Effects of alcohol- and cigarette-use disorders on global and specific measures of cognition in middle-age adults.

OBJECTIVE: This study examined the effects of alcohol- and tobacco-use disorders on global and specific cognitive abilities in middle age. METHOD: The sample consisted of 118 men and 169 women ranging in age from 31 to 60 years (M [SD] = 43.59 [6.58]). Lifetime diagnoses were determined from a semistructured interview. Information about current levels of alcohol and cigarette use was also collected. A comprehensive neurocognitive assessment measuring global cognition, memory, and executive-functioning abilities was administered. Baseline cognition was estimated from average composite scores of the Iowa Test of Basic Skills school-achievement tests administered from third through eighth grade. Repeated-measures analysis of variance was used. Covariates comprised baseline cognition, current depression symptoms, and medication use. RESULTS: Lifetime alcohol- and tobacco-use disorders were not associated with cognition among men. Women having a diagnosis of tobacco dependence (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV]) performed less well on measures of global cognition and executive functioning. A lifetime diagnosis of DSM-IV alcohol abuse or dependence was associated with higher working memory among women only. CONCLUSIONS: These results demonstrate few negative effects of alcohol-use disorders on midlife cognition, especially if current consumption is light. Differential susceptibility to the effects of cigarette use on cognition was found with women showing greater deficits in visuospatial abilities, processing speed, and executive-functioning abilities.

IQ estimate smackdown: comparing IQ proxy measures to the WAIS-III.

Brief assessments of general cognitive ability are frequently needed by neuropsychologists, and many methods of estimating intelligence quotient (IQ) have been published. While these measures typically present overall correlations with the Wechsler Adult Intelligence Scale (WAIS) Full Scale IQ, it is tacitly acknowledged that these estimates are most accurate within 1 standard deviation of the mean and that accuracy diminishes moving toward the tails of the IQ distribution. However, little work has been done to systematically characterize proxy measures at the tails of the IQ distribution. Additionally, while these measures are all correlated with the WAIS, multiple proxy measures are rarely presented in one manuscript. The current article has two goals: (1) Examine various IQ proxies against Wechsler Adult Intelligence Scale (Third Version) scores, showing the overall accuracy of each measure against the gold standard IQ measure. This comparison will assist in selecting the best proxy measure for particular clinical constraints. (2) The sample is then divided into three groups (below, average, and above-average ability), and each group is analyzed separately to characterize proxy performance at the tails of the IQ distribution. Repeated measures multivariate analysis of variance compares the different proxy measures across ability levels. All IQ estimates are represented in tables so that they can be examined side by side.

Lifetime substance misuse and 5-year incidence rates of emergent health problems among middle-aged adults.

Understanding the impact of prior substance misuse on emergent health problems is important to the implementation of effective preventive care. This study examined the 5-year incidence rates using a sample of middle-aged adult adoptees (N = 309, mean(age) = 44.32, standard deviation(age) = 7.28). Subjects reported on health problems at two waves of study. DSM-IV diagnoses of substance misuse were obtained using a semi-structured diagnostic interview. Finally, health services utilization and perceived health status were collected. Lifetime diagnoses of marijuana and other non-marijuana substance misuse significantly predicted new occurrences of cardiovascular and metabolic disease. Alcohol misuse predicted earlier onset of cardiovascular disease among men. Marijuana and other non-marijuana drugs predicted earlier onset of cardiovascular disease for men and women. Finally, marijuana and other non-marijuana drugs predicted earlier onset of metabolic disease among men. Substance misuse did not predict health services utilization despite higher rates of disease. These findings emphasize the need to assess lifetime substance misuse when evaluating health risks associated with use.

Co-morbid health conditions at mid-life in the Iowa adoptees.

Adverse health effects due to alcohol and illicit drug abuse and dependence have been well documented. This study examines the effect of substance misuse on five major groups of health conditions using a sample of well characterized adoptees. The sample consisted of 742 adoptees interviewed in the last wave of the Iowa Adoption Studies. Death rate analyses included an additional 34 participants who had died prior to the last follow-up. Substance use patterns and medical history were assessed using the SSAGA-II (Bucholz, K. K., Cadoret, R. J., Cloninger, C. R., Dinwiddie, S. H., Hesselbrock, V. M., Nurnberger, J. L., Jr., et al. (1994). A new, semi-structured psychiatric interview for use in genetic linkage studies: a report on the reliability of the SSAGA. Journal of Studies on Alcohol, 55 (2), 149-158). Subjects were divided into three groups according to DSM-IV diagnostic criteria, controls, alcohol abuse or dependence only (alcohol only), and the Alcohol-Drug group (abuse or dependence diagnosis on at least one illicit substance with or without alcohol diagnosis). Incidence rates of various diseases were measured using logistic regression. Survival analyses were used to examine whether substance abusers developed cardiovascular or metabolic disease at an earlier age than control subjects. Diagnostic grouping made no difference in the incidence rates or age of onset of health conditions. The amount of alcohol consumed by males significantly predicted higher number of overall health complaints as well as higher incidence rates of cardiovascular disease. The amount of illicit drug exposure did not predict an earlier age of diagnosis for cardiovascular or metabolic disease. Individuals in the Alcohol-Drug group had an increased incidence of deaths than either the alconly or the control groups.

Attachment as an organizer of behavior: implications for substance abuse problems and willingness to seek treatment.

BACKGROUND: Attachment theory allows specific predictions about the role of attachment representations in organizing behavior. Insecure attachment is hypothesized to predict maladaptive emotional regulation whereas secure attachment is hypothesized to predict adaptive emotional regulation. In this paper, we test specific hypotheses about the role of attachment representations in substance abuse/dependence and treatment participation. Based on theory, we expect divergence between levels of maladaptive functioning and adaptive methods of regulating negative emotions. METHODS: Participants for this study consist of a sample of adoptees participating in an ongoing longitudinal adoption study (n = 208). The Semi-Structured Assessment of the Genetics of Alcohol-II 41 was used to determine lifetime substance abuse/dependence and treatment participation. Attachment representations were derived by the Adult Attachment Interview [AAI; 16]. We constructed a prior contrasts reflecting theoretical predictions for the association between attachment representations, substance abuse/dependence and treatment participation. RESULTS: Logistic regression was used to test our hypotheses. As predicted, individuals classified as dismissing, preoccupied or earned-secure reported the highest rates of substance abuse/dependence. Individuals classified as dismissing reported significantly lower rates of treatment participation despite their high rates of substance abuse/dependence. As expected, the continuous-secure group reported lowest rates of both substance abuse/dependence and treatment participation. CONCLUSION: The findings from this study identify attachment representations as an influential factor in understanding the divergence between problematic substance use and treatment utilization. The findings further imply that treatment may need to take attachment representations into account to promote successful recovery.

Age effects in coding tasks: componential analysis and test of the sensory deficit hypothesis.

Multiple forms of a symbol-digit substitution task were used to provide a componential analysis of age differences in coding task performance. The results demonstrated age differences in feature encoding, memory, and visual search. A 2nd experiment was conducted with young adults to investigate a sensory deficit as a locus of age differences. The spatial contrast sensitivity deficit of older adults was simulated on forms by applying a digital filter. Persons in the age-simulated contrast condition performed worse than those in the normal contrast condition. The stimulus degradation effect was linked to visual search speed. The study illustrates the utility of componential analysis and offers direct support for the hypothesis that sensory deficits affect performance on tasks used to assess intelligence.

Globus pallidus volume is related to symptom severity in neuroleptic naive patients with schizophrenia.

This study compares globus pallidus (GP) volume between neuroleptic naive patients with schizophrenia and healthy controls using structural MRI. The volume of the external segment of the GP (GPe) was positively correlated with the severity of global symptoms, as measured by the Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms (SANS/SAPS, Andreasen and Olsen, 1982). The volume for the GP, GPe, and internal segment (GPi) did not differ between groups.

Association of the HOPA12bp allele with a large X-chromosome haplotype and positive symptom schizophrenia.

HOPA is a X-chromosome gene that encodes an essential nuclear receptor co-activator. Previously, we have demonstrated that an exonic polymorphism, termed HOPA(12bp), in the Opa (Opposite Paired) domain of this gene that is critical for neuronal growth and differentiation is associated with a low risk for schizophrenia. But curiously, we have also noted that all HOPA(12bp) probands have the same haplotype immediately surrounding the HOPA(12bp), and other investigators have found evidence of population stratification with the HOPA(12bp) allele. Since deleterious alleles are weeded from the population, and the HOPA(12bp) allele is not rare, these prior findings suggest the possibility that positive selection may be occurring with respect to the HOPA(12bp) allele and that unique phenotypic features may be associated with this allele. To test these hypotheses, we analyzed symptom data collected from schizophrenic probands and conducted haplotyping studies around the HOPA(12bp) polymorphism. Consistent with our hypotheses, genotyping studies of 43 unrelated HOPA(12bp) males and 137 HOPA(wild) males demonstrated that the HOPA(12bp) allele is associated with a large conserved DNA haplotype that extends over several genes known to be critical for human survival. Furthermore, ANOVA analysis of symptom data demonstrated that HOPA(12bp) schizophrenic probands (n = 14) have significantly lower severity of negative symptoms (P < 0.002) and better attention (P < 0.002) than matched controls (n = 30). Taken together, these findings further refine the behavioral endophenotype associated with the HOPA(12bp) allele and suggest that the sequence surrounding HOPA may need to be considered to fully understand the molecular basis of the phenotype associated with the HOPA(12bp) allele.

Manual and automated measurement of the whole thalamus and mediodorsal nucleus using magnetic resonance imaging.

The thalamus is an important relay structure in the brain that may be relevant to a variety of brain diseases. It is divided into multiple subnuclei with different cortical connections. The medial dorsal (MD) nucleus is particularly important because it forms key connections with the prefrontal cortex. The current study reports precise and efficient methods for measuring the whole thalamus and the MD with MRI that have a high degree of interrater reliability. A multispectral image acquisition and novel image processing technique were used to improve structure visibility. The tricolor image assigns a color to each of the T1, T2, and PD weighted images, represented by red, green, and blue, respectively. The manually defined regions were then used to train an artificial neural network (ANN) to automatically define both the whole thalamus and the MD. The ANN provides an efficient automated method, making studies using larger sample sizes more feasible.