| Abstrakt: |
Impairments in impulse control and related neurocognitive functioning have been well documented in both substance use and mental disorder populations. While high impulsivity and other executive dysfunction have been linked to negative treatment outcomes in these populations, no study to date has examined their clinical relevance among individuals with co-occurring substance use and mental disorders (or concurrent disorders [CD]).Objective This study investigated impulsivity and working memory among CD inpatients across treatment and compared to controls.Methods Patients (N = 56, Mage= 38.2, SD = 11.7, 17F) and healthy controls (N = 50, Mage= 31.9, SD = 10.0, 25F) completed a battery of self-report questionnaires and behavioural tasks assessing working memory and impulsivity (response inhibition, delay discounting, reflection, decision-making). Patients were assessed within 2 weeks of admission (baseline) and at 6 months (follow-up). Controls completed a single session at baseline. Patient demographics, diagnostic status, and treatment outcome (discharge with or without medical advice) were retrieved from medical records.Results Group differences in demographics were probed for inclusion as covariates. At baseline, patients had greater self-reported impulsivity on the UPPS-P (negative and positive urgency) and BIS (motor and non-planning), and greater delay discounting than controls. Among patients, there was no association between treatment adherence and working memory, self-report, or behavioural impulsivity, and no change in behavioural impulsivity was observed from baseline to follow-up.Conclusions This is the first study to assess impulsivity and working memory in the context of CD treatment. Patients exhibited greater impulsivity on choice-based and various self-report measures. The absence of treatment-related changes in impulsivity and working memory outcomes suggests that conventional treatments may be neglecting to target potentially key areas of functioning. Further research is needed to examine how treatment affects impulsivity and related functions in individuals with CD, and their impact on clinical outcomes. |
