RESUMO
BACKGROUND: The US National Institutes of Mental Health Research Domain Criteria (RDoC) seek to stimulate research into biologically validated neuropsychological dimensions across mental illness symptoms and diagnoses. The RDoC framework comprises 39 functional constructs designed to be revised and refined, with the overall goal of improving diagnostic validity and treatments. This study aimed to reach a consensus among experts in the addiction field on the 'primary' RDoC constructs most relevant to substance and behavioural addictions. METHODS: Forty-four addiction experts were recruited from Australia, Asia, Europe and the Americas. The Delphi technique was used to determine a consensus as to the degree of importance of each construct in understanding the essential dimensions underpinning addictive behaviours. Expert opinions were canvassed online over three rounds (97% completion rate), with each consecutive round offering feedback for experts to review their opinions. RESULTS: Seven constructs were endorsed by ≥ 80% of experts as 'primary' to the understanding of addictive behaviour: five from the Positive Valence System (reward valuation, expectancy, action selection, reward learning, habit); one from the Cognitive Control System (response selection/inhibition); and one expert-initiated construct (compulsivity). These constructs were rated to be related differentially to stages of the addiction cycle, with some linked more closely to addiction onset and others more to chronicity. Experts agreed that these neuropsychological dimensions apply across a range of addictions. CONCLUSIONS: The study offers a novel and neuropsychologically informed theoretical framework, as well as a cogent step forward to test transdiagnostic concepts in addiction research, with direct implications for assessment, diagnosis, staging of disorder, and treatment.
Assuntos
Comportamento Aditivo/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Ásia , Austrália , Comportamento Aditivo/diagnóstico , Comportamento Aditivo/psicologia , Comportamento Aditivo/terapia , Comportamento Compulsivo , Tomada de Decisões , Técnica Delphi , Europa (Continente) , Hábitos , Humanos , Inibição Psicológica , Aprendizagem , National Institute of Mental Health (U.S.) , América do Norte , Recompensa , América do Sul , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Estados UnidosRESUMO
INTRODUCTION: There is a renewed interest in incorporating personality variables in criminology theories in order to build models able to integrate personality variables and biological factors with psychosocial and sociocultural factors. The aim of this article is the assessment of personality dimensions that contribute to the prediction of antisocial behavior in adolescents. METHODS: For this purpose, a sample of adolescents from El Salvador, Mexico, and Spain was obtained. The sample consisted of 1035 participants with a mean age of 16.2. There were 450 adolescents from a forensic population (those who committed a crime) and 585 adolescents from the normal population (no crime committed). All of participants answered personality tests about neuroticism, extraversion, psychoticism, sensation seeking, impulsivity, and violence risk. RESULTS: Principal component analysis of the data identified two independent factors: (i) the disinhibited behavior pattern (PDC), formed by the dimensions of neuroticism, psychoticism, impulsivity and risk of violence; and (ii) the extrovert behavior pattern (PEC), formed by the dimensions of sensation risk and extraversion. Both patterns significantly contributed to the prediction of adolescent antisocial behavior in a logistic regression model which properly classifies a global percentage of 81.9%, 86.8% for non-offense and 72.5% for offense behavior. CONCLUSIONS: The classification power of regression equations allows making very satisfactory predictions about adolescent offense commission. Educational level has been classified as a protective factor, while age and gender (male) have been classified as risk factors.
Assuntos
Transtorno da Personalidade Antissocial/epidemiologia , Transtorno da Personalidade Antissocial/psicologia , Personalidade , Adolescente , El Salvador , Feminino , Humanos , Masculino , México , Medição de Risco , EspanhaRESUMO
Benzodiazepines and methadone use has been associated with various neuropsychological impairments. However, to the best of our knowledge, no studies have been carried out on the effect of these substances (either separately or combined) on impulsive personality, including studies in prisoners. The aim of this study is to examine the impulsive personality of a sample of 134 male prisoners using the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (Torrubia, Avila, Molto, & Caseras, 2001) and the UPPS-P Scale (Cyders et al., 2007). Some of these were methadone users, methadone and benzodiazepines users, polydrug users in abstinence and non-dependent drug users. The results showed that drug users have greater sensitivity to reward, positive urgency, negative urgency and sensation seeking than non-dependent users. Methadone users showed more sensitivity to punishment and lack of perseverance with respect to other users. No differences were found between methadone+benzodiazepines users and other groups. The secondary aim is to examine which impulsive personality dimensions are related to the two motivational systems proposed by Gray (BIS-BAS) using exploratory factor analysis. Results showed two different components. One component was defined by the subscales sensitivity to reinforcement, positive urgency, negative urgency and sensation seeking. The second component was defined by the subscales sensitivity to punishment, lack of perseverance and lack of premeditation.
El consumo de benzodiacepinas y metadona se ha asociado a diversas alteraciones neuropsicológicas. Sin embargo, no conocemos estudios sobre el efecto de estas sustancias tanto de forma separada como de forma combinada en rasgos de personalidad impulsiva, y en menor medida en población penitenciaria. El objetivo principal de este estudio es examinar la impulsividad rasgo, medida con el Cuestionario de Sensibilidad al Castigo Sensibilidad a la Recompensa (Torrubia, Avila, Moltó y Caseras, 2001), y la escala de Evaluación del Comportamiento Impulsivo UPPS-P (Cyders et al., 2007), en una muestra de 134 varones de un centro penitenciario con consumo de metadona, metadona y benzodiacepinas, abstinentes de consumo, y no dependientes del consumo de sustancias (criterios DSM-IV). Los resultados mostraron que los grupos de consumidores presentan mayor sensibilidad a la recompensa, urgencia positiva, urgencia negativa y búsqueda de sensaciones que los no consumidores; los grupos de consumo de metadona presentan mayor sensibilidad al castigo y falta de perseverancia. El grupo de no consumidores presenta menor falta de perseverancia que el grupo de metadona y el grupo de metadona+benzodiacepinas. No se han encontrado diferencias específicamente del grupo de metadona+benzodiacepinas con el resto de los grupos. Como objetivo secundario, examinar, mediante análisis factorial exploratorio, qué dimensiones de personalidad impulsiva se relacionan con los dos sistemas motivacionales propuestos por Gray (SIC-SAC). Los resultados mostraron un componente definido por las subescalas sensibilidad al refuerzo, urgencia positiva, urgencia negativa y búsqueda de sensaciones, y un segundo definido por las subescalas sensibilidad al castigo, falta de perseverancia y falta de premeditación.
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Benzodiazepinas/uso terapêutico , Comportamento Impulsivo/efeitos dos fármacos , Metadona/uso terapêutico , Prisioneiros/psicologia , Adolescente , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJETIVE: The objective of the present study was the validation and scaling of the Plutchik's Violence Risk Scale (EV) in adolescent Spanish-speaking population. METHODS: For this purpose, a sample of adolescents from El Salvador, Mexico and Spain was obtained. The sample consisted of 1035 participants with a mean age of 16.2. There were 450 adolescents from forensic population (those who committed crime) and 585 adolescents from normal population (no crime committed). RESULTS: The internal consistency of the EV was estimated by Cronbach's alpha coefficient and with a value of 0.782. As for validity, the factorial structures found explain a large proportion of the variance (53.385%); the convergent validity was estimated by the correlation between the dimensions found, the EV and sociodemographic, criminological and personality variables. The developed scales are presented, for the first time in a cross-cultural sample, differentiating between gender and continent. CONCLUSIONS: Consequently, the obtained results suggest that the EV is a valid and reliable instrument within adolescent Spanish-speaking population. Furthermore, it is a quick scale, easy to apply, which is something valuable in forensic assessment.
Assuntos
Escalas de Graduação Psiquiátrica , Psicometria , Violência , Adolescente , El Salvador , Humanos , México , Reprodutibilidade dos Testes , EspanhaRESUMO
The main objective of this study was to analyze emotional response to a set of everyday emotional visual stimuli unrelated to drug use. Two groups of prescribed opiate drug abusers (heroin+methadone vs. methadone-only groups) currently participating in the Andalusian Experimental Prescribed Drug Program (Programa Experimental de Prescripcion de Estupefacientes de Andalucia, PEPSA) were studied, and comparisons made between them, within them for different phases, and between them and a normative group of nonusers. For this purpose we used the I.C.E.R.E., an instrument based on the I.A.P.S. (International Affective Picture System) and on Peter Lang's S.A.M. (Self-Assessment Manikin). The results showed patterns of emotional response in the opiate users, compared to the non-users, characterized by a lower rating of the everyday natural stimuli of a pleasant nature and a greater sensitivity to the stimuli of a neutral and negative nature. These patterns were quite stable even in different clinical situations and stages of development of the P.E.P.S.A.