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THE ROLE OF PERSONAL CHARACTERISTICS IN THE FORMATION AND
MANIFESTATION OF POST-TRAUMATIC STRESS AND ALCOHOL ADDICTION
1
Sultanov Shoxrux Xabibullayevich
2
Ulashev Mashrab Avlayor o‘g‘li
3
Uzoqova Dinoraxon Mamurjon qizi
1
Doctor of Science, SciencesDepartment of Therapeutic direction No.3, Tashkent State Dental
Institute, Tashkent, Uzbekistan
2-3
Student of group 505 of the Faculty Medical Pedagogy of Samarkand State Medical
University, Samarkand, Republic of Uzbekistan
https://doi.org/10.5281/zenodo.14926487
Abstract.
The role of personal characteristics in the development, progression, and
manifestation of post-traumatic stress disorder (PTSD) and alcohol addiction is crucial, as
individual differences can influence susceptibility to these conditions, the ways in which
individuals cope with stress and trauma, and their response to treatment. Factors such as
personality traits, genetic predisposition, emotional regulation abilities, and past life experiences
play a significant role in determining the likelihood of developing PTSD or alcohol addiction.
Additionally, the interaction between psychological resilience, social support, and behavioral
tendencies can shape the severity and chronicity of these conditions, ultimately affecting treatment
efficacy and long-term recovery outcomes. Understanding these individual characteristics can
provide valuable insights for the development of personalized therapeutic interventions and
preventive strategies.
Keywords:
Development, progression, manifestation, post-traumatic stress disorder,
alcohol addiction, individual differences.
Introduction.
When stress arises, individual characteristics of a person play a crucial role,
as they determine how an individual perceives and responds to stressful situations. In certain
conditions, specific triggers can act as psychological stress factors, influencing emotional and
behavioral reactions. However, it is important to note that no single situation can universally
induce stress in all individuals, as personal resilience, past experiences, coping mechanisms, and
personality traits significantly shape how stress is experienced and managed [1,2].
In borderline forms of mental disorders, the primary cause of impaired cognitive adaptation
lies in the weakened functioning of the mental adaptation system. According to the author, the
degree and nature of cognitive dysfunction and its manifestation vary among individuals, largely
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depending on the rate and progression of these changes. The intensity and depth of persistent
influences on the mental adaptation system play a crucial role in shaping the severity of cognitive
impairment. Additionally, the literature highlights the significance of pathogenic conditions,
environmental factors, and the extent and severity of their impact on mental adaptation [3-5].
These external and internal influences contribute to the complexity of mental
maladaptation, affecting an individual’s ability to cope with stress, maintain psychological
stability, and adjust to changing circumstances. If there is a pre-existing constitutional
insufficiency of systems, whether genotypic or phenotypic, the development of neurosis may occur
as a result of psychological trauma. It is believed that character accentuations, which represent an
extreme variation of the norm, contribute to selective vulnerability to certain types of psychogenic
influences while simultaneously demonstrating resilience or even heightened resistance to others.
This suggests that individual predispositions, shaped by genetic and environmental factors,
play a crucial role in determining how a person responds to psychological stressors. In some cases,
these accentuations may act as protective mechanisms, enabling individuals to withstand certain
pressures, while in other cases, they may increase susceptibility to specific forms of mental
distress. Understanding these interactions is essential for assessing psychological resilience and
developing targeted therapeutic approaches [6-9].
Several authors emphasize the role of organic brain damage in altering the clinical
manifestations of psychogenic disorders, highlighting its pathological influence in shaping
symptom severity and progression. They also place particular importance on additional
psychogenic factors that may exacerbate these conditions. For instance, war veterans who find
themselves in a minority status or who experience a disruption in the ideological foundations of
their wartime experiences may face significant psychological distress. This, in turn, can contribute
to the deepening and intensification of post-traumatic symptoms in the aftermath of trauma. The
combination of organic brain impairments and psychosocial stressors creates a complex interplay
that influences the persistence, severity, and treatment responsiveness of post-traumatic
conditions, underscoring the need for comprehensive diagnostic and therapeutic approaches
tailored to individual experiences and vulnerabilities [10-13].
Among individuals who have experienced extreme situations, there are some who appear
to recover quickly from the trauma they have endured. However, in many cases, symptoms of
psychological disorders may emerge much later, sometimes even after many years, in the form of
what is known as “delayed stress.”
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These individuals may initially seem resilient, but over time, the lingering effects of their
past trauma can resurface, often triggered by new stressors or life challenges [14].
Furthermore, according to many researchers, the consequences of severe stress not only
persist in those who have undergone traumatic events but may also be exacerbated by subsequent
stressors encountered later in life. This suggests that the impact of extreme psychological stress is
not always immediate and that its effects can accumulate over time, leading to a heightened
vulnerability to future mental health issues. Understanding this delayed manifestation of stress-
related disorders is crucial for developing long-term support and intervention strategies for those
at risk [15-17].
After extensively studying the causes of mental disorders that persist long after trauma,
many researchers have identified social factors as playing a crucial role in the development and
progression of these conditions. It is widely believed that in the absence of adequate social
support—such as a lack of emotional encouragement from loved ones or strained relationships
with others—individuals are more likely to experience repeated stress, which inevitably leads to a
worsening of their psychological state [18, 19].
Moreover, research has examined the level of social and professional adaptation among
individuals suffering from post-traumatic stress disorder (PTSD) in prolonged emergency
situations. Findings suggest that prolonged exposure to extreme conditions not only deepens
psychological distress but also significantly impacts a person’s ability to reintegrate into society
and maintain stable employment. The lack of supportive social environments exacerbates
symptoms, making recovery more challenging and increasing the risk of chronic psychological
dysfunction. This highlights the critical need for effective psychosocial interventions and support
systems to mitigate the long-term consequences of trauma and improve the overall well-being of
affected individuals [20-22].
Common stress factors that can lead to the development of post-traumatic stress disorder
(PTSD) include military combat, natural disasters, transportation accidents, serious incidents,
witnessing violent deaths, armed robbery, torture, sexual assault, and fires. These traumatic events
often overwhelm an individual's coping mechanisms, potentially resulting in long-term
psychological distress and dysfunction [23].
At the same time, an individual's vulnerability to PTSD plays a significant role in
determining their likelihood of developing the disorder. Research suggests that certain premorbid
personality traits can contribute to increased susceptibility to PTSD. These traits include emotional
immaturity, asthenic (weak or fragile) characteristics, heightened sensitivity, dependence on
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others, a tendency toward excessive self-control aimed at suppressing unwanted emotions, and a
predisposition toward victimization. Individuals with these traits may have difficulty processing
traumatic experiences effectively, leading to prolonged psychological distress and a higher risk of
developing PTSD symptoms [24-26].
Understanding the interplay between external stressors and individual predispositions is
crucial in identifying at-risk individuals and developing targeted interventions. By recognizing
these vulnerability factors, mental health professionals can implement preventative strategies and
personalized treatment approaches to mitigate the long-term psychological impact of trauma [27].
Studies on the factors that contribute to susceptibility to post-traumatic stress disorder
(PTSD) have generated significant interest among researchers. Several key risk factors have been
identified, including distinct personality traits, substance or alcohol dependence, a history of
psychological trauma, and a family history of mental illness. These factors can increase an
individual’s likelihood of developing PTSD following exposure to traumatic events.
Coping with extreme situations tends to be particularly challenging for both the very young
and the elderly. In children, this difficulty is largely attributed to the underdevelopment of coping
mechanisms, making them more vulnerable to the psychological effects of trauma. In contrast,
elderly individuals may struggle due to age-related declines in resilience, as well as physiological
changes affecting the nervous and cardiovascular systems, which can exacerbate stress responses.
The ability to effectively process and recover from trauma is therefore influenced not only
by psychological factors but also by physiological limitations associated with different stages of
life [28-32].
Additionally, research suggests that PTSD is more commonly observed in individuals who
experience social and economic hardships. Those who are isolated, divorced, widowed, or
struggling with financial instability are at a higher risk of developing PTSD, as a lack of social
support can hinder emotional recovery. Social isolation and financial difficulties may intensify the
psychological burden of trauma, leading to prolonged distress and a reduced ability to cope with
stressors [33].
Recognizing these vulnerability factors is crucial for the early identification of at-risk
individuals and the implementation of targeted interventions. Providing appropriate psychological
support, fostering social connections, and addressing underlying risk factors can significantly
improve outcomes for individuals exposed to traumatic experiences [34, 35].
By examining the causes of the evolution of acute stress disorders in military personnel
with PTSD, researchers have highlighted the role of individual predisposition in shaping long-term
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psychological outcomes. It has been emphasized that certain personality traits and psychological
tendencies may contribute to the consolidation of maladaptive coping mechanisms, which, in turn,
increase the likelihood of developing chronic or prolonged forms of PTSD in the future [36].
This suggests that some individuals, due to their inherent psychological vulnerabilities,
may struggle to process and adapt to extreme stress effectively. Instead of successfully overcoming
traumatic experiences, they may develop persistent dysfunctional responses that reinforce
pathological patterns of adaptation. Over time, these maladaptive mechanisms become deeply
ingrained, making the transition from acute stress reactions to chronic PTSD more likely [37-39].
Understanding these predisposing factors is crucial in identifying military personnel at risk
of developing long-term PTSD. Early intervention strategies, including psychological support,
resilience training, and targeted therapy, can play a vital role in preventing the progression of acute
stress responses into chronic post-traumatic stress disorder, ultimately improving mental health
outcomes for service members exposed to combat and other extreme stressors [40].
Long-lasting reactive states in large groups of individuals, such as concentration camp
prisoners, repressed persons, and interned individuals, were first described after World War II.
These individuals exhibited a range of psychological and physiological symptoms,
including heightened vulnerability, hostility toward others, chronic fatigue, sleep disturbances, and
autonomic dysfunction. In addition, they often experienced profound social isolation, depression,
and nervous irritability, making their condition distinct from other forms of psychological distress
[41-43].
When describing the clinical presentation of these cases, researchers primarily focused on
the unique personality changes observed in the affected individuals. These changes led scholars to
propose specific terms to accurately define these conditions, such as "depressive development"
and "depressive personality transformation." These terms were intended to capture the deep-seated
alterations in the psychological and emotional makeup of individuals suffering from prolonged
trauma [44-46].
Further studies on the progression and dynamics of these disorders revealed that neurotic
depression exhibited a tendency toward evolution and transformation over time. This finding
suggested that prolonged exposure to extreme stressors did not simply result in static psychological
damage but instead led to ongoing changes in personality structure, emotional regulation, and
coping mechanisms. Understanding this progression has been crucial in the study of trauma-related
disorders, emphasizing the need for long-term psychological support, early intervention strategies,
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and a nuanced approach to treatment that considers both the immediate and evolving effects of
extreme stress on mental health [47].
To date, various forms of pathological personality development have been described in
psychological and psychiatric research. Based on constitutional predisposition to psychogenic
influences and the severity of these impacts, scholars have identified two main types of abnormal
personality development: psychopathological and psychogenic. These, in turn, are further
categorized based on their underlying nature and manifestation into "simple" and "internal
conflict" or "conflict-based" personality developments [48-50].
Pathological (Psychopathological) Development – This form of personality development
is characterized by deep-seated pathological alterations that result in significant and often
irreversible personality disturbances. These changes typically arise due to inherent vulnerabilities
and long-term exposure to adverse conditions. Psychogenic or Post-Reactive Development – This
type refers to personality distortions that emerge as a result of past reactive states, meaning that an
individual’s character undergoes specific changes following the experience of intense
psychological trauma. These transformations are often conditional and reactive in nature [51-53].
Pathocharacterological Development – This variant occurs due to prolonged exposure to
situational factors, leading to the gradual formation of pathological personality traits over time.
Unlike psychogenic development, which is more reactive, pathocharacterological changes
develop progressively under sustained environmental stressors.
Researchers have also identified and described different patterns of pathological
personality development, including hysterical, obsessive-phobic, and explosive (impulsive-
aggressive) types. Each of these variants exhibits distinct psychological characteristics and coping
mechanisms.
Furthermore, neurotic depression has been regarded by scholars as the initial stage of
neurotic personality development. This perspective highlights how untreated or prolonged neurotic
states can evolve into more ingrained and persistent psychological dysfunctions over time.
Understanding these different forms of personality development and their underlying
mechanisms is crucial for early diagnosis, targeted therapeutic interventions, and the prevention
of long-term personality disorders in individuals exposed to chronic stress, trauma, or adverse life
conditions.
In the study of alcoholism, special attention must be given to the role of constitutional
factors in the development and progression of the disorder. A review of scientific research
dedicated to the issue of personality in addiction medicine is primarily found in local literature,
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revealing a significant diversity in approaches to studying this complex subject. When examining
the pathogenesis of substance dependence, two fundamentally opposing perspectives emerge, each
emphasizing different primary contributing factors:
Biological and Genetic Factors – This perspective highlights the hereditary and
neurobiological components of addiction, suggesting that genetic predisposition, neurochemical
imbalances, and innate vulnerabilities play a decisive role in the development of alcohol
dependence.
Psychological and Environmental Factors – This viewpoint emphasizes the influence of
personality traits, individual psychological predispositions, early life experiences, and external
socio-environmental conditions (such as family dynamics, social stressors, and cultural influences)
in shaping addictive behaviors.
The contrast between these two perspectives, rooted in historical debates within
psychopathology and psychoanalysis, can be traced back to the theoretical distinctions made by
Karl Jaspers and Sigmund Freud. For a long time, this dichotomy was not explicitly recognized in
local addiction psychiatry; however, over the past decade, it has become increasingly pronounced.
This shift has been reflected in the relatively autonomous development of psychiatric
(psychopharmacological) and psychotherapeutic approaches to addiction treatment [41-48].
The growing divergence between biological and psychological models of addiction has led
to significant advancements in both pharmacological interventions (e.g., medications targeting
neurochemical pathways involved in dependence) and psychotherapy-based rehabilitation
strategies (e.g., cognitive-behavioral therapy, motivational enhancement therapy). Understanding
the interplay between these factors remains crucial for developing comprehensive, individualized
treatment approaches that address both the physiological and psychological dimensions of
alcoholism.
Until recently, in psychiatry, the concept of hedonistic accentuation in the premorbid
personality structure of individuals suffering from alcoholism and substance dependence had long
been dominant. This theory suggested that individuals predisposed to addiction exhibited an
excessive drive for pleasure-seeking behaviors, a lack of early voluntary self-regulatory traits, and
a strong inclination toward easily attainable goals. Their motivational instability was characterized
by a failure to balance immediate desires with the ability to coordinate and regulate needs in
accordance with the principle of reality, which is typically present in a psychologically stable
individual [38-42].
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Moreover, such individuals were often marked by aggressive tendencies and self-
destructive motivations, further contributing to their vulnerability to addiction. These personality
traits led some researchers to identify and describe what they referred to as "pre-alcoholic" and
"pre-addictive" personality types, emphasizing the presence of impulsivity as a central
characteristic.
From a typological and diagnostic perspective, impulsivity plays a crucial role in
predisposing individuals to addictive behaviors. Supporting this hypothesis, several researchers
have provided additional evidence suggesting that individuals vulnerable to addiction, when
compared to general population statistics, display a higher prevalence of antisocial tendencies and
delinquent behaviors in their premorbid personality. Signs of rule-breaking, disregard for social
norms, and increased involvement in deviant activities have been observed at significantly higher
rates in individuals who later develop alcohol or substance use disorders [43-47].
These findings have significant implications for understanding the role of personality
structure in addiction pathology, emphasizing the importance of early psychological assessment
and preventive interventions for at-risk individuals. The recognition of impulsivity, motivational
instability, and antisocial tendencies as potential risk factors for substance dependence underscores
the necessity of multidimensional treatment approaches, integrating both psychopharmacological
and psychotherapeutic strategies to address the complex interplay between personality traits and
addiction susceptibility [42-44].
Attempts have been made to develop a typology of alcoholism by comparing the
phenomenological and dynamic characteristics of an individual's hedonistic traits with the clinical
presentation and outcomes of the disease. According to this perspective, a more severe and chronic
course of alcoholism, which is associated with a poor prognosis, is often linked to individuals
displaying "oral character" traits.
Individuals fitting this "true alcoholism" profile, as defined by the author, tend to exhibit
passivity and a pronounced dependency on their primary caregivers from an early age. These
individuals are characterized by hypertrophied hedonistic needs, which manifest in a heightened
fixation on food, medications, and desires that are erotically charged—often expressed through
constant chewing, biting, or sucking behaviors. This dependency-driven and gratification-seeking
personality structure appears to contribute to the progressive deterioration seen in this subtype of
alcoholism.
In contrast, another identified subtype, referred to as "regressive alcoholism," tends to
emerge later in life and is marked by a compulsive pattern of alcohol consumption.
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However, this subtype is generally associated with a better prognosis compared to the
former. Individuals within this category often exhibit premorbid "anal character" traits, which are
typically associated with rigidity, orderliness, and control. Their transition into alcoholism is
thought to be shaped by psychodynamic factors, in which repressed conflicts and control-oriented
psychological structures eventually give way to alcohol as a coping mechanism [45-47].
The distinction between these two typological forms of alcoholism—one driven by deep-
seated oral dependency and hedonistic gratification, and the other by compulsive behavioral
patterns emerging later in life—highlights the importance of individualized treatment approaches.
By recognizing the underlying personality structures that predispose individuals to
different courses of addiction, clinicians may be better equipped to tailor interventions that address
both the psychodynamic and behavioral aspects of alcohol dependence [48-50].
They are distinguished by stenic characteristics, such as perseverance in achieving goals, a
strong desire for dominance, and assertiveness. These traits often contribute to their ability to exert
control over their environment and influence others.
If we set aside R. Knight’s psychoanalytic interpretation of pathological personality, we
can assert that his conclusions have been fully confirmed by subsequent clinical studies. These
studies have established a strong correlation between the psychopathological indicators of
alcoholism and the premorbid personality traits of individuals, which tend to vary along different
axes. Among these, the most notable are the "stenic-astenic" spectrum—where individuals range
from highly energetic and goal-driven to passive and lacking resilience—and the "extrovert-
introvert" dimension, which affects social behavior, coping mechanisms, and susceptibility to
addiction [51-53].
Further research into these personality structures has reinforced the notion that certain pre-
existing character traits may influence both the development and course of alcoholism. Individuals
with stenic features, who exhibit high levels of determination and dominance, may initially
maintain greater functional control over their addictive behaviors, potentially leading to a more
prolonged and insidious progression of alcoholism. Conversely, those with asthenic
characteristics, who struggle with low energy, anxiety, and dependency, may experience a more
rapid emotional and psychological decline when exposed to chronic substance use [53-55].
The recognition of these personality-based predispositions is essential in both diagnostic
assessments and therapeutic interventions for alcohol dependence. By identifying whether an
individual leans toward a more dominant and assertive personality structure or a more passive and
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emotionally fragile disposition, clinicians can develop tailored treatment approaches that address
the specific psychological and behavioral mechanisms underlying their addiction [56-59].
Research indicates that individual predispositions play a crucial role in determining how
quickly and severely pathological changes develop in substance use disorders. Certain personality
traits and inherent temperamental factors—such as impulsivity, emotional instability, vulnerability
to stress, and deficits in self-regulation—may increase the likelihood of more severe disease
progression and poorer long-term outcomes [57].
Moreover, studies emphasize that individuals with different premorbid personality
structures exhibit distinct patterns of clinical manifestation, response to treatment, and relapse
susceptibility. For instance, those with highly impulsive or emotionally reactive personalities may
struggle with self-control and long-term abstinence, whereas those with more rigid or obsessive
tendencies may develop compensatory mechanisms that temporarily mask the disorder but
eventually lead to psychological breakdowns [58-60].
These findings underscore the importance of comprehensive personality assessments in
addiction psychiatry, as understanding a patient’s pre-existing psychological makeup can
significantly inform treatment planning, prognosis estimation, and relapse prevention strategies.
It has been observed that alcoholism tends to progress more favorably in patients who
exhibit stenic personality traits during the premorbid period. These individuals are characterized
by higher resilience, determination, and a more structured temperament, which contribute to a
slower disease progression, a later onset of alcohol abuse, and a prolonged first stage of
alcoholism. Additionally, in such cases, the chronic nature of the disease predominates, with a
more controlled pattern of alcohol consumption and a later age of seeking medical assistance [61-
63].
Conversely, alcoholism is significantly more dangerous in patients with hysterical
excitability and emotional instability. These individuals are at a higher risk of developing severe
alcohol dependence and are more likely to become part of the marginalized and antisocial
segments of society, including those with criminal tendencies. Their behavioral patterns often lead
to legal issues, social dysfunction, and a greater overall burden on public health and law
enforcement systems.
Furthermore, research highlights a notable dissociation between the severity of
alcoholism’s clinical manifestations and the relative social security of the individual. This suggests
that even individuals with a seemingly stable socioeconomic background can develop severe forms
of alcoholism, while those from disadvantaged backgrounds may sometimes display less
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pronounced clinical symptoms [64-66]. This discrepancy underscores the complex interplay of
psychological, environmental, and genetic factors in the development and course of alcohol
dependence, emphasizing the need for personalized approaches to treatment and prevention
strategies.
Conclusion:
Thus, at present, it seems illogical to speak of a pre-existing "alcoholic
personality", as the concept lacks empirical support. Instead, it is more appropriate to focus on the
role of personality traits in the pathogenesis of substance dependence, including alcoholism.
Given the increasing recognition of individual psychological factors in the development of
addictive behaviors, psychiatrists are now paying serious attention to the influence of personality
characteristics on the onset and progression of alcoholism. These traits not only contribute to the
emergence of psychogenic reactions but also shape their form, intensity, and course over time.
A particularly pressing issue in modern psychiatry is the interaction between PTSD and
secondary alcoholism. Individuals suffering from post-traumatic stress disorder often develop
comorbid alcohol dependence, as they attempt to self-medicate their psychological distress. In this
context, understanding how specific personality traits influence both PTSD and alcohol addiction
becomes crucial for developing effective prevention and treatment strategies.
By thoroughly investigating the role of personality in substance abuse disorders, clinicians
can better predict individual susceptibility to alcoholism, tailor personalized therapeutic
interventions, and improve long-term recovery outcomes for those struggling with PTSD and
alcohol dependence.
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