Measuring the subjective: revisiting the psychometric properties of three rating scales that assess the acute effects of hallucinogens.

OBJECTIVE: In the present study we explored the psychometric properties of three widely used questionnaires to assess the subjective effects of hallucinogens: the Hallucinogen Rating Scale (HRS), the Mystical Experience Questionnaire (MEQ), and the Addiction Research Center Inventory (ARCI). METHODS: These three questionnaires were administered to a sample of 158 subjects (100 men) after taking ayahuasca, a hallucinogen whose main active component is N,N-dimethyltryptamine (DMT). A confirmatory factorial study was conducted to check the adjustment of previous data obtained via theoretical proposals. When this was not possible, we used an exploratory factor analysis without restrictions, based on tetrachoric and polychoric matrices and correlations. RESULTS: Our results sparsely match the theoretical proposals of the authors, perhaps because previous studies have not always employed psychometric methods appropriate to the data obtained. However, these data should be considered preliminary, pending larger samples to confirm or reject the proposed structures obtained. CONCLUSIONS: It is crucial that instruments of sufficiently precise measurement are utilized to make sense of the information obtained in the study of the subjective effects of psychedelic drugs. Copyright © 2016 John Wiley & Sons, Ltd.

[Evaluation of occupational performance in everyday life in addicted population. Development of a measuring instrument: the ADO]. / Evaluación del desempeño ocupacional en la vida cotidiana en adictos. Creación de un instrumento de medida: el ADO.

Addiction is a complex disorder of brain function, which involves primarily the frontal cortex as a structure responsible for the organization of intentional behavior. The performance of everyday life activity is one of the key factors in assessing the impact of cognitive impairment. There are no validated instruments in Spanish applicable to addicts for assessing self-perceived efficacy in the performance of everyday activities. Based on the Occupational Self-Assessment, a questionnaire was developed for the exploration of: perceived level of performance quality, evaluation of competences and the influence of environment on performance. For the study, a sample of 425 non-clinical participants and 300 patients treated for substance addiction was used. The Occupational Performance Self- Report (ADO) has 37 items and showed adequate internal consistency (Alpha = 0.93, 0.75 and 0.87 for the subscales) and a stable structure in confirmatory factor analysis. The self-assessment of performance showed consistent correlation with dysexecutive symptoms in daily life (-0.54 < r < -0.66). The ADO emerges as a reliable and valid instrument for the exploration of self-perceived level of performance in the everyday lives of individuals with substance addiction, and may be useful for establishing treatment goals in conditions of high ecological validity.

Evaluación del desempeño ocupacional en la vida cotidiana en adictos. Creación de un instrumento de medida: el ADO / Evaluation of occupational performance in everyday life in addicted population. Development of a measuring instrument: the ADO

La adicción es una alteración compleja del funcionamiento cerebral, que implica de forma prioritaria al córtex frontal como estructura encargada de la organización de la conducta intencional. El desempeño de la actividad en la vida cotidiana es uno de los factores claves a la hora de valorar el impacto del deterioro cognitivo. No contamos con instrumentos validados en español aplicables en adictos que valoren la autopercepción de eficacia en el desempeño de actividades en la vida cotidiana. Basándonos en el Occupational Self-Assessment, se desarrolla un cuestionario que evalúa: nivel percibido de calidad en la ejecución, valoración de las competencias e influencia del ambiente en el desempeño. Para el estudio se obtuvo una muestra de 425 sujetos de población no clínica y 300 de población tratada por adicción a sustancias. El Autoinforme de Desempeño Ocupacional (ADO) consta de37 ítems y ha mostrado adecuada consistencia interna (α = 0,93, entre0,75 y 0,87 para las subescalas) y una estructura estable en el análisis factorial confirmatorio. Las medidas de autoevaluación en la calidad del desempeño muestran correlaciones consistentes con sintomatología disejecutiva en la vida cotidiana (-0,54 < r < -0,66). El ADO se presenta como un instrumento fiable y válido para la exploración del nivel autopercibido de desempeño en la vida cotidiana de sujetos con adicción a sustancias y puede ser de utilidad para el establecimiento de objetivos de tratamiento en condiciones de elevada validez ecológica (AU)

Addiction is a complex disorder of brain function, which involves primarily the frontal cortex as a structure responsible for the organization of intentional behavior. The performance of everyday life activity is one of the key factors in assessing the impact of cognitive impairment. There are no validated instruments in Spanish applicable to addicts for assessing self-perceived efficacy in the performance of everyday activities. Based on the Occupational Self-Assessment, a questionnaire was developed for the exploration of: perceived level of performance quality, evaluation of competences and the influence of environment on performance. For the study, a sample of 425 non-clinical participants and 300 patients treated for substance addiction was used. The Occupational Performance Self-Report (ADO) has 37 items and showed adequate internal consistency (α = 0.93, 0.75 and 0.87 for the subscales) and a stable structure in confirmatory factor analysis. The self-assessment of performance showed consistent correlation with dysexecutive symptoms in daily life (-0.54

Diferencias de personalidad entre adictos al alcohol y controles emparejados: relación con sintomatología frontal y subtipos de adictos / Personality differences between alcohol abusers and matched controls: Relation to frontal symptoms and subtypes of addicts

Los estudios epidemiológicos muestran estrecha relación entre trastornos de personalidad y adicciones. Los modelos dimensionales de la personalidad, como el de Cloninger, permiten formular diagnósticos capaces de discriminar entre estilos de conducta disfuncionales transitorios y rasgos relativamente más estables. Se han propuesto determinadas localizaciones cerebrales, como sustratos de los rasgos, basados en la activación de zonas cerebrales específicas. Este trabajo explora las diferencias en rasgos de personalidad entre una muestra de adictos al alcohol (N= 95) y un grupo de control de población no-clínica (N= 95), emparejados a partir de variables sociodemográficas, utilizando el TCI-R-67 y la FrSBe-Sp. Se hipotetiza que tales diferencias se relacionan con sintomatología frontal y se estudia la existencia de diversos subgrupos de adictos a partir de determinadas combinaciones de rasgos. Los resultados muestran diferencias significativas en dos rasgos temperamentales (Búsqueda de Novedad y Evitación del Daño) y uno caracterial (Autodirección). Se encontró una correlación con gran tamaño del efecto entre estos rasgos y sintomatología frontal. El análisis de clusters clasificó a los participantes en diversos subtipos con diferentes combinaciones de rasgos que se corresponden con sintomatología frontal variada. Se discuten las posibles explicaciones neurobiológicas de las diferencias y su importancia en la clínica (AU)

Epidemiological studies usually show a link between personality disorders and addictions. Dimensional models of personality, such as that of Cloninger, are able to diagnose and discriminate between transient dysfunctional behavior styles and relatively more stable traits. Certain brain areas have been proposed, as trait locations, based on their activation. This paper explores differences in personality traits among a sample of alcohol abusers (N= 95) and a control group of nonclinical population (N= 95), matched in sociodemographic variables, using the TCI-R-67 and the FrSBe- Sp. It is hypothesized that such differences are associated with frontal symptomatology. The existence of different subgroups of addicts based on certain combinations of traits is also analyzed. Results showed significant differences in two temperament traits (Novelty Seeking and Harm Avoidance) and a characterial trait (Self-Direction). We also found a correlation with a large effect size between these traits and frontal symptomatology. Cluster analysis classified the participants into several subtypes with different combinations of traits that matched diverse frontal symptomatology. Possible neurobiological explanations of these differences and their importance in the clinical practice are discussed (AU)

[Personality differences between alcohol abusers and matched controls: Relation to frontal symptoms and subtypes of addicts]. / Diferencias de personalidad entre adictos al alcohol y controles emparejados: relación con sintomatología frontal y subtipos de adictos.

Epidemiological studies usually show a link between personality disorders and addictions. Dimensional models of personality, such as that of Cloninger, are able to diagnose and discriminate between transient dysfunctional behavior styles and relatively more stable traits. Certain brain areas have been proposed, as trait locations, based on their activation. This paper explores differences in personality traits among a sample of alcohol abusers (N= 95) and a control group of non-clinical population (N= 95), matched in sociodemographic variables, using the TCI-R-67 and the FrSBe-Sp. It is hypothesized that such differences are associated with frontal symptomatology. The existence of different subgroups of addicts based on certain combinations of traits is also analyzed. Results showed significant differences in two temperament traits (Novelty Seeking and Harm Avoidance) and a characterial trait (Self-Direction). We also found a correlation with a large effect size between these traits and frontal symptomatology. Cluster analysis classified the participants into several subtypes with different combinations of traits that matched diverse frontal symptomatology. Possible neurobiological explanations of these differences and their importance in the clinical practice are discussed.

[Spanish version of the Dysexecutive Questionnaire (DEX-Sp): psychometric properties in addicts and non-clinical sample]. / Versión española del Cuestionario Disejecutivo (DEX-Sp): propiedades psicométricas en adictos y población no clínica.

OBJECTIVE: Several studies have shown evidence of executive function impairment associated with substance abuse. This suggests the potential usefulness of a baseline assessment measure to screen for dysexecutive impairments in individuals beginning treatment. The Dysexecutive Questionnaire (DEX) is a test widely used to estimate executive dysfunction. The main objective of this work is to study the psychometric properties of the Spanish version of the Dysexecutive Questionnaire (DEX-Sp). A complementary goal is to study its potential utility for initial screening in addicted individuals seeking treatment. METHOD: A sample of 131 non-clinical and 127 clinical individuals meeting the DSM-IV-TR substance abuse or dependence criteria were recruited. RESULTS: Internal consistency of the questionnaire was assessed (Cronbach's Alfa=0.91), as well as other reliability indicators. Exploratory and confirmatory factor analysis offers four- and five-factor solutions. Also tested were the dimensionality and structural model and its convergent and discriminant validity with other instruments. Differences between clinical and non-clinical individuals and total scores were also analyzed. CONCLUSIONS: The data suggest that the Spanish version of the DEX is a useful measure for assessing general symptoms of dysexecutive syndrome, and a valid, reliable and adequate screening test for estimating cognitive impairment associated with substance abuse.

Versión española del Cuestionario Disejecutivo (DEX-Sp): propiedades psicométricas en adictos y población no clínica / Spanish version of the Dysexecutive Questionnaire (DEX-Sp): psychometric properties in addicts and non-clinical sample

Objetivo: Diversos estudios han evidenciado el deterioro de las funciones ejecutivas asociado al abuso de sustancias. Este hecho sugiere la conveniencia de contar con algún instrumento de cribado que sirva para establecer una línea base sobre los déficits que presentan los sujetos que inician tratamiento. El Cuestionario Disejecutivo (DEX) es un test ampliamente utilizado para estimar disfunción ejecutiva. El principal objetivo del presente trabajo se centra en estudiar las propiedades de la versión española del Cuestionario Disejecutivo (DEX-Sp). Complementariamente se pretende estudiar su potencial utilidad como instrumento de cribado en adictos en tratamiento. Método: 131 sujetos de población no clínica y 127 adictos (con criterios DSM-IVTR para abuso o dependencia). Resultados: Se estudia la consistencia interna (¬ de Cronbach = 0,91) entre otros indicadores de fiabilidad. El análisis factorial exploratorio y confirmatorio ofrece soluciones de 4 y 5 factores. Se estudió la dimensionalidad y el modelo estructural de base, así como la validez convergente y discriminante. Se estudiaron las diferencias apreciadas entre adictos y población no clínica. Conclusiones: Los datos sugieren que la versión española del DEX es un instrumento útil para evaluar síntomas disejecutivos generales, con la suficiente fiabilidad y validez para explorar deterioro cognitivo asociado al abuso desustancias (AU)

Objective: Several studies have shown evidence of executive function impairment associated with substance abuse. This suggests the potential usefulness of a baseline assessment measure to screen for dysexecutive impairments in individuals beginning treatment. The Dysexecutive Questionnaire (DEX) is a test widely used to estimate executive dysfunction. The main objective of this work is to study the psychometric properties of the Spanish version of the Dysexecutive Questionnaire (DEX-Sp). A complementary goal is to study its potential utility for initial screening in addicted individuals seeking treatment. Method: A sample of 131 non-clinical and 127 clinical individuals meeting the DSM-IV-TR substance abuse or dependence criteria were recruited. Results: Internal consistency of the questionnaire was assessed (Cronbach’s ¬ =0.91), as well as other reliability indicators. Exploratory and confirmatory factor analysis offers four- and five-factor solutions. Also tested were the dimensionality and structural model and its convergent and discriminant validity with other instruments. Differences between clinical and non-clinical individuals and total scores were also analyzed. Conclusions: The data suggest that the Spanish version of the DEX is a useful measure for assessing general symptoms of dysexecutive syndrome, and a valid, reliable and adequate screening test for estimating cognitive impairment associated with substance abuse (AU)

[Personality disorder dimensions of MCMI-II in treated substance addicts]. / Dimensiones de los trastornos de personalidad en el MCMI-II en adictos a ustancias en tratamiento.

OBJECTIVE: To know the underlying dimensional structure of personality disorders in the MCMI-II through factor analysis. METHOD: A sample of 749 patients who start a treatment by substance abuse or dependence, according to DSM-IV criteria, compliment the MCMI-II, once free of the direct influences (intoxication, withdrawal) of abuse drugs. Their answers in the MCMI-II were studied, through first and second order factorial analysis. RESULTS: An initial factorial solution of 46 components is obtained. The first of them refers to changes experienced in last years, explaining 25.51% of the variance. A second order factor analysis groups the former factors in 7 components. The first of them reunites symptoms of Axis I around the components of change in two last years and in the last months and weeks (14.17% of the total variance). The other components reflect those dimensions usually found in some other factor studies of personality. DISCUSSION: Results show that a wide proportion of the variance in the MCMI-II is better explained by recent changes than stable traits and their extreme combinations. As these results are obtained in substance addict population, it is suggested part of which the MCMI-II measures can be referred to changes in personality. These changes may be associated to inadequate answers to stressful environmental factors. They can be also associated to changes in brain functions due to direct or indirect influences of substances on brain locations.

Dimensiones de los trastornos de personalidad en el MCMI-II en adictos a sustancias en tratamiento / Personality disorder dimensions of MCMI-II in treated substance addicts

Objetivo: Conocer la estructura dimensional subyacente a los trastornos de la personalidad en el MCMI-II mediante análisis factorial. Método: Se estudian las respuestas ofrecidas por una muestra de 749 pacientes que inician tratamiento por abuso/dependencia de sustancias, según criterios DSM-IV, y cumplimentan el MCMI-II una vez libres de los efectos directos (intoxicación, abstinencia) de las drogas de abuso. Se efectúa análisis factorial de primer y segundo orden. Resultados: Se obtiene una solución factorial inicial de 46 componentes, explicando el 25,51% de la varianza el primero de ellos, que se refiere a cambios experimentados en los dos últimos años. Un análisis de segundo orden agrupa los factores en 7 componentes, siendo el primero de ellos (14,17% de la varianza total) el que agrupa todos los síntomas del Eje I en torno a los componentes de cambio en los dos últimos años y en los últimos meses y semanas. El resto de componentes refleja las dimensiones generalmente encontradas en otros estudios factoriales de la personalidad. Discusión: los resultados apuntan a que una considerable proporción de la varianza en el MCMI-II se explica por cambios recientes más que por rasgos estables y sus combinaciones extremas. Puesto que estos resultados se obtienen en personas adictas a sustancias se sugiere que buena parte de lo que el MCMI-II mide puede referirse a cambios en la personalidad debidos a respuestas inadecuadas frente a factores ambientales estresantes o bien a cambios en funciones cerebrales como efectos directos o indirectos de las propias sustancias sobre regiones cerebrales (AU)

Objective: To know the underlying dimensional structure of personality disorders in the MCMI-II through factor analysis. Method: A sample of 749patients who start a treatment by substance abuse or dependence, according to DSM-IV criteria, compliment the MCMI-II, once free of the direct influences (intoxication, withdrawal) of abuse drugs. Their answers in the MCMI-II were studied, through first and second order factorial analysis. Results: An initial factorial solution of 46 components is obtained. The first of them refers to changes experienced in last years, explaining 25.51% of the variance. A second order factor analysis groups the former factors in 7 components. The first of them reunites symptoms of Axis I around the components of change in two last years and in the last months and weeks (14.17% of the total variance). The other components reflect those dimensions usually found in some other factor studies of personality. Discussion: Results show that a wide proportion of the variance in the MCMI-II is better explained by recent changes than stable traits and their extreme combinations. As these results are obtained in substance addict population, it is suggested part of which the MCMI-II measures can be referred to changes in personality. These changes may be associated to inadequate answers to stressful environmental factors. They can be also associated to changes in brain functions due to direct or indirect influences of substances on brain locations (AU)

[Social values and addiction: applicability and psychometric properties of VAL-89 questionnaire]. / Valores sociales y adiccion: aplicabilidad y propiedades psicometricas del cuestionario VAL-89.

OBJECTIVE: To study the psychometric properties of the VAL-89 questionnaire and its possible use in addict individuals who ask for treatment. METHOD: Analysis of the psychometric properties of the questionnaire and its factorial structure, applying it to 792 individuals. 365 of them were substance users seeking treatment and 427 were general population. RESULTS: Reliability of the questionnaire is confirmed, although its factorial structure appears to be different from the original. In our study appear 12 factors, instead of the original 10. These factors are named: Power, Stimulation, Submission, Tradition, Spirituality, Self-Sufficience, Hedonism, Sociability, Universality, Convencionalism, Idealism and Self-Realization. These factors are distributed through several dimensions represented by four axis: individual-social, dominance-equality, tradition-pleasure and great values-anomie. CONCLUSIONS: The VAL-89 questionnaire seems to be a useful tool to explore which are the more appreciated social values, being of special interest to know which are specially selected by addict individuals.

[Personality differences between substance addicts and general population. Study of clinical cases with matched controls using Cloninger's TCI-R.] / Diferencias de personalidad entre adictos a sustancias y poblacion general. Estudio con el TCI-R de casos clinicos con controles emparejados.

Objective: This article explores differences in personality traits between subjects with substance addiction in treatment and subjects from the general population matched in the variables sex, age and educational level. Material and method: Consecutive sampling was used to obtain a sample of participants undergoing treatment for addictive disorders at a public centre (CAD 4). A sample of the general population was obtained by means of the snowball technique. Only pairs (one participant from each sample) with the same age, sex and educational level were considered. In this way, 55 pairs were obtained. Cloninger's TCI-R was used and the global results were compared, crossing all variables. Results: Significant and consistent differences were found in just two traits: Novelty-Seeking, greater in addicts, and Self- Directedness, greater in general population. Conclusions: Data strongly suggest that observed differences are not previous, but consecutive to the addiction, it being apparent that the effects of the substances and the psychosocial conditions associated with their consumption are what exacerbates or blocks development of the traits. Findings are related to studies linking these variables with neuropsychological functions, and the inclusion of this neuropsychological perspective is strongly proposed for application to the assessment and treatment of addictive disorders.

Diferencias de personalidad entre adictos a sustancias y población general. Estudio con el TCI-R de casos clínicos con controles emparejados / Personality differences between substance addicts and general population. Study of clinical cases with matched controls using Cloninger’s TCI-R

Objetivo: Explorar diferencias en rasgos de personalidad entre sujetos adictos a sustancias en tratamiento y sujetos de población general emparejados en las variables: sexo, edad y nivel de estudios. Material y método: Se obtuvo por muestreo consecutivo una muestra de sujetos que inician tratamiento por abuso/dependencia de sustancias en un centro público (CAD 4). Mediante la técnica de “bola de nieve” se obtuvo una muestra de población general. Se consideraron únicamente las parejas (un sujeto de cada muestra) que presentan la misma edad, el mismo sexo y el mismo nivel de estudios. De este modo se obtuvieron 55 parejas. Se utilizó el TCI-R de Cloninger y se compararon los resultados globales, cruzando las diversas variables. Resultados: Solo aparecieron diferencias significativas y consistentes en dos rasgos: Búsqueda de Novedad, mayor en adictos, y Autodirección, mayor en población general. Conclusiones: Los datos sugieren que las diferencias observadas no son previas, sino consecutivas al consumo, pareciendo que son los efectos de las sustancias y las condiciones psicosociales asociadas al consumo las que exacerban o impidenel desarrollo de los rasgos. Se relacionan los hallazgos con estudios que vinculan estas variables con funciones neuropsicológicas y se propone la inclusión de esta perspectiva neuropsicológica en la evaluación y tratamiento de los trastornos adictivos

Objective: This article explores differences in personality traits between subjects with substance addiction in treatment and subjects from the general population matched in the variables sex, age and educational level. Material and method: Consecutive sampling was used to obtain a sample of participants undergoing treatment for addictive disorders at a public centre (CAD 4). A sample of the general population was obtained by means of the snowball technique. Only pairs (one participant from each sample) with the same age, sex and educational level were considered. In this way, 55 pairs were obtained. Cloninger’s TCI-R was used and the global results were compared, crossing all variables. Results: Significant and consistent differences were foundin just two traits: Novelty-Seeking, greater in addicts, and Self-Directedness, greater in general population. Conclusions: Data strongly suggest that observed differences are not previous, but consecutive to the addiction, it being apparent that the effects of the substances and the psychosocial conditions associated with their consumption are what exacerbates or blocks development of the traits. Findings are related to studies linking these variables with neuropsychological functions, and the inclusion of this neuropsychological perspective is strongly proposed for application to the assessment and treatment of addictive disorders