返回Google圖書搜尋

The Reciprocal Effects of Neuropsychological Functioning and Substance Use in Youth

出版	University of California, San Diego, and San Diego State University, 1998
URL	http://books.google.com.hk/books?id=CxGtfu8otI0C&hl=&source=gbs_api

註釋Heavy use of alcohol and other drugs has been shown to influence neuropsychological (NP) functioning of adults. However, few sound studies have documented how substance use affects NP performance among youth. Conversely, cognitive impairments have been suggested to influence substance use patterns. This study examined the reciprocal effects of NP functioning and substance involvement in youth over an 8-year period. Participants were teens recruited from inpatient substance abuse treatment centers and demographically matched community teens without substance abuse at project intake. Exclusion criteria for both groups include head trauma, neurological illness, and psychiatric disorders. Participants were administered NP tests and substance involvement interviews at 7 time points spanning 8 years, from age 16 to 24, on average. The NP battery covered five domains of functioning as derived from principal axis factoring (PAF): Language, Visuospatial, Memory, Attention, and Executive functioning. Substance use involvement was assessed by self-report and corroboration from collateral reports. Experiment 1 investigated the influence of protracted adolescent substance use on subsequent NP functioning. Participants were excluded for recent substance use, leaving 47 treatment and 26 community youth. Oneway ANOVAs revealed group differences on measures of psychomotor processing (Trails B and Symbol Digit Modalities Test). Hierarchical regression analyses determined the influence of cumulative alcohol and drug involvement on subsequent performance on each NP domain, controlling for age, education, potential practice effects, and baseline NP functioning. General substance use over the 8-year follow-ups predicted 8-year Memory. After controlling for past 3-month substance use, alcohol use over the follow-up period predicted 8-year Attention, cumulative marijuana use predicted 8-year Attention and Executive functioning, and cumulative stimulant use predicted 8-year Attention. Alcohol and drug withdrawal over the 8-year follow-ups predicted Visuospatial and Attention functioning, above and beyond effects of past 3-month substance use and covariates. Experiment 2 examined the influence of early cognitive impairments on development and maintenance of substance abuse problems for community (n = 65) and treatment (n = 97) youth. Regression analyses controlled for gender, education, and baseline substance involvement. In the community sample, poor Language, Attention, and Executive functioning in adolescence predicted greater substance involvement in young adulthood. In the treatment sample, good Language and Executive functioning in adolescence predicted greater subsequent substance involvement. This effect was moderated by alcohol expectancies. Conclusions. Substance use in adolescence was associated with significant cognitive decrements in young adulthood. In a community sample, poor cognitive functioning was associated with substance involvement 8 years later. However, in a clinical treatment sample, good cognitive functioning was associated with poorer treatment outcome if alcohol expectancies were positive.