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Publication
Relação entre reserva cognitiva e funções executivas em dependentes de substâncias psicoativas atualmente abstinentes, com passado em situação de sem-abrigo
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Abstract(s)
Introdução: A Pessoa em Situação de Sem-Abrigo (PSSA) dependente de substâncias
psicoativas (SPA) encontra-se exposta a riscos que poderão comprometer as funções
executivas (FE). Contudo, alguns estudos mostram que existem PSSA dependentes de SPA
sem manifestações clínicas, apresentando-se a teoria da reserva cognitiva (RC) como uma
possível explicação para a heterogeneidade encontrada. Objetivo: Com base na teoria da
reserva pretendeu-se investigar a relação da RC com as FE nesta população e se as atividades
de sobrevivência poderão constituir uma variável não normativa de RC, com repercussões nas
FE. Método: Uma amostra de conveniência de 30 participantes do sexo masculino, com
passado em situação de sem-abrigo, dependentes de SPA, respondeu a provas
neuropsicológicas que avaliam o seu estado cognitivo global, as FE e a RC e a um inventário
de sintomas psicopatológicos. Para a avaliação da RC construiu-se uma escala adicional,
específica para as PSSA dependentes de SPA, complementar à prova padronizada. Foi
utilizada uma metodologia quantitativa e outra qualitativa, com recurso à análise de conteúdo.
Resultados: Verificou-se um índice Médio ou Médio-Alto de RC em 70% dos participantes,
mas não foi encontrada correlação entre a RC e o desempenho das FE. O número de meses
em situação de sem-abrigo e o número de meses de consumo de SPA não se relacionaram
com a RC, nem com as FE. A idade não se relacionou com a RC, mas apresentou correlação
negativa parcial com as FE. Entre as PSSA sem teto e as sem casa não foram encontradas
diferenças ao nível da RC e das FE. A análise qualitativa da escala adicional trouxe um
contributo importante para a compreensão de que as estratégias elaboradas em contexto de
situação de sem-abrigo dependente de SPA parecem estimular a RC e proteger as FE.
Conclusão: Apesar dos achados qualitativos e da confirmação de uma presença média de RC
nesta amostra, mais investigações serão necessárias para clarificar o nível de RC e a sua
função nas FE.
Problem: People Experiencing Homelessness (PEH) addicted to psychoactive substances (PS) are always exposed to several risks which may affect their executive functioning (EF). Nevertheless, some studies show that some PEH addicted to PS presented no clinical manifestations, which may be interpreted under the theory of cognitive reserve (CR). Objective: Based on the theory of reserve, this study aims not only to investigate the connection between CR and EF among this population but also to understand if the survival activities can be a non-normative factor to CR, causing an impact in the EF. Method: A convenience sampling of 30 male participants, who experienced homelessness and are addicted to PS, responded to neuropsychological tests assessing their global cognitive status, EF and CR, and to a psychopathological symptoms inventory. In order to assess CR, it was created an additional scale specific to PEH addicted to PS and complementary to the standardized test. A quantitative and qualitative research methodology was used, through a content analysis. Results: An overall CR index ranging from medium to medium-high in 70 % of the respondents was found, but with no correlation to the EF performance. Neither the number of months experiencing homelessness, nor the number of months using PS, were related to CR or EF. CR was not age-related, but a negative partial correlation was found between age and EF. No differences were found between PEH rough sleeping and PEH homelessness in CR or EF level. The qualitative analysis of the additional scale revealed to be an important contribution to understand that the elaborated strategies in the context of homelessness when people are addicted to PS seem to stimulate their CR and protect their EF. Conclusions: Although the qualitative findings and the medium CR level were confirmed in this sample, further investigation is required to clarify CR in this context and its role in EF.
Problem: People Experiencing Homelessness (PEH) addicted to psychoactive substances (PS) are always exposed to several risks which may affect their executive functioning (EF). Nevertheless, some studies show that some PEH addicted to PS presented no clinical manifestations, which may be interpreted under the theory of cognitive reserve (CR). Objective: Based on the theory of reserve, this study aims not only to investigate the connection between CR and EF among this population but also to understand if the survival activities can be a non-normative factor to CR, causing an impact in the EF. Method: A convenience sampling of 30 male participants, who experienced homelessness and are addicted to PS, responded to neuropsychological tests assessing their global cognitive status, EF and CR, and to a psychopathological symptoms inventory. In order to assess CR, it was created an additional scale specific to PEH addicted to PS and complementary to the standardized test. A quantitative and qualitative research methodology was used, through a content analysis. Results: An overall CR index ranging from medium to medium-high in 70 % of the respondents was found, but with no correlation to the EF performance. Neither the number of months experiencing homelessness, nor the number of months using PS, were related to CR or EF. CR was not age-related, but a negative partial correlation was found between age and EF. No differences were found between PEH rough sleeping and PEH homelessness in CR or EF level. The qualitative analysis of the additional scale revealed to be an important contribution to understand that the elaborated strategies in the context of homelessness when people are addicted to PS seem to stimulate their CR and protect their EF. Conclusions: Although the qualitative findings and the medium CR level were confirmed in this sample, further investigation is required to clarify CR in this context and its role in EF.
Description
Dissertação de Mestrado apresentada no ISPA –
Instituto Universitário para obtenção de grau de Mestre
na especialidade de Psicologia Clínica.
Keywords
Pessoa em situação de sem-abrigo Dependência de substâncias psicoativas Funções executivas Reserva cognitiva People experiencing homelessness Addiction to psychoactive substances Executive functions Cognitive reserve