Influence of substance use and cognitive impairment on adherence to antiretroviral therapy in HIV+ patients. / Perfil cognitivo de los alcohólicos abstinentes durante un periodo de tiempo prolongado en comparación con un grupo de hombres que no consumen alcohol.

Scarce studies have focused on the cognitive profile of chronic alcoholic men after long-term abstinence. Thus, we examined neuropsychological differences between long-term abstinent alcoholics for an average of 3.2 years (n = 40, LTAA; age = 45.55 ± 8.99) and matched for socio-demographic variables with non-alcoholic controls (n = 39; age = 42.05 ± 11.33). To this aim, we employed a neuropsychological assessment battery covered relevant cognitive domains: IQ, memory, attention, executive functions and empathy. LTAA presented deficits in abstract reasoning, speed processing, sustained attention, working and long-term memory (verbal and visuospatial), cognitive flexibility, inhibition and planning. Although our results must be interpreted with caution because of the cross-sectional nature of our study, it may offer a broader knowledge and understanding of alcohol-related socio-cognitive deficits after long-term abstinence. These deficits might entail risk factors for relapse in alcohol consumption, as they may interfere with recording therapeutic advice and internalizing the verbal material presented in rehabilitation programs. In turn, these impair the global efficacy of alcohol-relapse prevention programs. Hence, this knowledge could be applicable in guiding the development of early coadjutant treatments.

Solo pocos estudios han analizado el perfil cognitivo de los hombres con un trastorno por consumo de alcohol tras un periodo de abstinencia prolongado. Por tanto, este estudio tiene como principal objetivo analizar las diferencias neuropsicológicas entre un grupo de hombres con trastorno por consumo de alcohol pero abstinentes de forma ininterrumpida durante 3,2 años (n = 40, edad = 45,55 ± 8,99) en comparación con un grupo de hombres sin trastorno por consumo de alcohol pero con unas características socio-demográficas similares a las del grupo experimental (n = 39; edad = 42,05 ± 11,33) para establecer diferentes perfiles neuropsicológicos. Empleamos una batería neuropsicológica exhaustiva que evaluó los siguientes dominios cognitivos: CI, memoria, atención, funciones ejecutivas y empatía. El grupo de hombres alcohólicos abstinentes presentaron déficits en razonamiento abstracto, velocidad de procesamiento, atención sostenida, memoria de trabajo y a largo plazo (para información verbal y visuoespacial), flexibilidad cognitiva, y en las capacidades de inhibición y planificación. A pesar de que nuestros resultados deben interpretarse con cautela dado el carácter transversal de nuestro estudio, ofrece información relevante sobre el estado cognitivo de los hombres con un trastorno por consumo de alcohol tras una abstinencia prolongada. Estos déficits podrían estar implicados en las frecuentes recaídas en esta población. Del mismo modo, interferirían en la asimilación de contenidos teóricos de intervenciones psicoterapéuticas, lo que, a su vez, disminuiría la eficacia de las mismas. Por ello, estos resultados deberían ser empleados para el desarrollo de programas de rehabilitación cognitivos coadyuvantes a la psicoterapia.

Perfil cognitivo de los alcohólicos abstinentes durante un periodo de tiempo prolongado en comparación con un grupo de hombres que no consumen alcohol / Cognitive profile of long-term abstinent alcoholics in comparison with non-alcoholics

Solo pocos estudios han analizado el perfil cognitivo de los hombres con un trastorno por consumo de alcohol tras un periodo de abstinencia prolongado. Por tanto, este estudio tiene como principal objetivo analizar las diferencias neuropsicológicas entre un grupo de hombres con trastorno por consumo de alcohol pero abstinentes de forma ininterrumpida durante 3,2 años (n = 40, edad = 45,55 ± 8,99) en comparación con un grupo de hombres sin trastorno por consumo de alcohol pero con unas características socio-demográficas similares a las del grupo experimental (n = 39; edad = 42,05 ± 11,33) para establecer diferentes perfiles neuropsicológicos. Empleamos una batería neuropsicológica exhaustiva que evaluó los siguientes dominios cognitivos: CI, memoria, atención, funciones ejecutivas y empatía. El grupo de hombres alcohólicos abstinentes presentaron déficits en razonamiento abstracto, velocidad de procesamiento, atención sostenida, memoria de trabajo y a largo plazo (para información verbal y visuoespacial), flexibilidad cognitiva, y en las capacidades de inhibición y planificación. A pesar de que nuestros resultados deben interpretarse con cautela dado el carácter transversal de nuestro estudio, ofrece información relevante sobre el estado cognitivo de los hombres con un trastorno por consumo de alcohol tras una abstinencia prolongada. Estos déficits podrían estar implicados en las frecuentes recaídas en esta población. Del mismo modo, interferirían en la asimilación de contenidos teóricos de intervenciones psicoterapéuticas, lo que, a su vez, disminuiría la eficacia de las mismas. Por ello, estos resultados deberían ser empleados para el desarrollo de programas de rehabilitación cognitivos coadyuvantes a la psicoterapia

Scarce studies have focused on the cognitive profile of chronic alcoholic men after long-term abstinence. Thus, we examined neuropsychological differences between long-term abstinent alcoholics for an average of 3.2 years (n = 40, LTAA; age = 45.55 ± 8.99) and matched for socio-demographic variables with non-alcoholic controls (n = 39; age = 42.05 ± 11.33). To this aim, we employed a neuropsychological assessment battery covered relevant cognitive domains: IQ, memory, attention, executive functions and empathy. LTAA presented deficits in abstract reasoning, speed processing, sustained attention, working and long-term memory (verbal and visuospatial), cognitive flexibility, inhibition and planning. Although our results must be interpreted with caution because of the crosssectional nature of our study, it may offer a broader knowledge and understanding of alcohol-related socio-cognitive deficits after longterm abstinence. These deficits might entail risk factors for relapse in alcohol consumption, as they may interfere with recording therapeutic advice and internalizing the verbal material presented in rehabilitation programs. In turn, these impair the global efficacy of alcohol-relapse prevention programs. Hence, this knowledge could be applicable in guiding the development of early coadjutant treatments

Emotional and autonomic dysregulation in abstinent alcoholic men: An idiosyncratic profile?

Men who misuse alcohol tend to experience negative affect, which may entail difficulties in regulating emotions to cope effectively with stressful or anxiety-provoking situations, thus increasing the risk of alcohol relapse. This dysphoric state has been associated with alexithymia, which compromises an individual's abilities to acknowledge, recognize, and regulate emotional states. A physiological correlate of emotional regulation is autonomic flexibility, as shown by emotional dysregulation in men who misuse alcohol being correlated with reduced parasympathetic activation to control heart rate variability during stress and/or conflict situations. Hence, the main aim of this study was to investigate whether long-term abstinent alcoholic (LTAA) men exhibit higher levels of negative affect and sympathetic activation (cardiovascular and electrodermal) in response to acute standardized laboratory stress than non-alcoholic controls. In addition, we hypothesized that the higher the alexithymic traits, the greater would be the increase in negative affect and sympathetic activation in response to stress, especially in LTAAs. Our data demonstrated that LTAAs experienced slightly greater increases in anxiety, states of anger, and worsening of mood than controls. Moreover, they exhibited lower high-frequency heart rate variability, respiratory sinus arrhythmia values, shorter pre-ejection periods, and higher respiratory rates than controls. Finally, alexithymic traits imply greater worsening of mood and sympathetic predominance (shorter pre-ejection periods and smaller magnitude of response), with the associations being stronger in LTAAs. These findings indicate a different emotional and cardiovascular response to psychosocial stress in LTAA than non-alcoholic men. Improving our knowledge of the way this population reacts to stress may help identify risk factors for alcohol relapse.

Could Alcohol Abuse Drive Intimate Partner Violence Perpetrators' Psychophysiological Response to Acute Stress?

Proactively aggressive individuals have been shown to present a different pattern of autonomic nervous system (ANS) dysregulation from that of individuals characterized by reactive violence. Although attempts have been made to classify intimate partner violence (IPV) perpetrators based on ANS reactivity to acute stress, subsequent studies have failed to replicate this classification. Notably, the proposed classification neglected the role of chronic alcohol abuse in ANS dysregulation and the fact that this dysregulation entails an abnormal stress response. The aim of the present study was to analyze the response profile (psychological state and ANS response) of groups of IPV perpetrators with high (n = 27) and low (n = 33)-risk alcohol use to an acute stressor, compared to controls (n = 35). All IPV perpetrators scored higher on executive dysfunctions and impulsivity and showed larger decreases in positive affect, less satisfaction, and a higher external locus of control after the stressor than controls. IPV perpetrators with low-risk alcohol use had higher skin conductance levels and breathing reactivity than controls, especially during preparatory, task, and recovery periods. This information could help to develop methods for increasing batterers' behavioral self-regulation, thus decreasing IPV recidivism risk.

Differential cognitive profiles of intimate partner violence perpetrators based on alcohol consumption.

Despite extensive evidence of heterogeneity in intimate partner violence (IPV) perpetrator profiles, there has been little research into neuropsychological deficits that might help us understand differences within this violent population. Moreover, studies on this topic have not paid much attention to the role of alcohol abuse in neuropsychological domains of IPV perpetrators. Hence, the current study was designed to examine neuropsychological differences among individuals who have committed domestic violence with high (n = 28, HA) and low (n = 35, LA) levels of alcohol consumption, and non-violent individuals (n = 37) to establish differential neuropsychological profiles. An exhaustive neuropsychological assessment battery was employed which combined the computer-based Cambridge Neuropsychological Test Automated Battery with pencil-and-paper measures. Compared to controls, HA IPV perpetrators had slower processing speed and significantly more impairments in attentional set-shifting or switch attention, working and long-term memory, cognitive flexibility, planning, decision-making, emotion decoding skills, and perspective taking. Furthermore, there were differences between IPV perpetrator subgroups in attentional set-shifting or switch attention and cognitive empathy, with HA IPV perpetrators displaying more severe impairments in both cognitive domains than LA IPV perpetrators. Finally, the LA IPV perpetrators had significantly more impairments in working and long-term memory, executive functioning, and emotion decoding skills than controls, but they did not differ in processing speed, attentional set-shifting or switch attention, decision making, or perspective taking. Thus, the current findings suggest that IPV perpetrators with neuropsychological difficulties, especially those who are heavy drinkers, may have the greatest need for cognitive interventions. These cognitive deficits could be employed as targets for developing specific cognitive rehabilitation programs adjuvant to psychotherapeutic intervention for IPV perpetrators.

A cognitive-behavioural intervention improves cognition in caregivers of people with autism spectrum disorder: A pilot study / La intervención cognitivo-conductual mejora la cognición de los cuidadores de personas con trastorno del espectro autista: estudio piloto

As postulated by the stress process model, chronically stressed individuals, such as caregivers of people with chronic psychological disorders, have poorer cognitive performance and higher age-related cognitive decline than individuals not exposed to chronic stress. When analysing this topic in caregivers, the majority of research has been conducted in populations in which the care recipient has dementia and/or Alzheimer's disease, while relatively few studies have analysed cognition in caregivers of offspring with autism spectrum disorder (ASD). The main objective of this pilot study was to analyse the effect of a cognitive-behavioural intervention on cognition in caregivers of people with ASD. Specifically, we sought to gather evidence on whether there were clinically significant improvements in speed/attention, memory, and visuospatial, language and executive functions after the intervention. The participants were 17 parents (mean age of 52 years, 59% females) of ASD-diagnosed people who had cared for their offspring for approximately 14 years. The study had a pre-post design. After the cognitive-behavioural intervention, ASD caregivers had better selective attention, short- and long-term memory for words, stories and images, naming, cognitive flexibility and planning skills (p=.01 for all). Nevertheless, no changes were observed in general cognitive status, working memory for digits, verbal fluency, processing speed or inhibitory control (p>.05 for all). These findings underline the relevance of proper support and respite services to help caregivers cope with and reduce stress. A comprehensive neuropsychological assessment together with adjuvant domain-specific procedures and programmes to improve cognitive abilities are required to improve caregivers' well-being and health

Según los postulados del modelo del proceso del estrés, los individuos con situación de estrés crónico, tales como los cuidadores de personas con trastornos psicológicos crónicos, tienen un desempeño cognitivo más pobre y un deterioro cognitivo relacionado con la edad más acentuado que los individuos no expuestos al estrés crónico. Al analizar esta cuestión en los cuidadores, la mayoría de los estudios se han realizado en poblaciones en las que los receptores de los cuidados padecen demencia y/o Alzheimer, y pocos estudios han analizado la cognición en los cuidadores de los hijos con trastorno del espectro autista (ASD). El objetivo principal de este estudio piloto fue analizar el efecto de una intervención cognitivo-conductual en los cuidadores de personas con ASD. De manera específica, tratamos de reunir evidencia sobre las posibles mejoras con significación clínica en cuestiones tales como velocidad/atención, memoria y funciones visuoespaciales, del lenguaje y ejecutivas tras la intervención. Los participantes fueron 17 padres (edad media de 52 años, 59% de mujeres) de personas diagnosticadas de ASD que habían cuidado de sus hijos durante aproximadamente 14 años. El estudio tenía un diseño pre-post. Tras la intervención cognitivo-conductual, los cuidadores de las personas con ASD tenían mejor atención selectiva, memoria a corto y largo plazo en relación con las palabras, cuentos e imágenes, es decir, flexibilidad cognitiva y técnicas de planificación (p=0.01 en total). Sin embargo, no se observaron cambios con relación al estado cognitivo general, memoria operativa para cifras, fluidez verbal, velocidad de procesamiento o control inhibitorio (p>0.05 en total). Estos hallazgos subrayan la relevancia de un respaldo adecuado y de unos servicios de relevo que ayuden a los cuidadores a enfrentarse al estrés, y reducir el mismo. Se precisan amplias valoraciones neuropsicológicas y procedimientos y programas adyuvantes, específicos en la materia, para mejorar las capacidades cognitivas, así como el bienestar y la salud, de los cuidadores