Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
New York State Psychiatric Institute, New York, NY, USA.
Addiction. 2017 Dec;112(12):2132-2143. doi: 10.1111/add.13911. Epub 2017 Jul 31.
To evaluate relationships between measures of cognitive functioning and alcohol or drug use among adults (≥ 18 years) in the US general population.
Two cognitive scales were created based on dimensionality and reliability of self-reported Executive Function Index items. Relationships between the two scales and validators were evaluated. Associations between the cognitive scales and past-year frequency of alcohol or drug use were estimated with adjusted odds ratios (aOR).
United States, using the 2012-13 National Epidemiologic Survey on Alcohol and Related Conditions-III, a nationally representative adult sample selected by multi-stage probability sampling.
36 085 respondents.
Past-year substance use outcome variables categorized binge drinking, marijuana, cocaine, opioid, sedative/tranquilizer and stimulant use as frequent (at least weekly to daily), infrequent (any to two to three times/month) or no use, assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Key predictors were the two cognitive scales. Construct validators included education and functional impairment. Covariates included age, gender, income and race/ethnicity.
Nine cognitive items fitted a two-factor model (comparative fit index = 0.973): attention (five items) and executive functioning (four items). Both scales were associated positively with higher education (Ps < 0.001) and negatively with functional impairment (Ps < 0.001), demonstrating construct validity. Poorer attention was associated with frequent and infrequent binge drinking and use of drugs [aOR range = 1.07 (binge drinking) to 1.72 (stimulants), Ps ≤ 0.01]. Poorer executive functioning was associated with frequent binge drinking and use of drugs [aOR range = 1.22 (binge drinking) to 2.03 (cocaine), Ps < 0.001] and infrequent use of all drugs [aOR range = 1.19 (marijuana) to 1.63 (cocaine), Ps < 0.001].
Impairments in attention and executive functioning are positively associated with substance use in the US general population.
评估美国普通人群中成年人（≥18 岁）的认知功能测量值与酒精或药物使用之间的关系。
根据自我报告的执行功能指数项目的维度和可靠性创建了两个认知量表。评估了这两个量表与效标之间的关系。使用调整后的优势比（aOR）估计认知量表与过去一年酒精或药物使用频率之间的关联。
美国，使用 2012-13 年全国酒精和相关条件 III 期流行病学调查，这是一个通过多阶段概率抽样选择的具有全国代表性的成年样本。
36085 名受访者。
过去一年的物质使用结果变量分为狂欢饮酒、大麻、可卡因、阿片类药物、镇静剂/安定剂和兴奋剂使用（至少每周至每天）、不频繁（任何至每两到三个月一次）或不使用，通过酒精使用障碍和相关残疾访谈时间表-5 评估。主要预测因素是两个认知量表。结构效标包括教育和功能障碍。协变量包括年龄、性别、收入和种族/民族。
九个认知项目符合两因素模型（比较拟合指数=0.973）：注意力（五个项目）和执行功能（四个项目）。两个量表均与较高的教育程度呈正相关（P<0.001），与功能障碍呈负相关（P<0.001），表现出结构效度。注意力较差与频繁和不频繁的狂欢饮酒和使用药物有关[优势比范围=1.07（狂欢饮酒）至 1.72（兴奋剂），P 值均≤0.01]。执行功能较差与频繁狂欢饮酒和使用药物有关[优势比范围=1.22（狂欢饮酒）至 2.03（可卡因），P 值均<0.001]以及所有药物的不频繁使用有关[优势比范围=1.19（大麻）至 1.63（可卡因），P 值均<0.001]。
在美国普通人群中，注意力和执行功能障碍与物质使用呈正相关。
