從仿繪表現差異探討女性毒品施用者認知功能缺損之特性

Exploring the Characteristics of Cognitive Impairment in Female Drug Users through Discrepancies in Copying Performance

毒品濫用乃嚴重社會問題，過去針對男性毒品施用者的研究證實對大腦認知功能有所危害，然毒品對大腦的影響在性別上是有差異的，而過去針對毒品對女性認知功能造成損傷的研究相對較少，因此結果是否能類推有待商榷。因而，本研究者好奇女性毒品施用者在神經心理測驗的表現是否也有類似大腦認知功能損傷之跡象，以及有何不同之處。
Rey-Osterrieth複雜圖形測驗（RCFT）在評估認知功能，特別是規劃和組織策略上是常用的神經心理測驗，其初始的仿繪（Copy）階段需要受試者的視覺空間能力、規劃、注意力等多種執行功能。過去便有研究嘗試將仿繪情形分組後探討受試者的認知功能，亦有研究者發現部分毒品施用者在繪圖中出現衝動性，干擾後續的回憶階段表現。
本研究蒐集123名毒品施用者，以Rey-Osterrieth複雜圖形測驗（RCFT）（以有無通過仿繪測驗劃分正常組及異常組）及第四版中文魏氏成人智力量表等工具，透過平均數的變異數分析比較其認知功能的差異。
結果顯示：受試者中有51.2 %有仿繪缺損，48.8%仿繪正常。兩組比較下在智力測驗的視覺拼圖分測驗與符號替代分測驗有顯著差異，RCFT仿繪異常組的表現皆顯著比RCFT仿繪正常組差，整體智力（FSIQ）亦有顯著差異。在RCFT仿繪正常組中發現再認記憶指標有顯著性差異存在。
本研究發現毒品的施用會造成大腦功能的損害，尤其對視覺空間建構與記憶等能力。本研究也推測高達一半的受試者在RCFT仿繪階段便出現異常，其可能原因較非完全是記憶功能缺失所致，而是在一開始的執行功能便出狀況。依研究結果，長期使用毒品對於認知功能的影響非常明顯。這些結果除了可以在毒品處遇設計上，強化認知功能重塑，協助收容人的復健外，也可以做為衛生教育宣導的預防素材。

Drug abuse is a serious social problem. Past studies on male drug users have confirmed that drug abuse harms cognitive function. However, the effects of drugs on the brain differ between genders, and relatively few studies have examined the cognitive impairments caused by drugs in women, leading to questions about the generalizability of these findings. Therefore, it remains unclear whether findings from male samples can be generalized to females, and whether female drug users show similar or distinct patterns of cognitive impairment in neuropsychological performance.
The Rey-Osterrieth Complex Figure Test(RCFT) is a common neuropsychological test used to assess cognitive functions, especially planning and organizational strategies. The initial Copy phase of the test requires participants to use various executive functions, including visuospatial ability, planning, and attention. Previous research has attempted to group copying performance to explore participants' cognitive functions. Researchers have also found that certain drug users exhibit impulsivity when they drawing, which then interferes with their performance in the subsequent Recall phase.
This study collected data from 123 drug users. Their cognitive functions were compared through ANOVA using the RCFT and the WAIS-IV-Short Form score. The participants were divided into two groups based on their RCFT copying performance: a ''normal'' group (those who passed the copying test) and an ''abnormal'' group (those who did not pass).
The results show that 51.2% of the participants had a copying deficit, while 48.8% performed within the normal range. Comparing two groups, significant differences were found in the Visual Puzzles and Digit Symbol subtests of the WAIS-IV-Short Form. The abnormal group performance scored significantly lower on both of these subtests than normal group. The Full Scale IQ (FSIQ) also showed a significant difference between the two groups. Within the normal group, a significant difference was observed in the Recognition phase.
This study found that drug abuse causes damage to brain function, particularly to visuospatial construction and memory abilities. The research also speculates that the high percentage of participants(51.2%) who showed abnormalities in the RCFT Copying phase may not be solely due to memory deficits. Instead, the impairment likely originates from a breakdown in executive functions. Based on these findings, the long-term impact of drug use on cognitive function is very significant. The results can be used to inform the design of drug abuse treatment programs, also serve as valuable educational material for public health campaigns and prevention programs.