Self-reported cognitive scales in a US National Survey: reliability, validity, and preliminary evidence for associations with alcohol and drug use.

Abstract

AIMS:

To evaluate relationships between measures of cognitive functioning and alcohol or drug use among adults (≥ 18 years) in the US general population.

DESIGN:

Two cognitive scales were created based on dimensionality and reliability of self-reported Executive Function Index items. Relationships between the two scales and validators were evaluated. Associations between the cognitive scales and past-year frequency of alcohol or drug use were estimated with adjusted odds ratios (aOR).

SETTING:

United States, using the 2012-13 National Epidemiologic Survey on Alcohol and Related Conditions-III, a nationally representative adult sample selected by multi-stage probability sampling.

PARTICIPANTS:

36 085 respondents.

MEASUREMENTS:

Past-year substance use outcome variables categorized binge drinking, marijuana, cocaine, opioid, sedative/tranquilizer and stimulant use as frequent (at least weekly to daily), infrequent (any to two to three times/month) or no use, assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Key predictors were the two cognitive scales. Construct validators included education and functional impairment. Covariates included age, gender, income and race/ethnicity.

FINDINGS:

Nine cognitive items fitted a two-factor model (comparative fit index = 0.973): attention (five items) and executive functioning (four items). Both scales were associated positively with higher education (Ps < 0.001) and negatively with functional impairment (Ps < 0.001), demonstrating construct validity. Poorer attention was associated with frequent and infrequent binge drinking and use of drugs [aOR range = 1.07 (binge drinking) to 1.72 (stimulants), Ps ≤ 0.01]. Poorer executive functioning was associated with frequent binge drinking and use of drugs [aOR range = 1.22 (binge drinking) to 2.03 (cocaine), Ps < 0.001] and infrequent use of all drugs [aOR range = 1.19 (marijuana) to 1.63 (cocaine), Ps < 0.001].

CONCLUSIONS:

Impairments in attention and executive functioning are positively associated with substance use in the US general population.

• Authors: Efrat Aharonovich, Dvora Shmulewitz, Melanie M Wall, Bridget F Grant, Deborah S Hasin
• Journal: Addiction (Abingdon, England) (Addiction) Vol. 112 Issue 12 Pg. 2132-2143 (Dec 2017) ISSN: 1360-0443 [Electronic] England
• PMID: 28623859 (Publication Type: Journal Article)
• Copyright: © 2017 Society for the Study of Addiction.

Topics

• Adult
• Alcoholism (epidemiology)
• Cognition Disorders (diagnosis, epidemiology)
• Comorbidity
• Female
• Health Surveys (methods, statistics & numerical data)
• Humans
• Male
• Neuropsychological Tests (statistics & numerical data)
• Reproducibility of Results
• Self Report
• Substance-Related Disorders (epidemiology)
• United States