Personality and alcohol related problems. Epidemiological findings including gender identity, anxiety and depression in women

Abstract

Background: In developed countries 9.2% of all disability-adjusted life years are attrib-uted to alcohol (in both sexes). In Sweden there has been a rapid increase in alcohol consumption, stressing the need for further knowledge on processes leading to the disor-der and recovery from it. The aetiology is multi-factorial, personality being one of a number of antecedents to alcohol dependence/abuse (ADA).Aim: The overall aim of this thesis was to study associations between personality, gender identity and ADA in women. Specific aims were to analyse associations between person-ality traits and ADA and the co-occurring disorders depression and anxiety, treatment for ADA, and stability in and change of personality traits related to changes in psychiat-ric diagnoses in a general population sample.Methods: This thesis is based on data from the population-based longitudinal project titled Women and Alcohol in Göteborg (WAG) , including a clinical sample. A two-stage sampling procedure, a screening and an interview phase, was used to increase the number of participants with ADA. Psychiatric diagnoses were made according to DSM-III-R codes. Respondents completed the Karolinska Scales of Personality (KSP) and the Masculinity/Femininity-questionnaire (M/F-Q). A case-control design with mostly retrospectively collected data is used in all studies. Number of participants (participation rates):Samples: Screening 1st Interview 2nd interviewPopulation Year Questionnaire Year Interview Year InterviewBorn -25,-35,-45,-55,-65 1986 2.433 (77.7%) 1990 399 (83.3%) 1995 320 (75.7%)Born 1970/1975 1995 2.247 (77.2%) 1995 615 (74.2%) 2000 491(65.5%)Born 1980 2000 829 (75.2%) 2000 358 (72.9%) Clinical sample 1986 2.154 (75.5%) 1990 220 (54.5%) 1995 156 (70.9%)Results: Women with lifetime ADA were more anxious, tense, socially conformist, im-pulsive and irritable. They were more easily fatigued and less satisfied with their present life situation and childhood experiences. This was more marked among women with current ADA and women with an additional diagnosis of depression and/or anxiety. About 20% of women with resolved ADA had treatment experience. They showed more anxiety related traits, guilt and irritability, while untreated women with resolved ADA resembled the reference group in these respects. Women with lifetime ADA were more often low in self-assertiveness/leadership and/or high on emotionality. Women with lifetime severe anxiety disorders were more often low on caring/self-assertiveness and/or high on emotionality. Women with bipolar disorders were more often low on leadership. In general, personality traits were stable over 5 years in this general population sample. Changes in psychiatric diagnoses were associated with changes in some personality traits.Conclusions: In general, personality traits were stable in adult women. Personality and gender identity interacted with ADA as well as anxiety and depression. This knowledge can be useful in evaluation of treatment needs and treatment outcome.