Etiologic connections among substance dependence, antisocial behavior and personality: Modeling the externalizing spectrum.
Abstract
A hierarchical biometric model is presented of the origins of comorbidity among substance dependence, antisocial behavior, and a disinhibited personality style. The model posits a spectrum of personality and psychopathology, united by an externalizing factor linked to each phenotype within the spectrum, as well as specific factors that account for distinctions among phenotypes within the spectrum. This model fit self-report and mother-report data from 1,048 male and female 17-year-old twins. The variance of the externalizing factor was mostly genetic, but both genetic and environmental factors accounted for distinctions among phenotypes within the spectrum. These results reconcile evidence for general and specific causal factors within the externalizing spectrum and offer the externalizing factor as a novel target for future research.
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Externalizing traits share genetic liability.
“Collectively, this group of correlated traits are classified as externalizing3. Twin studies have demonstrated that externalizing liability is highly heritable (~80%)4,5.”
From Multivariate analysis of 1.5 million people identifies genetic associations with traits related to self-regulation and addiction. (2021) · cites this paper as [5]
Externalizing liability is highly heritable, around 80%, according to twin studies.
“Twin studies have demonstrated that externalizing liability is highly heritable (~80%)4,5.”
From Multivariate analysis of 1.5 million people identifies genetic associations with traits related to self-regulation and addiction. (2021) · cites this paper as [5]
Another influential dispositional profile combines high negative emotionality, impulsivity, and low agreeableness.
“Another influential dispositional profile combines high negative emotionality, impulsivity, and low agreeableness (Sher and Trull 2002; Krueger et al. 2002; Miller et al. 2003).”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Krueger et al. 2002
Temperamental traits such as disinhibition, negative affectivity, and heightened reward sensitivity are key predispositions for both externalizing behaviors and alcohol misuse.
“Temperamental traits such as disinhibition, negative affectivity, and heightened reward sensitivity are key predispositions for both externalizing behaviors and alcohol misuse.”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Krueger et al. 2002
These traits show moderate heritability and contribute to a broader 'behavioral disinhibition' liability spanning both domains.
“These traits show moderate heritability and contribute to a broader “behavioral disinhibition” liability spanning both domains (Krueger et al. 2002; Iacono et al. 2008; Young et al. 2009).”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Krueger et al. 2002
Biological, psychological, and social risk factors interact dynamically over development.
“These biological, psychological, and social risk factors interact dynamically over development (Krueger et al. 2002; Iacono et al. 2008).”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Krueger et al. 2002
The entire spectrum of externalizing behavior is related to a core set of impulsive traits evident early in development.
“the entire spectrum of externalizing behavior appears to be related to a core set of impulsive traits (Kreuger et al., 2002) that is evident early in development”
From Adolescent risk taking, impulsivity, and brain development: Implications for prevention (2010) · cites this paper as Kreuger et al., 2002
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Self-citationVulnerable Narcissism Is (Mostly) a Disorder of Neuroticism
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Genome-Wide Association Studies of a Broad Spectrum of Antisocial Behavior
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Human Aggression Across the Lifespan
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“On a phenotypic level, disruptive and problem behaviors within the disinhibitory spectrum can be united by a common higher order externalizing factor (Krueger et al., 2002, 2005, 2007).”
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Evidence for a Multi-Dimensional Latent Structural Model of Externalizing Disorders
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“range of substantive topics, including reports that have examined how specific and generalized risk are associated with the development of adolescent SU (Krueger et al., 2002; Maes et al., 2004; Palmer et al., 2012, 2013b, 2009; Young et al., 2006, 2000), the strong relationship of antisocial behavior to alcohol and d…”
Self-citationPTSD and substance-related problems: the mediating roles of disconstraint and negative emotionality
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“Co-occurring ADs may modify the relationship between PG severity and mood disorders because ADs belong to a category of disorders characterized by internalizing behaviors (Krueger et al., 2002).”
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- Authors
- Krueger, R. F., Hicks, B. M., Patrick, C. J., Carlson, S. R., Iacono, W. G., & McGue, M.
- Affiliations
- University of Minnesota (US)
- ORCID
- Venue
- Journal of Abnormal Psychology
- Published
- 2002-08
- Volume
- 111
- Issue
- 3
- Pages
- 411-424
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- OpenAlex
- W2074805244
- Cited by
- 1,378
- References
- 114
- Citations by year
- 2026: 13 · 2025: 19 · 2024: 20 · 2023: 50 · 2022: 41 · 2021: 43 · 2020: 75 · 2019: 70 · 2018: 57 · 2017: 65 · 2016: 76 · 2015: 89 · 2014: 84 · 2013: 84 · 2012: 91
- FWCI
- 40.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Abnormal Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1k02aa000175-01)
- National Institute on Alcohol Abuse and Alcoholism (AA-00175, AA-09367)
- National Institute of Mental Health (MH65137, R21MH065137)
- National Institute on Drug Abuse (DA-05147)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- substance dependence, antisocial behavior, comorbidities, genetic factors, environmental factors, personality traits, adolescent twins, mothers' reports, self-report
- MeSH terms
- Adolescent, Adolescent Behavior, Adult, Alcoholism, Antisocial Personality Disorder, Child Behavior Disorders, Female, Humans, Inhibition, Psychological, Interviews as Topic, Male, Models, Psychological, Personality, Personality Assessment, Personality Disorders, Psychiatric Status Rating Scales, Self Disclosure, Twins, Comorbidity, Diagnosis, Dual (Psychiatry), Substance-Related Disorders
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