Types of Impairments

Attention

Smoking associated with loss of brain volume

Cortical activity of never-smokers was larger, reflecting greater processing attention

Memory

MDMA produces neurotoxic damage in both animals (Wang et al. 2004) and humans (Cowan et al.)

(Brown et al. 2010) - investigated memory deficits in human ecstasy users

  • Verb Paired Associates (VPA) - i.e frog-table
  • Stem Cued Recall Task - finish a word from a list of previously seen

Ecstasy users showed selective memory impairment in the VPA task but not in cued stem completion

Reversal Learning

Probes the ability to change behaviour in the face of changed outcomes that occur as a result of that behaviour

  1. Acquisition: Reinforcement learning to do the 'right' thing
  2. Reversal Stage: The options are switched

The number of errors before switching to the new stage indexes the inability to learn the new response strategy

Cocaine and methamphetamines render subjects less able to learn to switch strategies

Habits / Response Inhibition

Two types of instrumental behaviour

  1. Goal-directed instrumental response - idea of the reward + response that should produce that reward
  2. Habitual instrumental response - occurs after training | context elicit the response

There needs to be a balance between these two types of response.


Even after the devaluation procedure, amphetamine-injected rats still decided to press the lever. This indicates that they were less able to act in a goal-direct instrumental response.

Impulsivity

The tendency to do things without thinking about the consequences

Drug users have a higher impulsivity

Comorbidity

the simultaneous presence of two or more diseases or medical conditions in a patient.

43.6M with mental illness
20.2M substance use disorder
7.9 dual diagnosis

High metric of depression and substance use disorder


(Hart et al. 2012) - Impairments in addicts often fall within the normal range of the population as a whole,.

Addiction is determined by a multitude of factors.

  • Need to try to enjoy the drug
  • Risks of drugs only multiply the possibility