Cognitive Impairments and Dysregulated Affect in Chronic Substance Users: Insights from Empirical Evidence

Introduction: Adolescence and young adulthood are critical periods of neurocognitive, psychological, and emotional development. In Assam, the rising prevalence of substance use among youth has become a pressing public health concern, shaped by rapid socio-cultural transitions and limited mental health awareness. Early initiation of substance use is strongly linked to impairments in attention, working memory, executive functioning, and emotion regulation. However, empirical evidence on these deficits among Assamese youth remains scarce. This study examined the cognitive and emotional regulation difficulties associated with Substance Use Disorder (SUD).

Methodology: A cross-sectional, comparative study was conducted with 320 participants (160 youths with clinically identified SUD and 160 matched healthy controls). Substance use severity was assessed using WHO-ASSIST, emotion regulation with the Difficulties in Emotion Regulation Scale (DERS), and cognitive functioning with the Trail Making Test (TMT-A and TMT-B) and a Cognitive Assessment Questionnaire. Independent t-tests evaluated group differences, and MANOVA assessed multivariate effects of substance use on cognition.

Results:
Youths with Substance Use Disorder demonstrated significantly poorer cognitive performance across all measures compared to healthy controls (p<.001), with large effect sizes observed for attention, processing speed, and executive functioning. Deficits were particularly evident on TMT-A and TMT-B, indicating impairments in processing speed, cognitive flexibility, working memory, inhibitory control, and sustained attention. Additionally, youths with SUD reported significantly greater difficulties in emotion regulation, particularly in impulse control, goal-directed behavior, and emotional clarity (p<.001).

Conclusion:
Substance use among youths in Assam is associated with marked cognitive impairments and significant emotion regulation difficulties, highlighting the need for early screening, preventive strategies, and integrated interventions tailored to young populations.

Substance Use Disorder; Youth; Cognitive Impairment; Emotion Regulation; Assam

1. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review, 30(2), 217-237. [Google Scholar] [Crossref]

2. Bates, M. E., Bowden, S. C., & Barry, D. (2002). Neurocognitive impairment associated with alcohol use disorders: implications for treatment. Experimental and clinical psychopharmacology, 10(3), 193. [Google Scholar] [Crossref]

3. Bechara, A. (2005). Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective. Nature neuroscience, 8(11), 1458-1463. [Google Scholar] [Crossref]

4. Berking, M., & Wupperman, P. (2012). Emotion regulation and mental health: recent findings, current challenges, and future directions. Current opinion in psychiatry, 25(2), 128-134. [Google Scholar] [Crossref]

5. Codding, R. S., Chan-Iannetta, L., Palmer, M., & Lukito, G. (2009). Examining a classwide application of cover-copy-compare with and without goal setting to enhance mathematics fluency. School Psychology Quarterly, 24(3), 173. [Google Scholar] [Crossref]

6. Connor, J. P., Gullo, M. J., White, A., & Kelly, A. B. (2014). Polysubstance use: diagnostic challenges, patterns of use and health. Current opinion in psychiatry, 27(4), 269-275. [Google Scholar] [Crossref]

7. Crews, F., He, J., & Hodge, C. (2007). Adolescent cortical development: a critical period of vulnerability for addiction. Pharmacology Biochemistry and Behavior, 86(2), 189-199. [Google Scholar] [Crossref]

8. Debbarma, B., Srivastava, A., & Saikia, N. (2023). Association between social networks and substance use among male tribal adolescents in the North-East Indian state of Tripura. medRxiv, 2023-05. [Google Scholar] [Crossref]

9. Dhawan, A., Chatterjee, B., Bhargava, R., Chopra, A., Mandal, P., Rao, R., ... & Khan, A. W. (2025). Substance use among school-going adolescents in India: Results from a nationwide survey. THE NATIONAL MEDICAL JOURNAL OF INDIA, 38(6). [Google Scholar] [Crossref]

10. Fernandez-Serrano, M. J., Pérez-García, M., Schmidt Río-Valle, J., & Verdejo-Garcia, A. (2010). Neuropsychological consequences of alcohol and drug abuse on different components of executive functions. Journal of psychopharmacology, 24(9), 1317-1332. [Google Scholar] [Crossref]

11. Fox, H. C., Axelrod, S. R., Paliwal, P., Sleeper, J., & Sinha, R. (2007). Difficulties in emotion regulation and impulse control during cocaine abstinence. Drug and alcohol dependence, 89(2-3), 298-301. [Google Scholar] [Crossref]

12. Goldstein, R. Z., & Volkow, N. D. (2011). Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implications. Nature reviews neuroscience, 12(11), 652-669. [Google Scholar] [Crossref]

13. Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment, 26(1), 41-54. [Google Scholar] [Crossref]

14. Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychological bulletin, 112(1), 64. [Google Scholar] [Crossref]

15. Kandel, D. B. (Ed.). (2002). Stages and pathways of drug involvement: Examining the gateway hypothesis. Cambridge University Press. [Google Scholar] [Crossref]

16. Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard review of psychiatry, 4(5), 231-244. [Google Scholar] [Crossref]

17. Koob, G. F., & Volkow, N. D. (2016). Neurobiology of addiction: a neurocircuitry analysis. The lancet psychiatry, 3(8), 760-773. [Google Scholar] [Crossref]

18. McCabe, S. E., Veliz, P., Boyd, C. J., & Schulenberg, J. E. (2017). Medical and nonmedical use of prescription sedatives and anxiolytics: Adolescents' use and substance use disorder symptoms in adulthood. Addictive Behaviors, 65, 296-301. [Google Scholar] [Crossref]

19. Ray, R. (2004). The extent, pattern and trends of drug abuse in India: National survey. Ministry of Social Justice and Empowerment, Government of India & United Nations Office on Drugs and Crime, Regional Office for South Asia. [Google Scholar] [Crossref]

20. Saikia, N., & Debbarma, B. (2020). The socioeconomic correlates of substance use among male adults in Northeast India. Clinical epidemiology and global health, 8(1), 149-157. [Google Scholar] [Crossref]

21. Sawrikar, V., Hawes, D. J., Moul, C., & Dadds, M. R. (2018). The role of parental attributions in predicting parenting intervention outcomes in the treatment of child conduct problems. Behaviour Research and Therapy, 111, 64-71. [Google Scholar] [Crossref]

22. Scott, J. C., Woods, S. P., Matt, G. E., Meyer, R. A., Heaton, R. K., Atkinson, J. H., & Grant, I. (2007). Neurocognitive effects of methamphetamine: a critical review and meta-analysis. Neuropsychology review, 17(3), 275-297. [Google Scholar] [Crossref]

23. Simons, J. S., Carey, K. B., & Wills, T. A. (2009). Alcohol abuse and dependence symptoms: a multidimensional model of common and specific etiology. Psychology of addictive behaviors, 23(3), 415. [Google Scholar] [Crossref]

24. Squeglia, L. M., Jacobus, J., & Tapert, S. F. (2009). The influence of substance use on adolescent brain development. Clinical EEG and neuroscience, 40(1), 31-38. [Google Scholar] [Crossref]

25. Stavro, K., Pelletier, J., & Potvin, S. (2013). Widespread and sustained cognitive deficits in alcoholism: a meta‐analysis. Addiction biology, 18(2), 203-213. [Google Scholar] [Crossref]

26. Verdejo-García, A., & Bechara, A. (2009). A somatic marker theory of addiction. Neuropharmacology, 56, 48-62. [Google Scholar] [Crossref]

27. Verdejo-Garcia, A., Chong, T. T. J., Stout, J. C., Yücel, M., & London, E. D. (2018). Stages of dysfunctional decision-making in addiction. Pharmacology Biochemistry and Behavior, 164, 99-105. [Google Scholar] [Crossref]

28. Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4), 363-371. [Google Scholar] [Crossref]

29. Wilcox, C. E., Pommy, J. M., & Adinoff, B. (2016). Neural circuitry of impaired emotion regulation in substance use disorders. American Journal of Psychiatry, 173(4), 344-361. [Google Scholar] [Crossref]

30. Wills, T. A., Simons, J. S., Manayan, O., & Robinson, M. K. (2017). Emotion regulation and substance use disorders in adolescents. Emotion regulation and psychopathology in children and adolescents, 210-234. [Google Scholar] [Crossref]

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