The four-factor personality model and its qualitative correlates among opioid agonist therapy clients

Ioan T Mahu; Patricia J Conrod; Sean P Barrett; Aïssata Sako; Jennifer Swansburg; Sherry H Stewart

doi:10.3389/fpsyt.2023.1129274

The four-factor personality model and its qualitative correlates among opioid agonist therapy clients

Front Psychiatry. 2023 Jun 9:14:1129274. doi: 10.3389/fpsyt.2023.1129274. eCollection 2023.

Authors

Ioan T Mahu¹, Patricia J Conrod^{2

3}, Sean P Barrett^{1

4}, Aïssata Sako⁵, Jennifer Swansburg¹, Sherry H Stewart^{1

4}

Affiliations

¹ Department of Psychology and Neuroscience, Life Sciences Centre, Dalhousie University, Halifax, NS, Canada.
² Ste-Justine Hospital, Centre de Recherche, Montreal, QC, Canada.
³ Department of Psychiatry and Addictology, University of Montreal, Montreal, QC, Canada.
⁴ Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, NS, Canada.
⁵ Quebec-Atlantic Node, Canadian Research Initiative in Substance Misuse, Centre de Recherche du CHUM, Montreal, QC, Canada.

Abstract

Background: The Four Factor Personality Vulnerability model identifies four specific personality traits (e.g., sensation seeking [SS], impulsivity [IMP], anxiety sensitivity [AS], and hopelessness [HOP]) as implicated in substance use behaviors, motives for substance use, and co-occurring psychiatric conditions. Although the relationship between these traits and polysubstance use in opioid agonist therapy (OAT) clients has been investigated quantitatively, no study has examined the qualitative expression of each trait using clients' voice.

Method: Nineteen Methadone Maintenance Therapy (MMT) clients (68.4% male, 84.2% white, mean age[SD] = 42.71 [10.18]) scoring high on one of the four personality traits measured by the Substance Use Risk Profile Scale [SURPS] completed a semi-structured qualitative interview designed to explore their lived experience of their respective trait. Thematic analysis was used to derive themes, which were further quantified using content analysis.

Results: Themes emerging from interviews reflected (1) internalizing and externalizing symptoms, (2) adversity experiences, and (3) polysubstance use. Internalizing symptoms subthemes included symptoms of anxiety, fear, stress, depression, and avoidance coping. Externalizing subthemes included anger, disinhibited cognitions, and anti-social and risk-taking behaviors. Adverse experiences subthemes included poor health, poverty, homelessness, unemployment, trauma, and conflict. Finally, polysubstance use subthemes include substance types, methods of use, and motives. Differences emerged between personality profiles in the relative endorsement of various subthemes, including those pertaining to polysubstance use, that were largely as theoretically expected.

Conclusion: Personality is associated with unique cognitive, affective, and behavioral lived experiences, suggesting that personality may be a novel intervention target in adjunctive psychosocial treatment for those undergoing OAT.

Keywords: methadone; motives; opioid agonist therapy; personality; polysubstance use; qualitative–quantitative analysis.