Impulsividad en varones con prescripción de benzodiacepinas y metadona en prisión

Luis Moreno-Ramos, María José Fernández-Serrano, Miguel Pérez-García, Antonio Verdejo-García

Resumen


El consumo de benzodiacepinas y metadona se ha asociado a diversas alteraciones neuropsicológicas. Sin embargo, no conocemos estudios sobre el efecto de estas sustancias tanto de forma separada como de forma combinada en rasgos de personalidad impulsiva, y en menor medida  en población penitenciaria.  El objetivo principal de este estudio es examinar la impulsividad rasgo, medida con  el Cuestionario de Sensibilidad al Castigo Sensibilidad a la Recompensa (Torrubia, Avila, Moltó y Caseras, 2001), y la escala de Evaluación del Comportamiento Impulsivo UPPS-P (Cyders et al., 2007), en una muestra de 134 varones de un centro penitenciario con consumo de metadona, metadona y benzodiacepinas, abstinentes de consumo, y no dependientes del consumo de sustancias (criterios DSM-IV). Los resultados mostraron que los grupos de consumidores presentan mayor sensibilidad a la recompensa, urgencia positiva, urgencia negativa y búsqueda de sensaciones que los no consumidores; los grupos de consumo de metadona presentan mayor sensibilidad al castigo y falta de perseverancia. El grupo de  no consumidores presenta menor falta de perseverancia que el grupo de metadona y el grupo de metadona+benzodiacepinas. No se han encontrado diferencias específicamente del grupo de metadona+benzodiacepinas con el resto de los grupos. Como objetivo secundario, examinar, mediante análisis factorial exploratorio, qué dimensiones de personalidad impulsiva se relacionan con los dos sistemas motivacionales propuestos por Gray (SIC-SAC). Los resultados mostraron un componente definido por las subescalas sensibilidad al refuerzo, urgencia positiva, urgencia negativa y búsqueda de sensaciones, y un segundo definido por las subescalas sensibilidad al castigo, falta de perseverancia y falta de premeditación. 


Palabras clave


benzodiacepinas; metadona; impulsividad; prisión; UPPS-P; SCSR.

Texto completo:

PDF PDF (English)

Referencias


Abdi, R., Roudsari, A. B., y Aliloo, M. M. (2011). The sensitivity level of behavioral approach and inhibition systems in substance abusers, smokers and normal subjets. Iranian Journal of Psychiatry and Clinical Psychology, 17,241-247.

Acheson, A., Reynolds, B., Richards, J. B., y de Wit, H. (2006). Diazepam impairs behavioral inhibition but not delay discounting or risk taking in healthy adults. Experimental and Clinical Psychopharmacology, 14, 190-198. doi: 10.1037/1064-1297.14.2.190.

Adan, A. (2012). Impulsividad funcional y disfuncional en jóvenes con consumo intensivo de alcohol (binge drinking). Adicciones, 24, 17-22.

Albein-Urios, N., Martínez-González, J. M., Lozano, O., Clark, L., y Verdejo-García, A. (2012). Comparison of impulsivity and working memory in cocaine addiction and pathological gambling: Implications for cocaine-induced neurotoxicity. Drug and Alcohol Dependence, 126, 1-6. doi: 10.1016/j.drugalcdep.2012.03.008.

American Psychiatric Association, APA (2002). DSM-IV-TR. Manual diagnóstico y estadístico de los trastornos mentales. Texto revisado. Barcelona: Masson.

Arce, E., y Santisteban, C. (2006). Impulsivity: a review. Psicothema, 18,213-220.

Balconi, M., Finocchiaro, R., y Campanella, S. (2014). Reward-sensitivity, decisional bias and metacognitive deficits in cocaine drug addiction. En 30th International Congress of Clinical Neurophysiology (pp. 1022-1022). International Federation of Clinical Neurophysiology.

Barker, M. J., Greenwood, K. M., Jackson, M., y Crowe, S. F. (2004). Cognitive effects of long-term benzodiazepine use. CNS Drugs, 18, 37-48. doi:10.2165/00023210-200418010-00004.

Bijttebier, P., Beck, I., Claes, L., y Vandereycken, W. (2009). Gray’s Reinforcement Sensitivity Theory as a framework for research on personality–psychopathology associations. Clinical Psychology Review, 29,421-430. doi:10.1016/j.cpr.2009.04.002.

Billieux, J., Rochat, L., Ceschi, G., Carré, A., Offerlin-Meyer, I., Defeldre, A. C., ... Van der Linden, M. (2012). Validation of a short French version of the UPPS-P impulsive behavior scale. Comprehensive Psychiatry, 53, 609-615. doi:10.1016/j.comppsych.2011.09.001.

Bravo de Medina, R., Echeburúa, E., y Aizpiri, J. (2007). Psychopathological symptoms and personality traits in alcohol-dependent patients: a comparative study. Adicciones, 19, 373-381.

Bravo de Medina, R., Echeburúa, E., y Azpiri, J. (2010). Psychopathological symptoms and personality traits in young adult cannabis-dependent treatment seekers: A comparative study. Adicciones, 22, 245-251.

Cano-Cervantes, G. J., Araque-Serrano, F., y Cándido-Ortiz, A., (2011). Addiction, Impulsivity And Temporal Curves Of Desire. Adicciones, 23, 141-148.

Carlson, S. R. y Pritchard, A. A. (2013). Externalizing behavior, the UPPS-P Impulsive Behavior scale and Reward and Punishment Sensitivity. Personality and Individual Differences, 54, 202-207. doi:10.1016/j.paid.2012.08.039.

Carroll, A., Hemingway, F., Bower, J., Ashman, A., Houghton, S., y Durkin, K. (2006). Impulsivity in juvenile delinquency: Differences among early-onset, late-onset, and non-offenders. Journal of Youth and Adolescence, 35, 517-527. doi:10.1007/s10964-006-9053-6.

Casares-López, M. J., González-Menéndez, A., Bobes-Bascarán, M. T., Secades, R., Martínez-Cordero, A., y Bobes, J. (2011). Necesidad de evaluación de la patología dual en contexto penitenciario. Adicciones, 23, 37-44.

Caseras, X., Avila, C., y Torrubia, R. (2003). The measurement of individual differences in behavioural inhibition and behavioral activation Systems: a comparison of personality scales. Personality and Individual Differences, 34, 999-1013. doi:10.1016/S0191-8869(02)00084-3.

Cortés Tomás, M. T., Giménez Costa, J. A., Motos Sellés, P. y Cadaveira Mahía, F. (2014). The importance of expectations in the relationship between impulsivity and binge drinking among university students. Adicciones, 26, 134-145.

Cyders, M. A., y Smith, G. T. (2007). Mood-based rash action and its components: Positive and negative urgency. Personality and Individual Differences, 43, 839–850. doi:10.1016/j.paid.2007.02.008.

Cyders, M. A., Smith, G. T., Spillane, N. S., Fischer, S., Annus, A. M., y Peterson, C. (2007). Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency. Psychological Assessment, 19, 107–118. doi:10.1037/1040-3590.19.1.107.

Cyders, M. A., y Coskunpinar, A. (2011). Measurement of constructs using self-report and behavioral lab tasks: Is there overlap in nomothetic span and construct representation for impulsivity? Clinical Psychology Review, 31, 965-982. doi:10.1016/j.cpr.2011.06.001.

Dassanayake, T. L., Michie, P. T., Jones, A., Carter, G., Mallard, T., y Whyte, I. (2012). Cognitive impairment in patients clinically recovered from central nervous system depressant drug overdose. Journal of Clinical Psychopharmacology, 32, 503-510. doi:10.1097/JCP.0b013e31825d6ddb.

Dawe, S., y Loxton, N. J. (2004). The role of impulsivity in the development of substance use and eating disorders. Neuroscience and Biobehavioral Reviews, 28, 343-351. doi:10.1016/j.neubiorev.2004.03.007.

Dawe, S., Gullo, M. J., y Loxton, N. J. (2004). Reward drive and rash impulsiveness as dimensions of impulsivity: implications for substance misuse. Addictive Behaviors, 29, 1389–1409. doi:10.1016/j.addbeh.2004.06.004.

Derefinko, K., DeWall, C. N., Metze, A. V., Walsh, E. C., y Lynam, D. R. (2011). Do different facets of impulsivity predict different types of aggression?. Aggressive Behavior, 37, 223-233. doi:10.1002/ab.20387.

Dissabandara, L O., Loxton, N. J., Dias, S. R., Daglish, M., y Stadlin, A. (2012). Testing the fear and anxiety distinction in the BIS/BAS scales in community and heroin-dependents samples. Personality and Individual Differences, 52, 888-892. doi:10.1016/j.paid.2012.01.023.

Dissabandara, L. O., Loxton, N. J., Dias, S. R., Dodd, P. R., Daglish, M., y Stadlin, A. (2014). Dependent heroin use and associated risky behaviour: The role of rash impulsiveness and reward sensitivity. Addictive Behaviors, 39, 71-76. doi:10.1016/j.addbeh.2013.06.009.

Dougherty, D. M., Mathias, C .W., Marsh-Richard, D. M., Nouvion, S. O., y Dawes, M. A. (2008). Distinctions in Behavioural Impulsivity: Implications for Substance Abuse Research. Addictive Disorders and Their Treatment, 8,61-73. doi: 10.1097/ADT.0b013e318172e488.

Ersche, K. D., Roiser, J. P., Clark, L., London, M., Robbins, T. W., y Sahakian, B. J. (2005). Punishment induces risky decision-making in methadone-maintained opiate users but not in heroin users or healthy volunteers. Neuropsychopharmacology, 30, 2115-2124. doi:10.1038/sj.npp.1300812.

Evenden, J. L. (1999). Varieties of impulsivity. Psychopharmacology, 146, 348–361. doi:10.1007/PL00005481.

Fernández-Serrano, M. J., Moreno-López, L., Pérez-García, M., Viedma-del Jesús, M. I., Sánchez-Barrera, M. B., y Verdejo-García, A. (2011). Negative mood induction normalizes decision making in male cocaine dependent individuals. Psychopharmacology, 217, 331-339. doi: 10.1007/s00213-011-2288-2.

Fernández-Sobrino, A. M., Fernandez-Rodriguez, V., y López-Castro, J. (2009). Consumo de benzodiacepinas en una muestra de pacientes en Programa de Tratamiento con Derivados Opiáceos (PTDO). Adicciones, 21, 143-146.

Franken, I. H. A., y Muris, P. (2006). Gray’s impulsivity dimension: A distinction between reward sensitivity versus rash impulsiveness. Personality and Individual Differences, 40, 1337–1347. doi:10.1016/j.paid.2005.11.016.

Franken, I. H. A., Muris, P., y Georgieva, I. (2006). Gray’s model of personality and addiction. Addictive Behaviors, 31, 399−403. doi:10.1016/j.addbeh.2005.05.022.

Gordon, V., y Egan, V. (2011). What self-report impulsivity measure best postdicts criminal convictions and prison breaches of discipline? Psychology, Crime and Law, 17, 305-318. doi:10.1080/10683160903203946.

Gray, J. A., y McNaughton, N. (2000). The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system (2nd ed.). Oxford, UK: Oxford University Press.

Gullo, M. J., Loxton, N. J., y Dawe, S. (2014). Impulsivity: Four ways five factors are not basic to addiction. Addictive Behaviors, 39, 1547-1556 doi:10.1016/j.addbeh.2014.01.002.

Jones, J. D., Mogali, S., y Comer, S. D. (2012). Polydrug abuse: a review of opioid and benzodiazepine combination use. Drug and Alcohol Dependence, 125, 8-18. doi:10.1016/j.drugalcdep.2012.07.004.

Lane, S. D., Tcheremissine, O. V., Lieving, L. M., Nouvion, S., y Cherek, D. R. (2005). Acute effects of alprazolam on risky decision making in humans. Psychopharmacology, 181, 364-373. doi:10.1007/s00213-005-2265-8.

Loxton, N. K., Wan, V. L. N., Hob, A. M. C., Cheungd, B. K. L., Tamb, N., Leung, F. Y. K., y Stadlin, A. S. (2008a). Impulsivity in Hong Kong-Chinese club-drug users. Drug and Alcohol Dependence, 95, 81–89. doi:10.1016/j.drugalcdep.2007.12.009.

Loxton, N. J., Nguyen, D., Casey, L. y Dawe, S. (2008b). Reward drive, rash impulsivity and punishment sensitivity in problem gamblers. Personality and Individual Differences, 45, 167-173. doi:10.1016/j.paid.2008.03.017.

Lykken, D. T. (1995). The antisocial personalities. Hillsdale, NJ: Erlbaum

Lyvers, M., Duff, H., Basch, V., y Edwards, M. S. (2012). Rash impulsiveness and reward sensitivity in relation to risky drinking by university students: Potential roles of frontal systems. Addictive Behaviors, 37, 940-946.doi:10.1016/j.addbeh.2012.03.028.

Mathias, C. W., Marsh-Richard, D. M., y Dougherty, D. M. (2008). Behavioral measures of impulsivity and the law. Behavioral Sciences and the Law, 26, 691-707. doi:10.1002/bsl.841.

Michel, L., y Lang, J. P. (2003). Benzodiazepines and forensic aspects. L’Encephale, 29, 479-485.

Miller, J. D., Zeichner, A., y Wilson, L. F. (2012). Personality correlates of aggression: evidence from measures of the five-factor model, UPPS model of impulsivity, and BIS/BAS. Journal of Interpersonal Violence, 27, 2903-2919. doi:10.1177/0886260512438279 .

Mintzer, M. Z., y Stitzer, M. L. (2002). Cognitive impairment in methadone maintenance patients. Drug and Alcohol Dependence, 67, 41-51. doi:10.1016/S0376-8716(02)00013-3.

Mitchell, J. T., Kimbrel, N. A., Hundt, N. E., Cobb, A. R. Nelson-Gray, R. O. y Lootens, C. M. (2007). An Analysis of Reinforcement Sensitivity Theory and the Five-Factor Model. European Journal of Personality, 21, 869-887. doi:10.1002/per.644.

Moshier, S. J., Ewen, M., y Otto, M. W. (2013). Impulsivity as a moderator of the intention–behavior relationship for illicit drug use in patients undergoing treatment. Addictive Behaviors, 38,1651-1655. doi: 10.1016/j.addbeh.2012.09.008.

Motos, P., Cortés Tomás, M. T., Giménez Costa, J. A., y Cadaveira Mahía, F. (2015). Predictors of weekly alcohol drinking and alcohol-related problems in binge-drinking undergraduates. Adicciones, 27, 119-131.

Navas, J. F., Torres, A., Cándido, A., y Perales, J. C., (2014). ¿‘Nada’? o ‘un poco’?¿‘Mucho’ o ‘demasiado’? La impulsividad como marcador de gravedad en niveles problemático y no problemático de uso de alcohol e Internet. Adicciones, 26, 159-167.

Nielsen, D. A. Ho, A., Bahl, A., Varma, P., Kellogg, S., Borg, L., y Kreek, M. J. (2012). Former heroin addicts with or without a history of cocaíne dependence are more impulsive than controls. Drug and Alcohol Dependence, 124, 113120. doi: 10.1016/j.drugalcdep.

Observatorio Europeo de las Drogas y las Toxicomanías (EMCDDA) (2013). Informe Europeo sobre Drogas

Pattij, T., y De Vries, T. J. (2013). The role of impulsivity in relapse vulnerability. Current Opinion in Neurobiology, 23, 700-705. doi.org/10.1016/j.conb.2013.01.023.

Perales, J. C., Verdejo-García, A., Moya, M. I., Lozano, O., y Pérez-García, M. (2009). Bright and dark sides of impulsivity: Performance of individuals with high and low trait impulsivity on neuropsychological tasks. Journal of Clinical and Experimental Neuropsychology, 31, 927-944. doi: 10.1080/13803390902758793.

Perry, J. L., y Carroll, M. E. (2008). The role of impulsive behaviour in drug abuse. Psychopharmacology ,200, 1-26. doi: 10.1007/s00213-008-1173-0.

Prosser, J., Cohen, L. J., Steinfeld, M., Eisenberg, D., London, E. D., y Galynker, I. I. (2006). Neuropsychological functioning in opiate-dependent subjects receiving and following methadone maintenance treatment. Drug and Alcohol Dependence, 84, 240-247. doi:10.1016/j.drugalcdep.2006.02.006.

Ratchford, M., y Beaver, K. M. (2008). Neuropsychological deficits, low self-control, and delinquent involvement toward a biosocial explanation of delinquency. Criminal Justice and Behavior, 36, 147-162. doi:10.1177/0093854808325967.

Robinson, T. E., y Berridge, K. C. (1993). The neural basis of drug craving: an incentive-sensitization theory of addiction. Brain Research Reviews, 18, 247-291. doi:10.1016/0165-0173(93)90013-P.

Secretaría General de Instituciones Penitenciarias. Ministerio del Interior (2013). Informe General 2012

Smith, G. T., Fisher, S., Cyders, M. A., Annus, A. M., Spillane, N. S., y McCarthy, D. M. (2007). On the Validity and Utility of Discriminating Among Impulsivity-Like Traits. Assesment, 14,155-170. doi:10.1177/1073191106295527.

Staiger, P. K., Kambouropoulos, N., y Dawe, S. (2007). Should personality traits be considered when refining substance misuse treatment programs?. Drug and Alcohol Review, 26, 17−23. doi:10.1080/09595230601036952.

Stautz, K., y Cooper, A. (2013). Impulsivity-related personality traits and adolescent alcohol use: a meta-analytic review. Clinical Psychology Review, 33, 574-592. doi:10.1016/j.cpr.2013.03.003.

Stewart, S. A. (2005). The effects of benzodiazepines on cognition. Journal of Clinical Psychiatry, 66, S9-S13.

Subdirección General de Sanidad Penitenciaria (2007). Estudio sobre salud mental en el medio penitenciario.

Torrubia, R., Avila, C., Moltó, J., y Caseras, X. (2001). The Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ) as a mesure of Gray´s anxiety and impulsivity dimensions. Personality and Individual Differences, 31, 837-862.

Verdejo-García, A., Sánchez-Fernández, M. M., Alonso-Maroto, L. M., Fernández-Calderón, F., Perales, J. C., Lozano, O., y Pérez-García, M. (2010a). Impulsivity and executive functions in polysubstance-using rave attenders. Psychopharmacology, 210,377-392. doi: 10.1007/S00213-010-1833-8.

Verdejo-García, A., Lozano, O., Moya, M. I., Alcázar, M. A., y Pérez-García, M. (2010b). Psychometric Properties of a Spanish Version of the UPPS-P Impulsive Behavior Scale: Reliability, Validity and Association with Trait and Cognitive Impulsivity. Journal of Personality Assessment, 92,70-77. doi:10.1080/00223890903382369.

Whiteside, S. P., y Lynam, D. R. (2001). The Five Factor Model and impulsivity: using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669-689. doi:10.1016/S0191-8869(00)00064-7.

Zermatten, A., Van der Linden, M., d’Acremont, M., Jermann, F., y Bechara, A. (2005). Impulsivity and decision making. The Journal of Nervous and Mental Disease, 193, 647–650. doi:10.1097/01.nmd.0000180777.41295.65.




DOI: https://doi.org/10.20882/adicciones.821

Enlaces refback

  • No hay ningún enlace refback.