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BACKGROUND: Gender-specific interventions are crucial in addressing substance use disorders -particularly cannabis use disorder - as they allow for tailored therapeutic approaches and increase the likelihood of successful outcomes. However, differences in therapeutic processes and outcomes between males and females are often not observed, making the prognosis and development of such interventions more difficult. OBJECTIVE: This study aimed to examine the moderating role of sex in the relationship between treatment admission profile characterized by indicators of cannabis use and sociodemographic sources of gender inequality (e.g., employment status) and adherence and outcome at discharge. METHOD: A multicentric retrospective observational study was conducted with a sample of 3,814 outpatients diagnosed with cannabis use disorder. Electronic health records were used for data analysis. RESULTS: The interaction between sex and the number of children, as well as pre-treatment cannabis use, predicted lower treatment adherence, particularly among females. Additionally, the interaction between sex and the number of children predicted outcomes at discharge, with females showing a higher likelihood of dropout compared to males. DISCUSSION AND CONCLUSION: Enhanced comprehensive treatment with intensified contingency management programs should be prioritized for females (especially those with children) who have consumed cannabis in the month before treatment. Adopting a treatment policy framework incorporating sex/gender-sensitive therapist training and evaluative measures is essential for optimizing treatment outcomes for all patients.
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Abuso de Marihuana , Humanos , Masculino , Femenino , Estudios Retrospectivos , Adulto , Factores Sexuales , Abuso de Marihuana/terapia , Abuso de Marihuana/psicología , Abuso de Marihuana/epidemiología , Resultado del Tratamiento , Adulto Joven , Persona de Mediana Edad , Adolescente , Admisión del Paciente/estadística & datos numéricosRESUMEN
OBJECTIVE: The aim of this work was to examine the profile and treatment outcomes of patients with dual pathology depending on whether the patients were attending addiction centers or are being treated in a coordinated model by mental health services. METHODS: Data from 7225 dual diagnosis patients were used, of whom 2417 (33.5%) received treatment in the mental health coordinated modality. Clinical information was taken from the patients' electronic health record. RESULTS: Differences were found in patients' sociodemographic and comorbidity profiles according to treatment modality. In general, coordinated care yielded favorable outcomes (higher attendance and lower dropout rates but no differences in retention). The logistic regression analysis identified predictors of patient profiles in coordinated care, emphasizing having a severe mental health disorder (OR = 3.878, 95% CI [3.443, 4.368]; p = .000), being referred by social/health services, or having retired status. Main differences were observed according to the comorbid diagnosis presented, particularly in cases in which the patient had impulse control, hyperkinetic, or cluster C personality disorder. CONCLUSIONS: While therapeutic outcomes are influenced by associated comorbidities, the disorders prognosis can be favorable with appropriate treatment. Furthermore, analysis of differences according to treatment modality allows for predicting the type of patient who will receive a particular service, which enables the development of tailored treatments.
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Trastornos Mentales , Servicios de Salud Mental , Trastornos Relacionados con Sustancias , Humanos , Diagnóstico Dual (Psiquiatría) , Femenino , Masculino , Adulto , Trastornos Mentales/terapia , Trastornos Mentales/epidemiología , Trastornos Mentales/diagnóstico , Trastornos Relacionados con Sustancias/terapia , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/diagnóstico , Servicios de Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , Resultado del Tratamiento , Centros de Tratamiento de Abuso de Sustancias , ComorbilidadRESUMEN
INTRODUCTION: Patients with cocaine use disorders have very high readmission rates. Our aim was to model the relationships between attributes of patients with cocaine use disorder at the beginning of treatment, therapeutic process indicators of time in treatment or proportion of appointments attended, and treatment outcomes, including outcomes at discharge and non-readmissions posttreatment as indicators of therapeutic success. METHOD: A retrospective observational design was used with 10,298 cocaine use disorder patients. Electronic health records were used for statistical analysis of the data. Randomized subsample 1 (n = 5,150) was used for exploratory analysis and subsample 2 (n = 5,148) for modeling relationships between the variables. RESULTS: Patients attributes at intake (e.g., legal services as the source of referral) were of limited significance in explaining time in treatment, proportion of appointments attended, and treatment outcomes. Time in treatment and proportion of appointments attended emerged as significant factors in explaining outcomes at discharge. However, readmissions were primarily explained by time in treatment and outcomes at discharge, although referrals to addiction centers by health services also appeared to be relevant for explaining readmission. DISCUSSION/CONCLUSION: Our study has shown that maintaining a sufficient appointment attendance rate and remaining in treatment for a longer duration are critical therapeutic process indicators for explaining outcomes at the point of discharge and therapeutic success, as indicated by a reduced likelihood of readmissions. Patients who remained in treatment for an extended period were found to have a reduced risk of future readmissions. In addition, our study highlights the importance of maintaining a satisfactory appointment attendance rate to attain successful short- and medium-term therapeutic discharge outcomes. These guidelines could help to increase the efficiency of patient treatment and alleviate the suffering of both patients and their families.
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Cocaína , Trastornos Relacionados con Sustancias , Humanos , Alta del Paciente , Readmisión del Paciente , Estudios Retrospectivos , Trastornos Relacionados con Sustancias/terapiaRESUMEN
Measurement of externalizing disorders such as antisocial disorders, attention-deficit/hyperactivity disorder or borderline disorder have relevant implications for the daily lives of people with these disorders. While the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) have provided the diagnostic framework for decades, recent dimensional frameworks question the categorical approach of psychopathology, inherent in traditional nosotaxies. Tests and instruments develop under the DSM or ICD framework preferentially adopt this categorical approach, providing diagnostic labels. In contrast, dimensional measurement instruments provide an individualized profile for the domains that comprise the externalizing spectrum, but are less widely used in practice. Current paper aims to review the operational definitions of externalizing disorders defined under these different frameworks, revise the different measurement alternatives existing, and provide an integrative operational definition. First, an analysis of the operational definition of externalizing disorders among the DSM/ICD diagnostic systems and the recent Hierarchical Taxonomy of Psychopathology (HiTOP) model is carried out. Then, in order to analyze the coverage of operational definitions found, a description of measurement instruments among each conceptualization is provided. Three phases in the development of the ICD and DSM diagnosis systems can be observed with direct implications for measurement. ICD and DSM versions have progressively introduced systematicity, providing more detailed descriptions of diagnostic criteria and categories that ease the measurement instrument development. However, it is questioned whether the DSM/ICD systems adequately modelize externalizing disorders, and therefore their measurement. More recent theoretical approaches, such as the HiTOP model seek to overcome some of the criticism raised towards the classification systems. Nevertheless, several issues concerning this model raise mesasurement challenges. A revision of the instruments underneath each approach shows incomplete coverage of externalizing disorders among the existing instruments. Efforts to bring nosotaxies together with other theoretical models of psychopathology and personality are still needed. The integrative operational definition of externalizing disorders provided may help to gather clinical practice and research.
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BACKGROUND: Patients with cannabis use disorder (CUD) show heterogeneous sociodemographic and consumption patterns. Although previous studies, focused on identifying subgroups of CUD patients using input variables, have yielded useful results for planning individualized treatments, no published research has analyzed the profiles of CUD patients according to their therapeutic progress. This study therefore aims to identify subgroups of patients using adherence and abstinence indicators and to explore whether these profiles are associated with sociodemographic characteristics, consumption variables, and long-term therapeutic outcomes. METHODS: This was a retrospective observational study with a multisite sample of 2055 CUD outpatients who were beginning treatment. The study monitored patient data at two-year follow-up. We conducted latent profiles analysis on the appointment attendance ratio and percentage of negative cannabis tests. RESULTS: A three profile solution emerged: i) moderate abstinence/moderate adherence (n = 997); ii) high abstinence/moderate adherence (n = 613); and iii) high abstinence/high adherence (n = 445). The study found the most marked differences at the beginning of treatment for education level (chi2 (8) = 121.70, p < .001), source of referral (chi2 (12) = 203.55, p < .001), and frequency of cannabis use (chi2 (10) = 232.39, p < .001). Eighty percent of patients from the "high abstinence/high adherence" group were relapse-free at two year follow-up. This percentage decreased to 24.3 % in the "moderate abstinence/moderate adherence" group. CONCLUSIONS: Research has shown adherence and abstinence indicators to be useful for identifying subgroups of patients with different prognoses regarding long-term success. Recognizing the sociodemographic and consumption variables associated with these profiles at the beginning of treatment could help to inform the design of more individualized interventions.
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Abuso de Marihuana , Pacientes , Cumplimiento y Adherencia al Tratamiento , Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Abuso de Marihuana/diagnóstico , Abuso de Marihuana/psicología , Abuso de Marihuana/rehabilitación , Abuso de Marihuana/terapia , Pacientes Desistentes del Tratamiento , Resultado del Tratamiento , Estudios Retrospectivos , Estudios de Seguimiento , Pronóstico , Pacientes/psicología , RecurrenciaRESUMEN
The Externalizing Spectrum Inventory-Brief Form (ESI-BF) measures tendencies toward disinhibition, lack of control, aggression, and substance use. This study adapts the ESI-BF to the Spanish population and assesses its psychometric properties. The study included 742 community adults obtained by stratified random sampling with proportional allocation according to gender, age, and geographical area of the Spanish territory and a clinical sample consisting of 333 patients. All participants completed the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (PID-5) and the Alcohol Substance Dependence Severity Scale, in addition to the Spanish version of the ESI-BF. Reliability was quantified using McDonald's omega and Cronbach's α reliability coefficients. Validity evidences were studied applying confirmatory factor analysis (CFA) and correlations. Results indicated adequate reliability of scores on the ESI-BF's general factors and most of its facets. Regarding internal structure, and in line with previous studies, both symmetric and S-1 hierarchical two-subfactor (bifactor) emerged as the best-fitting models. Considering both criticisms of symmetric models and parsimony, the S-1 bifactor model, which showed configural invariance across gender and samples, was retained. Validity evidence based on the relationship with other measures of personality and alcohol consumption show correlations values theoretically expected in both clinical and community samples. Findings suggest that the Spanish adaptation of the ESI-BF shows functional near-equivalence to the original version. Its effective psychometric properties make it useful instrument for further research related to the externalizing spectrum. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Trastornos de la Personalidad , Personalidad , Adulto , Humanos , Psicometría , Reproducibilidad de los Resultados , Inventario de Personalidad , Trastornos de la Personalidad/diagnósticoRESUMEN
INTRODUCTION: Treatment retention and adherence are used as outcomes in numerous randomized clinical trials and observational studies conducted in the addiction field. Although usual criteria are 3/6 months of treatment retention or number of sessions attended, there is not a methodological support for conclusions using these criteria. This study analyzed the usefulness of retention and adherence to predict therapeutic success. METHODS: Retrospective observational study using real-world data from electronic health records of 11,907 patients in treatment diagnosed with cocaine, alcohol, cannabis and opiate use disorders or harmful use. RESULTS: Moderate effect size relations were found between the different type of clinical discharge and months in retention (η2 = 0.12) and proportion of attendance (η2 = 0.10). No relationship was found with the number of sessions attended. Using cut-off points (i.e., 3 or 6 months in treatment or attending 6 therapy sessions) worsens the ability to predict the type of discharge. DISCUSSIONS/CONCLUSION: Treatment retention and adherence are indicators moderately related to therapeutic success. Research using these indicators to assess the effectiveness of therapies should complement their results with other clinical indicators and quality of life measures.
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Calidad de Vida , Trastornos Relacionados con Sustancias , Humanos , Cumplimiento y Adherencia al TratamientoRESUMEN
Inventory of Depression and Anxiety Symptoms-II (IDAS-II) constitutes a useful measurement tool with demonstrated psychometric properties that is contributing to the advancement of knowledge of emotional disorders within transdiagnostic models. To implement its use in clinical settings it is important that the scores can be interpreted in order to guide clinical decisions. This study aims to develops normative data for the Spanish version of the IDAS-II. An anonymous online survey was applied to 1,072 subjects, recruited through a stratified random sampling procedure taking into account population gender, age, and geographical region of Spain. Results show that women tend to score higher than men, particularly on the Dysphoria, General Depression, Appetite Gain, and Lassitude scales. Largest effect sizes for differences in the scores according to age were found for Lassitude, Dysphoria, and General Depression. Therefore, normative data according to gender and age group for each IDAS-II scale is provided. The norms provided in this work complement those already available, facilitating the decision-making of clinical professionals. Evidence of unidimensionality is provided for the 19 IDAS-II scales that allows researchers and clinicians to use specific IDAS-II scales independently.
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BACKGROUND: The impact of dual pathology on treatment outcomes is unclear, with the literature reporting both favorable and unfavorable evidence. The main aim of this study was to determine how dual pathology affects treatment outcomes using real world data obtained from inpatients that began treatment in therapeutic communities. METHOD: The data of 2458 inpatients were used. Clinical information was obtained from electronic medical records. Reliability of diagnosis was checked and revealed a mean kappa value of 0.88. RESULTS: Of the sample, 41.8% were discharged after achieving the therapeutic objectives. Patients diagnosed with Cluster B personality disorders were found to have a higher risk of dropping out of treatment (HR = 1.320; z = 2.61; p = 0.009). CONCLUSIONS: Personality traits exhibited by Cluster B patients can interfere with treatment in therapeutic communities. There is a need to develop specific interventions for these inpatient groups, which could be implemented in therapeutic communities.
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The Alternative Model for Personality Disorders defined in Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) has recently attracted considerable interest in empirical research, with different hypotheses being proposed to explain the discordant results shown in previous research. Empirical network analysis has begun to be applied for complementing the study of psychopathological phenomena according to a new perspective. This article applies this analysis to personality facets measured in a sample of 626 patients with mental disorders and a 1,034 normative sample, using the Personality Inventory for DSM-5. The results reveal five substructures partially equivalent to domains defined in the DSM-5. Discordant facets (suspiciousness, hostility, rigid perfectionism, attention seeking, and restricted affectivity) play the role of connectors between substructures. Invariance between clinical and community networks was found except for the connection between unusual beliefs and perceptual dysregulation (stronger in the clinical sample). Considering the strength centrality index, anxiousness, emotional lability, and depressivity can be highlighted for their relative importance within both clinical and normative networks.
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Trastornos de la Personalidad , Personalidad , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Humanos , Trastornos de la Personalidad/diagnóstico , Inventario de Personalidad , PsicopatologíaRESUMEN
OBJECTIVE: The purpose of this systematic review was to examine the evidence for impaired executive functioning in patients diagnosed with a dual pathology of personality disorder (PD) and substance use disorder, and to identify whether differences exist in comparison to those with a single diagnosis. Methods: A systematic search was conducted to identify studies using measures of executive functioning in patients with PD-substance use disorder dual pathology. Sixteen studies were selected. Results: The results indicate that dual pathology patients with Cluster C personality disorder do not differ from controls, and that the presence of dual pathology does not influence the updating domain of executive functioning. The findings were inconclusive with regard to dual pathology patients with Cluster B personality disorders. Whilst the various studies consistently show that these patients show worse performance than the control groups, here are contradictory results with regard to whether Cluster B personality disorders add more alterations in executive functioning to those that already appear in substance use disorder. Conclusions: The results suggest the need for further research that more adequately controls variables such as time in treatment, medication, and sample size, whilst there is also a need to employ longitudinal designs that include more patients from Clusters A and C.
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Trastornos de la Personalidad , Trastornos Relacionados con Sustancias , Función Ejecutiva , Humanos , Trastornos de la Personalidad/complicaciones , Trastornos de la Personalidad/epidemiología , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
BACKGROUND: Various authors have described the elements of impulsive approach and inhibitory control in drug users. These two components have been studied in terms of personality traits, performance on tasks that measure impulsive behavior, and neurophysiology. However, few studies have analyzed the association between these constructs. Thus, the aim of the present study is to analyze the associations between personality traits and performance on impulsivity tasks. METHODS: A follow-up study was conducted with a baseline assessment at the beginning and end of treatment. The sample was composed of 121 patients undergoing treatment in therapeutic communities. Personality domains were evaluated through the PID-5. The impulsivity tasks employed were the Iowa Gambling Task (IGT), Delay Discounting Test (DDT), Go/No-Go and Stroop test. RESULTS: A correlation was found between DDT scores and the domains of detachment (r = -.315; p<.01), antagonism (r = -.294; p<.01), and disinhibition (r = .215; p<.05). Performance on the Stroop task was significantly associated with psychoticism (r = .232; p<.05) and negative affect (r = .212; p<.05). Multivariate analysis revealed that IGT scores and negative affect predict retention in treatment. CONCLUSIONS: These findings partially support the hypothesized association between sensation-seeking personality traits and detachment with impulsive choice tasks; and the relationships between negative affect and psychoticism traits with performance on inhibitory control tasks. Further, impulsive choice task scores and negative affect are both shown to predict retention in treatment.
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Objective: The purpose of this study is to provide reliability and validity evidence of the Adult Self-Report Scale (ASRS) scores on different versions and scoring procedures in a Spanish substance use disorder (SUD) sample. Method: The sample was made up of 170 outpatients diagnosed with SUD. The ASRS, the Mini-International Neuropsychiatric Interview (MINI), and the Substance Dependence Severity Scale were administered. Results: The results of the confirmatory factor analysis (CFA) showed adequate fit to the structure proposed by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) in the 18-item version. On the screening scale, best fit was found for a model with two correlated factors (inattention and hyperactivity). The exploratory factor analysis (EFA) showed that the ADHD items converge and are differentiated from symptoms of withdrawal. The regression analyses showed that severity of dependence is explained by the ASRS scores. Conclusion: Both versions of the ASRS showed adequate psychometric properties. The polytomous or dichotomous score is relevant in patient classification.
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Trastorno por Déficit de Atención con Hiperactividad , Trastornos Relacionados con Sustancias , Adulto , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Humanos , Psicometría , Reproducibilidad de los Resultados , Autoinforme , Trastornos Relacionados con Sustancias/diagnósticoRESUMEN
BACKGROUND: The specialized literature provides solid evidence that substance use disorders (SUD) and personality disorders (PD) are interrelated. Given the relative novelty of the Alternative Model for PD, there are still few studies that have analyzed the relationship between the different facets, substance use disorder, and the various consumption profiles. OBJECTIVE: This paper analyzes the relationship between the facets of the Alternative Model for PD and different substance use disorder profiles, using the facet scores obtained in a sample of substance use disorder patients and comparing these with normative scores. A comparison is also conducted between types of patients. METHOD: The Personality Inventory for DSM-5-SF was administered to a sample of 289 patients diagnosed with SUD who began treatment for alcohol (ALC), cannabis (CAN), cocaine (COC), or heroin (HER) use disorder. A latent class analysis was conducted and scores obtained for each of the classes were compared with normative scores. Logistic regression analyzes were carried out to determine which facets and domains show the greatest explanatory capacity of belonging to each latent class. RESULTS: Four patient profiles were identified on the basis of their SUD: polydrug use (POLY), COC-HER, ALC, and CAN. When comparing the groups with the normative population, POLY presented higher scores on all the domains, COC-HER and ALC on all domains except antagonism, and CAN showed higher scores on detachment and psychoticism. The CAN cluster presented lower scores than the other 3 groups in different domains. No statistically significant differences were observed on any domain between the groups POLY and COC - HER, while differences were found between the classes POLY and ALC for the detachment domain. CONCLUSIONS: The results help to identify the personality profiles associated with various SUD profiles. In particular, patients from the groups POLY, COC-HER, and ALC present high scores on pathological facets related to borderline PD and schizotypal PD (all 3), and antisocial PD (POLY), while the CAN cluster is more normalized and its pathological facets are related to the schizotypal PD. Patients with POLY have a greater tendency toward pathological personality, with the involvement of a large number of facets, while COC-HER and ALC show a slightly less severe profile, and CAN users are characterized by lower scores, but high detachment and psychoticism.
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Diagnóstico Dual (Psiquiatría) , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos de la Personalidad/fisiopatología , Trastornos Relacionados con Sustancias/fisiopatología , Adulto , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Reproducibilidad de los Resultados , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
BACKGROUND: Some authors have pointed out the usefulness of the levels of substance use disorder (SUD) as a treatment outcome. However, in order to use this variable as an outcome measure, its impact needs to be addressed within a clinical context. The aim of this study was to analyze the sensitivity of SUD levels as a measure for detecting reliable changes and to make a comparison between the changes in SUD levels detected when using the number of criteria fulfilled and when using the reliable change index (RCI). METHODS: The sample consisted of 206 (106 in follow-up) patients diagnosed with abuse/dependence on alcohol and cocaine, according to DSM-IV criteria. The Substance Dependence Severity Scale for DSM-5 was used to determine current alcohol use disorder (AUD) and cocaine use disorder (CUD). Number of DSM-5 criteria fulfilled and RCI were used to determine the change in SUD levels. RESULTS: No association was found between adherence to/abandonment of treatment and AUD severity levels (χ2 = 7.029, p = 0.071) or CUD severity levels (χ2 = 2.044, p = 0.413). Statistical significant differences for levels of AUD (z = -3.870, p = 0.000) and CUD (z = -5.382, p = 0.000) were found between baseline assessment and follow-up. According to the number of DSM-5 criteria and RCI, the Kappa coefficient for the change in patient status (improved, worsened, or no change) was k = 0.61 for alcohol patients and k = 0.64 for cocaine patients. The "mild" category showed the greatest inconsistency between both procedures. CONCLUSIONS: Levels of SUD are sensitive to the impact of treatment as measured by the difference between the baseline assessment and 3-month follow-up. However, conclusions differ according to whether the DSM-5 criteria or the RCI is applied.
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Interpretación Estadística de Datos , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Aceptación de la Atención de Salud , Índice de Severidad de la Enfermedad , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Trastornos Relacionados con Sustancias/terapia , Resultado del TratamientoRESUMEN
Background: Interpretation bias tasks such as word association tests have shown a moderate relation with substance use, but most studies have been conducted in nonclinical samples and these tasks are difficult to rate. Objectives: To provide: (1) reliability evidence of the Word Association Task for Drug Use Disorder (WAT-DUD), a novel and easy-to-rate instrument for measuring interpretation bias and (2) validity evidence based on the relationship between the WAT-DUD and variables associated with patterns of drug use and treatment outcomes. Methods: 186 patients (67 outpatients and 119 inpatients, 90% males) participated in the study. The task consisted of a simultaneous conditional discrimination where an image (either explicit or ambiguous) was the sample and two words (drug-related or not) served as comparison stimuli. The Substance Dependence Severity Scale, the Cocaine Craving Questionnaire-Now, and the Multidimensional Craving Scale were also used. Results: The ambiguous images items showed adequate reliability in terms of internal consistency (α = .80) and test-retest reliability (79.7% on average). The interpretation of images as drug-related was positively correlated with craving for cocaine (r = .20; p = .029), alcohol (r = .30; p = . 01), and alcohol withdrawal (r = .31; p = .01) along with severity of alcohol dependence (r = .23; p = .04). No relationship was found with the severity of cocaine dependence, or its symptoms of abstinence. Conclusion: WAT-DUD shows psychometric properties that support its use in research contexts, although more research is needed for its use in the clinical setting.
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Psicometría/instrumentación , Trastornos Relacionados con Sustancias/psicología , Pruebas de Asociación de Palabras , Adulto , Alcoholismo/psicología , Reacción de Prevención , Sesgo , Trastornos Relacionados con Cocaína/psicología , Correlación de Datos , Ansia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Datos Preliminares , Reproducibilidad de los Resultados , España , Síndrome de Abstinencia a Sustancias/psicologíaRESUMEN
Section III of the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) has generated a personality paradigm consisting of 25 personality facets identified in five domains. The developed assessment instrument Personality Inventory for DSM-5 (PID-5) has showed good psychometric properties, but the potential for certain improvements still remain. In this article, a sample of 282 dual diagnosis patients is used to provide evidence of the psychometric properties of the PID-5-Short Form. The mean value of Cronbach's alpha coefficients reached .73 on the facets and .84 for domains and test-retest values ranged between .57 to .83 for facets and .70 to .87 for the domains. Confirmatory factor analyses conducted showed good fit on both models tested: the five correlated factor structure and hierarchical structure of personality traits. The WHODAS 2.0 domains of understanding and communicating, and participating in society, appear to show the strongest relationship with personality facets. In general, the PID-5-Short Form shows adequate psychometric properties for use in dual diagnosis patients.
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Diagnóstico Dual (Psiquiatría) , Trastornos de la Personalidad/psicología , Inventario de Personalidad , Adulto , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Análisis Factorial , Femenino , Humanos , Masculino , Trastornos de la Personalidad/diagnóstico , Psicometría , Reproducibilidad de los ResultadosRESUMEN
INTRODUCTION: Impulsivity has been consistently associated with poorer addiction treatment outcomes. However, impulsivity is a multifaceted construct and current evidence have failed to unravel which specific aspects explain this relationship. There is also limited research examining long-term outcomes. We aimed to examine the longitudinal association between baseline performance on a comprehensive battery of impulsivity measures and retention and relapse at the end of treatment. METHODS: The sample comprised 68 participants with miscellaneous diagnoses of substance use disorders and polysubstance use patterns, enrolled in public residential therapeutic communities in Andalusia (Spain). At baseline, we applied measures of selective attention (Stroop), response inhibition (Affective Go/No Go), delay discounting (Monetary Choice Questionnaire; MCQ), and decision-making (Iowa Gambling Task; IGT). At the end of treatment (meanâ¯=â¯148.36â¯days, rangeâ¯=â¯22-289â¯days), we collected outcome measures of retention (coded by the clinical team as completion or dropout based on statewide practice guidelines) and relapse (defined as at least two separate alcohol/drug use episodes based on urine analyses). RESULTS: Cox regression models showed that poorer decision-making in the IGT was associated with premature treatment dropout, whereas elevated commission errors in the Affective Go/No Go were associated with higher relapse rates. Selective attention and delay discounting were unrelated to outcomes. CONCLUSION: Long-term based decision-making skills are important to commit to the complex and intensive treatment programs of therapeutic communities. The ability to withhold behavioural responses under positive affect is relevant to prevent relapse. Both skills should be assessed and potentially trained during therapeutic community treatment.
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Cognición/fisiología , Toma de Decisiones/fisiología , Conducta Impulsiva/fisiología , Trastornos Relacionados con Sustancias/rehabilitación , Adulto , Descuento por Demora/fisiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Pacientes Desistentes del Tratamiento , Recurrencia , España , Comunidad TerapéuticaRESUMEN
The UPPS Impulsive Behaviour Scale (with five dimensions of impulsive behaviour) is being widely used. One of the handicaps of this instrument is its relatively long administration time. This has led to the development of a short version: SUPPS-P. There are no studies comparing the relationship between the SUPPS-P scores and the original UPPS-P scores. The objectives of this study, therefore, were to analyse the psychometric properties, concordance of person measures, and efficiency of the SUPPS-P compared to those on UPPS-P, applying an Item Response Theory Model. The UPPS-P and SUPPS-P were administered to 455 undergraduate students. Confirmatory factorial analysis replicated structures reported in previous studies: the five correlated factors structure and the model with two second-order factors (Urgency and Lack of Awareness) with Sensation Seeking dimension as a different factor. Rasch analysis show that both of the instruments presented adequate model-data fit. The results show the measurement for each dimension of UPPS-P offered more precision than SUPPS-P. The structure of items location was maintained in each dimension of SUPPS-P compared to the UPPS-P, but with better person and item separation indices of the UPPS-P dimensions. The concordance analysis reveals high correlations values between scores on both versions. From the standpoint of reducing items, it can be considered that the reduced version is more efficient. This study does not support the equivalence of items on the dimensions of Sensation Seeking and Lack of perseverance.
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Conducta Impulsiva , Modelos Psicológicos , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , PsicometríaRESUMEN
Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition proposes an alternative diagnostic model for personality disorders based on the identification of pathological personality facets. Despite the existing evidence for the relationship between personality disorders and impulsivity in patients with substance use disorders, no study has yet been conducted within this framework. Thus, using a sample of 110 patients with substance use disorders, the present work aims to (a) analyze the relationship between the different personality facets and domains evaluated by the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PID-5) and impulsivity and (b) explore the relationships between severity of dependency and personality facets and dimensions of impulsivity. With respect to PID-5 domains, except for sensation-seeking, antagonism and disinhibition showed correlations higher than .30 with the following dimensions: urgency, premeditation, perseverance, sensation-seeking, and positive urgency (UPPS-P). The domains of detachment and psychoticism showed weaker correlations with different UPPS-P dimensions. The risk-taking PID-5 facet explains 49% variability of the sensation-seeking dimension of UPPS-P, whereas the impulsivity facet was significant on regression models computed with lack of premeditation, positive urgency, and negative urgency dimensions. Heroin and cocaine severity of dependence were moderately related to different personality facets. Lower relationships between alcohol and cannabis severity of dependence, impulsivity, and PID-5 facets were found. As a conclusion, the relationships between personality domains and impulsivity behave similarly to their five-factor equivalents for some dimensions but not for negative urgency, which might indicate the lack of specificity of this dimension of impulsivity on this type of patients. (PsycINFO Database Record