Right frontal stroke: extra-frontal lesions, executive functioning and impulsive behaviour

Abstract The aim of this study was to evaluate executive functioning (EF) and impulsiveness in three groups of people aged 30 to 79 years: post-frontal stroke (n= 13) and post-extra-frontal chronic stroke of the right hemisphere (n= 31) and control (n= 38). The years of education varied between the groups was as follows, frontal lesion group:M= 12 (SD= 6.11); extra-frontal lesion group: M = 9.06 (SD = 4.94); and control: M= 9.61 (SD= 4.24) years. The following instruments were used: Behavioural Assessment Dysexecutive Syndrome, Wisconsin Card Sorting Test (WSCT), Barratt Impulsivity Scale, Impulsivity Evaluation Scale, Delay Descounting Task and Go/No-Go Task. We found differences in EF between the extra-frontal lesion group and the control group with respect to cognitive flexibility (p= .018); number of WCST trials (p= .018); WCST perseverative errors (p= .014) and omission by impulsivity errors on the go/no-go task for 250 ms (p= .008) and 1750 ms trials (p= .006). The frontal lesion group made more errors of omission than the control group in the 1750 ms go/no-go trials (p= .006). These results suggest that extra-frontal lesions impair EF by influencing attentional impulsivity.(AU)

Ideação suicida, resolução de problemas, expressão de raiva e impulsividade em dependentes de substâncias psicoativas / Suicidal ideation, problem solving, expression of anger and impulsiveness in dependents on psychoactive substances

Este estudo teve por objetivo comparar homens dependentes de substâncias psicoativas, com não dependentes, quanto às funções executivas e à expressão emocional e comportamental relacionando com a presença de ideação suicida. A amostra foi composta por 25 dependentes de substâncias psicoativas e 25 não dependentes. Empregou-se na coleta de dados um questionário sociodemográfico e de aspectos de saúde, a Entrevista Diagnóstica (MINI-Plus), o Inventário de Expressão de Raiva como Estado e Traço, a Escala de Impulsividade de Barratt (BIS-11), o Teste Wisconsin de Classificação de Cartas e a Escala de Ideação Suicida de Beck. Conclui-se que os dependentes de substâncias psicoativas do estudo não apresentaram alterações cognitivas significativas, o que não vai ao encontro da literatura, porém apresentaram alterações quanto à impulsividade e à expressão de raiva.

This study aimed to compare men with substance use disorders and those who are no addicted/non-dependent on drugs in terms of their executive functions, emotional and behavioral expressions giving particular emphasis on the presence of suicidal ideation. The sample consisted of 25 individuals with substance use disorders and 25 non-dependent individuals. The data collection consisted of a questionnaire including sociodemographic and health data, the Diagnostic Interview (MINI-Plus), the Anger Expression Inventory - State and Trait (STAXI), the Barratt Impulsiveness Scale (I-BIS11), the Wisconsin Card Sorting Test (WCST) and the Beck Scale for Suicide Ideation (BSI). The data revealed that the substance dependent individuals showed no significant cognitive impairment, fact that does not math with the literature. However, they presented alterations with respect to impulsivity and expression of anger.

Drogas, violência e aspectos emocionais em apenados / Drugs, violence and emotional aspects in prisoners

Objetivo deste trabalho foi avaliar: o abuso/dependência de drogas; os aspectos emocionais de carcerários e relacionar o uso de drogas com a conduta agressiva; sintomas depressivos e ansiosos; tipo de crime e reincidência. Os instrumentos utilizados foram: BDI, BAI, STAXI e MINI Plus. Os participantes (N=60) tinham média de idade de 27,88 (±4,53) anos com período mínimo de quatro meses de prisão. Constatou-se um nível de agressividade baixo, de sintomas depressivos e ansiosos mínimos, elevado índice de uso abusivo de álcool e outras drogas e associação entre uso de drogas, sintomas depressivos e agressividade. Concluiu-se que na amostra estudada houve alta frequência de uso de álcool e crime por roubo e que o uso de drogas tem um papel importante na agressividade e nos sintomas depressivos.

The objectives of the present work were to evaluate the severity of drug abuse and drug dependence among prisoners as well as their emotional aspects, and to relate drug use with violent behavior, symptoms of depression and anxiety, type of crime and relapse. The instruments used were: BDI, BAI, STAXI and MINI Plus. The participants (N=60) were on average 27.88 years old (SD=4.53) and the minimum period of imprisonment was four months. The results showed that aggressiveness levels were low, and depression and anxiety levels were minimal in prisoners. However, a long history of alcohol consumption and other drugs abuse were observed among them as well as traits of depressive symptoms and aggressiveness. In conclusion, a large number of prisoners were alcohol addicted and their main kind of crime was robbery. They also showed emotional disorders related to aggressiveness and depression.

Frontal stroke: problem solving, decision making, impulsiveness, and depressive symptoms in men and women

The present study compared men and women who suffered a frontal lobe stroke with regard to problem solving, decision making, impulsive behavior and depressive symptoms and also correlated these variables between groups. The sample was composed of 10 males and nine females. The study period was 6 months after the stroke. The following instruments were used: Wisconsin Card Sort Test (WCST), Iowa Gambling Task (IGT), Barrat Impulsiveness Scale (BIS11), and Beck Depression Inventory (BDI). For the exclusion criteria of the sample, the Mini International Psychiatric Interview (M.I.N.I Plus) and Mini Mental Stage Examination (MMSE) were used. To measure functional severity post-stroke, the Rankin Scale was used. The average age was 60.90 ± 8.93 years for males and 60.44 ± 11.57 years for females. In females, total impulsiveness (p = .013) and lack of planning caused by impulsiveness (p = .028) were significantly higher compared with males, assessed by the BIS11. These data indicate that females in the present sample who suffered a chronic frontal lesion were more impulsive and presented more planning difficulties in situations without demanding cognitive processing. These results that show gender differences should be considered when planning psychotherapy and cognitive rehabilitation for patients who present these characteristics.

Dependência de álcool, cocaína e crack e transtornos psiquiátricos / Alcohol, cocaine, and crack dependence and psychiatric disorders

Este estudo objetivou verificar a frequência de transtornos psiquiátricos em dois grupos de dependentes químicos, cocaína/crack e álcool/cocaína/crack, por meio do Mini International Neuropsychiatric Interview (M.I.N.I Plus). Foram entrevistados 32 indivíduos do sexo masculino, com idade média de 27,65 (DP=7,38) anos. A maioria tinha Ensino Fundamental incompleto (34,37 por cento), era solteira (81,25 por cento) e relatou história familiar de consumo de álcool (76,5 por cento - grupo cocaína/crack; 53,3 por cento - grupo álcool/cocaína/crack). O período médio de abstinência era de 33,05 (DP=19,52) dias. Os resultados mostraram uma frequência maior de Transtorno do Humor nos dois grupos. Embora a diferença não tenha sido estatisticamente significativa, os dependentes de álcool/cocaína/crack apresentaram, adicionalmente, alta frequência de Transtorno de Personalidade, sugerindo a necessidade de tratamento diferencial para essa população.

This study investigated the frequency of psychiatric disorders in two groups of drug users, cocaine/crack and alcohol/cocaine/crack, by means of the Mini International Neuropsychiatric Interview (M.I.N.I Plus). The participants, 32 men, had an average age of 27.65 (SD=7.38) years. Most of them had not completed Fundamental School (34.37 percent), were single (81.25 percent) and reported a family history of alcohol consumption (76.5 percent - cocaine/crack; 53.3 percent - alcohol/ cocaine/crack). On average, the time of abstinence was 33.05 (SD=19.52) days. The results showed a high frequency of Mood Disorders in both groups. Although the difference was not statistically significant, the alcohol/cocaine/crack group presented, additionally, high frequency of Personality Disorder, suggesting the need of a distinct treatment for that population.

Atenção, ansiedade e raiva em dependentes químicos / La atención, ansiedad y rabia en los adictos químicos / Attention, anxiety and anger in drug-dependents

Este estudo teve como objetivo analisar e comparar a atenção difusa, atenção difusa complexa, atenção concentrada, atenção concentrada complexa, ansiedade e raiva entre três grupos: 1) controle; 2) dependentes de cocaína/crack e 3) dependentes de álcool e cocaína/crack. É uma pesquisa transversal, comparativa do tipo caso-controle, constituída por uma amostra não aleatória. Participaram 49 indivíduos, do sexo masculino com idades entre 18 e 57 anos, avaliados através da Bateria Geral das Funções Mentais 1 e 2; Inventário de Expressão de Raiva como Estado e Traço e Inventário de Ansiedade Beck. O tempo médio de abstinência das drogas foi de 33,05 (DP = 19,52) dias. Os resultados mostraram que na atenção não houve diferenças significativas na comparação entre os grupos. Entretanto, houve diferença nos níveis de ansiedade e raiva entre os dependentes químicos e controles. Conclui-se que não houve prejuízo cognitivo na atenção desses indivíduos, mas alterações emocionais na ansiedade e raiva.

This study had the objective to analyze and compare diffuse attention, complex attention, concentrated attention, anxiety and anger in control subjects and those dependent on alcohol, crack and cocaine. The participants (n = 49) were adult males from 18 to 57 years old, assigned to 3 groups: 1) controls; 2) cocaine/crack dependents; and 3) alcohol and cocaine/crack dependents. They were assessed by Mental Functions General Battery (BGFM 1 and 2); State-Trait Anger Expression Inventory (STAXI) and Beck Anxiety Inventory (BAI). The average time of abstinence was 33.05 (DP = 19.52) days. The results showed no statistically significant difference in cognition among the groups studied. However, there was a statistically significant difference in the anxiety and anger levels when comparing the control group to the group of alcohol, cocaine/crack dependents. It is possible to conclude that there was no cognitive deficit in attention, but emotional changes in anxiety and anger in these drug-dependent individuals.

Este estudio tuvo como objetivo analizar y comparar la atención difusa, atención difusa compleja, atención concentrada, atención concentrada compleja, ansiedad y rabia entre 3 grupos: 1) control, 2) adictos de cocaína/crack (pasta base) y 3) adictos de alcohol y cocaína/crack (pasta base). Es una investigación transversal, comparativa del tipo caso-control, constituida por una muestra no aleatoria. Participaron 49 individuos, del sexo masculino con edades entre 18 y 57 años, evaluados a través de la Batería General de Funciones Mentales 1 y 2; Inventario de Expresión de Rabia como Estado y Trazo e Inventario de Ansiedad Beck. El tiempo promedio de abstinencia de las drogas fue 33.,05 (DP = 19,5) días. Los resultados mostraron que en la atención no hubo diferencias significantes en la comparación entre los grupos. Sin embargo, hubo diferencia en los niveles de ansiedad y rabia entre los adictos químicos y controles. Se concluye que no hubo perjuicio cognitivo en la atención de estos individuos, pero alteraciones emocionales en la ansiedad y rabia.

Álcool e violência em homens e mulheres / Alcohol: gender and implications in the violence

O uso nocivo do álcool configura-se como um problema de saúde pública, associado ao aumento da violência, envolvendo ambos os sexos. Esse artigo tem por objetivo discutir sobre o impacto do uso do álcool em homens e mulheres do ponto de vista neurobiológico, enfatizando a ação psicoativa da substância e sua implicação no comportamento violento. Foi conduzida uma análise baseada em artigos selecionados nas fontes eletrônicas do Scielo, LILACS, MEDLINE, PubMed e Web of Science no período de 1996 a 2008. Do total de 420 artigos selecionados, 90 foram considerados relevantes para a análise. Verificou-se que o uso nocivo do álcool causa mudanças neuroquímicas e alterações nas funções cognitivas, podendo gerar comportamentos violentos em homens e mulheres, entretanto, evidenciou-se importantes diferenças entre os sexos quanto à ação psicoativa do álcool, assim como, no tipo de violência expressa. Estudos sobre a temática proposta ainda são escassos, sugerindo a necessidade de pesquisas futuras que possam contribuir para um melhor entendimento e para ações preventivas eficazes.

The abuse of alcohol can engender serious public health problems in certain people, particularly due to its link to violence involving both men and women. This article has the aim to discuss the impact of alcohol in men and women regarding neurobiological mechanisms, emphasizing its psychoactive effects as well as its implication for violent behavior. An analysis was conduct based on reviews and articles in electronic databases, selected from 1996 to 2008 at Scielo, Lilacs, MEDLINE, Pub Med and Web of Science. From a total of 420 selected articles 90 were considered relevant for this analysis. It was evident that the abuse of alcohol causes changes in neurochemistry and in cognitive functions, and some of those changes lead to violent behavior in men and women. However, there are important differences between both genders and the type of aggressive behavior expressed. Studies on this topic are still rare and more research is necessary in order to develop better diagnostic tools and favor relevant neurobiological mechanisms for more effective treatments.