Enhanced impulsivity, poorer planning and rigid patterns when drawing in substance use disorder: a preliminary study

Abstract

Neuropsychological assessment has uncovered deficits in several executive functions in substance use disorder (SUD) individuals. Nevertheless, research has reported moderate ecological validity in current neuropsychological paradigms. In this regard, drawing is a well-known cross-cutting task that integrates complex cognitive and affective processes. Therefore, its potential for improving the ecological validity of neuropsychological assessments has been outlined. The aim of the present study was threefold. First, we analyzed the impulsivity and planning capacity of SUD individuals (n = 16) compared to controls (n = 15) through a self-reported questionnaire and a neuropsychological paradigm. Second, we explored the differences between groups in drawing variables by means of the diagnostic drawing series, a validated drawing paradigm. Finally, we examined the relationship between the neuropsychological markers and the drawing variables. Compared to controls, SUD individuals reported higher impulsivity scores and worse planning capacity. Regarding drawing variables, SUD participants needed more time to complete the artwork, occupied more space with a predominant color and reported a lower tendency to use warmer and cooler colors than controls. Additionally, across the whole sample, higher impulsivity and worse planning capacity were related to a greater use of a predominant color. Our findings suggest difficulties in functions related to inhibitory control, as well as an alternative drawing pattern in SUD individuals. Remarkably, poor inhibitory control was associated with less variability in drawing. Together, the present preliminary study seems to reinforces the use of drawing as a valid tool for adding both diagnostic and therapeutic information to classical neuropsychological paradigms.