Shakespeare’s Brain: Part 1. Early Modern Brain Function Part 2. Brain Contents.
Brain Function Assessment
Transcript of Brain Function Assessment
Brain Function Assessment and
Emotional Profile of Young Persons
with Substance Use Disorders
Dr. Andrew M.H. Siu
Co-authors
Dr. Alex Wong, Prof. Chetwyn Chan,
The Hong Kong Polytechnic University
Ms. Debby Wong, Mr. Charlie Chan,
Caritas Youth & Community Service
Outline
Model of Service for Young Persons with
Substance Use Disorders
Research:
Brain Function Assessment
Emotional Profile: Depression & Anxiety
Motivation for Change
SERVICE FOR YOUNG PERSONS
WHO ABUSE DRUGS
Design of ServiceOutreach (Disco,
Night Club, Pub/Bar)Referral
Brain Function & Emotional Evaluation +
Motivational Interviewing
Case Follow-up Peer Counseling Life Partnership
Medical Check-up
Health Monitoring, Drug Counseling,
family Support, Emotions Management
Structure
Organizations People
Applied Cognitive
Neuroscience
Laboratory (ACNL)
of PolyU
Dr. Andrew Siu
Dr. Alex Wong
Prof. Chetwyn Chan
The Caritas Youth
and Community
Service, A Journey of
Awakening (Beat
Drugs Fund)
Ms. Debby Wong
Mr. Charlie Chan
Brain Function & Emotional Evaluation
Motivational Interviewing
Follow-up
Participants
Age
Range: 14 – 25
M = 19.6 (SD = 2.8)
Gender
Females (69.1%)
Education
F3 or Below : 47.4%
F4 to F5: 49.5%
Above F5: 3.1%
Work Status
Sales & Service, 16%
Clerical, 10%
Catering & Food, 9%
Construction & Engineering,
5%Transportation & Logistics, 4%Beauty &
Salon, 2%
Unemployed, 28%
Student, 26%
First Time They Take the Drug (n = 97)
Drug First contact
M SD
Hallucinogin
Cannabis (草) 15.2 2.1
Stimulant
Cocaine (可樂) 17.9 2.4
MDMA: Ecstacy (搖頭丸) 15.1 1.8
Amphetamine (冰) 16.1 2.5
Tranquilizer
Diazepam (5仔) 16.2 2.2
Triazol-lun (白瓜子) 15.2 1.6
First Time They Take the Drug (n = 97)
Drug First Contact
M SD
Ketamine (K仔) 15.1 1.9
Others
Cough medicine 15.8 1.9
Alcohol 13.6 2.8
Tobacco 13.0 2.2
Thinners, Cough tablets 15.2 1.8
BRAIN FUNCTION TESTING &
MOTIVATIONAL INTERVIEWING
Brain Function Assessment
We conducted a series of tests on selected brain
function, e.g. processing speed, attention, memory, etc.
The test package normally take 1.5 to 2 hours to
complete (with rest periods in between).
Compared with norms, 64.9 % of participants had at
least one deficit among all the functions tested.
Brain Function Tests
Processing Speed Symbol Digit Modalities Test
Concentration Digit Vigilance Test
Sustained attention Stroop Test
Verbal Memory Chinese Auditory Verbal Learning Test
Visual Memory Continuous Visual Memory Test
Reasoning Test of Non-verbal Intelligence Test
Verbal Fluency Verbal Fluency Test
Figural Fluency Ruff Figural Fluency Test
Mental Flexibility Trail Making Test
Assessment Tools
Function Normal (%) Mild
(%)
Moderate
(%)
Severe
(%)
Has Deficit
(%)
Processing Speed 86.6 3.1 8.2 2.1 13.4
Concentration 69.1 15.5 9.3 6.2 31.0
Sustained attention 90.7 3.1 4.1 2.1 9.3
Verbal Memory 88.7 7.2 4.1 0 11.3
Visual Memory 77.3 5.2 15.5 2.1 22.8
Reasoning 94.8 3.1 2.1 0 5.2
Verbal Fluency 90.7 5.2 2.1 2.1 9.4
Figural Fluency 64.9 16.5 10.3 8.2 35.0
Mental Flexibility 91.8 4.1 3.1 1.0 8.2
Assessment Results
Brain Function Assessment Results
EMOTIONAL PROFILE:
DEPRESSION & ANXIETY
Assessed using Beck Depression
Inventory II
According to cut-off scores, 62.2% are
depressed.
Overseas studies showed that 24 to 30
% of persons with substance abuse had
depression
Depression
Depression (BDI-II scores)
Anxiety
• Assessed using State-Trait Anxiety
Inventory (STAI)
• 15.8% had anxiety symptoms in state
scale.
• Overseas studies showed that 16 to
20% of persons with substance abuse
has anxiety disorders, many had Post-
Traumatic Stress Disorders
Anxiety (STAI scores)
Trait (%) State (%)
Normal 87.4 84.2
Mild 9.5 9.5
Moderate 3.1 5.3
Severe 0 1.0
Deficits
Total
12.6 15.8
Motivational Interviewing
Works by activating
patients’ own motivation
for change and
adherence to treatment.
Evocative: elicit what
the client already has,
(e.g. values, dreams,
goals, personal & social
resources), not what
s/he hasn’t.
Honoring patient autonomy
Evocative
Collaborative
Motivational Interviewing
protocol1. Present brain function assessment & emotional
profile
2. Explain & clarify test results
3. Invite participant to give feedback & comments
4. Listen to how the participant interpret the results
5. Listen to Ambivalence and elicit Change Talk
6. Explore Change Talk and Summarize the big picture
(forces of change)
7. Identify Key Struggles, Motivation for Change, and
Stage of Change)
Report Booklet
報告
Explanation on Brain Function
「梗係唔可以集中精神去完成一件事,忽然間會遊咗去唔知邊度。」 (Sustained Attention 注意力持久度)
Case 1:「係公司點點下貨忽然間停咗落嚟,遊晒魂,有幾次仲比同事拍我先識回魂!」
Impact of Deficits on Daily Activities
MOTIVATION FOR CHANGE
Method
Content analysis of interviews with 22
(around 30%) participants
Analysis of cases by counselor
Based on Motivational Interviewing &
Stage of Change Model
MI Model
Commitment
Taking Steps
Desire
Ability
Reasons
Need
Behavioral
Change
Listen to Change Talk
Commitment
(PC, C)?
Taking Steps
(A, M)?
Behavior Change
Desire
What do you want, like, wish,
hope?
AbilityWhat is possible? What can you do?
ReasonsWhy change?
What benefits? What risks?
NeedHow important is this change? How much
you like to do it?
Reasons for Drug Abuse (n = 22)
Drug Abuse
Family(n= 8)
Peer Influence
(n = 10)Manage Emotions
(n = 7)
Motivation (Reasons) for
Change
Motivation for
ChangeFinances
(13.6%)
Social Support
(18.2%)
Family:
Love, Support & Pressure
(45.5%)
Health:
(81.8%)
Achievement: work or study
(27.3%)
Dating, Marriage, Motherhood
(18.2%)
Stage of Change (n = 22)
Precontemplation (n = 5; 22.7%)
Contemplation (n = 12; 54.5%)
Action (n = 2; 9.1%)
Maintenance (n = 3; 13.6%)
Summary
Drug abuse is associated with poor
brain function and emotional health
64.9% of participants had at least one type
of cognitive deficit.
Deficits in concentration, visual memory, &
figural fluency are common
More than 60% of participants had
depressive symptoms, 15% had anxiety
symptoms.
Summary
Cognitive deficits could have great
impact on daily life or work functioning.
Need to develop a set of cognitive
training or compensation strategies for
addressing cognitive deficits
Need to address depression as co-
morbid illness to drug abuse
Summary
Clients need to develop alternative
strategies in managing emotions
Health, family issues, & emotions
management issues are important foci
in motivating client for change
Many clients need assistance to move
from Contemplation to Preparation and
Action
Contributions
1. Establish a model of assessment addressing
common cognitive & emotional issues in
drug users
2. Provide an understanding of cognitive &
emotional profile of young persons who
abuse drugs
3. Discuss Service Implications
Reference
Connors, G. J., Donovan, D. M., & DiClemente, C. C.
(2001). Substance abuse treatment and the stages of
change: Selecting and planning interventions. New
York: The Guildford Press.
Estroff, T. W. (Ed.) (2001) Manual of adolescent
substance abuse treatment. Washington, DC:
American Psychiatric Publishing, Inc.
Rollnick, S., Miller, W. R., & Butler, C. C. (2008).
Motivational interviewing in health care: helping
patients change behavior. New York: The Guildford
Press.