الفهرس 
Introduction, Aim and HypothesisOnly 14 pages are availabe for public view
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Abstract
The aim of this work is to comprehensively study the different dimensions of impulsive behavior in psychoactive substance dependent individuals, and find association between these dimensions and addiction related problems. Moreover, to examine the controversial association of different dimensions of impulsivity with diurnal salivary cortisol levels, selected as an indicator of baseline hypothalamo-pituito-adrenal (HPA) axis activity.
I. Theoretical Part
Chapter 1: Impulsivity, which discussed the various theories explaining impulsive and impulsive-like behavior, in terms of both psychological and neuro-pathophysilogical theorization. Also, various comprehensive viewing of facets of impulsivity, and their measurement were discussed.
Chapter 2: Substance Use Disorders from its historical background, its definition and sequelae, nosological classification and comprehensive review of studies regarding relation to personality traits and impulsivity facets.
Chapter 3:Salivary Cortisol Level both in diurnal and challenge measurement and its role reflecting hypothalamo-pituito-adrenal (HPA) axis functioning in relation to personality traits and facets of impulsive behavior.
II. Practical Part
Subjects: The study was done with a total of fifty subjects, consisting two groups, a case group (group 1) and a control group (group 2).
group 1
Twenty-five substance dependent patients were chosen from the out-patient and in-patient facilities of Addiction Unit, Kasr Al-Ainy Psychiatry and Addiction Hospital, Cairo University Teaching Hospitals, fulfilling the criteria for inclusion in the study. Diagnoses were made according to DSM -IV criteria. (American Psychiatric Association, 2000)
group 2
Including twenty-five consenting, unpaid, healthy volunteers, collected from nursing and administrative staff in Kasr Al-Ainy Psychiatry and Addiction Hospital. Subjects had no familial relations to each other or to patients to avoid genetic influence on the sample. This group was matched for age, sex and socio-economic status; with no history of substance use, psychiatric disorders or chronic systemic disorders.
Methodology
A sample of twenty-five patients of substance dependence was collected from Kasr Al-Ainy Psychiatry and Addiction Hospital, Cairo University Teaching Hospitals; whose diagnosis was established using DSM-IV and Kasr Alainy psychiatric sheet.A matching sample of twenty-five healthy volunteering controls was collected.
Both groups were subjected to the following assessment procedures:
1. Full psychiatric examination based on Kasr Al Ainy psychiatric interview with special emphasis on substance use, according to DSM-IV-TR criteria.(American Psychiatric Association, 2000)
2. The Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I), (First et al.,1996) Arabic version by (Hatata et al.,2004(
3. UPPS Impulsive Behavior Scale. (Whiteside et al., 2001(
4. Salivary cortisol level measurement, samples collected between 8 to 10 am.( Pruessner et al., 1997)
group 1was subjected to the Addiction Severity Index, (McLellan et al., 1992), Arabic Version (Qassem et al., 2003).
Results of this study
• On viewing the socio-demographic data of the sample. It can be noted that there were no statistically significant differences between the two groups concerning all of the socio-demographic data including age, sex, marital status, education and occupation.
• As regards the substance use history of the case group (group 1), this study showed that (68%) of the patients abused tramadol, (48%) abused heroin, (32%) abused cannabis, (12%) abused benzodiazepines, (4%) abused alcohol, (52%) of them abused more than one substance at one time.
• On the UPPS Impulsive Behavior scale:
a. The case group had higher scores on the Lack of Premeditation, subscale with a statistically significant value, where p=0.006.
b. The case group had higher scores on the Urgency subscale, with a statistically significant value, where p=0.00.
c. The case group also had higher scores on the Lack of perseverance subscale, with a statistically significant value, where p= 0.018.
• On the Addiction severity index (ASI):
a. The medical status subscale showed that (100%) of the patients had no medical problems.
b. The occupational status subscale showed that (92 %) had severe problems while (8 %) had moderate problems.
c. The drug use subscale showed that (100%) of patients had severe problems.
d. The alcohol use subscale showed that (76%) had no problem, (20%) had mild problems and (4%) had severe alcohol use problems.
e. Regarding the legal status subscale (44%) had no legal problems, (20%) had mild problems, while (20%) had severe legal problems and (16%) had moderate problems.
f. Regarding the family and social relationships subscale (96%) had severe problems, while (4%) had moderate problems.
g. The psychiatric status subscale showed that (92%) had no psychiatric problems while, (8%) had mild problems.
h. The family history of drug and alcohol use subscale showed that (56%) had positive family history of alcohol and drug use, (44%) had negative family history.
• Difference between the two groups in terms of salivary cortisol levels was not statistically significant.
• Case group showed a statistically significant negative correlation between the Sensation Seeking subscale of the UPPS Impulsive Behavior scale and ASI Occupation subscale (p=0.016).