Department of Clinical Psychology, University of Granada, Spain.
Arch Clin Neuropsychol. 2014 Feb;29(1):38-46. doi: 10.1093/arclin/act072. Epub 2013 Sep 6.
High impulsivity is common to substance and gambling addictions. Despite these commonalities, there is still substantial heterogeneity on impulsivity levels within these diagnostic groups, and variations in impulsive levels predict higher severity of symptoms and poorer outcomes. We addressed the question of whether impulsivity scores can yield empirically driven subgroups of addicted individuals that will exhibit different clinical presentations and outcomes. We applied latent class analysis (LCA) to trait (UPPS-P impulsive behavior scale) and cognitive impulsivity (Stroop and d2 tests) scores in three predominantly male addiction diagnostic groups: Cocaine with Personality Disorders, Cocaine Non-comorbid, and Gambling and analyzed the usefulness of the resulting subgroups to differentiate personality beliefs and relevant outcomes: Craving, psychosocial adjustment, and quality of life. In accordance with impulsivity scores, the three addiction diagnostic groups are best represented as two separate classes: Class 1 characterized by greater trait impulsivity and poorer cognitive impulsivity performance and Class 2 characterized by lower trait impulsivity and better cognitive impulsivity performance. The two empirically derived classes showed significant differences on personality features and outcome variables (Class 1 exhibited greater personality dysfunction and worse clinical outcomes), whereas conventional diagnostic groups showed non-significant differences on most of these measures. Trait and cognitive impulsivity scores differentiate subgroups of addicted individuals with more versus less severe personality features and clinical outcomes.
高冲动性是物质和赌博成瘾的共同特征。尽管存在这些共性,但在这些诊断群体中,冲动水平仍然存在很大的异质性,冲动水平的变化预测症状严重程度更高和预后更差。我们探讨了冲动分数是否可以产生具有经验驱动的成瘾个体亚组,这些亚组将表现出不同的临床特征和结果。我们应用潜在类别分析(LCA)对三个主要为男性的成瘾诊断组的特质(UPPS-P 冲动行为量表)和认知冲动性(Stroop 和 d2 测试)得分进行了分析:伴有人格障碍的可卡因、无共病的可卡因和赌博,并分析了由此产生的亚组对区分人格信念和相关结果的有用性:渴望、心理社会调整和生活质量。根据冲动分数,这三个成瘾诊断组最好用两个独立的类别来表示:第 1 类的特质冲动性较大,认知冲动性表现较差,第 2 类的特质冲动性较小,认知冲动性表现较好。这两个经验衍生的类别在人格特征和结果变量上表现出显著差异(第 1 类表现出更大的人格功能障碍和更差的临床结果),而传统的诊断组在这些测量中大多数表现出无显著差异。特质和认知冲动性得分区分了具有更多和更少严重人格特征和临床结果的成瘾个体亚组。