The relationships between personality disorder, substance dependence, self-esteem and coping behaviour within the homeless population

Abstract

This thesis examines the relationships between personality disorder, substance dependence, self-esteem and coping behaviour within the homeless population.  Research studies have repeatedly found high rates of personality and substance use disorders within homeless samples, with the dually diagnosed being at an increased risk for further trauma, service exclusion and more prolonged periods of homelessness.  Furthermore, the roles and interactions of low self-esteem and maladaptive coping behaviours have been highlighted within the homeless, addiction and personality pathology literature.  However, the empirical investigation of these relationships is limited and many findings are inconsistent and inconclusive.  Therefore, the current study examined these relationships within a homeless sample and investigated the particularly vulnerable personality-disordered subgroup.  The aim was to improve the understanding of the multiple processes and factors involved in homeless psychopathology and thus help in identifying more appropriate service needs.  The study results showed high prevalence rates for personality, mood and substance use disorders, where the personality-disordered group had significantly lower self-esteem, higher mood disturbance and higher drug dependence, although there were no significant differences in coping behaviour compared to the non-personality-disordered group.  This study was not without its methodological limitations, although the findings do highlight an especially vulnerable group of homeless individuals who are in need of more specialised and integrated mental health services than what is generally currently available.  Indeed, further research investigating the factors involved in homeless psychopathology is needed in order to match the service and clinical needs of a particularly vulnerable and complex population group.

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