Impulsivity and Cognitive Functioning in Inpatients with Concurrent Disorders: A Comparative Study with Healthy Controls and Evaluation of Treatment-Related Changes: Impulsivité et fonctionnement cognitif chez les patients hospitalisés présentant des troubles concomitants : étude comparative avec des témoins sains et évaluation des changements liés au traitement.

Abstract

This study investigated impulsivity and working memory among CD inpatients across treatment and compared to controls. Patients (N = 56, Mage = 38.2, SD = 11.7, 17F) and healthy controls (N = 50, Mage = 31.9, SD = 10.0, 25F) completed a battery of self-report questionnaires and behavioural tasks assessing working memory and impulsivity (response inhibition, delay discounting, reflection, decision-making). Patients were assessed within 2 weeks of admission (baseline) and at 6 months (follow-up). Controls completed a single session at baseline. Patient demographics, diagnostic status, and treatment outcome (discharge with or without medical advice) were retrieved from medical records. Group differences in demographics were probed for inclusion as covariates. At baseline, patients had greater self-reported impulsivity on the UPPS-P (negative and positive urgency) and BIS (motor and non-planning), and greater delay discounting than controls. Among patients, there was no association between treatment adherence and working memory, self-report, or behavioural impulsivity, and no change in behavioural impulsivity was observed from baseline to follow-up. This is the first study to assess impulsivity and working memory in the context of CD treatment. Patients exhibited greater impulsivity on choice-based and various self-report measures. The absence of treatment-related changes in impulsivity and working memory outcomes suggests that conventional treatments may be neglecting to target potentially key areas of functioning. Further research is needed to examine how treatment affects impulsivity and related functions in individuals with CD, and their impact on clinical outcomes.