Harrell P Truman, Mancha Brent Edward E, Martins Silvia S, Mauro Pia M, Kuo Julie H, Scherer Michael, Bolla Karen I, Latimer William W
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida.
Am J Addict. 2014 Sep-Oct;23(5):431-9. doi: 10.1111/j.1521-0391.2014.12124.x. Epub 2014 Mar 15.
The relationship between substance use and cognitive deficits is complex and requires innovative methods to enhance understanding. The present study is the first to use LCA to examine associations of drug use patterns with cognitive performance.
Cocaine/heroin users (N = 552) completed questionnaires, and cognitive measures. LCA identified classes based on past-month drug use and adjusted for probabilities of group membership when examining cognitive performance. Latent indicators were: alcohol (ALC), cigarettes (CIG), marijuana (MJ), crack smoking (CS), nasal heroin (NH), injection cocaine (IC), injection heroin (IH), and injection speedball (IS). Age and education were included as covariates in model creation.
Bootstrap likelihood ratio test (BLRT) supported a 5-class model. Prevalent indicators (estimated probability of over 50%) for each class are as follows: "Older Nasal Heroin/Crack Smokers" (ONH/CS, n = 166.9): ALC, CIG, NH, CS; "Older, Less Educated Polysubstance" (OLEP, n = 54.8): ALC, CIG, CS, IH, IC, and IS; "Younger Multi-Injectors" (MI, n = 128.7): ALC, CIG, MJ, IH, IC, and IS; "Less Educated Heroin Injectors" (LEHI, n = 87.4): CIG, IH; and "More Educated Nasal Heroin" users (MENH, n = ALC, CIG, NH. In general, all classes performed worse than established norms and older, less educated classes performed worse, with the exception that MENH demonstrated worse cognitive flexibility than YMI.
This study demonstrated novel applications of a methodology for examining complicated relationships between polysubstance use and cognitive performance.
Education and/or nasal heroin use are associated with reduced cognitive flexibility in this sample of inner city drug users.
物质使用与认知缺陷之间的关系复杂，需要创新方法来增进理解。本研究首次使用潜类别分析（LCA）来检验药物使用模式与认知表现之间的关联。
可卡因/海洛因使用者（N = 552）完成了问卷调查和认知测试。LCA根据过去一个月的药物使用情况确定类别，并在检验认知表现时对组成员概率进行了调整。潜在指标包括：酒精（ALC）、香烟（CIG）、大麻（MJ）、快克可卡因吸食（CS）、鼻吸海洛因（NH）、注射可卡因（IC）、注射海洛因（IH）和注射速球（IS）。年龄和教育程度作为协变量纳入模型构建。
自展似然比检验（BLRT）支持一个5类别模型。每个类别的流行指标（估计概率超过50%）如下：“年长的鼻吸海洛因/快克可卡因吸食者”（ONH/CS，n = 166.9）：ALC、CIG、NH、CS；“年长的、受教育程度较低的多物质使用者”（OLEP，n = 54.8）：ALC、CIG、CS、IH、IC和IS；“年轻的多重注射者”（MI，n = 128.7）：ALC、CIG、MJ、IH、IC和IS；“受教育程度较低的海洛因注射者”（LEHI，n = 87.4）：CIG、IH；以及“受教育程度较高的鼻吸海洛因使用者”（MENH，n = ALC、CIG、NH）。总体而言，所有类别表现均比既定规范差，年长的、受教育程度较低的类别表现更差，但MENH的认知灵活性比YMI差。
本研究展示了一种用于检验多物质使用与认知表现之间复杂关系的方法的新应用。
在这个城市内吸毒者样本中，教育程度和/或鼻吸海洛因使用与认知灵活性降低有关。
