Cognitive functioning, clinical profile and life events in young adults addicted to drugs. Does being a girl make a difference?

Objective: Gender features play a fundamental role as risk factors in drug addiction, entailing differences in vulnerability, onset, drug use and clinical trajectories. Even if increasing empirical evidence has attested that drug abuse in emerging adulthood is associated with cognitive impairments, personality disorders and psychological distress, limited research has analyzed these aspects from a gender perspective. The present research focuses on gender differences in youths (18–24 years of age) diagnosed with substance use disorders (SUDs), in order to detect possible differences between females and males as regards their neuropsychological functioning, clinical profiles and past life experiences. Method: Neuropsychological functioning (neuropsychological battery Esame Neuropsicologico Breve-2), the severity of the symptomatology (Symptom Checklist-90-Revised), personality profile and disorders (Shedler Westen Assessment Procedure-200) and life history were assessed in two groups of young adults with SUDs, 20 males and 20 females (mean age = 21 years, SD = 2.2). Participants were recruited in a therapeutic community in Venice, Italy. Results: Girls showed less cognitive impairment but higher psychological distress with respect to boys; between the two groups, no differences emerged regarding the personality profiles. The girls’ life histories presented more experiences of abuse and maltreatment; they also moved more quickly from substance use to dependence. Boys, instead, were more involved in criminal activity. Conclusions: Given our results, it seems that gender differences manifest early, at emerging adulthood. Consequently, a gender-oriented treatment for drug addiction should be offered even at an early age, focusing on early adverse experiences and their potential traumatic effect on girls. By contrast, young men seem to rely on compromised cognitive functions, which require a specific treatment approach, since they constitute a crucial factor for individual adjustment and treatment outcomes. Results should be interpreted relative to some limitations (such as the small sample size and the preliminary and cross-sectional nature of the research), and future studies are require

Alexithymia in young adults with substance use disorders: Critical issues about specificity and treatment predictivity

Several studies have reported high rates of alexithymia in drug-dependent individuals, but supporting evidence attests association between alexithymia and a variety of psychiatric disorders, raising doubts about its specificity. Moreover, controversies are emerging about alexithymia assessment: self-report measures present shortcomings with respect to discriminant validity and reliability. As regards treatment for substance use disorders (SUDs), alexithymia has been linked to poorer outcomes, but the results are inconsistent. The aim of the present study is to investigate alexithymia in substance-dependent young adults by examining: (a) the specificity of alexithymia in drug-dependent inpatients, compared to healthy individuals and patients with psychiatric disorders (behavioral and emotional disorders) and (b) the predictivity of alexithymia in determining treatment outcomes in terms of relapses, drop outs from treatment and the rate of relapse per month of treatment. Two studies were conducted to fulfill these aims: Study 1 and Study 2. Study 1 involved 90 late adolescents, aged 17-21. To fulfill the first aim, 30 inpatients diagnosed with SUD were compared with 30 healthy controls and 30 individuals referred to an outpatient neuropsychiatric unit (a). The participants completed the Toronto Alexithymia Scale-20 (TAS-20) and the Symptom Checklist-90-Revised (SCL-90-R). The results indicated that both clinical groups reported higher TAS-20 scores than the non-clinical subjects, but they did not differ from each other (a); moreover, a large correlation was detected between alexithymia and depressive symptoms, as assessed by the SCL-90-R. Study 2 involved 55 inpatients with SUD recruited in a therapeutic community. The participants completed the TAS-20, and clinicians filled out the Observer Alexithymia Scale (OAS). No association was found between self-report and observational measures. Neither self-reported nor observed alexithymia predicted the number of relapses, drop-out from treatment, or the rate of relapses per month of treatment (b). When the interaction with gender was explored, the global score of alexithymia and the "Distant" OAS subscale predicted the number rate relapses only in males. The TAS-20 did not discriminate between the clinical groups. The limited ability of both observed and self-reported measures in predicting treatment outcome raises questions on the specificity of alexithymia among the substance-dependent inpatient population

Medication overuse headache, addiction and personality pathology: a controlled study by SWAP-200

Background: Medication Overuse Headache (MOH) is a type of chronic headache, whose mechanisms are still unknown. Some empirical investigations examining the addiction-like behaviors and processes, as well as personality characteristics underlying MOH development, reached contrasting findings. This study aimed at detecting personality and its disorders (PDs) in MOH patients, with a specific attention to the features of addiction. Methods: Eighty-eight MOH patients have been compared with two clinical populations including 99 patients with Substance Use Disorder (SUD) and 91 with PDs using the Shedler-Westen Assessment Procedure-200 (SWAP-200). MANCOVAs were performed to evaluate personality differences among MOH, SUD and PD groups, controlling for age and gender. Results: MOH patients showed lower traits of the SWAP-200’s clusters A and B disorders than SUD and PD patients, whom presented more severe levels of personality impairment. No differences in the SWAP-200’s cluster C have been found, indicating common personality features in these populations. At levels of specific PDs, MOH patients presented higher obsessive and dysphoric traits, as well as better overall psychological functioning than SUD and PD patients. Conclusions: The study supported the presence of a specific pattern of personality in MOH patients including obsessive (perfectionist) and dysphoric characteristics, as well as good enough psychological resources. No similarities with drug addicted and personality-disordered patients were found. Practitioners’ careful understanding of the personality of MOH patients may be useful to provide more effective treatment strategies and patient-tailored intervention programs

Neuropsychological deficits in young drug addicts

Background: Adolescence is a highly vulnerable age for experimenting with drugs; increasing evidence attests that several substances might have detrimental effects on cognitive functioning in this developmental phase, when prefrontal brain areas are still immature and may actually be the main target of the neurotoxic effects of drugs. There are still, in any case, too few studies that specifically address early adulthood. Aim: The present study aims to investigate neuropsychological performance in young drug addicts in residential treatment (aged 18-24). Methods: 41 young drug addicts, after admission to residential treatment, were compared with 27 subjects in the control group. A battery of neuropsychological tests (Brief Neuropsychological Exam-2) was administered to detect possible cognitive impairments. Descriptive and non-parametric statistics (Pearson’s chi square test) were performed. Results and conclusions: Findings suggest that drug dependence in youth is distinguished by neuropsychological deficits, in particular, attention and executive function impairments – issues that now call for tailored and innovative treatment approaches

An Innovative Psychological Assessment Method for Young Drug-Addicts. Connections with the Clinical Intervention. An Illustrative Case-Study

The development of new assessment and treatment protocols for Substance Use Disorders (SUDs) has been recently fostered by epidemiological data, which indicates that drug-related problems mainly peak in young age; moreover, there have been important changes in the phenomenon of drug addiction, which often involves early onset, poly-drug use and the diffusion of new psychoactive drugs. An enhanced comprehension of the current manifestations of SUDs is the essential step to take, in order to inform and improve treatment programs targeting this clinical population. As a consequence, there is the strong need for assessment protocols that are age-appropriate and capable of addressing such a complex and multi-determined clinical condition. Reporting Adrian\u2019s case, a young inpatient undergoing a residential community program, the present study illustrates the most salient features of SUD in young age. Secondly, the paper offers the opportunity to describe an innovative psychological assessment protocol (multi-focus, multi-informant, multi-method and longitudinal) and its connections with the clinical treatment level, over one-year long treatment. Thirdly, it allows some important considerations about which psychological domains and characteristics should be primarily considered by treatment programs targeting substance dependence for individuals in their teens or twenties

Cognitive and Emotional Functioning in Young Drug-addicts. Preliminary findings

Introduction: Adolescence is a vulnerable age for experimenting with drugs, unfortunately early substance abuse has severe detrimental effects on cognitive functioning. Moreover, drug addiction is also characterized by affective dysregulation, in terms of high rates of sensation-seeking and alexithymia and poor emotional intelligence. Cognitive control and emotion regulation abilities are directly associated and are largely implemented by the same frontal cortex areas, which are also the main target of drug abuse. Objective: The present research aims to study the neuropsychological performance and the emotional functioning in young drug addicts, investigating possible interrelations between these two domains. Methods: a battery of neuropsychological tests (ENB-2) and self-report tools, addressing alexithymia (TAS-20), sensation seeking (SSS-VI) and emotional intelligence (EQ-i), were administered to 19 young drug-addicts. An observer scale to evaluate alexithymia (OAS) was also used. Results: subjects showed memory and attention deficits. High rates of alexithymia emerged, but only in the observer scale; also past experience of disinhibition and inadequate emotional intelligence abilities were identified. Several significant correlations were detected between cognitive functions and affective style, especially as regards executive functions and alexithymia. Conclusions: These findings suggest that drug-dependence in young age is not only characterized by neuropsychological deficits and difficulties in emotion regulations, but these two domains are associated, delineating a severe clinical conditions that requires specific treatment

Cognitive functioning clinical profile and life events in young adults addicted to drugs. Does being a girl make a difference?

Objective: Gender features play a fundamental role as risk factors in drug addiction, entailing differences in vulnerability, onset, drug use and clinical trajectories. Even if increasing empirical evidence has attested that drug abuse in emerging adulthood is associated with cognitive impairments, personality disorders and psychological distress, limited research has analyzed these aspects from a gender perspective. The present research focuses on gender differences in youths (18–24 years of age) diagnosed with substance use disorders (SUDs), in order to detect possible differences between females and males as regards their neuropsychological functioning, clinical profiles and past life experiences. Method: Neuropsychological functioning (neuropsychological battery Esame Neuropsicologico Breve-2), the severity of the symptomatology (Symptom Checklist-90-Revised), personality profile and disorders (Shedler Westen Assessment Procedure-200) and life history were assessed in two groups of young adults with SUDs, 20 males and 20 females (mean age = 21 years, SD = 2.2). Participants were recruited in a therapeutic community in Venice, Italy. Results: Girls showed less cognitive impairment but higher psychological distress with respect to boys; between the two groups, no differences emerged regarding the personality profiles. The girls’ life histories presented more experiences of abuse and maltreatment; they also moved more quickly from substance use to dependence. Boys, instead, were more involved in criminal activity. Conclusions: Given our results, it seems that gender differences manifest early, at emerging adulthood. Consequently, a gender-oriented treatment for drug addiction should be offered even at an early age, focusing on early adverse experiences and their potential traumatic effect on girls. By contrast, young men seem to rely on compromised cognitive functions, which require a specific treatment approach, since they constitute a crucial factor for individual adjustment and treatment outcomes. Results should be interpreted relative to some limitations (such as the small sample size and the preliminary and cross-sectional nature of the research), and future studies are required

Young girls who face motherhood in the context of drug-addiction. Which characteristics in terms of personality, cognition and alexithymia?

Introduction: Substance use disorders (SUD) are associated with several bio-psycho-social risk factors, which become even more worrisome if they intertwine with other two conditions of vulnerability: youth and motherhood. Young drug-addicted girls are at great risk for unintended pregnancy and in many cases they continue to use substances during the prenatal and postnatal age. SUDs encompass a number of impairments in terms of dual diagnosis, cognitive deficits and alexithymia, which contribute to the development and the maintenance of the disorder and they interfere with its treatment too. Nevertheless, little research has explored these domains in young drug-addicted girls, and even less in groups of addicted mothers in their early adulthood. AIMS Within the general purpose of investigating risk factors associated with parenting, the present study intends to explore potential characteristics of young drug-addicted mothers in the domains of cognition, personality and alexithymia. Material and methods: 2 groups of young girls (aged 18-25), admitted to a therapeutic community program, were involved: 10 drug-addicted non-mothers and 10 drug-addicted mothers. Personality was assessed with the q-sort Schedler Westen Assessment Procedure-II (Schedler, et al., 2014), neuropsychological functioning with the protocol Esame Neuropsicologico Breve-2 (Mondini, et al., 2011) and alexithymia with the self-report Toronto Alexithymia Scale-20 item (Bressi, et al., 1996). Results: Both drug-addicted mothers and non-mothers reported high rates of personality disorders (70-80% respectively), impaired global cognitive profile (40%) and alexithymia (20-60%). Non-parametric statistics revealed significant differences in paranoid and hostile personality traits, with mothers showing higher levels of dysfunctional traits. On the other hand, non-mothers reported more alexithymic difficulties, namely identifying their own inner states, and slightly more memory impairments. Conclusions: Given the presence of notable impairments in young mothers with SUDs, further studies should investigate whether and how these problematic features might adversely affect parenting and early mother-child interaction