Problematic and non-problematic ecstasy (MDMA) usage : cognitive and psychopathological aspects

Abstract

This research thesis aimed to explore the apparent dichotomy of ecstasy (MDMA) users who report cognitive and psychopathological problems which they attribute to their use of this drug (problematic users), and those who report no adverse ecstasy-related effects (nonproblematic users). In the first study, possible psychological sequalae linked to past ecstasy use were assessed in problematic and non-problematic ecstasy users using the modified Brief Symptom Inventory, aspects of the Rivermead Behavioural Memory Test, Tower of London and Auditory Verbal Learning Task. Problematic ecstasy users displayed higher psychopathological symptoms and a small number of selective cognitive deficits compared to non-problematic ecstasy users and polydrug controls. However, problematic ecstasy use did not appear to be related to patterns of ecstasy use or polydrug use. Using the same assessment measures, a case study based on a heavy problematic ecstasy user (RW), who had been abstinent for seven years, was presented. RW displayed cognitive deficits and extensive psychological problems suggesting that heavy ecstasy consumption may be associated with irreversible problems. The persistence of possible psychological and cognitive problems was further investigated in the second group study, using the same battery of tests. However no significant differences in cognitive and psychopathological performances were found between polydrug controls, current and ex-ecstasy users. It is argued that impairments in performance were possibly masked by poor cognitive performance in polydrug controls. The validity of the polydrug control group was addressed (in the third study) by assessing 20 drug-naive participants on the same measures. The introduction of a drug-naive control group only suggested that problematic and non-problematic ecstasy users were exhibiting more errors on the Tower of London task compared to polydrug and drug-naive controls. The final study assessed psychopathological symptoms in problematic and non-problematic ecstasy users relative to drug-naive and polydrug controls, and explored factors which may be integral in the development of problematic ecstasy use, including certain pre-existing factors. Users were assessed on the BSI and Locus of Control scale. Pre-existing psychiatric histories, the intensity of ecstasy dosing and the role of polydrug use in relation to ecstasy use, appeared to contribute in higher psychopathological symptoms in problematic ecstasy users. Together these studies suggest that only self-reported problematic ecstasy users consistently display cognitive and psychopathological problems. For these vulnerable individuals the intensity of ecstasy use, patterns of other drug use and pre-existing psychiatric histories are thought to contribute to the development of these problems.