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Personality, Personality Disorders, and Substance Use Disorders:
Because BPD is frequently associated with substance use disorders (SUDs), Dr. Trull began to study the reasons why these conditions frequently co-occur within the same individuals. To date, he has published many papers on the topic of personality disorders and SUDs. In addition, he has served as Co-Investigator on two federally-funded grants (both from the NIAAA) that support projects that will provide data to address these and related questions. Dr. Trull is also a senior faculty member of the NIAAA-funded Alcoholism Research Center (ARC) that is based at Washington University in St. Louis (Andrew Heath, PI). For example, Dr. Trull was the Principal Investigator of Project 6, “Ecological momentary assessment of emotional regulation.” This project uses ecological momentary assessment (EMA) to examine the use of alcohol to regulate emotions, how these efforts compare to other forms of emotional regulation observed in BPD (e.g., smoking, self-harm), and the effects of these regulation strategies on subsequent mood.
BPD exhibits exceptionally high comorbidity with alcohol use disorders (AUDs) in both clinical and population-based samples. Cardinal symptoms of BPD, impulsivity and affective instability, are central constructs in theories of AUD etiology, so BPD represents a type of “model system” for studying the role of emotion regulation and disordered self-control in the genesis of AUD. We recently finished this data collection which included EMA data from both random and event-based (e.g., drinking, smoking) assessments. Our papers that are submitted or in preparation will address: (1) The role of both positive and negative moods in alcohol use in BPD and in non-affected controls (CON), (2) Are BPD patients drinking episodes associated with heavier consumption (sex and body weight adjusted) and estimated blood alcohol concentrations than CON? Do both affective instability and impulsivity moderate this effect? (3) Is alcohol consumption’s effect on mood characterized by positive and/or negative reinforcement? (4) Are negative post-drinking effects of alcohol on mood larger in BPD patients than controls?
In addition, Dr. Trull was a Co-Investigator on an NIAAA-funded project that uses NESARC data from over 40,000 U.S. residents to examine the course and development of alcohol problems and related comorbidities across the life span. Most of his work focuses on personality disorder-substance dependence comorbidities. Papers from this project presented an alternative and (we believe) more accurate scoring of the personality disorder items from the NESARC interview, as well as examine PD-SUD comorbidities, and methods for clustering symptoms and evaluating both general/shared and specific factors associated with comorbid conditions. For the research described above, Dr. Trull played critical roles in all aspects of the research (i.e., study planning, obtaining funding, framing the research question, data analytic approach, and ms. preparation).
Related Publications:
Trull, T. J., Sher, K. J., Minks-Brown, C., Durbin, J., & Burr, R. (2000). Borderline personality disorder and substance use disorders: A review and integration. Clinical Psychology Review, 20, 235-253. PMID: 10721499
Trull, T. J., Waudby, C. J., & Sher, K. J. (2004). Alcohol and substance use disorders and personality disorder symptoms. Experimental and Clinical Psychopharmacology, 12, 65-75. PMID: 14769101
Jahng, S., Solhan, M. B., Tomko, R., Wood, P. K., Piasecki, T. A., & Trull, T. J. (2011). Affect and alcohol use: An EMA study of Outpatients with borderline personality disorder. Journal of Abnormal Psychology, 120, 572-584. PMC4262451
Jahng, S., Trull, T. J., Wood, P. K., Tragesser, S. L., Tomko, R., Grant, J. D., Bucholz, K. K., & Sher, K. J. (2011). Distinguishing General and Specific Personality Disorder Features and Implications for Substance Dependence Comorbidity. Journal of Abnormal Psychology, 120, 656-669. PMC4241053
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