Fernández-Serrano María José, Cesar Peraleslópez José, Moreno-López Laura, Santos-Ruiz Ana, Pérez-García Miguel, Verdejogarcía Antonio
Departamento de Psicología, Universidad de Jaén, España.
Adicciones. 2012;24(2):105-13.
A recent theoretical approach describes addiction as a dynamic behavioural change process on the impulsivity-compulsivity axis. However, on the basis of current evidence, it is still difficult to establish a selective association between the course of addiction and individual transition along this axis. The aim of this study is to categorize each of the individuals in a sample of cocaine-dependent patients (CDI) as mainly impulsive or mainly compulsive, on the basis of their performance in neuropsychological inhibition and perseveration tests, and to test the association between the assigned category and their scores in trait impulsivity, and severity of cocaine addiction (measured by means of self-report assessment tools). A total of 42 CDI and 65 healthy control individuals (HCI) were assessed using the UPPS-P Scale (to explore trait impulsivity), the Stroop and Go/No Go (to assess response inhibition), and Revised-Strategy Application and Probabilistic Reversal tests (to assess response perseveration). Forty-five per cent of the CDIs were classified as compulsive, and this subgroup scored significantly higher than the impulsive group on the UPPS-P dimensions of lack of perseverance and lack of premeditation. A substantial proportion of CDIs can be classified as compulsive. No differences between compulsive and impulsive CDIs were found with regard to severity of exposure to cocaine; however, patients classified as compulsive by means of neuropsychological tasks are less perseverative in the pursuit of long-term objectives and more prone to make under-meditated decisions, as shown by trait impulsivity assessment questionnaires.
最近的一种理论方法将成瘾描述为冲动-强迫轴上的动态行为变化过程。然而,基于目前的证据,仍然难以确定成瘾过程与个体在该轴上的转变之间的选择性关联。本研究的目的是根据可卡因依赖患者(CDI)样本中每个人在神经心理学抑制和持续性测试中的表现,将其分类为主要冲动型或主要强迫型,并测试所分配类别与其特质冲动得分以及可卡因成瘾严重程度(通过自我报告评估工具测量)之间的关联。使用UPPS-P量表(以探索特质冲动性)、斯特鲁普测验和Go/No Go测验(以评估反应抑制)以及修订后的策略应用和概率反转测验(以评估反应持续性)对总共42名CDI和65名健康对照个体(HCI)进行了评估。45%的CDI被归类为强迫型,该亚组在UPPS-P量表的缺乏毅力和缺乏预谋维度上的得分显著高于冲动型组。相当一部分CDI可被归类为强迫型。在可卡因暴露严重程度方面,强迫型和冲动型CDI之间未发现差异;然而,通过神经心理学任务分类为强迫型的患者在追求长期目标时缺乏毅力,并且更容易做出欠考虑的决定,特质冲动性评估问卷显示了这一点。