Self-report and objective measures of cognitive deficit in patients entering substance abuse treatment.

The relationship between self-reported cognitive deficits and objectively measured cognitive performance was examined in 86 patients entering substance abuse treatment. Self-ratings of cognitive impairment were strongly correlated with indices of depression and vulnerability to stress, but not with objective cognitive performance. Confirming the lack of relationship between self-report and objective cognitive measures, cognitive performance did not differ between patients at the extremes of the cognitive-complaint distribution; and cognitively impaired patients did not differ from cognitively intact patients in their self-ratings of impairment.

Recommendations for health care professionals to improve compliance and treatment outcome among patients with cognitive deficits.

A significant body of research demonstrates that alcoholics and drug addicts presenting for treatment have poor attention and concentration, memory, abstraction, and problem-solving skills even after a significant detoxification period. Such deficits result in poor understanding of medical and psychological treatment recommendations, which is likely to decrease treatment compliance. Although psychological test results are frequently available, many health care professionals are unfamiliar with the implications of deficits signaled by test scores. Even when such testing is available, reports often fail to recommend interventions for improving treatment understanding and compliance. The present study reviewed the cognitive testing of 206 male veterans admitted to the Substance Abuse Treatment Center. Descriptive data, along with implications for real-world tasks, are presented. Specific recommendations for providing treatment to patients with vocabulary, abstraction, and memory difficulties are made. With this information, health care professionals who receive testing reports will be better able to relate testing information to patient behavior and to provide efficacious treatment.

Psychosocial and psychopathology differences in hospitalized male and female cocaine abusers: a retrospective chart review.

While considerable amounts of psychological and pharmacological data have been collected on male substance abusers in public treatment facilities, relatively little information is available about the psychosocial characteristics of men in private treatment settings and of women presenting for substance abuse treatment. The present study reviewed the records of 100 male and female cocaine abusers admitted to a private substance abuse treatment program between 1987 and 1989. Patterns of cocaine use and levels of impairment were found to be similar for men and women, with male cocaine abusers more likely to abuse additional substances. Male cocaine abusers were employed more frequently than women and held higher status jobs despite equivalent levels of education. Female cocaine abusers were more likely to be diagnosed with concurrent psychiatric disorders and were more likely to report family histories of substance abuse. Both groups produced elevations on MMPI scales indicating depression, anxiety, paranoid features, and acting-out tendencies. These data suggest that while male and female cocaine abusers show similarities on some measures, there are significant gender differences that may have implications for both research and treatment.

Long-term smoking status of cardiac patients following symptom-specific cessation advice.

Although physicians routinely advise postcardiac event patients to stop smoking, the effect of a modified advice format targeting specific health concerns has not been investigated. Also, no studies of cessation advice with cardiac patients have used biochemical verification of self-reported abstinence. The present study included 48 veterans with a history of smoking and cardiac problems; of these, 31 were smoking and 17 were abstinent at initial assessment. Alveolar carbon monoxide (COa) levels served to: (1) augment cessation advice by demonstrating smoking risks and cessation benefits specific to cardiac patients and (2) verify self-report. At 12 months followup, following cessation advice, 18% of the abstinent subjects had resumed smoking while none of the smokers had become abstinent. Those who maintained abstinence significantly increased their estimates of the contribution of smoking to their cardiac problems whereas those who continued to smoke showed no change.