![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
ABSTRACT
Background: In substance abusers, deficits in executive functioning (EF) are relevant to understanding the behavioral regulation of substance consumption and the failure to remain abstinent. Objective: To determine the course of EF impairment, measured with traditional and ecological instruments, after 1 and 3 months of abstinence in patients with cocaine dependence. Methods: 26 cocaine-only-dependent in-patients (cocaine-dependent group, CDG) and 24 nondependent controls (control group, CG) recruited from a typical population were assessed using several EF tests and questionnaires [Stroop, verbal and graphic fluency, Wisconsin Card-Sorting Test (WCST), Tower of London (TOL), and Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A)] after three periods of abstinence: 1 week, 1 month, and 3 months. Results: At 1 week (baseline), CDG underperformed CG on most EF measures (WCST categories completed; TOL-total number of moves, execution time, and rule violations; and various BRIEF-A subscales). At 1 month, CDG moderately improved its performance on several measures, meanwhile the improvement in the 12 patients who would eventually complete the 3-month abstinence proved particularly significant when compared to their baseline values. In the a posteriori comparison of the baseline values of noncompleters versus completers, scores for the former were lower on the EF tasks, but higher on the BRIEF-A. Both groups, showed significantly worse scores than CG on both instruments. Conclusions/importance: Cocaine-dependent patients showed marked difficulties in the EF associated mainly with adaptive behavior to their environment. Cocaine-dependent patients with better EF at baseline improved significantly during abstinence and had better treatment adherence. Results suggest that executive improvement and treatment adherence in cocaine abusers in abstinence is related to intrinsic cognitive characteristics of patients.
Glossary
Cocaine dependence: A desire to use cocaine regularly in large doses.
Ecological measures: Psychological instruments that allow predicting or inferring a patient's functional capacity in daily life.
Executive functions: A set of cognitive processes that are necessary for behavioral regulation and organization of cognitive activity.
Longitudinal study: Repeated measures in the same subjects in different periods over time.
Treatment adherence: Capability to complete a course of treatment.
Acknowledgments
The authors gratefully acknowledge the voluntary participation of patients in the study; they also thank the rehabilitation clinics, the Centro de Integración Juvenil, DIF Jalisco, Unidad de Zapopan, and the Regreso a la Vida clinic and their medical staff for the assistance in recruiting the patients with substance dependence. We appreciate the technical support of Martha Adriana Franco González.
Declaration of interest
All authors declare that they have no conflict of interest, including any financial, personal or other relationship with people or organization that could inappropriately influence this work.
Funding
This work was supported by the Consejo Nacional de Ciencia y Tecnología [Grant number CB-2006#62366].
Additional information
Notes on contributors
Olga Inozemtseva
Olga Inozemtseva, Ph.D., is Full-time Professor-Researcher of Neuroscience Institute and Department of Education of University of Guadalajara. Her work is focused on examining the role of the EFs—particularly the inhibitory control—in addictive behavior of both, substance and behavioral dependence, particularly in pathological gamblers. Her professional interest is the study of factors involved in addictive behavior, including EFs deficit that may be a consequence of the negative effects of substance abuse on the CNS, or a factor implicated in the acquisition and maintenance of addictive behavior. Her work (articles and book chapters) has been published in peer reviewed journals and scientific books. She participates actively in the training of postgraduate students in the Neuroscience area.
Lina Pérez-Solís
Lina Pérez Solís, M.S., is a clinical psychologist who works at the Mexican Social Security Institute in care of patients with different psychological problems, including substance dependent patients. She was postgraduate student in the laboratory of Neuropsychology and Neurolinguistic of Neuroscience Institute of University of Guadalajara. She obtained the Master's grade with research work in the field of addictions, particularly with cocaine dependent patients.
Esmeralda Matute
Esmeralda Matute earned a Ph.D. in Neuropsychology. She is full professor of Neuropsychology and the Director of the Instituo de Neurociencias of the University of Guadalajara, Mexico. Her research interests focus on three main areas: the effect of learning to read on brain organization and cognitive development; the interaction of biological and environmental factors on typical development and neurodevelopmental disorders; and the neuropsychology of adults. Dr. Matute's research has been published in numerous international scientific journals and books. She is actively involved in several research networks and has participated in long-term international collaborations.
Jorge Juárez
Jorge Juárez, Ph.D., is Full Professor-Researcher at Neuroscience Institute of University of Guadalajara, Mexico. His area of interest is oriented towards the study of the neurophysiological substrate of motivational aspects and behavioral disorders, primarily those related to substance abuse and behavioral addictions. He is head of laboratory of Pharmacology and Behavior over 23 years, and Research Coordinator at the Neuroscience Institute. He has a consolidated research career with over 50 peer-reviewed articles and scientific book chapters in his expertise area.