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Does substance abuse fall exclusively along the externalizing spectrum?

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Area of Science:

  • Psychiatry
  • Psychology
  • Behavioral Science

Background:

  • Substance abuse is often categorized as an externalizing disorder.
  • However, its relationship with internalizing and externalizing dimensions requires further investigation.

Purpose of the Study:

  • To test the hypothesis that substance abuse exhibits characteristics of both internalizing and externalizing disorders.
  • To differentiate the dimensional structure of substance abuse and offending behaviors.

Main Methods:

  • Confirmatory factor analysis (CFA) was used on data from 1,177 adjudicated delinquents.
  • Temperament/personality indicators were correlated with substance misuse and offending measures.

Main Results:

  • A three-factor model (negative emotionality, fearlessness, disinhibition) best explained the data, outperforming one- and two-factor models.
  • Substance abuse and offending were identified as separate dimensions.
  • Substance misuse showed a stronger alignment with the internalizing dimension (negative emotionality) and a weaker alignment with the externalizing dimension (fearlessness).

Conclusions:

  • Substance abuse is not solely an externalizing disorder; it shares features with internalizing disorders.
  • Negative emotionality is a significant correlate of substance misuse in this population.
  • Future research should consider the distinct and overlapping features of internalizing and externalizing psychopathology in substance use disorders.