Predicting Smoking and Nicotine Dependence from the DSM-5 Alternative Model of Personality

Individuals with personality disorders (PDs) have higher morbidity and mortality than thegeneral population, and this may be due to maladaptive health behaviors such as smoking.Individual differences in underlying personality dimensions of behavioral undercontrol, affectivedysregulation, psychoticism, and antagonism are thought to explain the high comorbidity betweenPDs and smoking and nicotine dependence. However, little is known about how the Diagnostic andStatistical Manual of Mental Disorders (5th Ed.; DSM-5) Section III trait model of personalitypathology relates to smoking and nicotine dependence. The current study examined this questionin a sample of 500 participants using the Levels of Personality Functioning Scale to assess generalpersonality dysfunction, the Personality Inventory for DSM-5 to measure specific traits, theFagerstrom Test for Nicotine Dependence to assess nicotine dependence, and questions aboutcurrent and past smoking to assess lifetime smoking behavior. Results demonstrated that two ofthe five higher-order personality traits (i.e., negative affectivity and detachment) predictedsmoking status (current vs former/never smokers), but none of the personality traits predictedlevel of nicotine dependence within the smokers. General personality pathology was notpredictive of smoking status or nicotine dependence. The relationships between negativeaffectivity and detachment and smoking status were still significant after controlling for othersmoking risk factors (i.e., drug/alcohol use and depression/anxiety symptoms), and afteraccounting for general personality pathology. Findings are discussed in regard to the generalvalidity of this new personality disorder diagnostic system.