Assessment of Executive Function in Patients With Substance Use Disorder: A Comparison of Inventory- and Performance-Based Assessment
Assessment of Executive Function in Patients With Substance Use Disorder: A Comparison of Inventory- and Performance-Based Assessment
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DOI：
10.1016/j.jsat.2016.02.010
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发表时间：
2016-07-01
影响因子：
3.9
通讯作者：
Walderhaug, Espen
中科院分区：
文献类型：
--
作者：
Hagen, Egon;Erga, Aleksander H.;Walderhaug, Espen
简介：慢性多种物质滥用（SUD）与神经生理学和神经解剖学的变化。神经认知障碍往往会影响生活质量、职业功能和从治疗中获益的能力。因此，神经认知评估是重要的，但成本高，不能广泛使用。因此，在忙碌的临床环境中，包括针对核心认知缺陷的现成措施的程序将是有益的。本文探讨了实用的心理测试和基于量表的库存评估“热”和“冷”的神经认知措施的执行功能（EF）在成年人的物质使用障碍。热决策过程与情绪、情感和内脏反应有关，而冷执行功能与理性决策有关。材料和方法：多物质滥用受试者（n = 126）和健康对照组（n = 32）进行了比较，（爱荷华州赌博任务）和寒冷（Stroop和连线测验）测量EF，以及评估日常EF相关问题的问卷（BRIEF-A;成人执行功能行为评定量表，自我报告版本）。通过自我报告评估药物滥用和社会适应的信息。应用Logistic回归分析评估SUD状态和社会适应的独立相关因素。多元线性回归进行预测以前的治疗attempts.Results的数量：热EF（爱荷华州赌博任务）的心理测试没有区分与控制的多物质滥用的患者，并没有与社会调整。冷EF的心理测试区分组之间的一些，并与社会适应的一个指标。BRIEF-A在所有临床量表上对各组进行了区分，并与五个社会适应指标中的三个（“犯罪生活方式”、“与照顾者的冲突”和“稳定的住房”）相关。“）.结论：BRIEF-A清单是物质使用障碍患者执行功能的最敏感措施，其次是冷执行功能的措施。因此，在评估SUD患者时，应将BRIEF-A视为临床常规的组成部分。(C)2016作者爱思唯尔公司出版
Introduction: Chronic polysubstance abuse (SUD) is associated with neurophysiological and neuroanatomical changes. Neurocognitive impairment tends to affect quality of life, occupational functioning, and the ability to benefit from therapy. Neurocognitive assessment is thus of importance, but costly and not widely available. Therefore, in a busy clinical setting, procedures that include readily available measures targeting core cognitive deficits would be beneficial. This paper investigates the utility of psychometric tests and a questionnaire-based inventory to assess "hot" and "cold" neurocognitive measures of executive functions (EF) in adults with a substance use disorder. Hot decision-making processes are associated with emotional, affective, and visceral responses, while cold executive functions are associated with rational decision-making.Material and Methods: Subjects with polysubstance abuse (n = 126) and healthy controls (n = 32) were compared on hot (Iowa Gambling Task) and cold (Stroop and the Trail Making Test) measures of EF, in addition to a questionnaire assessing everyday EF related problems (BRIEF-A; Behavior Rating Inventory of Executive Function Adult, self-report version). Information about the substance abuse and social adjustment were assessed by self-report. Logistic regression analyses were applied to assess independent correlates of SUD status and social adjustment. A multiple linear regression was performed to predict the number of previous treatment attempts.Results: The psychometric test of hot EF (the Iowa Gambling Task) did not differentiate the patients with polysubstance abuse from controls, and was not associated with social adjustment. The psychometric tests of cold EF distinguished somewhat between the groups and were associated with one indicator of social adjustment. The BRIEF-A differentiated between groups on all the clinical scales and was associated with three out of five social adjustment indicators ("criminal lifestyle," "conflict with caregiver," and "stable housing.").Conclusions: The BRIEF-A inventory was the most sensitive measure of executive function in patients with substance use disorder, followed by measures of cold executive function. BRIEF-A should therefore be considered as an integral part of the clinical routine when assessing patients with SUD. (C) 2016 The Authors. Published by Elsevier Inc.