Abstract
BACKGROUND: Maladaptive personality traits are often associated with adverse childhood experiences and substance use disorders. At the same time, there is a multidirectional relationship between experiencing life stressors and maladaptive personality traits. A variable that also enters these relationships is relational attachment, which has an impact on an individual's overall functioning. We aimed to examine these interconnections in a clinical sample. METHODS: A clinical sample of adult patients with substance use disorder (n = 63, m(age) = 38.87 ± 10.34 years, 71.43% men) was assembled. The data on adverse childhood experience (Adverse Childhood Experience International Questionnaire; ACE-IQ), attachment anxiety and avoidance (Experiences in Close Relationships - Revised; ECR-R), maladaptive personality traits (Personality Inventory for DSM-5 Short Form; PID-5-SF) were collected, and associations between variables were assessed by correlations and exploratory network analysis. RESULTS: Adverse childhood experiences were reported by 92% of patients in the clinical sample. Spearman correlation analysis revealed significant associations between attachment anxiety and the PID-5 domains of Negative Affectivity, Antagonism, and Disinhibition. Attachment avoidance correlated with Detachment and Disinhibition. Specific ACEs, such as emotional neglect, emotional abuse, and parental loss, were significantly associated with Psychoticism and other maladaptive personality traits. Exploratory network analysis visualized robust links between attachment dimensions and personality traits, with Negative Affectivity, Detachment, and Disinhibition emerging as central nodes. These findings suggest that maladaptive personality traits serve as a key connecting point between early adversity and relational patterns in individuals with substance use disorders. CONCLUSIONS: The findings underscore the clinical relevance of maladaptive personality domains in understanding how adverse childhood experiences shape adult relational patterns in individuals with substance use disorders. Targeting these personality domains in assessment and intervention may enhance the effectiveness of therapeutic approaches addressing both addiction and attachment-related difficulties. Integrating this perspective into treatment planning could support more individualized interventions, particularly for patients with histories of early adversity. Furthermore, findings point to the potential benefit of trauma-informed and personality-focused therapeutic approaches to address underlying relational and emotional regulation difficulties. Sufficient preventive programs for maltreated children and youth should be a topic in question.