Personality Functioning and Antisociality of Youth Accessing Residential Substance Use Withdrawal in Australia

ABSTRACT Introduction This study examined the prevalence and associations of personality dysfunction and antisociality among youth accessing residential substance use disorder (SUD) withdrawal. Methods Participants were 100 youth (57% female) aged 18–25 scheduled or admitted to residential SUD withdrawal in Victoria, Australia. Personality dysfunction was assessed using the Level of Personality Functioning Scale—Self Report and Antisocial Personality Disorder (ASPD) Impairment Interview. SUDs were assessed using the Structured Clinical Interview for DSM‐5, early maladaptive schemas using the Young Schema Questionnaire‐Rach, and antisocial attitudes using the Measures of Criminal Attitudes and Associates. Results All participants met criteria for at least one SUD ( M = 2.2, SD = 2.1); 66% endorsed two or more SUDs. Nearly half the sample met the threshold for likely general personality disorder (PD; 48%), while 43% met criteria for likely ASPD. Chi‐square analyses indicated that likely general personality disorder ( χ 2 = 12.4, p < 0.001) and likely ASPD ( χ 2 = 13.5, p < 0.001) were associated with polysubstance use. Likely ASPD was associated with cannabis ( χ 2 = 9.3, p < 0.01), methamphetamine ( χ 2 = 4.9, p < 0.05), alcohol ( χ 2 = 4.3, p < 0.05) and sedative ( χ 2 = 4.9, p < 0.05) use disorders. Elevated early maladaptive schemas were common; 59% reported a prior arrest, and 23% reported 10 or more. Discussion and Conclusions Personality dysfunction and antisociality appear common among youth accessing residential withdrawal, supporting the assessment of personality functioning in this population. Future research should examine whether integrating personality‐informed or schema‐focused approaches within withdrawal services improves outcomes.