Affective Factors in the Co-Occurrence of Personality Disorders and Substance Use Disorders

Personality disorders (PDs) and substance use disorders (SUDs) co-occur at high rates. Transdiagnostic mechanisms such as affective processes could improve our understanding of etiology, maintenance, and treatment of co-occurring disorders. We review the role that affective factors play in the overlap between PDs and SUDs and focus on current directions in assessment and evaluation of affective processes.

Recent affect-related work informing PD and SUD co-occurrence has focused on conceptualizing PDs dimensionally, testing affective processes as transdiagnostic constructs, issues in affect measurement, using ecological momentary assessment to identify proximal risk pathways, and debate on the role of affect in SUD.

Affective changes can be reliably measured in daily life, and evidence supports using dimensional models of PDs compared to categorical diagnoses. Future work should build on these strengths and focus on careful translations of SUD theories to research.