Delving Deeper into Substance Use: Affect Regulation, Defenses, and Personality Factors Influencing Drug Choice in Addictions

According to E. J. Khantzian’s (2003) theory of Self-Medication, substance addiction functions as a compensatory means to modulate affects and self-soothe in response to distressing psychological states. Khantzian’s theory has two main components: 1) addictive drugs
become addicting because they have the power to alleviate, remove, or change (and in turn control) human psychological suffering, and 2) there is a considerable degree of specificity in a person’s choice of drugs, and individuals gravitate to a certain drug because of its psychological
and physiological effects (Khantzian & Albanese, 2008). This project tests the tenets of Khantzian’s (2003) Self-Medication theory in a treatment sample of addicts (N = 304), using content and supplementary scales of the MMPI-2, the PAI, and YSQ. Using an algorithm based on medical records, addicted individuals were reliably classified as being either addicted to a Depressant, Stimulant, or Opiate. Based on Self-Medication theory, I predicted the three groups would function in different ways across combinations of the following variables: Subjective Depression, Psychomotor Acceleration, Post-Traumatic Stress, Over-controlled Hostility, Cynicism, Aggression, Paranoia, Antisocial Tendencies, Emotional Inhibition, Insufficient-Self Control, and Ego Strength. I used MANOVAs to test three theory-driven hypotheses regarding drug group differences on the personality variables. The MANOVAs for hypothesis I (Depressant versus all other addicts) and hypothesis II (Opiate versus other) were statistically significant. The MANOVA for hypothesis III (stimulant versus other) was non-significant. Across the three hypotheses, there were 18 a priori Univariate predictions. Of these, 17 were in the predicted direction, nine were statistically significant. These multivariate and Univariate findings partially support the Self-Medication theory, particularly in its characterization of personality functioning of those addicted to Depressants and Opiates.