Development of a screening test for cognitive impairment in alcoholic population: TEDCA.

INTRODUCTION: Several studies have found cognitive impairment in patients with a history of alcohol use disorder, affecting their psychosocial functioning and the achievement of therapeutic goals. In order to identify these effects, several cognitive screening tests have been used, though they were not specific for alcoholic population, possibly leading to an increase in the risk of error. OBJECTIVE: The aim of this study is to assess the main cognitive deficits in patients with history of alcohol use disorders, through the development of a specific screening test for alcohol-related cognitive impairment. METHODOLOGY: The TEDCA (Test of detection of cognitive impairment in alcoholism) was designed based on three dimensions: Visuospatial Cognition, Memory / Learning and Executive Function. The study was divided in two phases: During phase 1, test items with greater capacity for discrimination between patients with different levels of cognitive impairment were selected, and during phase 2, the analysis for validity and reliability indexes took place. The sample consisted of 248 participants, 88 controls (phase 2) and 160 patients (phase 1: n=70 and phase 2: n=90). RESULTS: TEDCA test obtained a high reliability (Cronbach’s alpha 0.754) value and the factor analysis confirmed the presence of the three dimensions previously defined. The present screening tool also discriminated between patients and control group, together with a good diagnostic validity of cognitive impairment. CONCLUSIONS: TEDCA is a new screening test, which identifies the possible presence of cognitive impairment in patients with a history of alcohol use disorders, which can be used in the fields of psychiatry, primary care and research.

Desarrollo de un test de detección de deterioro cognitivo en población alcohólica: TEDCA / Development of a screening test for cognitive impairment in alcoholic population: TEDCA

Introducción. Numerosos estudios han encontrado alteraciones cognitivas en pacientes con historia de trastorno por consumo de alcohol, afectando su funcionamiento psicosocial y consecución de objetivos terapéuticos. Para identificar estas afectaciones se han utilizado pruebas de cribado cognitivo a pesar de que no han sido diseñadas para esta población, aumentando el riesgo de error. Objetivo. Valorar los principales déficits cognitivos en pacientes con historia de trastorno por consumo de alcohol, para desarrollar una prueba de cribado de alteraciones cognitivas específica para estos pacientes. Metodología. El TEDCA (Test de detección de deterioro cognitivo en alcoholismo) se diseñó en base a tres dimensiones: Cognición Viso-espacial, Memoria/Aprendizaje y Función Ejecutiva. El estudio se dividió en dos fases: En la fase 1 se seleccionaron las pruebas con mayor capacidad de discriminación entre pacientes con diferentes niveles de afectación cognitiva, y en la fase 2 se realizaron los análisis de validez y fiabilidad. La muestra estuvo formada por 248 participantes, 88 controles (fase 2) y 160 pacientes (fase 1: n=70 y fase 2: n=90). Resultados. El TEDCA obtuvo una fiabilidad elevada (alfa de Cronbach 0.754), el análisis factorial confirmó la presencia de las 3 dimensiones definidas previamente, discriminó entre pacientes y controles, y presenta una buena validez diagnóstica de afectación cognitiva. Conclusiones. El TEDCA es una nueva prueba de cribado, que permite identificar la posible presencia de afectación cognitiva en pacientes con historia de trastorno por (AU)

Introduction. Several studies have found cognitive impairment in patients with a history of alcohol use disorder, affecting their psychosocial functioning and the achievement of therapeutic goals. In order to identify these effects, several cognitive screening tests have been used, though they were not specific for alcoholic population, possibly leading to an increase in the risk of error. Objective.The aim of this study is to assess the main cognitive deficits in patients with history of alcohol use disorders, through the development of a specific screening test for alcohol-related cognitive impairment. Methodology. The TEDCA (Test of detection of cognitive impairment in alcoholism) was designed based on three dimensions: Visuospatial Cognition, Memory / Learning and Executive Function. The study was divided in two phases: During phase 1, test items with greater capacity for discrimination between patients with different levels of cognitive impairment were selected, and during phase 2, the analysis for validity and reliability indexes took place. The sample consisted of 248 participants, 88 controls (phase 2) and 160 patients (phase 1: n=70 and phase 2: n=90). Results.TEDCA test obtained a high reliability (Cronbach's alpha 0.754) value and the factor analysis confirmed the presence of the three dimensions previously defined. The present screening tool also discriminated between patients and control group, together with a good diagnostic validity of cognitive impairment. Conclusions. TEDCA is a new screening test, which identifies the possible presence of cognitive impairment in patients with a history of alcohol use disorders, which can be used in the fields of psychiatry, primary care and research (AU)

Validación de la versión española del Test Stroop de Alcohol / Validation of the Spanish Version of the Alcohol Stroop Test

El sesgo atencional para el alcohol se ha mostrado útil para identificar a personas con consumo patológico así como a personas dependientes con altas probabilidades de recaída. El objetivo de este trabajo fue validar la versión española del Test Stroop de Alcohol diseñado para evaluar el sesgo atencional en pacientes dependientes del alcohol. La muestra estuvo compuesta por 173 participantes divididos en dos grupos: Un grupo de pacientes (n = 88) cumpliendo criterios de dependencia alcohólica y un grupo control (n = 85) con riesgo bajo de consumo de alcohol, que realizaron el Test de palabras y colores de Stroop (Stroop clásico), el Test de Stroop neutro y el Test de Stroop de Alcohol. Se observaron diferencias estadísticamente significativas en las interferencias para el Stroop Clásico y el Stroop de Alcohol. Los pacientes con dependencia, en comparación a los participantes control, mostraron mayores interferencias para estímulos de contenido alcohólico que para estímulos de contenido neutro. Este efecto fue explicado por un sesgo atencional para información relacionada con el alcohol en pacientes con dependencia. Se calcularon curvas COR, observándose áreas bajo la curva estadísticamente significativas para las interferencias del Stroop clásico y del Stroop de alcohol. Este trabajo sirvió para validar la versión española del Test Stroop de Alcohol para evaluar sesgos atencionales hacia el alcohol en personas con problemas de consumo y dependencia alcohólica

Attention bias for alcohol has proved useful to distinguish people with a pathological consumption of people who do not, and dependents who are more likely to fall in consumption. The aim of this study was to validate the Spanish version of the Alcohol Stroop test, designed to evaluate attention biases for alcohol in alcohol-dependent patients. The sample was composed by 173 participants divided into 2 groups: 1) “Patients” (n = 88) meeting criteria for alcohol dependence; and 2) “Control” (n = 85) having a low risk for alcohol consumption, that completed the Stroop color naming Task (Classic Stroop), the Neutral Stroop test and the alcohol Stroop test. Statistically significant differences were found in the interference effects calculated for the Classic and Alcohol Stroop tests. Patients compared to control participants showed a higher interference effect for alcohol-related stimuli than for neutral stimuli. These effects were accounted by an attention bias for alcohol-related information in patients. ROC curves were calculated for the three interference effects, showing an area under the curve statistically significant in the Classic Stroop interference and the Alcohol Stroop interference. This study provides the validation of the Spanish version of the Alcohol Stroop test that allows to evaluate attention biases for alcohol stimuli in individuals with both pathologic alcohol consumption and alcohol dependence