نقش تکانشگری در انصراف از درمان مصرف سیگار

Impulsivity is a variable that has been associated with drug use. This study analyzes impulsivity from two different paradigms, one considering it as a trait and the other based on its behavioral correlates, such as disinhibition and impulsive decision-making in the treatment prognosis (maintain abstinence, relapse and dropout) of smokers after outpatient treatment. The participants in the study were 113 smokers who requested treatment for nicotine addiction. They were assigned to three groups according to whether or not they remained abstinent one month after beginning treatment; thus, group 1 was abstinent, group 2 had relapsed, and group 3 had dropped out of treatment. The participants filled out the Semi-structured Interview for Smokers, the Fargerström Test for Nicotine Dependence, the Temperament and Character Inventory-Revised (TCI-R) and the Delay Discounting Task (DDT). The Delay Discounting variable presents lower scores in the dropout group than in the relapse and abstinent groups, with the highest scores in the relapse group. Differences were also found on the Harm Avoidance (HA) variable, with lower scores in the dropout group compared to the relapse group. The importance of these results lies in the consideration of the smoker’s personality profile in order to prevent both dropout and relapse.

Impulsivity is one of the variables most consistently linked to drug addiction [5], [10], [11], [17], [23], [29], [34] and [35]. Traditionally, impulsivity has been understood as a personality trait that involves quick reward seeking when presented with environmental stimuli, without considering the negative consequences of the behavior [2], and it has been evaluated by various questionnaires (Barrat Impulsiveness Scale [28]; Adjective Checklist [14]; Eysenck Personality Inventory [13]; Sensation Seeking Scale [40] and Cloninger Tridimensional Personality Questionnaire [1] and [6]). Recently, clinical neuroscience studies have analyzed impulsivity from paradigms that evaluate its behavioral correlates, such as disinhibition and impulsive decision-making [3] and [22]. Specifically, the delay discounting paradigm has shown that impulsive decisions can be evaluated simply and effectively in diverse addictive behaviors [18]. Delay discounting operatively describes how quickly rewards lose their value as the delay in receiving them increases, and it also explains how the long-term consequences of a behavior lose their ability to control said behavior. Studies [18], [26] and [33] that explore the relationship between impulsivity and nicotine addiction based on this paradigm have used a delay discounting task (DDT). This task presents different trials where one has to select options with a relative value (an immediate reward versus a delayed one); that is, participants can choose to obtain a large amount of money after a period of time (delay) or a small amount immediately. Results have consistently shown that smokers usually present impulsive tendencies, with this factor being responsible for the inability to stop smoking and for increasing the probability of relapse [27] and [39]. The purpose of the present study was to analyze impulsivity from two different paradigms, one considering it as a trait, and the other based on its behavioral correlates, such as disinhibition and impulsive decision-making, in the treatment prognosis (maintain abstinence, relapse and dropout) to quit smoking.