研究背景

酒癮的形成原因至今尚未有一個明確的定論，回顧近年來與酒癮相關的研究，大部分的研究者相信酒癮是由多重因素所共同引起的，其中基因和人格的因素被認為和酒癮有很大的關連。根據過去的研究指出，酒癮的病因有50%以上與基因遺傳有關。另外更有人進一步提出多巴胺乙型受體基因(DRD2)以及血清素轉運子基因(5-HTTLPR)皆與酒癮有關聯，但一直以來都沒有獲得直接的研究證實。在人格向度方面，Cloninger根據神經科學的知識推論第二型酒癮者可能具有較高的尋求刺激與較低的逃避傷害人格特質。因此，本研究嚐試以酒癮診斷中近似於第二型酒癮的反社會酒癮亞型對這些假設做進一步的驗證，探討反社會酒癮者的人格特質，以及酒癮候選基因與特定人格特質的關連性。

研究方法

由於台灣漢族具有酒癮保護因子ALDH2*1/*2 或 *2/*2基因型，因此我們得以收集到反社會非酒癮作為控制組來驗證Cloninger的假設。我們共收集了127個受試樣本，其中符合反社會酒癮診斷的有43人，符合反社會非酒癮診斷的有84人。我們請所有受試者自填三向度性格量表 (Tridimensional Personality Questionnaire, TPQ) 的中文修訂版，並進行抽血及DNA萃取，經過實驗室方法獲得DRD2與5-HTTLPR的基因多型性資料。接著對這些資料進行適當的統計分析。

研究結果

我們發現在三向度人格量表的尋求刺激向度分數上，反社會酒癮組顯著地高於反社會非酒癮組(t=2.61, p=0.01)，但在逃避傷害向度分數上兩組沒有差異(t=0.15, p=0.88)。另外我們發現5-HTTLPR基因型與反社會酒癮有關，而DRD2 TaqI A1+ (包括 A1/A1 或 A1/A2)及5-HTTLPR S/S兩者均與尋求刺激人格特質有關。

結論

在以DRD2 TaqI A 基因型分組之後，反社會酒癮與反社會非酒癮的尋求刺激向度分數上僅在某一種5-HTTLPR 的基因多型性中才有差異(t=2.75, p=0.01)，這顯示了DRD2 TaqI A1+(包含 A1/A1 或 A1/A2)及5-HTTLPR S/S 基因型間有交互作用。然而，在逃避傷害向度分數上，即使以基因型分組後，反社會酒癮與反社會非酒癮兩組仍沒有差異。

Objective: Cloninger suggested that type II alcoholism was associated with higher novelty seeking and less harm avoidance behaviors, which was similar to antisocial alcoholism. Most previous studies have failed to recruit antisocial personality disorder without alcoholism due to the high likelihood of having antisocial personality disorder coexist with alcoholism in the majority of the examined populations. Thus, recruitment of individuals with antisocial non-alcoholism (antisocial personality disorder) served as the important control group in examining Cloninger’s hypothesis. Methods: Due to the documented protective effects against alcoholism of ALDH2*1/*2 or *2/*2 genotype among the Han Chinese population, we recruited antisocial non-alcoholics from the Han Chinese population in Taiwan to verify Cloninger’s hypotheses. A total of 127 Han Chinese subjects were recruited who met the diagnosis of antisocial alcoholism (n=43) or antisocial non-alcoholism (n=84). Results: We found that the antisocial alcoholism group scored higher on the novelty seeking behavior than did the antisocial non-alcoholism group (t=2.61, p=0.01), but no difference was observed on the harm avoidance dimension between these two groups (t=0.15, p=0.88).
Conclusion: In the novelty seeking scores, after stratification of DRD2 TaqI A genotypes, only a significant difference in 5-HTTLPR polymorphisms between antisocial alcoholics and antisocial non-alcoholics was found, indicating an interaction between DRD2 TaqI A1+ (include 3 A1/A1 or A1/A2) and 5-HTTLPR S/S genotype (t=2.75, p=0.01) However, no significant difference was found in the harm avoidance personality trait between these two groups of Han Chinese in Taiwan.

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