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Original contribution| Volume 2, ISSUE 1, P5-17, 1985

Neuropsychological assessment substance abusers: Review and recommendations

DOI:https://doi.org/10.1016/0740-5472(85)90017-0
Neuropsychological assessment substance abusers: Review and recommendations
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      Abstract

      Neuropsychological assessment of substance abusers frequently proves useful for the evaluation of those aspects of cognitive functioning that may be relevant for optimal therapeutic management and treatment planning. Research has demonstrated the presence of neuropsychological impairment in chronic abusers of CNS depressants, including alcohol, as well as opiates and possibly cocaine, especially when such substances are combined in a polydrug pattern of abuse. Clinical neuropsychological evaluation of individual substance abusers should take into account the various personal, demographic and neuromedical background variables that can affect cognitive functioning. Efforts should be made to distinguish between acute drug effects and more long-term stable deficits that may not become apparent for some time. Neuropsychological referrals should be made, and measures selected to answer particular questions about neurocognitive functioning that are relevant to treatment and eventual overall adjustment. A neuropsychological review of systems is likely to show a pattern of impairment in substance abusers that involves the integration of different cognitive functions for effective problem solving. Strongly focal or lateralized deficit patterns are less likely to be the result of drug abuse alone, and should prompt the appropriate neuromedical follow-up.

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      References

        • Acord L.D.
        • Barker D.D.
        Hallucinogenic drugs and cerebral deficit.
        Journal of Nervous and Mental Disease. 1973; 156: 281-283
        • Adams K.M.
        • Grant I.
        Failure of nonlinear models of drinking history variables to predict neuropsychological performance in alcoholics.
        American Journal of Psychiatry. 1984; 141: 663-667
        • Adams K.M.
        • Rennick P.M.
        • Schoof K.G.
        • Keegan J.F.
        Neuropsychological measurement of drug effects: Polydrug research.
        Journal of Psychedelic Drugs. 1975; 7: 151-160
        • Adams R.D.
        • Victor M.
        Principles of neurology.
        McGraw-Hill, New York1977
        • Belenko S.
        Alcohol abuse by heroin addicts: A review of research findings and issues.
        International Journal of the Addictions. 1979; 14: 965-975
        • Bennett A.E.
        Alcoholism and the brain.
        Stratton Intercontinental Medical Book, New York1977
        • Berger F.
        Alcoholism rehabilitation: A supportive approach.
        Hospital and Community Psychiatry. 1983; 34: 1040-1043
        • Brandt J.
        • Doyle L.F.
        Concept attainment, tracking and shifting in adolescent polydrug abusers.
        Journal of Nervous and Mental Disease. 1983; 171: 559-563
        • Bruhn P.
        • Maage N.
        Intellectual and neuropsychological functions in young men with heavy and long-term patterns of drug abuse.
        American Journal of Psychiatry. 1975; 132: 397-401
        • Cantwell D.P.
        Psychiatric illness in the families of hyperactive children.
        Archives of General Psychiatry. 1972; 27: 414-417
        • Cantwell D.P.
        Minimal brain dysfunction in adults: Evidence from studies of psychiatric illness in the families of hyperactive children.
        in: Bellak L. Psychiatric aspects of minimal brain dysfuntion in adults. Grune & Stratton, New York1979: 37-44
        • Carlin A.S.
        • Trupin E.W.
        The effects of long-term chronic marijuana use on neuropsychological functioning.
        International Journal of the Addictions. 1977; 12: 617-624
        • Croughan J.L.
        • Miller J.P.
        • Wagelin D.
        • Whitman B.Y.
        Psychiatric illness in male and female narcotic addicts.
        Journal of Clinical Psychiatry. 1982; 43: 225-228
        • Culver C.M.
        • King F.W.
        Neuropsychological assessment of undergraduate marijuana and LSD users.
        Archives of General Psychiatry. 1974; 31: 707-711
        • Cutting J.
        The relationship between Korsakov's syndrome and “alcoholic dementia”.
        British Journal of Psychiatry. 1978; 132: 240-251
        • Cutting J.
        Specific psychological deficits in alcoholism.
        British Journal of Psychiatry. 1978; 133: 119-122
        • Dackis C.A.
        • Gold M.S.
        Opiate addiction and depression–Cause or effect?.
        Drug and Alcohol Dependance. 1983; 11: 105-109
        • Dikmen S.
        • Reitan R.M.
        • Temkin N.R.
        Neuropsychological recovery in head injury.
        Archives of Neurology. 1983; 40: 333-338
        • Dorus W.
        • Senay E.C.
        Depression, demographic dimensions and drug abuse.
        American Journal of Psychiatry. 1980; 137: 699-704
        • Ellenberg L.
        • Rosenbaum G.
        • Goldman M.S.
        • Whitman R.D.
        Recoverability of psychological functioning following alcohol abuse: Lateralization effects.
        Journal of Consulting and Clinical Psychology. 1980; 48: 503-510
        • Fields S.
        • Fullerton J.
        Influence of heroin addiction on neuropsychological functioning.
        Journal of Consulting and Clinical Psychology. 1975; 43: 114
        • Gabrielli W.F.
        • Mednick S.A.
        Intellectual performance in children of alcoholics.
        Journal of Nervous and Mental Disease. 1983; 171: 444-447
      23. Gold Award: Individualized treatment for substance abusers.
        Hospital and Community Psychiatry. 1984; 35: 1141-1144
        • Goldman M.S.
        • Williams D.L.
        • Klisz D.K.
        Recoverability of psychological functioning following alcohol abuse: Prolonged visual-spatial dysfunction in older alcoholics.
        Journal of Consulting and Clinical Psychology. 1983; 51: 370-378
        • Gomez R.L.
        • Janowsky D.
        • Zetin M.
        • Leighton H.
        • Clopton P.L.
        Adult psychiatric diagnosis and symptoms compatible with the hyperactive child syndrome: A retrospective study.
        Journal of Clinical Psychiatry. 1981; 42: 389-394
        • Goodwin D.
        Is alcoholism hereditary?.
        Oxford University Press, New York1976
        • Grant I.
        • Adams K.M.
        • Carlin A.S.
        • Rennick P.M.
        • Judd L.L.
        • Schoof K.
        The collaborative neuropsychological study of polydrug users.
        Archives of General Psychiatry. 1978; 35: 1063-1074
        • Grant I.
        • Adams K.M.
        • Carlin A.S.
        • Rennick P.M.
        • Judd L.L.
        • Schoof K.
        • Reed R.
        Organic impairment in polydrug users: Risk factors.
        American Journal of Psychiatry. 1978; 135: 178-184
        • Grant I.
        • Adams K.M.
        • Reed R.
        Aging, abstinence and medical risk factors in the prediction of neuropsychological deficit among long-term alcoholics.
        Archives of General Psychiatry. 1984; 41: 710-718
        • Grant I.
        • Judd L.L.
        Neuropsychological and EEG disturbances in polydrug users.
        American Journal of Psychiatry. 1976; 133: 1039-1042
        • Grant I.
        • Reed R.
        • Adams K.M.
        Natural history of alcohol and drug-related brain disorders: Implications for neuropsychological research.
        Journal of Clinical Neuropsychology. 1980; 2: 321-331
        • Grant I.
        • Rochford J.
        • Fleming T.
        • Stunkard A.
        A neuropsychological assessment of the effects of moderate marijuana use.
        Journal of Nervous and Mental Disease. 1973; 156: 278-280
        • Heaton R.K.
        • Baade L.E.
        • Johnson K.L.
        Neuropsychological test results associated with psychiatric disorders in adults.
        Psychological Bulletin. 1978; 85: 141-162
        • Heaton R.K.
        • Pendleton M.G.
        Use of neuropsychological tests to predict adult patients' everyday functioning.
        Journal of Consulting and Clinical Psychology. 1981; 49: 807-821
        • Hecaen H.
        • Albert M.L.
        Human neuropsychology.
        John Wiley, New York1978
        • Hegedus A.M.
        • Alterman A.I.
        • Tarter R.E.
        Learning achievement in sons of alcoholics.
        Alcoholism: Clinical and Experimental Research. 1984; 8: 330-333
      37. Heilman K.M. Valenstein E. Clinical neuropsychology. Oxford University Press, New York1979
        • Lezak M.
        Neuropsychological assessment.
        2nd ed. Oxford University Press, New York1983
        • Lishman W.A.
        Cerebral disorder in alcoholism: Syndromes of impairment.
        Brain. 1981; 104: 1-20
        • Matarazzo J.D.
        Wechsler's measurement and appraisal of adult intelligence.
        5th ed. Williams & Wilkins, Baltimore1972
        • McAllister T.W.
        Cognitive functioning in the affective disorders.
        Comprehensive Psychiatry. 1981; 22: 572-586
        • McGlothlin W.H.
        • Arnold D.O.
        • Freedman D.X.
        Organicity measures following repeated LSD ingestion.
        Archives of General Psychiatry. 1969; 21: 704-709
        • Parker E.S.
        • Noble E.P.
        Alcohol consumption and cognitive functioning in social drinkers.
        Journal of Studies on Alcohol. 1977; 38: 1224-1232
        • Parsons O.A.
        • Farr S.P.
        The neuropsychology of alcohol and drug use.
        in: Filskov S.B. Boll T.J. Handbook of clinical neuropsychology. John Wiley, New York1981: 320-365
        • Parsons O.A.
        • Prigatano G.P.
        Methodological considerations in clinical neuropsychological research.
        Journal of Consulting and Clinical Psychology. 1978; 46: 608-619
        • Reige W.H.
        • Thomaszewski R.
        • Lanto A.
        • Netter J.
        Age and alcoholism: Independent memory decrements.
        Alcoholism: Clinical and Experimental Research. 1984; 8: 42-47
        • Rounsaville B.J.
        • Jones C.
        • Novelly R.A.
        • Kleber H.
        Neuropsychological functioning in opiate addicts.
        Journal of Nervous and Mental Disease. 1982; 170: 209-216
        • Rounsaville B.J.
        • Novelly R.A.
        • Kleber H.D.
        • Jones C.
        Neuropsychological impairment in opiate addicts: Risk factors.
        in: Research developments in drug and alcohol use, Annals of the New York Academy of Sciences. Vol. 362. New York Academy of Sciences, New York1981: 79-90
        • Rounsaville B.J.
        • Weissman M.M.
        • Kleber H.
        • Wilber C.
        Heterogeneity of psychiatric diagnosis in treated opiate addicts.
        Archives of General Psychiatry. 1982; 39: 161-166
        • Rourke B.P.
        Issues in the neuropsychological assessment of children with learning disabilities.
        Canadian Psychological Review. 1976; 17: 89-102
        • Rutter M.
        Developmental neuropsychiatry: Concepts, issues and prospects.
        Journal of Clinical Neuropsychology. 1982; 4: 91-115
        • Seidman M.
        Schizophrenia and brain dysfunction: An integration of recent neurodiagnostic findings.
        Psychological Bulletin. 1983; 94: 195-238
        • Small L.
        Neuropsychodiagnosis in psychotherapy.
        rev. ed. Brunner/Mazel, New York1980
        • Spreen O.
        • Benton A.L.
        Comparative studies of some psychological tests for brain damage.
        Journal of Nervous and Mental Disease. 1965; 140: 323-333
        • Victor M.
        • Adams R.D.
        • Collins G.H.
        The Wernicke-Korsakoff syndrome.
        F.A. Davis, Philadelphia1971
        • Wechsler D.
        Manual for the Wechsler Intelligence Scale for Children-Revised.
        The Psychological Corporation, New York1974
        • Wechsler D.
        Manual for the Wechsler Adult Intelligence Scale-Revised.
        The Psychological Corporation, New York1981
        • Wilford B.B.
        Drug abuse: A guide for the primary care physician.
        American Medical Association, Chicago1981
        • Wood D.R.
        • Reimherr F.W.
        • Wender P.H.
        • Johnson G.E.
        Diagnosis and treatment of minimal brain dysfunction in adults: A preliminary report.
        Archives of General Psychiatry. 1976; 33: 1453-1460
        • Wright D.R.
        • Hogan T.P.
        Repeated LSD ingestion and performance on neuropsychological tests.
        Journal of Nervous and Mental Disease. 1972; 154: 432-438
        • Yeudall L.T.
        Neuropsychological assessment of forensic disorders.
        Canadian Mental Health. 1977; 25: 7-15

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      DOI: https://doi.org/10.1016/0740-5472(85)90017-0

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      © 1985 Published by Elsevier Inc.

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