Evidence of Executive Dysfunction in Co-occurring Substance Use Disorder and Major Depressive Disorder or Antisocial Personality Disorder

Abstract

Background and Aims: Executive dysfunction is pervasive in substance-dependent individuals (Verdejo-García, Bechara, Recknor, & Perez-Garcia, 2006). As many as four-fifths of individuals in treatment for substance use disorders (SUDs) have co-existing lifetime psychopathology. Executive function deficits are tied to markers of decreased quality of life including increases in negative life events (Green, Kern, Braff, & Mintz, 2000), maladaptive social functioning (Kurtz, Moberg, Ragland, Gur, & Gur, 2005) and worsened treatment outcomes (Czuchry & Dansereau, 2003). Despite evidence of executive dysfunction across several mental disorders, few studies investigate how the co-occurrence of psychopathologies in SUDs impacts executive functioning.

Methods: Here, we compare measures of executive function (i.e., the Iowa Gambling Test, Letter Number Sequencing Test, Stroop Test, Wisconsin Card Sorting Test, Continuous Performance Test, Towers Test, and Delay Discounting Test) in individuals with a) substance use disorder, b) substance use disorder and co-occurring major depressive disorder, c) substance use disorder and co-occurring antisocial personality disorder, d) substance use disorder and co-occurring major depressive disorder and antisocial personality disorder and e) no substance use disorder or co-occurring psychopathology.

Results: Regression models of respective executive function measure outcomes as a function of education, income, age, and group membership indicated that the Delay Discounting Test and Continuous Performance Test were the only significant overall models (F(4, 313) = 12.699, p < 0.001 and F(4, 307) = 2.659, p = 0.033, respectively). Conclusions: Overall the Delay Discounting Test and Continuous Performance Test were the most sensitive to differences between substance use and psychopathology profiles assessed.