone to distress. • relaxed, peaceful, objective, calm, unemotional, even-tempered, secure, patient, uninhibited McAdams, D.P. (1992). The five factor model in personality: A critical appraisal. Journal of Personality 60, 329-361 http://users.wmin.ac.uk/~buchant/wwwffi/

42. H, L = high, low based on DSM Criteria; h, l = high, low based on DSM associated features; H/h, L/l = high, low based on clinical literature. Widiger, et all (1998). A description of the DSM-III-R and DSM-IV personality disorders with the five-factor model of personality. In P. Costa & T. Widiger (eds) Personality Disorders and the Five Factor Model. Washington, DC; American Psychological Association, p.42.