Matthew Steinfeld

Albert Einstein College of Medicine, New York City, NY, United States

Are you Matthew Steinfeld?

Claim your profile

Publications (8)12.34 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We have demonstrated previously that former opiate-dependent subjects treated and detoxified from methadone maintenance therapy suffer deficits in neuropsychological performance and have abnormal pain thresholds. This study examined the impact of pain on the performance of the Stroop test, a well-known test of neuropsychological performance. Twenty-three former opiate-dependent subjects treated and detoxified from methadone maintenance therapy and 24 comparison (COM) subjects without a history of opiate dependence were tested using the Stroop test under 2 conditions: Stroop under usual conditions and Stroop under painful conditions. The painful condition was induced using a Medoc Thermal Sensory Analyzer to deliver a heat stimulus at and below the subjects' pain threshold. COM subjects performed better than former opiate-dependent subjects, and females performed better than males on the Stroop under usual conditions. These differences were missing when the Stroop under painful conditions was performed. Analysis of these differences revealed that male former opiate-dependent subjects had a larger improvement in Stroop scores under the painful condition than male COM subjects or females of either group. Performance on a neuropsychological test was adversely impacted by previous opiate addiction, and these effects seemed to be greater in males compared with females. Treated patients with opiate dependence showed improvement in Stroop test performance under painful conditions, and this improvement was greater in males than females.
    Journal of Addiction Medicine 03/2011; 5(1):50-6. · 1.73 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Given the recent interest in the concept of sexual addictions, it is instructive to study subjects with pedophilia alongside chemically addicted individuals and non-addicted controls in order to help identify which factors may determine the objects of people's respective addictions, as well as any factors that may predispose people to developing an addictive disorder. In this study, we considered whether childhood sexual abuse (CSA) is a specific risk factor for pedophilia as opposed to other types of addictive disorders by comparing the childhood sexual histories of 48 pedophilic sex offenders, 25 subjects with opiate addiction in remission, and 61 healthy controls. CSA was assessed with The Sexual History Questionnaire and the Child Trauma Questionnaire (CTQ). Compared with both opiate addicted subjects and healthy controls, subjects with pedophilia were more likely to report experiencing adult sexual advances when they were children and a first sexual contact by age 13 with a partner at least 5 years older. Although both subjects with pedophilia and those with opiate addiction first had sex at a younger age than healthy controls, opiate addicted subjects, compared with healthy controls, reported neither increased reception of sexual advances as children nor increased rates of first sexual contact before age 13 with a partner at least 5 years older. Further, subjects with pedophilia but not those with opiate addiction scored significantly higher than healthy controls on the CTQ. Sexual abuse in childhood may be a specific risk factor for sexual addictions such as pedophilia but may not be a specific risk factor for chemical addictions.
    Journal of psychiatric practice. 11/2010; 16(6):394-404.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Disorders of driven sexual behavior have been conceptualized as sexual addictions. In the following study, we compared 51 subjects with pedophilia, 53 subjects with opiate addiction, and 84 healthy control subjects on neuropsychological tests that tap executive functions. The test battery included the Wisconsin Card Sorting Test (WCST), Stroop Color-Word Test, the Matching Familiar Figures Test (MFFT), Porteus Mazes, Controlled Word Association (COWA), and Trailmaking Test. The groups differed on tests of cognitive flexibility and set switching (WCST), sustained attention (Stroop), and impulsivity (MFFT and Porteus Mazes). There were no differences on verbal fluency (COWA). The subjects with pedophilia differed significantly from those with opiate addiction on several tests, with longer latency to response on MFFT and fewer completed mazes but also fewer errors on Porteus Mazes. Thus, while both subjects with pedophilia and those with opiate addiction show executive dysfunction, the nature of that dysfunction may differ between the two groups; specifically, opiate addicted subjects may be more prone to cognitive impulsivity.
    Journal of psychiatric practice. 11/2010; 16(6):405-12.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the model of pedophilia as a disorder of addictive behavior, pedophiles and chemically addicted individuals were compared on personality traits potentially associated with impaired behavioral inhibition. Twenty-nine pedophiles, 25 opiate addicts (OA's), and 27 healthy controls were administered the Barratt Impulsivity Scale, Hare Psychopathy Checklist-Revised (PCL-R), and Structured Clinical Interview for DSM-V for Axis-II. OA's scored higher than either pedophiles or controls on the Barratt. Pedophiles and OA's scored higher than controls on all 3 Psychopathy Checklist-Revised scores but OA's scored marginally higher than pedophiles on factor 2 (behavioral) and total scores. On Structured Clinical Interview for DSM-V for Axis-II, pedophiles scored higher than controls on paranoid and schizoid scores whereas OA's did so on paranoid scores. Thus, both pedophiles and OA's may have elevated psychopathic traits and propensity toward cognitive distortions, as reflected in cluster A traits. Such similarities support the conceptualization of pedophilia as a behavioral addiction. Pedophiles may be less impulsive than OA's, however, and more prone toward cognitive distortions.
    The Journal of nervous and mental disease 12/2008; 196(11):829-37. · 1.77 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cognitive deficits and personality pathology are prevalent in opiate dependence, even during periods of remission, and likely contribute to relapse. Understanding the relationship between the two in vulnerable, opiate-addicted patients may contribute to the design of better treatment and relapse prevention strategies. The Millon Multiaxial Clinical Inventory (MCMI) and a series of neuropsychological tests were administered to three subject groups: 29 subjects receiving methadone maintenance treatment (MM), 27 subjects in protracted abstinence from methadone maintenance treatment (PA), and 29 healthy non-dependent comparison subjects. Relationships between MCMI scores, neuropsychological test results, and measures of substance use and treatment were examined using bivariate correlation and regression analysis. MCMI scores were greater in subjects with a history of opiate dependence than in comparison subjects. A significant negative correlation between MCMI scores and neuropsychological test performance was identified in all subjects. MCMI scores were stronger predictors of neuropsychological test performance than measures of drug use. Formerly methadone-treated opiate dependent individuals in protracted opiate abstinence demonstrate a strong relationship between personality pathology and cognitive deficits. The cause of these deficits is unclear and most likely multi-factorial. This finding may be important in understanding and interpreting neuropsychological testing deficiencies in opiate-dependent subjects.
    Substance Abuse Treatment Prevention and Policy 12/2008; 3:23. · 1.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patients receiving methadone maintenance therapy (MMT) for opiate dependence have altered nociception, complicating analgesic treatment. Increasing numbers of patients are choosing opiate-free treatment programs, yet data on the course of this abnormality months after detoxification from methadone is contradictory and based exclusively on cold pressor experiments. Heat and pain thresholds were measured by quantitative sensory testing (QST) in 23 subjects with heroin dependence in full, sustained remission months after detoxification from methadone and 27 healthy non-drug using controls. Self reports of pain intensity and unpleasantness were also collected. Test scores were compared across groups and correlated with measures of drug use history. There were significant differences between remitted opiate-dependent subjects and controls on the measures of heat threshold (38.83 vs. 35.96; Mann-Whitney U=177.5, p=0.006), and the measure of pain threshold (48.73 vs. 47.62; Mann-Whitney U=217.5, p=0.043). There was no correlation of any measure of drug use history with the heat or pain experience. Abstinent, formerly opioid-dependent patients continue to demonstrate abnormal noxious perception months after detoxification from methadone.
    Drug and Alcohol Dependence 07/2008; 95(3):237-44. · 3.14 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: An accumulating body of research suggests that former heroin abusers in methadone maintenance therapy (MMT) exhibit deficits in cognitive function. Whether these deficits are present in former methadone maintained patients following discontinuation of MMT is unknown. This study tests the hypothesis that former heroin users who have detoxified from methadone maintenance therapy and are drug-free have less pronounced cognitive impairment than patients continuing long-term MMT. A series of neuropsychological tests were administered to three groups of subjects: 29 former heroin addicts receiving methadone maintenance treatment, 27 former heroin addicts withdrawn from all opiates, and 29 healthy controls without a history of drug dependence. Testing included Wechsler Adult Intelligence Scale-Revised Vocabulary Test, the Stroop Color-Word Test, the Controlled Oral Word Association Test, the Benton Visual Retention Test, and a Substance Use Inventory. Both methadone-maintained and abstinent subject groups performed worse than controls on tasks that measured verbal function, visual-spatial analysis and memory, and resistance to distractibility. Abstinent subjects performed worse than their methadone maintained counterparts on tests measuring visual memory and construct formation. Cognitive impairment did not correlate with any index of drug use. We confirmed previous findings of neuropsychological impairment in long-term MMT recipients. Both patients receiving MMT and former heroin users in prolonged abstinence exhibited a similar degree of cognitive impairment. Cognitive dysfunction in patients receiving methadone maintenance may not resolve following methadone detoxification.
    Drug and Alcohol Dependence 11/2006; 84(3):240-7. · 3.14 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite research suggesting that education may mitigate cognitive sequelae of neural injury, little is known about interactions between education and regional brain function. We examined whether educational experience is associated with relative glucose metabolism in brain regions that are important for sustained attention and learning. Fourteen healthy adults, with 12-18 years of schooling, underwent positron emission tomography scanning with 18F-fluorodeoxyglucose during an auditory continuous discrimination task. Years of education correlated positively with relative glucose metabolism in the lingual gyri (bilaterally), left posterior cingulate gyrus, and left precuneus. Previously, these structures have shown early impairment in dementia. Further investigation should explore whether metabolic changes in these regions contribute to the possible protective effect of education on cognition.
    Neuroreport 10/2005; 16(13):1473-6. · 1.40 Impact Factor