Inhibitory Control and Craving in Dual Disorders and Recurrent Substance Use. Preliminary Findings.

Objective: In Dual Disorders (DD), which involves the co-occurrence of a disorder in substance use and a mental disorder, recurrent struggles with addictive behavior are frequent. Neuropsychological knowledge concerning the profile of inhibitory control and the irresistible urge to use substances (craving) within the DD patient group may contribute to the prevention of this recurrent addictive behavior. Methods: Inhibitory control and craving were assessed in 25 patients with DD and 25 healthy controls (HC). Inhibitory control tasks (Go/No-go task and Stop Signal Task) were performed combined with brain measurements (Event Related Potentials) mapping inhibitory control. Moreover, implicit and explicit measures concerning craving were administered. Statistical DD and HC comparisons, correlational and regression analyses on exploratory base were conducted. Results: DD patients committed more inhibitory control errors than HC when confronted with (alcohol) consumption-related picture stimuli. Furthermore, patients with DD showed higher levels of implicit and explicit craving. The number of inhibitory control errors was positively related to levels of implicit and explicit craving. Moreover, explicit craving and impulsivity (as a dimension of inhibitory control) predicted the severity of addictive behavior. Event Related Potential analyses did not show differences in inhibitory control-associated brain activity between DD patients and HC; both groups showed reduction of P300 amplitudes in response to alcohol pictures. Conclusions: Impulsivity and craving are elevated in DD patients and show predictive value for the severity of addictive behavior. One's level of impulsive action tendency may trigger less effort to control (recurrent) substance use. The findings may contribute to existing DD treatment indications by the promotion of impulse control training via "stop-think-act" methods for DD patients.

Dutch translation and adaptation of the Barkley Deficits in Executive Functioning Scale (BDEFS)

Abstract Background Based on his model of self-regulation and executive functions, Barkley developed a self- and other-report questionnaire (the Barkley Deficits in Executive Functioning Scale - BDEFS). The BDEFS measures deficits in executive functions as expressed in daily life activities like self-management of time, self-organization, self-restraint, self-motivation, and self-regulation of emotion. Objectives This study created and analyzed a Dutch translation and adaptation in conformance with official guidelines. Methods The Dutch and English BDEFS were completed by 25 bilingual Dutch adults to evaluate semantic correspondence. Consequently, 60 Dutch participants completed the Dutch BDEFS, Barratt Impulsiveness Scale-Eleventh edition (BIS-11) and the Dysexecutive Questionnaire (DEX) to evaluate concurrent validity and internal consistency. Results The versions demonstrated sufficient semantic equivalence and Spearman's rho of total scores was high; items mostly showed moderate-to-high correlations. Regression analysis showed no proportional bias. Internal consistency was also high. Correlations between BDEFS, BIS-11 and DEX supported concurrent validity. Discussion We conclude that a successful BDEFS translation and adaptation was created with satisfactory reliability and validity. Further research should assess the utility of the BDEFS in Dutch clinical practice.