Beyond Abstinence: The Influence of Dark Triad Personality Traits on Cognitive and Psychosocial Rehabilitation Outcomes in Substance Use Disorders
Abstract
Background: Substance Use Disorders (SUDs) are linked with significant cognitive, behavioral and psychosocial
impairments, such as deficits in executive functioning, attention, working memory and decision making. These
impairments negatively impact treatment adherence and relapse prevention. Emerging evidence also indicates
that maladaptive personality characteristics, particularly Dark Triad traits (Machiavellianism, narcissism and
psychopathy), may contribute to substance use behaviors, poor self-regulation, resistance to treatment and
vulnerability to relapse. Despite their clinical relevance, these personality traits have not been extensively
discussed in rehabilitation models. Psychosocial rehabilitation remains the cornerstone of treatment in many deaddiction settings, often without systematically considering the impact of cognitive deficits and personalityrelated risk factors.
Objective: This review aims to evaluate the role of Dark Triad personality traits in substance use disorders and
the efficacy of combined cognitive and psychosocial rehabilitation approaches to improve recovery outcomes.
Methods: A systematic review in accordance with PRISMA guidelines was performed. Peer-reviewed studies
published between 2015 and 2025 were identified by online databases. Studies were included if they involved
participants with substance use disorders and focused on cognitive rehabilitation, psychosocial rehabilitation,
Dark Triad personality traits or treatment outcomes. The…
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