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Sex-Related Differences in Self-Reported Neurocognitive Impairment among High-Risk Cocaine Users in Methadone Maintenance Treatment Program.

Shrestha R, Huedo-Medina TB, Copenhaver MM - Subst Abuse (2015)

Bottom Line: Women reported greater impairment than men, as evidenced by significantly higher scores on several NIS subscales, after controlling for demographic and other confounding variables.These findings suggest that cocaine users enter into treatment with a range of NCI - with women having significantly more neurocognitive deficits than men - that may contribute to differential treatment outcomes.This highlights the need to include additional services such as neuropsychological screening and sex-specific treatment programs to optimally reduce adverse health outcomes in these high-risk, cognitively impaired patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA.

ABSTRACT

Background: Previous research has suggested possible sex-related differences in executive functioning among cocaine users; however, no studies specifically explain sex-related differences in neurocognitive impairment (NCI) among cocaine users receiving clinical care. Knowledge about this association can aid in the development of targeted prevention strategies to reduce adverse health outcomes. This study was designed to examine the sex-related differences in NCI among high-risk cocaine users receiving substance-abuse treatment.

Methods: The Neuropsychological Impairment Scale (NIS) was administered to 199 cocaine users (98 men; 101 women), receiving methadone maintainance treatment, to assess self-reported NCI by identifying the patients' awareness of neuropsychological symptoms. We used T-test comparison to find differences in NCI between men and women and multiple regression analysis to explore the relative contribution of sex to NCI.

Results: Consistent with prior work, high NCI was evident within this sample, as indicated by high scores on most of the NIS subscales. Women reported greater impairment than men, as evidenced by significantly higher scores on several NIS subscales, after controlling for demographic and other confounding variables. Interestingly, cocaine craving significantly predicted NCI among men but not among women, as suggested by the significant association between cocaine craving and all except one of the NIS subscales.

Conclusions: These findings suggest that cocaine users enter into treatment with a range of NCI - with women having significantly more neurocognitive deficits than men - that may contribute to differential treatment outcomes. This highlights the need to include additional services such as neuropsychological screening and sex-specific treatment programs to optimally reduce adverse health outcomes in these high-risk, cognitively impaired patients.

No MeSH data available.


Related in: MedlinePlus

Comparison between male and participants on the NIS summary scores, clinical scales, and test-taking attitude scales.Note: *Significance P < 0.05.
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f1-sart-9-2015-017: Comparison between male and participants on the NIS summary scores, clinical scales, and test-taking attitude scales.Note: *Significance P < 0.05.

Mentions: NIS T-scores on each subscale were coded as “high” if they were within the range of the normative data provided in the NIS manual and used in prior study (ie, 50T–60T).25,31 The degree of impairment on all of the NIS subscales, except for symptom intensity measure (SIM) and defensiveness (DEF), was found to be “high” (ie, ranged from 50T to 60T) among all participants in our sample relative to the general population norm. Furthermore, women had significantly higher scores on one of the three NIS summary scores: global measure of impairment (GMI) [F (165) = 6.1, P < 0.015]. Similarly, women had significantly higher scores on four of the seven clinical subscales scores: cognitive efficiency (COG) [F (165) = 5.6, P < 0.019], attention (ATT) [F (165) = 5.6, P < 0.019], frustration tolerance (FRU) [F (165) = 9.8, P < 0.002], and academic skills (ACD) [F (165) = 5.1, P < 0.025]. On the validity subscales assessing test-taking attitudes, female patients had higher affective disturbance scores (AFF) [F (165) = 6.5, P < 0.012] as compared to males (Fig. 1; Table 4).


Sex-Related Differences in Self-Reported Neurocognitive Impairment among High-Risk Cocaine Users in Methadone Maintenance Treatment Program.

Shrestha R, Huedo-Medina TB, Copenhaver MM - Subst Abuse (2015)

Comparison between male and participants on the NIS summary scores, clinical scales, and test-taking attitude scales.Note: *Significance P < 0.05.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4363005&req=5

f1-sart-9-2015-017: Comparison between male and participants on the NIS summary scores, clinical scales, and test-taking attitude scales.Note: *Significance P < 0.05.
Mentions: NIS T-scores on each subscale were coded as “high” if they were within the range of the normative data provided in the NIS manual and used in prior study (ie, 50T–60T).25,31 The degree of impairment on all of the NIS subscales, except for symptom intensity measure (SIM) and defensiveness (DEF), was found to be “high” (ie, ranged from 50T to 60T) among all participants in our sample relative to the general population norm. Furthermore, women had significantly higher scores on one of the three NIS summary scores: global measure of impairment (GMI) [F (165) = 6.1, P < 0.015]. Similarly, women had significantly higher scores on four of the seven clinical subscales scores: cognitive efficiency (COG) [F (165) = 5.6, P < 0.019], attention (ATT) [F (165) = 5.6, P < 0.019], frustration tolerance (FRU) [F (165) = 9.8, P < 0.002], and academic skills (ACD) [F (165) = 5.1, P < 0.025]. On the validity subscales assessing test-taking attitudes, female patients had higher affective disturbance scores (AFF) [F (165) = 6.5, P < 0.012] as compared to males (Fig. 1; Table 4).

Bottom Line: Women reported greater impairment than men, as evidenced by significantly higher scores on several NIS subscales, after controlling for demographic and other confounding variables.These findings suggest that cocaine users enter into treatment with a range of NCI - with women having significantly more neurocognitive deficits than men - that may contribute to differential treatment outcomes.This highlights the need to include additional services such as neuropsychological screening and sex-specific treatment programs to optimally reduce adverse health outcomes in these high-risk, cognitively impaired patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA.

ABSTRACT

Background: Previous research has suggested possible sex-related differences in executive functioning among cocaine users; however, no studies specifically explain sex-related differences in neurocognitive impairment (NCI) among cocaine users receiving clinical care. Knowledge about this association can aid in the development of targeted prevention strategies to reduce adverse health outcomes. This study was designed to examine the sex-related differences in NCI among high-risk cocaine users receiving substance-abuse treatment.

Methods: The Neuropsychological Impairment Scale (NIS) was administered to 199 cocaine users (98 men; 101 women), receiving methadone maintainance treatment, to assess self-reported NCI by identifying the patients' awareness of neuropsychological symptoms. We used T-test comparison to find differences in NCI between men and women and multiple regression analysis to explore the relative contribution of sex to NCI.

Results: Consistent with prior work, high NCI was evident within this sample, as indicated by high scores on most of the NIS subscales. Women reported greater impairment than men, as evidenced by significantly higher scores on several NIS subscales, after controlling for demographic and other confounding variables. Interestingly, cocaine craving significantly predicted NCI among men but not among women, as suggested by the significant association between cocaine craving and all except one of the NIS subscales.

Conclusions: These findings suggest that cocaine users enter into treatment with a range of NCI - with women having significantly more neurocognitive deficits than men - that may contribute to differential treatment outcomes. This highlights the need to include additional services such as neuropsychological screening and sex-specific treatment programs to optimally reduce adverse health outcomes in these high-risk, cognitively impaired patients.

No MeSH data available.


Related in: MedlinePlus