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Scandinavian Journal of Psychology, 2011, 52, 257260 DOI: 10.1111/j.1467-9450.2010.00872.

Personality and Social Sciences


Do men with excessive alcohol consumption and social stability have an
addictive personality?
KRISTINA BERGLUND,1 ERIKA ROMAN,2 JAN BALLDIN,3 ULF BERGGREN,3 MATTS ERIKSSON,3
PETTER GUSTAVSSON4 and CLAUDIA FAHLKE1
1
Department of Psychology, University of Gothenburg, Sweden
2
Department of Pharmaceutical Biosciences, Division of Pharmacology, Uppsala University, Sweden
3
Sahlgrenska Academy at University of Gothenburg, Institute of Clinical Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Sweden
4
Department of Neurobiology, Care Science and Society, Karolinska Institutet, Sweden

Berglund, K., Roman, E., Balldin, J., Berggren, U., Eriksson, M., Gustavsson, P. & Fahlke, C. (2011). Do men with excessive alcohol consumption and
social stability have an addictive personality? Scandinavian Journal of Psychology 52, 257260.
The existence of an addictive personality has been extensively debated. The current study investigated personality in male individuals with excessive
alcohol consumption (n = 100) in comparison to a population-based control group (n = 131). The individuals with excessive alcohol consumption were
recruited by advertisements in a regional daily newspaper and controls from a population based Swedish Twin Registry. Personality was assessed by the
Karolinska Scales of Personality (KSP). Comparisons were made with normative data. Furthermore, by using a multivariate projection-based approach
(Principal Component Analysis; PCA), hidden structures of traits and possible relationships among the individuals with excessive consumption and the
controls was investigated. The individuals with excessive alcohol consumption as well as the controls had mean values within the normative range in all
scales of the KSP. Moreover, the PCA analysis revealed no systematic between-group separation. Taken together, this result demonstrates that male individ-
uals with excessive alcohol consumption do not have a personality different from that of a general population, which supports the notion of no addictive
personality.
Key words: Personality, men, excessive alcohol consumption.
Kristina Berglund, Department of Psychology, University of Gothenburg, PO Box 500, SE-405 30 Goteborg, Sweden. Tel: 46-31-786 18 78; fax: 46-31-
786 46 28; e-mail: Kristina.Berglund@psy.gu.se

INTRODUCTION the antisocial personality disorder, than alcoholism itself (Schuckit


& Irwin, 1989). The personality prole of type 2 individuals is
There have been several attempts to describe individuals with thus fairly well investigated and discussed in the literature
excessive alcohol consumption according to personality and other (Cloninger et al., 1981, 1996, Sher, Trull, Bartholow & Vieth,
characteristics and then classify them into cluster groups or multi- 1999). Less is known whether Cloningers type 1 alcoholics also
dimensional typologies. Besides the typologies of alcoholism by are characterized by such a distinctive personality pattern as their
Babor (1996) and Lesch and Walter (1996), one of the most com- type 2 counterpart.
monly used typology is the type 1 and type 2 alcoholism devel- The majority of individuals with excessive alcohol consump-
oped by Cloninger, Bohman and Sigvardsson (1981). According tion have characteristics resembling those of type 1 alcoholics
to this classication individuals with type 1 alcoholism are charac- (Cloninger et al., 1996), that is, few social complications and psy-
terized by social stability with late onset of alcoholism, few psy- chopathological symptoms, and late onset of alcohol-related prob-
chopathological symptoms and social complications (Cloninger, lems (see Berglund, 2009; Schuckit, 2009). To our knowledge,
Sigvardsson & Bohman, 1996). In contrast, the type 2 alcoholics there are no studies which have investigated whether individuals
have an earlier onset of alcoholism, more severe dependence with with excessive alcohol consumption per se are characterized by
serious social and medical consequences due to their drinking specic personality patterns.
behavior and also a more severe psychopathology (Cloninger
et al., 1981, 1996; Sigvardsson, Bohman & Cloninger, 1996).
Studies have also found that type 2 alcoholics have a different Aim
personality prole in comparison to type 1 alcoholics, character- The main objective of the present study was to investigate person-
ized by sensation seeking, impulsiveness, monotony avoidance ality traits in a group of male individuals with excessive alcohol
and aggressiveness (Cloninger et al., 1996; von Knorring, von consumption and in controls by comparison with normative data
Knorring, Smigan, Lindberg & Edholm, 1987). Furthermore, they and also by a multivariate projection-based approach. For the lat-
have a lower degree of harm avoidance and less feelings of guilt ter purpose, principal component analysis (PCA) was used for pat-
(Cloninger et al., 1996, von Knorring et al., 1987). This personal- tern recognition and image compression, thus identifying the most
ity pattern has some resemblance with various personality disor- important gradients, that is, revealing the hidden structure of traits
ders. In fact, some researchers have, for example, proposed that (Eriksson, Johansson, Kettaneh-Wold, Trygg, Wikstrom & Wold,
type 2 alcoholism rather represents a separate diagnostic entity, 2006). Personality traits were investigated by using the Karolinska

2011 The Authors.


Scandinavian Journal of Psychology 2011 The Scandinavian Psychological Associations. Published by Blackwell Publishing Ltd., 9600 Garsington
Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA. ISSN 0036-5564.
258 K. Berglund et al. Scand J Psychol 52 (2011)

Scales of Personality (KSP), which quanties individual differ- Assessment of personality


ences in habitual, overt behavior preferences, cognitive style and The Karolinska Scales of Personality (KSP) comprises 135 items with a
reaction to a given situation (Schalling, Asberg, Edman & Ore- four-point response format grouped in 15 scales (Ramklint & Ekselius,
land, 1987). 2003; Schalling et al., 1987). Four scales are related to anxiety proneness
(i.e. somatic anxiety, psychic anxiety, muscular tension and psychasthe-
nia), three scales to vulnerability for disinhibitory psychopathology (i.e.
METHOD impulsiveness, monotony avoidance and socialization) and six scales to
aggressiveness and hostility (i.e. verbal aggression, indirect aggression,
irritability, suspicion, guilt and inhibition of aggression). The remaining
Participants two scales are detachment and social desirability.
Male individuals (n = 100) with excessive alcohol consumption were
recruited by advertisements in a regional daily newspaper. The advertise-
ments were entitled with the questions: Do you drink more alcohol than Statistics
you actually want? followed by Are you male and between
In the present study all individual raw data from the personality test KSP
1865 years, healthy and with a permanent residence? Excessive alco-
was transformed into normative T-scores (mean SD: 50 10) (Gu-
hol consumption was dened as consuming more than three standard
stavsson et al., 1997; Schalling et al., 1987).
drinks of alcohol (about 40 g of pure alcohol) per day (Miller, Anton,
The Soft Independent Modelling of Class Analogy (SIMCA) Principal
Egan, Basile & Nguyen, 2005). To be included in the study they also
Component Analysis (PCA) was used for pattern recognition and image
had to be employed or living on a pension. They had to be without phys-
compression. One advantage of this PCA is that it handles many
ical or psychiatric disorders not associated with excessive alcohol intake
variables and few observations as well as few variables and many obser-
or have abuse or dependence on substances other than alcohol and nico-
vations. The SIMCA PCA is a projection method which can deal with
tine. The subjects in the present study have been included in earlier stud-
non-linear relationships, based on how the various measures for each
ies of ours, when investigating possible pharmacotherapeutical
individual form a multidimensional space. Thus, the individuals and not
interventions for alcohol-dependence (Balldin, Berggren, Engel, Eriksson,
the groups (i.e. individuals with excessive alcohol consumption and con-
Hard & Soderpalm, 1994; Eriksson, Berggren, Blennow, Fahlke & Ball-
trols) are tested in this model. This PCA method includes scaling and
din, 2001a; Eriksson, Fahlke, Hansen, Berggren, Marin & Balldin,
mean-centering to facilitate that the variables are given the same
2001b). However, data for the personality proles have only been pub-
weight in the model. The method is designed to extract and display the
lished for a sub-group (n = 33) of these individuals (Berglund, Fahlke,
systemic variation in a data set. The PCA creates a score plot showing a
Berggren, Eriksson & Balldin, 2006).
summary of the relationship among the individuals and a loading plot
For the PCA analysis a control group was recruited from the ongoing
identifying variables important for creating these relationships, that is,
population-based Swedish Adoption/Twin Study of Ageing (SATSA),
the different personality dimensions of KSP. How much a variable con-
which consists of twins separated at an early age and reared apart and a
tributes can be read from the loading plot. The closer to the origin of
matched sample of twins who were reared together (Pedersen, McClearn,
coordinates the more the variable contributes to the pattern recognition
Plomin, Nesselroade, Berg & DeFaire, 1991). In 1995 twin pairs from
(Eriksson et al., 2006; Wold, Ebensen & Geladi, 1987). The SPSS 15.0
the SATSA cohort born in 1935 or later were considered eligible for par-
and SIMCA-P + 11.5 software (Umetrics AB, Umea, Sweden) were used
ticipation in a substudy on the relationship between personality and
for the analyses. Differences were considered statistically signicant at
health (Gustavsson, Weinryb, Goransson, Pedersen & Asberg, 1997). Out
p < 0.05.
of 194 males in the SATSA cohort 136 gave their informed consent and
answered a postal survey (response rate 70%). Of these individuals, ve
had too many missing data; therefore 131 individuals were included in RESULTS
this study as controls.
This investigation has been approved by the Ethics Committee of Background data
Goteborg and Karolinska Institutet, Stockholm.

At the time of investigation, the individuals with excessive alco-


Procedure hol consumption had an age (mean sd; range) of 49 7 (28
64) years. Out of the individuals, 66 fullled the DSM-IV criteria
After a telephone interview/screening, eligible individuals with excessive
alcohol consumption were invited for an examination at the research cen- for alcohol-dependence and the remaining 34 the criteria for alco-
ter. They were examined psychiatrically using a semi-structured interview hol abuse. Age at onset of excessive alcohol consumption was
by an experienced psychiatrist from the alcoholism treatment unit at a 40 10 years (n = 96) and the reported duration of such con-
University Hospital. This interview also included questions whether the sumption was 9 8 years (n = 95). The scores for HDS and for
subjects fullled the DSM-IV criteria for alcohol abuse or dependence
HAM were within the normal range (3.2 3.9 and 7.4 6.8
(American Psychiatric Association, 1994). In addition, they were
requested to estimate for how long a time-period (in years) they had con- [n = 84], respectively).
sumed this excessive level of alcohol. The age of the subjects at onset of The age of the control group was 53 7 (3861) years. In this
excessive alcohol consumption could thus be calculated and recorded. group 85% reported that they were married (or living together
Determination of illicit drugs and bensodiazepines in urine samples was with a partner) and 84% were employed (8% non-employed and
also performed using suitable laboratory screening procedures in order to
8% retired).
follow the exclusion criteria. During two weeks thereafter individuals
had to record their daily alcohol consumption on a self-monitoring form
called an alco-card (for details, see Balldin et al., 1994).
After these two weeks an experienced research nurse at the research Patterns of personality proles among male individuals with
center assessed possible depressive and anxiety symptoms using the excessive alcohol consumption and controls
Hamilton Depression Scale (HDS; Hamilton, 1967; total sum of scores
The individuals with excessive alcohol consumption as well as
ranging from 052) and Hamilton Anxiety Scale (HAS; Hamilton, 1959;
total sum of scores ranging from 056), respectively. The nurse also the controls had mean values within the normative range (T-scores
administered the self-rating scale KSP for assessment of the personality mean 2 SD; 3070), in all 15 scales of the KSP, see Fig. 1a and
prole, see below. 1b.

2011 The Authors.


Scandinavian Journal of Psychology 2011 The Scandinavian Psychological Associations.
Scand J Psychol 52 (2011) Personality in men with excessive alcohol consumption 259

Individuals with excessive


(a) alcohol consumption (b) Controls
80 80

70 70

60 60

50 50
T-scores

T-scores
40 40

30 30

20 20

10 10

0 0
SA PA MT PS IM MA SO IA VA IR SU GU IoA DE SD SA PA MT PS IM MA SO IA VA IR SU GU IoA DE SD

Fig. 1. T-scores (mean SD) for personality traits as assessed by the Karolinska Scales of Personality: (a) the T-scores for male individuals with excessive
alcohol consumption (n = 100); (b) the T-scores for the male controls (n = 131). Note: SA = somatic anxiety, PA = psychic anxiety, MT = muscular
tension, PS = psychasthenia, IM = impulsiveness, MA = monotony avoidance, SO = socialization, IA = indirect aggression, VA = verbal aggression, IR =
irritability, SU = suspicion, GU = guilt, IoA = inhibition of aggression, DE = detachment and SD = social desirability.

The systematic variance of individuals with excessive alcohol (a) PCA score plot for individuals with excessive alcohol
consumption (A) and controls (C)
consumption and controls in the scales of the KSP was investi-
4
gated using the PCA. The score plot indicated no between-group A
3 A A
separation (see Fig. 2a). There was, however, signicantly more AA A
A A AC C A AA
AA A
2 C
A C A
outliers in the group of individuals with excessive alcohol con- C CC A C CCA CA A A C
C
A CA C C C CAAA A C
C CAC C
1 C CC AC C
ACC CACCC A
sumption (n = 11; 11%) in comparison to controls (n = 4; 3%); C CC CCC CA CA A
CC CCC AC CCA
v2 = 4,94, 1 df, p < 0.05. The majority of the outliers in the group 0
A
C CCC C
AA
AC
A
C
A
CAC
CC
C C C CCACA CCA
C C
CC CC CC CC C
C C
CC CC C
CAA
AC C
CCA CC
of individuals with excessive alcohol consumption had higher C A C
C A
A CCC
C
AA A CAC
C
A C C
1 CC C A CC A C C AC A C
psychic anxiety and lower impulsiveness and monotony avoid- AC CC C C CC C
A
AA
2 A AACA AA AA AAA A
ance. Figure 2b shows how the dimensions of the KSP loaded in A A A AA
3 CAA A AA A
the model, regardless of the two groups. Dimensions appearing A AA A
A A
close to the origin are less signicant, whereas dimensions appear- 4 A A
A
ing at some distance are more important. Psychic anxiety and 5 4 3 2 1 0 1 2 3 4 5 6 7 8
impulsiveness loaded opposite with the largest span to each other,
which indicates an inverse relationship between these two dimen-
(b) PCA loading for the 15 dimensions of KSP
sions.
0.5 MAIM
0.4
DISCUSSION 0.3
Our hypothesis that male individuals with excessive alcohol 0.2
consumption do not have a specic addictive personality, was 0.1 IA
VA SU IR PS SA
conrmed in this study. Thus, this group as well as the popula- 0.0 GU
tion-based control group had mean values within the normative 0.1 MT
DE
IoA
range in all scales of the KSP. Furthermore the score plot in the 0.2
PCA did not indicate a between-group separation. Our ndings,
0.3
obtained by either norm group comparisons or through the use of PA
0.4 SO SD
the statistical method of PCA, are thus in agreement with our own
0.2 0.1 0.0 0.1 0.2 0.3 0.4
previous ndings (Berglund et al., 2006; Eriksson et al., 2001a)
that individuals with excessive alcohol consumption do not differ Fig. 2. (a) the PCA score plot for male individuals with excessive alcohol
in personality patterns from a general reference population as consumption (n = 100) and male controls (n = 131). The ellipse denotes
assessed by the Temperament and Character Inventory (Cloninger, the limit for 2 SD; (b) the PCA loading plot for the 15 dimensions of the
KSP for both groups together. Note: SA = somatic anxiety, PA = psychic
Svrakic & Przybeck, 1993). These results are also in agreement
anxiety, MT = muscular tension, PS = psychasthenia, IM = impulsiveness,
with the notion that there exists little empirical evidence for a cer- MA = monotony avoidance, SO = socialization, IA = indirect aggression,
tain addictive personality (e.g. Mulder, 2002; Sher & Trull, VA = verbal aggression, IR = irritability, SU = suspicion, GU = guilt, IoA
1994; Sutker & Allain, 1988; Weijers et al., 1999) at least regard- = inhibition of aggression, DE = detachment and SD = social desirability.
ing individuals with excessive alcohol consumption resembling
either type 1 alcoholics (Cloninger et al., 1981) or those with excessive alcohol consumption (11%) as compared to controls
social stability (Berglund, 2009; Schuckit, 2009). (3%). The majority of these outliers had higher psychic anxiety
Despite no between-group separation in the PCA analysis, there and lower impulsiveness scores. According to the denition of
was, however, more outliers in the group of individuals with KSP (Schalling et al., 1987), higher scores of the dimension

2011 The Authors.


Scandinavian Journal of Psychology 2011 The Scandinavian Psychological Associations.
260 K. Berglund et al. Scand J Psychol 52 (2011)

psychic anxiety reect anxiousness, lack of self-condence and Cloninger, R. C., Svrakic, D. M. & Przybeck, T. R. (1993). A psychobi-
social anxiety (i.e. neuroticism or negative emotionality). Lower ological model of temperament and character. Archives of General
Psychiatry, 50, 975990.
scores of the dimension impulsiveness reect well-planned behav-
Eriksson, M., Berggren, U., Blennow, K., Fahlke, C. & Balldin, J.
ior and less acting on the spur of the moment. Since this study is (2001a). Further investigation of citalopram on alcohol consumption
cross-sectional, we cannot conclude whether this deviating per- in heavy drinkers: Responsiveness possibly linked to the DRD2 A2/
sonality pattern in the outliers had a causal role in the develop- A2 genotype. Alcohol, 24, 1523.
ment of alcoholism, or if this personality pattern rather is a Eriksson, M., Fahlke, C., Hansen, S., Berggren, U., Marin, P. & Balldin,
J. (2001b). No effect of the cortisol-synthesis inhibitor metyrapone
consequence of excessive alcohol consumption. It should, how-
on alcohol drinking: A pilot study. Alcohol, 25, 115122.
ever, be emphasized that 89% of male individuals with excessive Eriksson, L., Johansson, E., Kettaneh-Wold, N., Trygg, J., Wikstrom, C.
alcohol consumption have personality traits within the normal & Wold, S. (2006). Multi- and megavariate data analysis. Part I:
range. Basic principles and applications. Second revised and enlarged
There are some limitations in the present study. First, only mid- edition (p. 425). Umea: Umetrics AB.
Gustavsson, J. P., Weinryb, R. M., Goransson, S., Pedersen, N. L. &
dle-aged men were included in this study. Secondly, they were
Asberg, M. (1997). Stability and predictive ability of personality
recruited by advertisements, mainly aimed to investigate pharma- traits across 9 years. Personality and Individual Differences, 22, 783
cotherapeutical interventions for excessive alcohol consumption 791.
(Balldin et al., 1994; Eriksson et al., 2001a, 2001b). These limita- Hamilton, M. (1959). The assessment of anxiety states by rating. British
tions may impede the generalization of the ndings to other Journal of Psychology, 32, 5055.
Hamilton, M. (1967). Development of a rating scale for primary depres-
groups of individuals with excessive alcohol consumption. More-
sive illness. British Journal of Social and Clinical Psychology, 6,
over, the control group was recruited from a population-based 278296.
Swedish Twin Registry (Pedersen et al., 1991). It cannot be Lesch, O. M. & Walter, H. (1996). Subtypes of alcoholism and there role
excluded that some individuals within that group also had exces- in therapy. Alcohol and Alcoholism, 31(Suppl.1), 6367.
sive alcohol consumption. Finally, it may be argued that the Miller, P. M., Anton, R. F., Egan, B. M., Basile, J. & Nguyen, S. A.
(2005). Excessive alcohol consumption and hypertension: Clinical
samples were relatively small for such statistical analysis as PCA.
implications of current research. Journal of Clinical Hypertension
It should, however, be noted that the total sample was 231 (Greenwich), 7, 346351.
individuals. Mulder, R. T. (2002). Alcoholism and personality. Australian and New
Zealand Journal of Psychiatry, 36, 4452.
Pedersen, N. L., McClearn, G. E., Plomin, R., Nesselroade, J. R., Berg,
CONCLUSION S. & DeFaire, U. (1991). The Swedish adoption twin study of aging:
An update. Acta Geneticae Medicae Gemellologie, 40, 720.
The majority of male individuals with excessive alcohol consump- Ramklint, M. & Ekselius, L. (2003). Personality traits and personality
tion, recruited by advertisement and at the time of the study not disorders in early onset versus late onset major depression. Journal
participating in any treatment, do not have a personality different of Affective Disorders, 75, 3542.
from that of a general population. This nding thus supports the Schalling, D., Asberg, M., Edman, G. & Oreland, L. (1987). Markers for
vulnerability to psychopathology: Temperament traits associated with
notion that there exists no addictive personality. As socially
platelet MAO activity. Acta Psychiatrica Scandinavica, 76, 172182.
stable men with excessive alcohol consumption may represent the Schuckit, M. A. (2009). Alcohol-use disorders. Lancet, 373, 492501.
majority of the population with alcohol problems, this nding Schuckit, M. A. & Irwin, M. (1989). An analysis of the clinical rele-
may be of importance when formulating national guidelines for vance of type 1 and type 2 alcoholics. Addiction, 84, 869876.
care-giving and treatment of this group. Sher, K. J. & Trull, T. J. (1994). Personality and disinhibitory psychopa-
thology: Alcoholism and antisocial personality. Journal of Abnormal
Psychology, 103, 92102.
Sher, K. J., Trull, T. J., Bartholow, B. D. & Vieth, A. (1999). Personality
REFERENCES and alcoholism: Issues, methods and etiological processes. In K. E.
American Psychiatric Association (1994). Diagnostic and Statistical Leonard & H. T. Blane (Eds.), Psychological theories of drinking
Manual of Mental Disorders (4th edn). Washington, DC: APA. and alcoholism (pp. 54105). New York: Guilford Press.
Babor, T. F. (1996). The classication of alcoholics. Alcohol Health & Sigvardsson, S., Bohman, M. & Cloninger, C. R. (1996). Replication of
Research World, 20, 615. the Stockholm Adoption Study of alcoholism: Conrmatory cross-
Balldin, J., Berggren, U., Engel, J., Eriksson, M., Hard, E. & Soderpalm, fostering analysis. Archives of General Psychiatry, 53, 681687.
B. (1994). Effect of citalopram on alcohol intake in heavy drinkers. Sutker, P. B. & Allain, A. N. (1988). Issues in personality conceptualiza-
Alcoholism Clinical and Experimental Research, 18, 11331136. tions of addicitive behaviors. Journal of Consulting and Clinical
Berglund, K. (2009). Socially stable alcoholics: What characterises Psycholology, 56, 172182.
them? Drinking patterns, personality and health aspects of psychoso- von Knorring, L., Knorring, A-L. von, Smigan, L., Lindberg, U. &
cial and clinical importance (p. 150). Vastra Frolunda: Intellecta Inf- Edholm, M. (1987). Personality traits in subtypes of alcoholics. Jour-
olog AB. nal of Studies on Alcohol, 48, 523527.
Berglund, K., Fahlke, C., Berggren, U., Eriksson, M. & Balldin, J. Weijers, H-G., Wiesbeck, G. A. & Boning, J. (1999). Temperament- und
(2006). Personality prole in type 1 alcoholism: Long duration of character- merkmale sowie merkmal- muster bei alkoholkranken
alcohol intake and low serotonergic activity are predictive factors of mannern und kontrollen. Nervenarzt, 70, 9981008.
anxiety proneness. Journal of Neural Transmission, 113, 12871298. Wold, S., Esbensen, K. & Geladi, P. (1987). Principal Component Analy-
Cloninger, C. R., Bohman, M. & Sigvardsson, S. (1981). Inheritance of sis. Cemimetrics and Intelligent Laboratory Systems, 2, 3752.
alcohol abuse. Archives of General Psychiatry, 38, 861868.
Cloninger, C. R., Sigvardsson, S. & Bohman, M. (1996). Type I and II Received 3 November 2010, accepted 26 November 2010
alcoholism. Alcohol Health and Research World, 20, 1823.

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