Researchers identify personality traits that predict alcohol relapse after treatment

Having a high novelty-seeking personality trait may raise the risk of relapse after alcohol withdrawal. This finding comes from new research published in the Journal of Psychiatric Research.

Alcohol use disorder remains a major public health challenge in France, where millions struggle with harmful drinking patterns. Personality traits can shape a person’s vulnerability to addiction, but few studies have examined how these traits influence recovery in the months following withdrawal. Past research suggests that impulsivity, difficulty regulating emotions, and sensitivity to rewards may all play a role in addiction.

Led by Anne-Laure Virevialle from Centre Hospitalier Esquirol, the team aimed to better understand why some individuals relapse soon after treatment. Virevialle and colleagues recruited 88 adults undergoing inpatient alcohol withdrawal at a psychiatric hospital in France. Participants completed several assessments, including a personality questionnaire, a craving scale, a cognitive test, and measures of anxiety and depression.

Blood samples were taken to measure carbohydrate-deficient transferrin, a biological marker that reflects recent heavy drinking. The researchers also measured brain-derived neurotrophic factor, a protein involved in the brain’s ability to adapt and rewire itself. Three months later, 46 participants returned for follow-up testing.

The researchers analyzed 76 participants who had complete, usable data, finding that 29 had relapsed by the three-month mark. Those who relapsed scored higher on novelty-seeking, a personality trait associated with impulsivity and a tendency to act quickly without considering consequences. These individuals also scored lower on harm avoidance, meaning they were less sensitive to potential negative outcomes.

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Relapsers also showed higher self-directedness, a trait typically associated with better self-control. The authors suggest this reflects a temporary boost in confidence during inpatient treatment rather than long-term resilience. They wrote, “the hospitalization context may temporarily reinforce self-esteem and self-efficacy through social validation and structured support.”

The researchers used statistical modeling to identify the strongest predictor of relapse, and novelty-seeking stood out. Although it explained only about one-fifth of the variation in relapse outcomes, it was the most reliable single factor. This suggests that certain traits may shape a person’s recovery trajectory over time.

The study also explored how personality traits relate to craving, mood, and cognition. People with higher harm avoidance and higher alexithymia, which is a difficulty identifying and expressing emotions, reported stronger cravings. Depression and anxiety were also more common among those with high harm avoidance and low self-directedness.

Brain-derived neurotrophic factor increased over the three-month period for both relapsers and non-relapsers. This increase is expected during brain recovery as patients abstain from or reduce their alcohol intake. However, there was no significant difference in these protein levels between the two groups at the three-month mark, suggesting it is not a reliable relapse predictor on its own.

The researchers believe these findings can help doctors tailor treatment to individual patients. “This study highlights the need to develop a global evaluation of individuals for personalised care because the motivation to change concerning alcohol also requires the management of psychiatric comorbidities, taking into account the personality profile of the individual,” the authors concluded.

The study has a few limitations, including a high dropout rate. Nearly half of the original participants did not return for the follow-up, which may skew the final results. Craving scores were also unusually low, likely because the initial assessments were conducted in a protected inpatient environment.

The study, “Personality traits and craving in patients undergoing alcohol withdrawal treatment,” was authored by Anne-Laure Virevialle, Benjamin Calvet, Murielle Girard, Mirvat Hamdan-Dumont, Alexandra Foucher, Brigitte Plansont, Aurélie Lacroix, and Philippe Nubukpo.