Cognition In Adolescents At Risk for Substance Abuse

这些实验的目的是确定是否青少年在药物滥用（SA）的风险表现出受损的认知表现的任务，揭示了赤字的表现与SA的历史的成年人。成年人长期暴露于滥用药物后的异常认知表现可以反映对SA的脆弱性（主要效应）或药物对大脑的影响（次要效应）。这项研究测试的假设，在青少年的易感认知缺陷有助于药物滥用的风险。到目前为止，81名青少年完成了研究的初始阶段，31名完成了3年的随访。健康青少年（N=31）进行类似的健康成人赌博任务（GT），其目标是冲动和判断，并取决于眶额皮质功能。滥用药物的成年人在这项任务上往往比健康的成年人表现得更差。有药物滥用风险的青少年（N=33）在这项任务上的表现也比健康青少年差，这表明在这项任务上的异常表现可能先于暴露于滥用物质。这些结果是初步的，有待通过研究更大的人群来确认，并直接评估这些发现在后续数据中的意义。自我报告和父母报告与执行功能相关的困难（例如，计划，组织和启动）显着相关的外部控制点在37个青少年男孩（年龄12-18岁，有和没有多动症）参加了这项研究。与适应和抑郁、焦虑等情绪困难有关的外部控制点也对药物滥用的发生很敏感。对这些参与者的后续研究将测试感知控制与功能失调适应（如药物滥用）的关联。 使用从参加本研究的青少年中获得的数据，我们评估了一些测试工具的评分员间的可靠性，内部一致性和/或时间的可靠性。我们评估了内部的一致性和时间稳定性的康纳斯？连续性表现测试（CCPT）作为一种临床工具，用于评估注意力缺陷多动障碍（ADHD）的CCPT在51名青少年的样本中，（19名ADHD，8名ADHD和另一种疾病，24名对照）。CCPT具有足够的分半信度，并且发现在1.3年的跨度内，性能适度相关。ADHD参与者在第一次（而不是第二次）CCPT给药期间的表现往往比对照组差。CCPT被认为是诊断状态的不敏感指标，而几个CCPT性能指标与父母的ADHD认知功能评分相关，这些相关性的模式在很大程度上独立于测试手册中提供的解释性指南。我们的结论是，CCPT评分的诊断有效性差，功能相关性不明确，可能会混淆CCPT的临床解释。我们评估了一个样本的青少年参与本研究的评价者之间的协议和内部一致性的雷伊复杂图形测试（RCFT）。我们发现每个RCFT结局指标与临床可接受的评分者间可靠性估计相关。此外，我们发现复制和召回准确性得分与临床可接受的内部一致性相关。我们评估的组织评分方法，虽然与内部一致性，是可以接受的研究目的，被发现有点低于与临床可接受性相关的估计。我们评估了短期和长期稳定性的Stroop颜色和文字测试，市售版本的Stroop？在87名青少年中进行的原始任务。参与者在基线时平均间隔一个月进行测试，并以大约15个月的间隔进行两次测试。我们发现，所有常用的性能指标与实践效果和三个主要的分数，但不是公式推导的干扰分数，与可接受的可靠性。

These experiments are designed to determine whether adolescents at risk for substance abuse (SA) exhibit impaired cognitive performance on a task that reveals a deficit in performance by adults with a history of SA. Abnormal cognitive performance in adults after long-term exposure to drugs of abuse can reflect either vulnerability to SA (primary effect) or drug effects on the brain (secondary effect). This study tests the hypothesis that a predisposing cognitive deficit in adolescents contributes to risk for substance abuse. To date, 81 adolescents completed the initial phase of the study and 31 have completed their 3-year follow-up visit. Healthy adolescents (N=31) performed similarly to healthy adults on a gambling task (GT), which targets impulsivity and judgment and depends on orbitofrontal cortical function. Substance abusing adults tend to perform more poorly than healthy adults on this task. Adolescents at risk for substance abuse (N=33) also perform more poorly on this task than healthy adolescents, suggesting that abnormal performance on this task may precede exposure to substances of abuse. These results are preliminary and await confirmation by studying a larger population, and assessing directly the significance of the findings in follow-up data. Self-reports and parental reports of difficulties associated with executive function (e.g., planning, organization and initiation) are significantly correlated with an external locus of control in 37 adolescent boys (aged 12-18, with and without ADHD) enrolled in this study. An external locus of control, which has been associated with adaptation and emotional difficulties such as depression and anxiety, is also sensitive to the onset of substance abuse. Follow-up studies of these participants will test the association of perceived control with dysfunctional adaptations such as substance abuse. Using data acquired from adolescents enrolled in this study, we evaluated the inter-rater reliability, internal consistency and/or temporal reliability of a number of the test instruments. We assessed the internal consistency and temporal stability of Conners? Continuous Performance Test (CCPT) as a clinical tool for the assessment of attention-deficit/hyperactivity disorder (ADHD) the CCPT in a sample of 51 adolescents, (19 with ADHD, 8 with ADHD and another disorder, and 24 controls). The CCPT has adequate split-half reliability, and performance was found to be moderately correlated over the span of 1.3 years. ADHD participants tended to perform worse than controls during the first, but not second, CCPT administration. The CCPT was found to be an insensitive indicator of diagnostic status and, while several CCPT performance measures correlated with parent ratings of ADHD symptomatology, the pattern of these correlations was largely independent of the interpretive guidelines provided in the test manual. We conclude that the poor diagnostic validity and the unclear functional relevance of CCPT scores might confound clinical interpretation of the CCPT. We assessed the inter-rater agreement and internal consistency of the Rey Complex Figure Test (RCFT) in a sample of adolescents enrolled in this study. We found each of the RCFT outcome measures to be associated with clinically acceptable inter-rater reliability estimates. Additionally, we found the copy and recall accuracy scores to be associated with clinically acceptable internal consistency. The organizational scoring method we evaluated, while associated with internal consistency that is acceptable for research purposes, was found to be somewhat below estimates associated with clinical acceptability. We assessed the short- and long-term stability of the Stroop Color and Word Test, a commercially-available version of Stroop?s original task in 87 adolescents. Participants were tested an average of one month apart at baseline and twice more at approximately 15 month intervals. We ffound that all of the commonly used performance indices are associated with practice effects and that the three primary scores, but not the formula-derived interference score, were associated with acceptable reliability.