Prognostic value of impulsivity in treatment outcomes in patients with alcohol use and/or cocaine use disorder in a rehabilitation programme

Introduction: Impulsivity is linked to factors that are negatively correlated with drug and alcohol use. Individuals with substance use disorder (SUD) often suffer from cognitive deficits and, additionally, have high levels of impulsivity. Studies show that cognitive deficits are associated with lower self-efficacy (SE), and the latter is considered an important indicator of SUD management and treatment outcomes. The relationship between impulsivity and SE, however, remains unclear. This prospective study examined impulsivity as a prognostic indicator for SE in SUD populations admitted for inpatient treatment. Methods: Fifty individuals, aged 18–61, with either a cocaine use and/or alcohol use disorder diagnosis were examined within 72 hours of (1) the start and (2) completion of treatment. Results: Impulsivity was a significant predictor of SE. Duration of abstinence (in days), estimated intelligence, global assessment of functioning (GAF) and patient age explained 16% of the variance in the change in SE at discharge. After including impulsivity in the regression model, the total variance explained by the model was 28% (F [5.505] = 3.47, p = 0.01). Impulsivity explained an additional 12% of the variance after controlling for the above variables (R2 change = 0.12, F change [4.45] = 7.206, p = 0.01). Conclusion: Impulsivity is a significant predictor of SE following an 8-week impatient treatment programme for individuals diagnosed with SUD. To our knowledge, this is the first study to demonstrate that impulsivity holds prognostic value in respect of the change in SE after inpatient treatment of individuals with SUD. Based on our findings, replication studies are warranted

Cognitive insight is associated with perceived body weight in overweight and obese adults

CITATION: Suliman, S., et al. 2021. Cognitive insight is associated with perceived body weight in overweight and obese adults. BMC Public Health, 21:534, doi:10.1186/s12889-021-10559-5.The original publication is available at https://bmcpublichealth.biomedcentral.comBackground: Accurate perception of body weight is necessary for individuals with a high body mass index (BMI) to initiate strategies to improve their health status. Furthermore, identifying factors that influence accurate body weight perception can assist in designing appropriate educational and weight management programs. We therefore aimed to investigate whether levels of cognitive functioning and insight influence the ability to correctly judge body weight. Methods: One hundred and eighty four overweight and obese adults who participated in a cross- sectional casecontrol study and were controls in the aforementioned study were included. The study was conducted in Cape Town, South Africa. Demographic, weight-related, neuropsychiatric, neurocognitive and cognitive insight measures were administered. Regression analysis was conducted to determine the factors associated with correct weight perception. Results: The final regression model explained 52.3% of variation in accurate perception of body weight and was significant (p ≤ 0. 001). The model correctly classified 79.3% of individuals who were able to correctly and incorrectly judge their weight. Adults with higher BMI, and lower self-certainty, those who reported that they had gained weight in the previous year and those who were told by a healthcare professional to lose or maintain a healthy weight were more likely to correctly judge their weight. Conclusion: Some aspects of cognitive insight (self-certainty) but not cognitive functioning were associated with perception of body weight in this sample. Awareness of recent weight changes, higher BMI and advice from of health care professionals were also significantly associated with perception of body weight, while demographic variables were not. Understanding the factors that contribute to the correct perception of weight is important in identifying appropriate health interventions that may address the burden of associated non-communicable diseases in overweight and obese individuals.https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10559-5Publisher's versio

A pilot randomized control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD.

Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance when delivered to South African adolescents with PTSD.Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. At baseline, post- and 1-month follow-up participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690)Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (wald test = -2.18, p=0.029), mean slope = -0.2 (95%CI: -0.37 to -0.02) (p=0.583). On the CPSS-5, interaction between groups was also not significant (p=0.291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: -18.00 to -0.21), p=.045 and the 1-month follow-up contrast -11.22 (95%CI: -22.43 to -0.03), p=0.049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n=10; 32%) and control (n=8; 26,7%) groups. Reasons provided for dropout were mostly school commitments or travel related.Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated. <br/