Clinical validation of the Allen's Cognitive Level Screen in acquired brain injury.

BACKGROUND: The evaluation of functional cognition is a central concern in clinical practice. However, there are few standardized or validated tools, and many of them take too long, requiring screening tests. AIMS: To explore the convergent validity of the ACLS-5 with other cognitive screening test and functional independence test in a sample of people with acquired brain injury. Moreover, to examine the prediction of ACLS-5 on functioning and cognitive performance outcomes. MATERIALS AND METHODS: A cross-sectional design was applied following the guidelines of the STROBE checklist. A consecutive sample of people with acquired brain injury was recruited from rehabilitation centers. A cognitive screening test and daily living activity tests were implemented, such as ACLS-5, MoCA, Barthel, and FIM+FAM. Data were analyzed using non-parametric methods. In addition, a structural analysis and simple regression models were performed. RESULTS: Eighty patients with chronic acquired brain injury, with a mean age of 52, were recruited. All tests are significantly related to the ACLS-5 score, a moderate effect size for MoCA (ρ = 0.36), and a strong effect size for the other two (ρ > 0.50). CONCLUSIONS: ACLS-5 predicts functional and cognitive performance quickly and effectively, optimizing assessment time and avoiding mental fatigue or physical exhaustion.

The UPPS model of impulsivity in the abuse of Information and Communication Technologies (ICT). / El modelo UPPS de impulsividad en el abuso de las Tecnologías de la Información y la Comunicación (TIC).

The UPPS model of impulsivity has recently been proposed, has been widely applied to substance abuse and is one of those recommended in the context of Research Domain Criteria, RDoC. However, its application to the abuse of information and communication technologies (ICTs) has been very limited. In the present work, a sample of n = 748 (67% females) was recruited through the Internet, and the reduced version of the UPPS-P was administered, in addition to the MULTICAGE-TIC and the Prefrontal Symptoms Inventory (PSI-20). The psychometric properties of UPPS-P were satisfactory in terms of internal consistency (0.87 > ω > 0.75) and structural validity. Impulsivity measured by UPPS-P correlated with all MULTICAGE-TIC scales, although with a very small effect size, and with greater magnitude with prefrontal dysfunction symptoms. The impulsivity dimension most related to ICT abuse was Urgency (0.3 > r > 0.2). A structural analysis of all the variables was carried out, with impulsivity appearing as a product of the prefrontal malfunction that predicted, through Positive Urgency, the abuse of ICTs. Impulsivity does not seem to be the central nucleus of ICT abuse, but rather failures in the superior control of behavior, of which impulsivity would be a consequence, but not the most important. This makes it advisable to design cognitive rehabilitation interventions that improve the functioning of superior behavior control mechanisms in the prevention and treatment of ICT abuse.

El modelo UPPS de impulsividad se ha propuesto recientemente, ha sido ampliamente aplicado al abuso de sustancias y es uno de los recomendados en el contexto de investigación Research Domain Criteria, RDoC. Sin embargo, su aplicación al abuso de tecnologías de la información y la comunicación (TIC) ha sido muy limitado. En el presente trabajo se reclutó a través de Internet una muestra de n = 748 (67% mujeres) y se administró la versión reducida de la UPPS-P, además del MULTICAGE-TIC y el Inventario de Síntomas Prefrontales (ISP-20). Las propiedades psicométricas de la UPPS-P resultaron satisfactorias en consistencia interna (0,87 > ω >0,75) y validez estructural. La impulsividad medida por la UPPS-P correlacionó con todas las escalas del MULTICAGE-TIC, aunque con un tamaño del efecto muy pequeño, y con mayor magnitud con las de síntomas de mal funcionamiento prefrontal. Las dimensiones de impulsividad más relacionadas con el abuso de las TIC fueron las de Urgencia (0,3 > r > 0,2). Se realizó un análisis estructural de todas las variables apareciendo la impulsividad como un producto del mal funcionamiento prefrontal que predecía, a través de la Urgencia Positiva, el abuso de las TIC. La impulsividad no parece ser el núcleo central del abuso de las TIC, sino los fallos en el control superior de la conducta, de los que la impulsividad sería una consecuencia, pero no la más importante. Ello hace recomendable el diseño de intervenciones de rehabilitación cognitiva que mejoren el funcionamiento de los mecanismos de control superior de la conducta en la prevención y tratamiento del abuso de las TIC.

MADRID+90 study on factors associated with longevity: Study design and preliminary data.

The progressive aging of the population represents a challenge for society. In particular, a strong increase in the number of people over 90 is expected in the next two decades. As this phenomenon will lead to an increase in illness and age-related dependency, the study of long-lived people represents an opportunity to explore which lifestyle factors are associated with healthy aging and which with the emergence of age-related diseases, especially Alzheimer's type dementia. The project "Factors associated with healthy and pathologically aging in a sample of elderly people over 90 in the city of Madrid" (MADRID+90) brings together a multidisciplinary research team in neurodegenerative diseases that includes experts in epidemiology, neurology, neuropsychology, neuroimaging and computational neuroscience. In the first phase of the project, a stratified random sampling was carried out according to the census of the city of Madrid followed by a survey conducted on 191 people aged 90 and over. This survey gathered information on demographics, clinical data, lifestyles and cognitive status. Here, the main results of that survey are showed. The second phase of the project aims to characterize individual trajectories in the course of either healthy and pathological aging, from a group of 50 subjects over 90 who will undergo a comprehensive clinical examination comprised of neurological and cognitive testing, MRI and EEG. The ultimate goal of the project is to characterize the biophysical and clinical profiles of a population that tends to receive little attention in the literature. A better understanding of the rapidly increasing group of nonagenarians will also help to design new policies that minimize the impact and future social and economic consequences of rapidly aging societies.

Impulsivity-Compulsivity Axis: Evidence of Its Clinical Validity to Individually Classify Subjects on the Use/Abuse of Information and Communication Technologies.

The compulsive habit model proposed by Everitt and Robbins has accumulated important empirical evidence. One of their proposals is the existence of an axis, on which each a person with a particular addiction can be located depending on the evolutionary moment of his/her addictive process. The objective of the present study is to contribute in addressing the identification of such axis, as few studies related to it have been published to date. To do so, the use/abuse of Information and Communication Technologies (ICT) was quantified on an initial sample of 807 subjects. Questionnaires were also delivered to measure impulsivity, compulsivity and symptoms of prefrontal dysfunction. Evidence of the existence of the proposed axis was obtained by means of Machine Learning techniques, thus allowing the classification of each subject along the continuum. The present study provides preliminary evidence of the existence of the Impulsivity-Compulsivity axis, as well as an IT tool so that each patient that starts getting treatment for an addiction can be statistically classified as "impulsive" or "compulsive." This would allow the matching of each person with the most appropriate treatment depending on his/her moment in the addiction/abuse process, thus facilitating the individualized design of each therapeutic process and a possible improvement of the results of the treatment.

Reliability and Validity of the Spanish Version of the Executive Function Performance Test (EFPT) in Assessing People in Treatment for Substance Addiction.

IMPORTANCE: Assessing people's executive function (EF) during addiction treatment makes it possible to design individualized occupational goals. OBJECTIVE: To determine the reliability and validity of the Spanish version of the Executive Function Performance Test (EFPT) in the occupational assessment of people being treated for substance addiction. DESIGN: Cross-sectional, observational study to determine the EFPT's internal consistency as well as its convergent and discriminant validity with complementary tests. SETTING: A public, free addiction treatment center operated by Madrid Salud (Madrid City Council, Spain). PARTICIPANTS: Fifty-two people referred to an occupational therapy department for evaluation and intervention. Inclusion was based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) criteria for substance abuse or dependence; the exclusion criterion consisted of any circumstances that made it difficult for a person to understand or perform the test. OUTCOMES AND MEASURES: The EFPT, other occupational tests (Allen Cognitive Level Screen-5, Lowenstein Occupational Therapy Cognitive Assessment), and a battery of neuropsychological EF tests. RESULTS: The EFPT had an unequivocal unifactorial structure and showed strong correlations between its components and adequate consistency with the scales and the complete test. As expected, the EFPT correlated with the neuropsychological tests with a considerable effect size (-.40 < r < -.60). CONCLUSIONS AND RELEVANCE: The EFPT's psychometric properties are adequate to assess the EF of people being treated for substance addiction from an occupational perspective using real activities of daily living (ADLs). WHAT THIS ARTICLE ADDS: The results show that the EFPT can be used to assess performance of ADLs without needing to use tests from disciplines other than occupational therapy. Further studies in different sociocultural settings are needed to generalize the results.

Obsession and compulsion in mobile phone use/abuse: OCDUS-ICT. / Obsesión y compulsión en el uso/abuso del móvil: el OCDUS-TIC.

Compulsiveness has been considered one of the core characteristics of addictive behaviours. One of the abusive behaviours that has acquired importance in recent times involves the use of mobile phones. The aim of this study is to obtain a version of the Obsessive-Compulsive Drug-Use Scale (OCDUS) to study the compulsivity associated with mobile phone abuse, its basic psychometric properties and the results of its application. The OCDUS-ICT was created and administered over the Internet, through instant messaging programs, social networks and e-mail, and anonymous and voluntary participation was requested. Additionally, MULTICAGE-ICT and the Inventory of Prefrontal Symptoms were administered. A sample of n=748 subjects, 33% males and 94% born and resident in Spain was obtained. The test obtained adequate values of internal consistency, applying different estimators. Confirmatory factor analysis of the theoretical scales yielded adequate fit indices. Obsessive-compulsive components were observed to become stronger as mobile phone use increased and approached abuse levels. OCDUS-ICT scales showed large correlations with prefrontal malfunction symptoms, especially Thoughts-Interference (r>0.80). In conclusion, OCDUS-ICT explores with psychometric accuracy the obsessive-compulsive components of mobile use/abuse, which are closely related to malfunctions in daily life attributable to the prefrontal cortex. If impulsivity has so far been the focus in the study of mobile phone abuse, the data from the present study suggest that greater attention should be paid to compulsivity as a factor in maintaining abuse.

La compulsividad ha sido considerada una de las características nucleares de las conductas adictivas. Uno de los comportamientos abusivos que ha adquirido importancia en tiempos recientes es el uso del teléfono móvil. El objetivo del presente trabajo es obtener una versión de la Escala de Uso Obsesivo-Compulsivo de Drogas (OCDUS) para estudiar la compulsividad asociada al abuso del móvil, conocer sus propiedades psicométricas básicas y resultados de su aplicación. Se creó y administró el OCDUS-TIC por Internet, mediante mensajería instantánea, redes sociales y correo electrónico, solicitándose la participación anónima y voluntaria. Adicionalmente se administraron el MULTICAGE-TIC y el Inventario de Síntomas Prefrontales (ISP). Se obtuvo una muestra de n=748 sujetos, 33% varones y 94% nacidos y residentes en España. El test obtuvo adecuados valores de consistencia interna, aplicando diferentes estimadores. Se realizó un análisis factorial confirmatorio sobre las escalas teóricas, alcanzando adecuados estimadores de ajuste. Se observó que los componentes obsesivo-compulsivos son de mayor magnitud a medida que se incrementa la implicación en el uso y su progresión al abuso del móvil. Las escalas del OCDUS-TIC mostraron correlaciones de gran magnitud con los síntomas de mal funcionamiento prefrontal, especialmente la de Pensamiento-Interferencia (r>0,80). En conclusión, el OCDUS-TIC explora con garantías psicométricas los componentes obsesivo-compulsivos del uso/abuso del móvil, que se relacionan estrechamente con fallos cotidianos de origen prefrontal. Si la impulsividad ha centrado el interés en el estudio del abuso del móvil, los datos del presente estudio aconsejan prestar mayor atención a la compulsividad como factor de mantenimiento del abuso.

Opiate drug use in the city of Madrid: Associated health and sociodemographic factors. / Consumo de fármacos opiáceos en la ciudad de Madrid: Factores sanitarios y sociodemográficos asociados.

The use of opiate analgesics has led to a health and social emergency in the United States. In Spain, according to official data, the prescription of these drugs has risen dramatically in the last decade. This study explores the prevalence of the use of these drugs and the health and socio-demographic characteristics of their consumers in the city of Madrid. A telephone survey was carried on a stratified, randomised sample, asking about the use of these drugs and whether or not they were medically prescribed. The sample consisted of n=8,845 subjects aged between 15 and 98 years. Sixteen percent stated that they had used these drugs in the last year and 9.1% had taken them in the last two weeks. Consumption was more frequent among women, lower social class and lower level of education. Among the youngest group (15-29 years old) 12.5% had already used it. Those who use opioids report worse perceived health, lower quality of life, more mental health problems, more loneliness, more use of other psychoactive drugs, more frequent daily use of tobacco and less problematic consumption of alcohol. Ten percent of those who use them do so without a doctor's prescription. Combining these data with the prescription data offered by the Ministry of Health, it is necessary to pay attention to a problem that may become apparent in the coming years, and the adoption of urgent measures to tackle it before it brings the Spanish situation closer to that already well known in countries of our socio-political environment is advised.

El consumo de analgésicos opiáceos ha provocado una situación de emergencia sanitaria y social en Estados Unidos. En España, según datos oficiales, la prescripción de estos fármacos ha experimentado un espectacular ascenso en la última década. Este estudio explora la prevalencia del uso de estos fármacos y las características sanitarias y sociodemográficas de sus consumidores en la ciudad de Madrid. Se realizó una encuesta telefónica aplicando un muestreo estratificado y aleatorizado, en la que se preguntó por el uso de estos fármacos y si fueron médicamente prescritos o no. La muestra estuvo compuesta por n= 8.845 sujetos de edades entre 15 y 98 años. Un 16,0% declara haber usado estos fármacos en el último año y un 9,1 los toma en las dos últimas semanas. El consumo es más frecuente en mujeres, clase social baja y menor nivel de estudios. El grupo más joven (15-29 años) ya lo usa en el 12,5%. Quienes usan opioides refieren peor salud percibida, menor calidad de vida, más problemas de salud mental, más soledad no deseada, más uso de otros psicofármacos, más frecuente uso diario de tabaco y menos consumo problemático de alcohol. Un 10% de quienes los usan lo hacen sin prescripción médica. Combinando estos datos con los de prescripción ofrecidos por el Ministerio de Sanidad, resulta necesario prestar atención a un problema que puede hacerse patente en los próximos años, aconsejando la adopción de medidas urgentes para atajarlo antes de que aproxime la situación española a la ya bien conocida en otros países.

Smartphone Nonusers: Associated Sociodemographic and Health Variables.

Smartphone abuse and the associated consequences have been intensely studied. However, little attention has been given to the group of people who have a smartphone and yet barely use it. One might think that they are at the opposite end of abuse, both behaviorally and in relation to the consequences. This study aims to establish sociodemographic variables and health indicators for smartphone nonusers. A population survey through random stratified sampling in a large city (Madrid, Spain) obtained 6,820 people between 15 and 65 years who own a smartphone. About 7.5 percent (n = 511) stated they do not use their smartphone regularly. This group comprised more of men than of women with a higher mean age, underprivileged social class, residence in less-developed districts, and a lower education level. They showed worse mental health indicators, lower perceived quality of life relating to their health, more sedentarism, and greater tendency toward being overweight/obese and a higher feeling of loneliness. When looking at all these variables together, the regression model showed that in addition to sex, age, social class, and education level, the only significantly associated health indicator was a feeling of loneliness. Mobile phone abuse is associated with health problems, but nonregular use does not reflect the opposite. It is important to study the group of nonusers and explore the reasons and related consequences, particularly the role of perceived loneliness, which is paradoxical as a smartphone is a tool that can foster interpersonal contact.

Information and Communications Technologies (ICT): Problematic use of Internet, video games, mobile phones, instant messaging and social networks using MULTICAGE-TIC. / Tecnologías de la Información y la Comunicación (TIC): abuso de Internet, videojuegos, teléfonos móviles, mensajería instantánea y redes sociales mediante el MULTICAGE-TIC.

Use/abuse of Information and Communications Technologies (ICT) has in recent years become a topic of great interest. Current discussion addresses whether it must be considered addictive behaviour and if it is a problem that primarily affects adolescents and youth. This study aims to understand the problems that affect people of all ages in controlling the use of these ICTs and whether they are related to mental health problems, stress and difficulties in executive control of behaviour. A survey was administered through social networks and email, using the MULTICAGE-ICT, a questionnaire that explores problems in the use of Internet, mobile phones, video games, instant messaging and social networks. Additionally, the Prefrontal Symptom Inventory, General Health Questionnaire and Perceived Stress Scale were administered. The sample was comprised of 1,276 individuals of all ages from different Spanish-speaking countries. The results indicate that about 50% of the sample, regardless of age or other variables, presents significant problems with the use of these technologies, and that these problems are directly related to symptoms of poor prefrontal functioning, stress and mental health problems. The results reveal the need for reconsidering whether we are facing an addictive behaviour or a new problem demanding environmental, psychological, sociological and sociopolitical explanations; therefore, it is necessary to reformulate actions to be implemented to address and refocus our understanding of the problem.

El uso/abuso de las Tecnologías de la Información y la Comunicación (TIC) es un tema que suscita enorme interés en los últimos años. Está en discusión si debe recibir la consideración de conducta adictiva y si es un problema que afecte prioritariamente a adolescentes y jóvenes. El presente estudio pretende conocer los problemas que afectan a las personas de todas las edades en el control del uso de estas TICs y si están relacionados con problemas de salud mental, estrés y dificultades en el control superior del comportamiento. Se realiza una encuesta a través de redes sociales y correo electrónico, en el que se administra el cuestionario MULTICAGE-TIC, que explora problemas en el uso de Internet, teléfono móvil, videojuegos, mensajería instantánea y redes sociales. Adicionalmente se administra el Inventario de Síntomas Prefrontales, el Cuestionario de Salud General y la Escala de Estrés Percibido. Se obtiene una muestra de 1.276 sujetos de todas las edades y diferentes países de habla hispana. Los resultados apuntan a que alrededor del 50% de la muestra presenta importantes problemas en el uso de estas tecnologías, y que esos problemas se relacionan directamente con síntomas de mal funcionamiento prefrontal, estrés y problemas de salud mental, independientemente de la edad u otras variables. Estos resultados sugieren reconsiderar si se trata de una patología adictiva o si estamos ante un problema novedoso que requiere de explicaciones de índole ambiental, psicológica, sociológica y sociopolítica, debiendo reformular las acciones a emprender para reorientar la comprensión y el abordaje del problema.

Loewenstein Occupational Therapy Cognitive Assessment to Evaluate People with Addictions.

BACKGROUND: The LOTCA (Loewenstein Occupational Therapy Cognitive Assessment) battery is a cognitive screening test which is widely used in occupational health. However, no work has been found that explores its use in addiction treatment. OBJECTIVES OF STUDY: To explore the convergent validity of LOTCA with neuropsychological tests that assess related cerebral functional areas. METHODS: The LOTCA, along with a battery of neuropsychological tests, was administered to a sample of 48 subjects who start a treatment by substance or gambling addictions. FINDINGS: A correlational pattern was observed of a considerable magnitude between the effects of the LOTCA scales and those of some neuropsychological tests, but not with others. There is barely any convergence in measures with memory and executive function tests. RELEVANCE TO CLINICAL PRACTICE: There is a lack of research applying test of occupational assessment to populations of patients treated by addictive behaviors. The LOTCA seems to be a reliable and valid test for preliminary screening of function in certain cognitive areas, easy, and quick to use (around 30 minutes). However, it must be supplemented with other tests for a full and ecological assessment of patients. LIMITATIONS: An incident, small-size sample. RECOMMENDATIONS FOR FURTHER RESEARCH: New studies are needed to explore the applicability, diagnostic validity, and whole psychometric quality of the test in addiction-related treatment.

Systematic Review of Occupational Therapy in the Treatment of Addiction: Models, Practice, and Qualitative and Quantitative Research.

OBJECTIVE: The authors conducted a systematic review of theoretical models, professional practice, and research findings to understand occupational therapy's role in the treatment of addiction. METHOD: PubMed, Academic Search Premier, CINAHL, ERIC, OTseeker, and Google Scholar were searched to identify scientific journal articles, book chapters, or any other similar literature published from 1970 through July 2015 that addressed theoretical approaches, intervention models, and professional roles or were qualitative or quantitative studies in which occupational therapy had a central role. RESULTS: The literature search yielded 16 theoretical and professional role studies, 8 qualitative studies, and 14 quantitative studies. All studies had low levels of evidence, and all were case series, sometimes with very small samples. CONCLUSION: Although occupational therapy has been involved in the treatment of people with substance addiction and, more recently, with behavioral addictions for more than half a century, the research that has been published is poor.

Allen Cognitive Level Screen for the classification of subjects treated for addiction.

Introduction The Cognitive Disabilities Model (CDM) is an occupational approach that can allow the classification of the functional-cognitive abilities of persons with addictions. The objective of the study was to explore the applicability of the ACLS-5 to assess a sample of persons undergoing addiction-rehabilitation treatment. Methods A sample of 232 participants was recruited from an outpatient treatment centre in Madrid (Spain). The ACLS-5, the Montreal Cognitive Assessment (MoCA), and the Prefrontal Symptom Inventory (PSI) were administered. Sociodemographic and addiction-related data were also obtained. Results Half of the sample showed serious deficits in functional cognition, which ultimately could be related to problems in their daily performance. Scores of ACLS-5 showed significant correlations with the severity of addiction, with those obtained with the MoCA, and with attentional symptoms on the PSI scale. Conclusions The data suggest the applicability of the ACLS-5 in assessing the degree of functional cognition in subjects treated for addiction, providing evidence to support ecological validity and facilitating the development of well-targeted cognitive rehabilitation programmes from an occupational perspective. The use of occupational-based instruments to assess the functioning of those with addictions is a requirement of occupational therapy professionals working in this general area.

Methadone dosage and its relationship to quality of life, satisfaction, psychopathology, cognitive performance and additional consumption of non-prescribed drugs. / Dosis de metadona y su relación con calidad de vida, satisfacción, psicopatología, rendimiento cognitivo y consumo adicional de sustancias no prescritas.

The effectiveness of methadone maintenance treatment is beyond any doubt, but there remains some incertitude about the appropriate and effective dosage and the objectives that should be achieved by this therapy. Some authors maintain that only doses higher than 50-60 mg/day ought to be considered effective, since only these block all the opioid receptors. But others propose the use of doses adjusted to the needs of the patient, based on their recovery process. Quality of life, satisfaction with treatment, psychopathological symptoms, cognitive performance and additional intake of illegal and unprescribed drugs were evaluated in a representative sample of all patients treated with opioid agonists in the Addiction Institute of Madrid (N = 1898, n = 450) and the Junta de Extremadura (N = 100, n = 65). The results revealed a negative relationship between dose and quality of life, psychopathological symptoms and cognitive performance. Satisfaction with treatment, based on doses negotiated together by doctor and patient, was very high, regardless of the dose. To establish hypothetical causal dependencies among the studied variables structural equation modelling was performed. The results reject the need for high dosage if not required by the patient, and highlight the benefits of other psychosocial interventions that lead to recovery, despite the chronification that could imply the use of high doses. Whereas high dosage programmes provide better indicators of social control, the patient's quality of life must be one of the main indicators of a successful treatment, as in any other health problem.

La efectividad de los tratamientos con metadona está fuera de toda duda, si bien persisten dudas sobre las dosis efectivas y los objetivos que debe perseguir un programa de mantenimiento. Algunos autores propugnan que sólo superiores a 50-60 mg/día deben ser consideradas efectivas, al bloquear los receptores opioides. Otros proponen dosis ajustadas a las necesidades del paciente, atendiendo prioritariamente a su recuperación. Se estudió una muestra representativa de todos los pacientes en tratamiento con agonistas del Instituto de Adicciones de Madrid (N=1898, n=450) y de la Junta de Extremadura (N=100, n=65). Se evaluaron calidad de vida, satisfacción con el tratamiento, sintomatología psicopatológica, rendimiento cognitivo y consumos adicionales. Los resultados muestran una relación negativa entre dosis y calidad de vida, sintomatología psicopatológica y rendimiento cognitivo. La satisfacción con el tratamiento, basado en dosis negociadas entre médico y paciente, fue muy elevada, con independencia de la dosis. Se formuló una ecuación estructural que relacionara todas las variables. Los resultados descartan la necesidad de utilizar dosis altas si el paciente no las precisa, y contar con otras intervenciones psicosociales que favorezcan la recuperación frente a la cronificación que supone el uso de dosis altas. Mientras los programas de altas dosis atienden prioritariamente a indicadores de control social, la calidad de vida del paciente debe ser uno de los principales indicadores de éxito del tratamiento, como en cualquier otro problema de salud.

Measuring the subjective: revisiting the psychometric properties of three rating scales that assess the acute effects of hallucinogens.

OBJECTIVE: In the present study we explored the psychometric properties of three widely used questionnaires to assess the subjective effects of hallucinogens: the Hallucinogen Rating Scale (HRS), the Mystical Experience Questionnaire (MEQ), and the Addiction Research Center Inventory (ARCI). METHODS: These three questionnaires were administered to a sample of 158 subjects (100 men) after taking ayahuasca, a hallucinogen whose main active component is N,N-dimethyltryptamine (DMT). A confirmatory factorial study was conducted to check the adjustment of previous data obtained via theoretical proposals. When this was not possible, we used an exploratory factor analysis without restrictions, based on tetrachoric and polychoric matrices and correlations. RESULTS: Our results sparsely match the theoretical proposals of the authors, perhaps because previous studies have not always employed psychometric methods appropriate to the data obtained. However, these data should be considered preliminary, pending larger samples to confirm or reject the proposed structures obtained. CONCLUSIONS: It is crucial that instruments of sufficiently precise measurement are utilized to make sense of the information obtained in the study of the subjective effects of psychedelic drugs. Copyright © 2016 John Wiley & Sons, Ltd.

[COOP/WONCA: Reliability and validity of the test administered by telephone]. / COOP/WONCA: fiabilidad y validez de la prueba administrada telefónicamente.

AIM: The COOP/WONCA test was initially proposed as a self-report in which the answers were supported by drawings illustrating the state investigated. Subsequent studies have confirmed its usefulness as a mere verbal self-report face-to-face administered. No data have been found about its useful when administered by telephone interview. The aim of this study was to determine the psychometric properties of the COOP / WONCA test to measure Related Quality of Life (HRQoL) administered by telephone and compare them with those obtained in other forms of prior administration. DESIGN: Cross-sectional study on a random. SETTING: City of Madrid. PARTICIPANTS: Random sample of 802 adult subjects, representative of the adult population in Madrid, obtained by stratification from the population census. MAIN MEASUREMENTS: Questionnaire COOP/WONCA with 9 ítems included in a broader battery, administered by telephone interview. RESULTS: The unrestricted factor analysis points to the unifactoriality of the scale, which measures a single latent construct (HRQOL), showing high internal consistency, not significantly different from those found by face-to-face administration, ruling out the existence of biases in the phone modality. CONCLUSIONS: The COOP/WONCA test appears as a reliable and valid measure of HRQOL and telephonic administration allows to assume no changes in the results, which can reduce costs in population studies, increasing efficiency without loss of quality in the information collected.

[Clinical utility and psychometric properties of Prefrontal Symptoms Inventory (PSI) in acquired brain injury and degenerative dementias]. / Utilidad clínica y propiedades psicométricas del inventario de síntomas prefrontales (ISP) en el daño cerebral adquirido y las demencias degenerativas.

INTRODUCTION: The cognitive, emotional and behavioural alterations secondary to acquired brain injury and degenerative dementias can be quantitatively and quantitatively appraised by administering self-reports that ask both patients and reliable informants about the difficulties patients have in their everyday life. SUBJECTS AND METHODS: The Prefrontal Symptoms Inventory (PSI) and the Modified Memory Failures in Everyday Life Questionnaire (MFE-30) were administered to 174 paired participants: 87 patients with brain damage or degenerative dementias and their 87 reliable informants. In addition to the psychometric goodness of the tests, the study also explored the clinical usefulness of applying these questionnaires to patients and their informants in order to obtain a rate of discrepancy in the scores as a measure of anosognosia. RESULTS: The results show how applying the PSI-20 (20 items) or the PSI (46 items), whether administered together with the MFE-30 (30 items) or not, is a very useful procedure for assessing the symptoms in individuals with acquired brain injury or degenerative dementias, since it yields a great deal of information about patients' difficulties in their daily life. CONCLUSIONS: We recommend that, in addition to the compulsory neuropsychological assessment, questionnaires or inventories of symptoms like those proposed here should be carried out, due to the fact that they offer a number of advantages from the clinical point of view, as well as being efficacious and effective in economic terms.

TITLE: Utilidad clinica y propiedades psicometricas del inventario de sintomas prefrontales (ISP) en el daño cerebral adquirido y las demencias degenerativas.Introduccion. Las alteraciones cognitivas, emocionales y comportamentales secundarias al daño cerebral adquirido y las demencias degenerativas pueden valorarse cuantitativa y cualitativamente mediante la administracion de autoinformes que interroguen ­a pacientes e informadores fiables­ sobre las dificultades de los pacientes en la vida cotidiana. Sujetos y metodos. Se administro el inventario de sintomas prefrontales (ISP) y el cuestionario de fallos de memoria en la vida cotidiana modificado (MFE-30) a 174 participantes emparejados: 87 pacientes con daño cerebral o demencias degenerativas y sus 87 informadores fiables. Se exploro, junto con la bondad psicometrica de las pruebas, la utilidad clinica de la aplicacion de estos cuestionarios a pacientes e informadores para obtener un indice de discrepancia de las puntuaciones como medida de la anosognosia. Resultados. Los resultados muestran como aplicar el ISP-20 (20 items) o el ISP (46 items), sean o no administrados conjuntamente con el MFE-30 (30 items), resulta un procedimiento muy util para la valoracion de la sintomatologia en los individuos con daño cerebral adquirido o demencias degenerativas, al proporcionar una gran cantidad de informacion sobre las dificultades de los pacientes en la vida cotidiana. Conclusiones. Se recomienda, junto con la obligada evaluacion neuropsicologica, la cumplimentacion de cuestionarios o inventarios de sintomas como los propuestos, dado que presentan ventajas desde el punto de vista clinico, ademas de resultar eficaces, efectivos y eficientes en terminos economicos.

[Prefrontal clinical symptoms in daily living: screening assessment by means of the short Prefrontal Symptoms Inventory (PSI-20)]. / Sintomatologia prefrontal en la vida diaria: evaluacion de cribado mediante el inventario de sintomas prefrontales abreviado (ISP-20).

INTRODUCTION: Estimation of daily symptoms of frontal dysfunction is considered to be essential in order to endow neuro-psychological assessments with ecological validity. The questionnaires available today were constructed to estimate executive problems in daily life in populations with neurological damage. There is a need for instruments focused on measuring these behaviours in the general population or in clinical populations with mild or moderate impairment. AIM: To examine the factorial validity and to find evidence of concurrent validity of the short version of the Prefrontal Symptoms Inventory. SUBJECTS AND METHODS: Three samples were obtained: the first, from the Internet (n = 504); the second, in a non-clinical population by means of paper and pencil (n = 1,257); and the third, from patients being treated for substance addiction (n = 602). A factorial analysis without restraints was used on the first sample and the results were submitted to confirmatory factorial analysis on the other two samples. RESULTS: The three-factor structure that was found was confirmed with excellent indicators of fit in the other two samples. Evidence of concurrent validity was found with quality of life and mental health tests. CONCLUSIONS: We propose a short questionnaire for detecting failures of a prefrontal origin in daily living, which improves on the psychometric qualities of similar tests, but is oriented towards severe neurological pathologies. The structural stability of the test ensures it can be used in the general population, for the early detection of cognitive impairment, and in clinical populations with mild or moderate deterioration. A set of criteria are proposed for use in interpreting the results.

TITLE: Sintomatologia prefrontal en la vida diaria: evaluacion de cribado mediante el inventario de sintomas prefrontales abreviado (ISP-20).Introduccion. La estimacion de sintomas cotidianos de disfuncion frontal se considera imprescindible para aportar validez ecologica a las evaluaciones neuropsicologicas. Los cuestionarios disponibles se construyeron para estimar problemas ejecutivos en la vida diaria en poblaciones con daño neurologico. Se requieren instrumentos enfocados a medir estos comportamientos en la poblacion general o en poblaciones clinicas con fallos leves o moderados. Objetivo. Estudiar la validez factorial y encontrar indicios de validez concurrente de la version abreviada del inventario de sintomas prefrontales. Sujetos y metodos. Se obtuvieron tres muestras: la primera, a traves de Internet (n = 504); la segunda, en poblacion no clinica mediante lapiz y papel (n = 1.257), y la tercera, de pacientes en tratamiento por adiccion a sustancias (n = 602). Se utilizo un metodo de analisis factorial sin restricciones sobre la primera muestra y los resultados se sometieron a analisis factorial confirmatorio sobre las otras dos muestras. Resultados. La estructura de tres factores encontrada se confirmo con excelentes indicadores de ajuste en las otras dos muestras. Se hallaron indicios de validez concurrente con pruebas de calidad de vida y salud mental. Conclusiones. Se propone un cuestionario breve para la deteccion de fallos de origen prefrontal en la vida diaria, que mejora las cualidades psicometricas de tests similares, pero orientados a patologias neurologicas graves. La estabilidad estructural de la prueba garantiza la utilidad en la poblacion general, para la deteccion precoz del deterioro cognitivo, y en poblaciones clinicas con deterioro leve o moderado. Se proponen baremos para la interpretacion de resultados.

Dysexecutive Questionnaire (DEX): Unrestricted structural analysis in large clinical and non-clinical samples.

The factorial structure of the Dysexecutive Questionnaire (DEX) is an unresolved issue in scientific literature. One-to-five-factor solutions have been found in several studies by applying different research methods. Only a few of these studies used appropriate analysis procedures to suit a Likert scale-type of answer or investigated large enough samples to ensure the stability of factorial solutions. The present study examines a sample of 2151 subjects, 1482 from the general population and 669 from a clinical population. An unrestricted factorial analysis was carried out on both samples. The results unequivocally point to a single-factor solution in both samples. This means that only one latent variable is displayed in the DEX, which accounts for symptoms of oversight malfunction in activities of daily living. It is concluded that the diversity of results previously obtained in other studies may be due to using research methods that depict Likert-type scales on a continuum when they are actually ordinal categorical measures. In conclusion, the DEX should be considered a screening test that reports symptoms of prefrontal malfunction, although it is unable to specify what areas or functions have been affected, as previous studies have claimed.

[Cognitive reserve in substance addicts in treatment: relation to cognitive performance and activities of daily living]. / Reserva cognitiva en adictos a sustancias en tratamiento: relacion con el rendimiento cognitivo y las actividades cotidianas.

INTRODUCTION: The concept of cognitive reserve has gradually attracted more interest as a greater body of evidence has been collected on its relationship with the resistance of the brain to decline in its functioning when faced with neurological threats or disorders. Although a large amount of research has been conducted on (degenerative, traumatic, psychopathological) conditions, very few studies relate cognitive reserve with substance addiction, a multidimensional process with a clear neurological base. AIMS: To explore the cognitive reserve of patients undergoing treatment for addiction to drugs of abuse by relating it with their cognitive performance in neuropsychological tests and in activities of daily living. PATIENTS AND METHODS: The study involved a sample of 57 patients being treated for substance abuse at a centre set up for this specific purpose. The cognitive reserve questionnaire, the Montreal cognitive assessment and the prefrontal symptoms inventory were administered, and variables related with the addiction were collected. RESULTS: A positive relation was found between the cognitive reserve and the time of abstinence, and a negative one was seen with the severity of the addiction. Significant differences were observed according to the cognitive reserve in neuropsychological performance (especially in certain cognitive domains) and in daily activities. CONCLUSIONS: The cognitive reserve appears as a variable related to addiction and the cognitive deficits that accompany it. It is thus a potential target for rehabilitation activities and is linked to the environmental enrichment paradigm, as a strategy for enhancing resistance against the cognitive impairment that favours and maintains the addiction, and for lowering the reinforcing potential of the behaviour of consuming.

TITLE: Reserva cognitiva en adictos a sustancias en tratamiento: relacion con el rendimiento cognitivo y las actividades cotidianas.Introduccion. El concepto de reserva cognitiva ha ido ganando interes en la medida en que se ha acumulado evidencia sobre su relacion con la resistencia del cerebro a declinar en su funcionamiento ante amenazas o alteraciones neurologicas. Aunque se ha estudiado en un gran numero de alteraciones (degenerativas, traumaticas, psicopatologicas), pocos trabajos relacionan la reserva cognitiva con la adiccion a sustancias, un proceso multidimensional con clara base neurologica. Objetivo. Explorar la reserva cognitiva de pacientes en tratamiento por adiccion a drogas, relacionandolo con su rendimiento cognitivo en pruebas neuropsicologicas y en actividades de la vida diaria. Pacientes y metodos. Muestra de 57 pacientes en tratamiento por adiccion a sustancias en un centro especifico. Se administraron el cuestionario de reserva cognitiva, la evaluacion cognitiva de Montreal y el inventario de sintomas prefrontales, y se recogieron variables relacionadas con la adiccion. Resultados. Se encontro una relacion positiva entre la reserva cognitiva y el tiempo de abstinencia, y negativa con la gravedad de la adiccion. Aparecieron diferencias significativas segun la reserva cognitiva en rendimiento neuropsicologico (especialmente en ciertos dominios cognitivos) y en actividades cotidianas. Conclusiones. La reserva cognitiva aparece como una variable relacionada con la adiccion y los deficits cognitivos que la acompañan; resulta ser una potencial diana de las actividades rehabilitadoras, vinculada al paradigma de enriquecimiento ambiental, como estrategia para potenciar la resistencia frente al deterioro cognitivo que favorece y mantiene la adiccion y para disminuir el potencial reforzador de la conducta de consumo.