Hoffmann Fabian, Völlm Birgit
Clinic for Forensic Psychiatry, University Medicine Rostock, Rostock, Germany.
Front Psychiatry. 2024 Oct 17;15:1476920. doi: 10.3389/fpsyt.2024.1476920. eCollection 2024.
The impact of cognitive functions on treatment outcomes in forensic psychiatric patients with substance use disorders is not well understood. This study investigates whether neuropsychological deficits, such as in attention, executive functions, and social-emotional cognition, are associated with impulsivity and criminal history.
109 male patients with substance use disorders at the Clinic for Forensic Psychiatry in Rostock were screened using inclusion and exclusion criteria, with 30 consenting to participate. The tests included the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive functions in the areas of attention, psychomotor speed, social and emotional perception, and executive functions, with a particular focus on decision making, planning and problem solving. The Barratt Impulsiveness Scale (BIS-11) was used to measure impulsiveness.
Participants displayed significantly higher impulsivity levels on the BIS-11 compared to the general population and showed marked deficits in attention, psychomotor speed, and executive functions. There was a minimal correlation between impulsivity and cognitive performance, suggesting that impulsivity does not directly predict cognitive impairments. Notably, extensive criminal histories correlated with poorer cognitive performance, particularly in tasks requiring planning and problem-solving.
We found mixed support for the hypothesized associations between neuropsychological functions and criminal histories among patients with substance use disorders. While tasks related to planning and sustained attention showed clearer links, broader cognitive functions displayed inconsistent correlations. These findings emphasize the complexity of the relationship between cognitive deficits, impulsivity, and criminal history, highlighting the necessity for tailored assessments and rehabilitation strategies to enhance outcomes. Future research should focus on larger, longitudinal studies to validate these findings and refine therapeutic approaches.
认知功能对患有物质使用障碍的法医精神病患者治疗结果的影响尚未得到充分理解。本研究调查了神经心理学缺陷,如注意力、执行功能和社会情感认知方面的缺陷,是否与冲动性和犯罪史相关。
对罗斯托克法医精神病诊所的109名患有物质使用障碍的男性患者进行了纳入和排除标准筛查,30人同意参与。测试包括剑桥神经心理测试自动成套系统(CANTAB),以评估注意力、心理运动速度、社会和情感感知以及执行功能等领域的认知功能,特别关注决策、规划和解决问题。使用巴氏冲动性量表(BIS-11)来测量冲动性。
与一般人群相比,参与者在BIS-11上表现出显著更高的冲动性水平,并且在注意力、心理运动速度和执行功能方面存在明显缺陷。冲动性与认知表现之间的相关性极小,这表明冲动性并不能直接预测认知障碍。值得注意的是,广泛的犯罪史与较差的认知表现相关,特别是在需要规划和解决问题的任务中。
我们发现对于患有物质使用障碍的患者,神经心理功能与犯罪史之间的假设关联得到了不同程度的支持。虽然与规划和持续注意力相关的任务显示出更清晰的联系,但更广泛的认知功能显示出不一致的相关性。这些发现强调了认知缺陷、冲动性和犯罪史之间关系的复杂性,突出了进行针对性评估和康复策略以改善结果的必要性。未来的研究应侧重于更大规模的纵向研究,以验证这些发现并完善治疗方法。