Relationships Between Alexithymia and Psychopathy in Heroin Dependent Individuals.

Nikola Atanassov,Svetoslav Savov,Jasmin Vassileva,Elena Psederska

doi:10.3389/fpsyg.2019.02269

Nikola Atanassov, Svetoslav Savov + Show 2 more

Open Access

https://doi.org/10.3389/fpsyg.2019.02269

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Abstract

BackgroundPsychopathy and substance use disorders are highly co-morbid and their co-occurrence is associated with higher severity of addictive behavior and increased risk of violent offending. Both substance use disorders and psychopathy are related to prominent impairments in emotion processing, which are also central features of alexithymia. The nature of the relationship between psychopathy and alexithymia is not well-understood and has been particularly understudied among substance dependent individuals.AimOur goal was to evaluate the levels of psychopathy and alexithymia in a relatively homogeneous sample of heroin dependent individuals (HDIs) and healthy controls and to examine group differences in the pattern of associations between these constructs.MethodsWe examined 62 participants (31 heroin dependent individuals and 31 healthy controls) with the Psychopathy Checklist: Screening version (PCL:SV, Hart et al., 1995) and the Toronto Alexithymia Scale-20 (TAS-20, Bagby et al., 1994).ResultsHeroin dependent individuals were characterized by higher levels of both psychopathy and alexithymia as compared to the control group. In addition, HDIs with higher levels of psychopathy reported more difficulties in identifying and verbalizing emotional states. In the heroin group, alexithymia was more strongly associated with the impulsive/antisocial characteristics (impulsivity, irresponsibility, antisocial behavior) than with the interpersonal/affective features of psychopathy (grandiosity, manipulativeness, lack of empathy, and remorse).ConclusionOur findings suggest that alexithymia may be one potential mechanism linking psychopathy with opioid use disorders. The development of interventions targeting alexithymia could have significant applications in relapse prevention programs and psychotherapy of substance use disorders with concurrent psychopathy.

Highlights

Substance Use DisordersSubstance use disorders (SUDs) are among the most prevalent mental health problems worldwide
Studies implementing machine-learning techniques have found that psychopathy was the only common predictor of substance dependence on different classes of drugs (Ahn and Vassileva, 2016; Vassileva et al, 2019). These findings suggest that psychopathy may be among the key diagnostic markers for drug addiction, which is reflected by the recent inclusion of psychopathy measure in the phenotypic battery recently proposed by the National Institute on Drug Abuse (NIDA) (Ramey, 2017)
heroin dependent individuals (HDIs) scored significantly higher than controls on both psychopathy and alexithymia

Summary

Introduction

Substance Use DisordersSubstance use disorders (SUDs) are among the most prevalent mental health problems worldwide. SUDs are among the most challenging psychiatric disorders, associated with frequent treatment drop-outs (Brorson et al, 2013) and increased risk of post-treatment relapse (Andersson et al, 2019), which are alarming in opioid use disorder (Smyth et al, 2010). Understanding the heterogeneity of addictions is pivotal, as it may have important implications for prevention and treatment of SUDs and lead to the development of more effective interventions based on individual differences in addictive behavior. Psychopathy and substance use disorders are highly co-morbid and their co-occurrence is associated with higher severity of addictive behavior and increased risk of violent offending. Both substance use disorders and psychopathy are related to prominent impairments in emotion processing, which are central features of alexithymia. The nature of the relationship between psychopathy and alexithymia is not well-understood and has been understudied among substance dependent individuals

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